@article{fdi:010083392,
  title = {{P}olicy action within urban {A}frican food systems to promote healthy food consumption : a realist synthesis in {G}hana and {K}enya},
  author = {{B}ooth, {A}. and {B}arnes, {A}. and {L}aar, {A}. and {A}kparibo, {R}. and {G}raham, {F}. and {B}ash, {K}. and {A}siki, {G}. and {H}oldsworth, {M}ichelle},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {O}besity and nutrition-related non-communicable diseases ({NR}-{NCD}s) are increasing throughout {A}frica, driven by urbanisation and changing food environments. {P}olicy action has been limited -and influenced by high income countries. {S}ocio-economic/political environments of {A}frican food systems must be considered in order to understand what policy might work to prevent {NR}-{NCD}s, for whom, and under what circumstances. {M}ethods: {A} realist synthesis of five policy areas to support healthier food consumption in urban {A}frica: regulating trade/foreign investment; regulating health/nutrition claims/labels; setting composition standards for processed foods; restricting unhealthy food marketing; and school food policy. {W}e drew upon {G}hana and {K}enya to contextualise the evidence base. {P}rogramme theories were generated by stakeholders in {G}hana/{K}enya. {A} two-stage search interrogated {MEDLINE}, {W}eb of {S}cience and {S}copus. {P}rogramme theories were tested and refined to produce a synthesised model. {R}esults: {T}he five policies operate through complex, inter-connected pathways moderated by global-, national-and local contexts. {C}onsumers and the food environment interact to enable/disable food accessibility, affordability and availability. {C}onsumer relationships with each other and retailers are important contextual influences, along with political/ economic interests, stakeholder alliances and globalized trade. {C}oherent laws/regulatory frameworks and government capacities are fundamental across all policies. {T}he increasing importance of convenience is shaped by demographic and sociocultural drivers. {A}wareness of healthy diets mediates food consumption through comprehension, education, literacy and beliefs. {C}ontextualised data (especially food composition data) and inter-sectoral collaboration are critical to policy implementation. {C}onclusion: {E}vidence indicates that coherent action across the five policy areas could positively influence the healthiness of food environments and consumption in urban {A}frica. {H}owever, drivers of (un)healthy food environments and consumption reflect the complex interplay of socio-economic and political drivers acting at diverse geographical levels. {S}takeholders at local, national, and global levels have important, yet differing, roles to play in ensuring healthy food environments and consumption in urban {A}frica.},
  keywords = {{A}frica ; {F}ood {E}nvironments ; {F}ood {P}olicy ; {F}ood {C}onsumption ; {R}ealist {R}eview ; {GHANA} ; {KENYA}},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {H}ealth {P}olicy and {M}anagement},
  volume = {10},
  numero = {12},
  pages = {828--844},
  year = {2021},
  DOI = {10.34172/ijhpm.2020.255},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083392},
}