Addressing different forms of malnutrition among rural women and children in East Africa: the contribution of processed fruits and vegetables

by Jacob Sarfo
Doctoral thesis
Date of Examination:2022-07-15
Date of issue:2023-07-06
Advisor:Prof. Dr. Elke Pawelzik
Referee:Prof. Dr. Liesbeth Colen
Referee:Prof. Dr. Tobias Plieninger
Persistent Address: http://dx.doi.org/10.53846/goediss-9968

 

 

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Abstract

English

Malnutrition in all its forms continues to be widespread in Africa, especially in rural areas and for women and children. Adequate consumption of fruits and vegetables could help address this malnutrition scourge, yet fruit and vegetables are seasonal and highly perishable and, as a result, are unavailable year-round. Processed fruits and vegetables could address this challenge. Hence it is also necessary to understand how processed fruits and vegetables could impact diets and help mitigate rising levels of malnutrition. Therefore, this study aimed to assess the impact of processed fruits and vegetables to address malnutrition through the characterization of patterns, diet modeling, and the assessment of knowledge, attitude, and practices – focusing on women and children in rural East Africa. The findings showed that among several patterns identified, two were dominant – plant-based pattern (characterized by unprocessed and minimally processed foods) and purchase pattern (characterized by highly processed foods). The plant-based pattern had a negative or no association with overweight and obesity, while the association with the purchase pattern was positive or none. Patterns with fruits and vegetables were characterized by unprocessed and minimally processed fruits and vegetables and had the same association results with overweight and obesity as the plant-based pattern. Adding processed fruits and vegetables to diet models reduced diet costs by up to 49% and 61% for women and children, respectively. However, for infants 6-11 months, diet costs rose. Additionally, processed fruits and vegetables addressed all micronutrient gaps in diets except for infants 6-11 months, where some micronutrient intakes were unfulfilled. Almost all fruits consumed were unprocessed, while vegetables were largely minimally processed for direct consumption. However, consumption amounts were below the recommended intake amounts. Most women expressed high knowledge on the benefits of fruit and vegetable processing and consumption. Also, they showed a positive attitude towards fruit and vegetable processing and consumption. But, in practice, a small number of women processed fruits and vegetables, largely due to limited processing know-how and equipment. The relationship between the knowledge and attitude parameters and fruit and vegetable consumption was negative or none. These results show that processed fruits and vegetables could provide a feasible option to address the increasing malnutrition among women and children. As a result, policy interventions to promote the processing of fruits and vegetables should be pursued at national and international levels.
Keywords: Nutrition; Malnutrition; Fruits; Vegetables; Processed foods; Women; Children; East Africa
 
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