**Strengthening the Supply and Demand for Nutritious, Local, and Agro-Ecologically-Produced Foods in Secondary Cities in Bangladesh, Kenya, and Rwanda**

**Tanja Barth-Jaeggi1 , Cornelia Speich1 , Cassien Havugimana1 , S. Fuad Praha2 , Francine Bayisenge1 , Simon Kimenju3 , Kesso Gabrielle van Zutphen4 , Marnie Pannatier5 , Dominique Barjolle6 , and Helen Prytherch1** <sup>1</sup> Swiss TPH, Allschwil, Switzerland

2Mitra and Associates, Dhaka, Bangladesh

3Kula Vyema Centre of Food Economics, Juja, Kenya

4Sight and Life Foundation, Kaiseraugst, Switzerland

5Syngenta Foundation for Sustainable Agriculture, Basel, Switzerland

#### 6ETH Zürich, Department of Environmental Systems Science, Zürich, Switzerland

While overweight and obesity are increasing worldwide, food security levels are worsening in many lowand middle-income countries, especially with the COVID-19 pandemic. Nutritious, locally and agroecologically produced foods can transform food systems, alleviate pressure on the environment, and improve diets. The Nutrition in City Ecosystems (NICE) project aims to improve nutrition for city populations through agricultural, food, and health sector collaborations. An assessment of nutritional and socio-economic status, knowledge, and consumption patterns, as well as an examination of the governance and environmental constraints of a city context, were conducted to inform the project design. Using a mixedmethods, cross-sectional design, baseline data were collected from 150 households (300 in Bangladesh) randomly selected in six secondary cities in Bangladesh (Dinajpur and Rangpur), Kenya (Bungoma and Busia), and Rwanda (Rubavu and Rusizi). Baseline data included the Household Food Insecurity Access Score (HFIAS; both current and before COVID-19), Household Diet Diversity Scores (HDDS), Minimum Dietary Diversity Scores Among Women (MDD-W), anthropometric measurements, household and socioeconomic information, and questions related to consumer behavior and food production decisions. Results show a substantial increase in food insecurity during the pandemic. Under-5 stunting rates are high, ranging from 9.1% in Busia to 49.4% in Rubavu, while around half of adult women are overweight (between 40.8% in Rusizi and 50.6% in Bungoma). Furthermore, many women did not consume an adequately diverse diet in all three countries (MDD-W is <5 for 29.3%, 47.5%, and 67.0%, respectively); however, many of the urban and peri-urban households owned farmland. Demand for and access to an affordable, healthy diet that comprises nutritious, local, and agroecologically produced foods presents a pathway for overcoming complex challenges related to malnutrition, a decline in biodiversity and soil fertility in city contexts. Further research with a specifically developed farmers survey is currently on-going to explore the potential of agroecological production practices and land ownership among the urban population. Transformation towards more resilient food systems with improved nutritional outcomes must be addressed holistically from farm to fork, and the learnings disseminated and scaled up.

Tanja Barth-Jaeggi1, Cornelia Speich1, Cassien Havugimana1, S. Fuad Pasha2, Francine Bayisenge1, Simon Kimenju3, Kesso Gabrielle van Zutphen4, Marnie Pannatier5, Dominique Barjolle6, and Helen Prytherch1

1 Swiss Tropical and Public Health Institute, Switzerland;


While overweight and obesity are increasing globally, food security is worsening in many low- and middle-income countries, especially with the COVID-19 pandemic. Nutritious and locally and agroecologically produced foods offer the potential to transform food systems, alleviate pressure on the environment, and improve diets. The Nutrition in City Ecosystems (NICE) project aims to improve nutrition for urban populations through agricultural, food and health sector collaborations. An assessment of nutritional indicators, socio-economic status, food production and consumption patterns was conducted in six secondary cities from three countries between April and June 2021 to inform the project design.

### Selected Results

Exclusive breastfeeding data collected within this survey. Low birth weight (<2500g) data and anaemia (hb>11g/dl) prevalence data collected through review of respective ANC records from Jan-May 2021 in Bangladesh and from Jan-Mar 2021 in Kenya.

1only NGOs1 antenatal care centers as governmental hospitals/clinics don't keep records of haemoglobin/anaemia.

#### **NICE is working across 6 SDGs:**

### Conclusions

The double burden of malnutrition is a public health concern in secondary cities, and food security is worsening with the COVID-19 pandemic.

Demand for and access to an affordable, healthy diet, including nutritious, local and agroecologically produced food, presents a pathway for overcoming complex challenges related to malnutrition, a decline in biodiversity and poor soil fertility in city contexts.

The transformation towards more resilient food systems with improved nutritional outcomes needs to be addressed holistically from farm to fork. Vulnerable populations should be targeted, and learnings disseminated and scaled up.
