Disclaimers: Views my own and I welcome feedback. Suggested citation below.
Last week, I talked about the Hidden Middle report published by AGRA in 2019 – this report outlines how small and medium enterprises (SME) in supply chains of all things food-related (fertilizer, chicken feed, cold-chain, logistics, food production) are changing the food environments in Africa. I alluded to possible effects of these SME on nutrition and health outcomes, and also impacts of nutrition interventions given changing food environments.
In the Hidden Middle report, three case studies from Ethiopia, Nigeria, and Tanzania are highlighted to show how SME revamped food supply1I am aware that a lot of the authors who were commissioned to write this report are from the global north. This is because they have done a substantial amount of research in the last several decades (because US fund these grants and they have published so there’s visibility). Important to note, there is a recent criticism of AGRA not being able to meet its mission based on this report (pay attention to reference #20). Despite this, I am curious if AGRA was able to improve other outcomes like research or organizational capacity building (and also curious to hear AGRA’s rebuttal).. The case study in Tanzania was of particular interest to me because some of my research is there. The report mentions that processed foods and maize are primarily sold by local or national firms while wheat products are sold by both international and Tanzanian national and local industries. In Tanzania, there are two kinds of maize – “sembe” (refined version) and “dona” (unhusked version). Ijumba, Snyder Tschirley, Reardon (2015) found that most Tanzanians prefer the refined sembe variety but dona variety is consumed in the Mwanza region.
[Flashback story time begins here]
In the DECIDE study set in peri-urban Dar es Salaam, our qualitative researcher Aloisia Shemdoe 2If you’re looking for a fantastic qualitative researcher in Tanzania, please reach out to Aloisia (aloisiashemdoe@gmail.com). She has done quite a lot of public health research and has a background in sociology and linguistics. found that “the word ‘dona’ has a history. In 1963 Tanzania faced a terrible drought, food aid was needed, the American government under President JF Kennedy offered food aid for the country. It was unhusked maize and the bags that were used for packing the maize flour were written donor-I think to mean donor support. Anyways this may need a further validation but it is of interest because almost all our respondents talk about dona at some points” (Personal communications, 2019).
When I started working in Tanzania (three years ago) I read this book called Food, Culture, and Survival in an African City by an anthropologist Karen Coen Flynn. The research for the book is conducted in Mwanza, Tanzania from 1993-1994. In one of the chapters, the author talks about how food aid from the US and Japan shaped food choice and have changed food consumption. See excerpt below from chapter 3 (behind paywall):
[Quote from 40-year-old resident]
Then the author mentions how aid was targeted to different population than the intended group.
“Since 1977 rice was made available to Tanzanians in the form of international aid—especially via the Japanese…Yet the rice was destined for distribution in Tanga, Dar es Salaam, Arusha, Dodoma regions, and Zanzibar—some of the country’s most urbanized areas.” 3Urban areas are often a focus of aid because of civil unrest (aka riots), largely fueled by high density and high reliance on purchased foods. I read this somewhere years ago when I was doing my thesis in Peru but cannot find the reference (will update once I find it). For now, please read Dr. Chris Barrett’s piece on avoiding social unrest under COVID-19.
“The foregoing discussion provides examples of some of how food consumption patterns have changed in Mwanza during recent history […] People’s choices in food were influenced by a wide range of forces including taste, palpability, price, government budget shortfalls, [religion] or the international political economy”. 4I attended a Decolonizing Aid webinar last week organized by Intersectional Feminist Foreign Policy and Adeso. One of the key takeaways for me is that global health and related fields are sometimes taught in an apolitical manner and it’s important to read about history, cultural, and political context of why we are here (not just in LMIC but also in the US). This hit home and realizing how much I need to be scaffolding context within my current research. Reminder to us all that if you’re getting into a new project/new study site, learn more about its history and context. Related to that, I would love to collect recommended books/articles by different country/study setting (so if you have any recommendations, please email me. I will create a post on these resources with proper attribution to you!).
[Back to the present]
I just put all of this together while researching for the post. Structural drivers such as aid have led to the massive shifts in preferences of staple food in Tanzania. In the article I cite above by Ijumba, Snyder Tschirley, Reardon (2015), authors mention that “in all cities [in Tanzania], packaged rice is found almost exclusively in supermarkets, and is targeted to middle and upper-income consumers”.
In searching for the connections between aid and food environment changes, I came across an excellent review by Dr.Christopher Barrett (and colleagues) on intended and unintended consequences of food aid, where he talks about mixed effects of aid at micro-, meso-, and macro-levels, mostly due to “poor targeting”.
Two things that really stood out to me, relating to this post:
1) Unintended consequences of aid: They do “change consumption pattern”; for example, aid during West African Sahel food crisis in the 1970s and 1980s is cited as shifting staple food consumption from sorghum and millet to western staples like wheat, and also caused a huge shift “from a protein-heavy to a carbohydrate-heavy diet” (I may talk about food preferences, aid, and measurement in a future blog post).
2) Intended consequence of market development – for example sourcing food aid from local, “small, village-based processors and traders” in the case of Operation Flood in India substantially increased local milk production, supply, accessibility and consumption. This is called the “White revolution” (analogous to “Green revolution”) and today, “India is the largest producer of milk globally”. While I couldn’t find any evaluation of the White Revolution on nutrition outcomes (diets do improve – yes!), I came across this wonderful report by Dr.Kenda Cunningham on “Operation Flood’s role in India Dairy Development” (read lessons learned if stumped for time).
In the last 50 years, the ‘structural’ drivers such as aid have shaped food choice with regard to staples and animal source foods by increasing demand. Today in Africa, SME plays a large role5Role of Asian entrepreneurs in African food industries (notably Indian Kenyans, Indian Nigerians, and Indian Tanzanians) is repeatedly mentioned both in the Hidden Middle report as well in the book Food, Culture, and Survival in an African City. I may talk about this in the future post. in meeting those demands, thus large shifts in food environments are occurring.
I end with the following questions to you:
- What can we learn from history and from the Hidden Middle report if we want to promote equitable access to nutritious foods (as promoted by the country’s dietary guidelines)?
- In light of COVID-19, where are the regions that require food aid (example: East Africa)? How will aid be procured? In these regions, should we (and how do we) monitor changes in food consumption and food environments?
- [From Dr.Nilupa Gunaratna]: Are we dancing around smaller issues because we cannot resolve the larger structural issues? And how does structural change happen?
Stay tune for part 3 of the Hidden Middle report, I will talk about different taxonomies of food industries and what that means for our current and future food environments.
As always, welcome your thoughts and feedback!
Suggested citation (for high school students?):
