Household Food Consumption Patterns In Addis Ababa Ethiopia

Overweight and obesity are rising rapidly in Ethiopia's urban areas, constituting a major public health concern. Dietary choices can be one of the key drivers of adult body-weight. Using data collected from a large household survey in Addis Ababa, we provide a snapshot of dietary patterns in Ethiopia's largest urban area. We find that starchy staples (cereals, roots, and tubers) are prominent in household food baskets, taking up 25 percent of the food budget and providing more than 50 percent of consumed calories, on average. In contrast, the consumption of all kinds of fruits and vitamin A-rich vegetables is very low. For the average household, meat products account for nearly 18 percent of the food budget but provide only 2 percent of total calories. Richer households consume relatively less starchy staples than poorer households, but more animal-source foods and vegetables. However, the importance of fruits in household diets rises very slowly with household incomes. Together, these findings suggest that further income growth will result in drastic changes in the composition of food demand in Addis Ababa. Considering projections for increasing incomes, especially in urban areas, this will have major implications for agricultural production in rural areas connected to Ethiopia’s cities. There is also an urgent need to design cost-effective public health campaigns to reduce the emerging overweight and obesity crisis in urban Ethiopia.

In early July 2020, we called by telephone a representative sample of nearly 600 households in Addis Ababa, Ethiopia to assess income changes and household food and nutrition security status during the COVID-19 pandemic (recall period covering June). This was the third administration of a COVID-19 related survey to these households, following surveys in early May 2020 and early June. About 64 percent of the households indicated in the third survey that their incomes were lower than expected (down from 67 percent reporting lower incomes than expected in previous month) and 42 percent reported that they are extremely stressed about the situation (down from 45 percent in previous month). Using a pre-pandemic wealth index, we find that less-wealthy households were considerably more likely to report income losses and high stress levels than were wealthier households. Compared to the period just before the pandemic (January and February 2020), indicators measuring food security have significantly worsened but during the pandemic they have remained relatively stable. Households now are less frequently consuming relatively more expensive but nutritionally richer foods, such as fruit and dairy products. However, overall food security status in Addis Ababa is not yet alarming and we see small signs of improvements in this July phone survey relative to previous months. However, many households have drawn down their savings over past months to buffer their food consumption. As the daily COVID-19 infection rates are still rising in Ethiopia, the food security situation in Addis Ababa may deteriorate over coming months, especially as the savings levels among the poorest households are now low. This calls for a further scale-up and strengthening of existing support programs.

In early June 2020, we called by telephone a representative sample of nearly 600 households in Addis Ababa, Ethiopia to assess income changes and household food and nutrition security status during the COVID-19 pandemic (survey period covering May). This was the second administration of a COVID-19 related survey to these households, following an initial survey conducted in early May 2020 covering the situation of the survey households in April. More than two-third of the households indicated in the second survey that their incomes were lower than expected (up from 58 percent in April) and 45 percent reported that they are extremely stressed about the situation (up from 35 percent in April). Using a pre-pandemic wealth index, we find that less-wealthy households were considerably more likely to report income losses and high stress levels than were wealthier households. Compared to a period just before the pandemic (January and February 2020), indicators measuring food security have significantly worsened but have remained the same since April. During the pandemic, households are less and less frequently consuming relatively more expensive but nutritionally richer foods, such as fruit and dairy products. However, overall food security status in Addis Ababa is not yet alarming, possibly because many households have been able to use their savings to buffer food consumption. As the pandemic is still in an early stage in Ethiopia, it is likely that these savings will not last throughout the pandemic, calling for a rapid scale-up of existing support programs.

We called by telephone a representative sample of 600 households in Addis Ababa, Ethiopia to assess household food and nutrition security status during the COVID-19 pandemic. More than half the households indicated that their incomes were lower than expected and more than one-third reported that they are extremely stressed about the situation. Using a pre-pandemic wealth index, we find that less-wealthy households were considerably more likely to report income losses and high stress levels than were wealthier households. Compared to a period just before the pandemic (January and February 2020), indicators measuring food security have significantly worsened. In April, households were less frequently consuming relatively more expensive but nutritionally richer foods, such as fruit and dairy products. However, overall food security status in Addis Ababa is not yet alarming, possibly because most households have used their savings to buffer food consumption. It is likely that these savings will not last for much longer, calling for a rapid scale-up of existing support programs.

Using survey data collected from 996 representative households in Addis Ababa, Ethiopia, this paper documents several insights to help understand urban consumer food purchasing and consumption choices. The findings can be summarized as follows: 1) We find that households face important dietary gaps; a large proportion eats insufficient amounts of nutrient-dense vegetables, animal-source foods, and fruits. 2) The consumption of ultra-processed foods increases with income and may become a pressing health concern as incomes rise. 3) From a purchasing perspective, we find that consumers buy foods for different purposes at different outlets. Nearby kiosks and informal street markets are frequented for small food items and for fruits and vegetables, while formal open markets and consumer cooperatives are used for bulky food items. 4) Respondents make food and food outlet choices based on their health and food safety concerns, but few consider the nutritional value of food when purchasing it. Concurrently, the availability of a wide variety of healthy and safe foods is highly valued by most respondents for outlet choice. Among consumers in lower income categories, they tend to make food and food outlet choices based on prices and location convenience. 5) Although nutrition is not a primary concern when making choices about food, consumers appear to have reasonable nutritional knowledge. Most respondents considered a healthy diet to be primarily plant-based. Most people are aware that they should eat more fruits and vegetables and less sugary, fatty, and salty foods, but they have limited knowledge on the nutrient content of specific foods and the causes of obesity. 6) Labelling would not be an effective way to increase nutritional knowledge; most respondents have limited understanding of the information that labels provide. Rather, most respondents trust the information provided by health professionals over other sources. In sum, these results are potentially relevant for policy and the design of future programs for improving nutritional outcomes through enhanced diets.

Using unique nationally representative household consumption data sets that extend from 1995/96 to 2010/11, this study looks at patterns and changes in ASF (animal-source food) consumption and attempts to identify some of the drivers of these dynamics. We further assess future demand in overall ASF consumption as well as for commercial market development.

Ethiopia has witnessed significant reductions in child mortality, undernutrition, and communicable diseases, but more substantial and faster progress is still needed. The rise in obesity and in noncommunicable diseases, particularly in urban areas, is alarming and requires urgent policy and programmatic attention. Unhealthy diets drive both undernutrition and obesity and are the underlying cause of significant proportion of both communicable and non-communicable diseases. Maintaining the relatively high breastfeeding practices and increasing the diversity of diets will be critical to improving nutrition in Ethiopia. Implementation of effective nutrition messaging that shapes consumer behavior to adopt healthy dietary patterns, while bridging gaps in both the reach and the quality of such messaging is warranted. The health extension program, which is the cornerstone of the transformation of the health sector, may need to be redesigned in a way that improves its reach and the quality of the services it provides and minimizes the risk of burnout of frontline health workers. Interventions focusing on making healthy diets available, affordable, and accessible are urgently needed.

Africa's food systems are changing fast amid rapid economic growth, emerging urbanization, and structural transformation. In this study, we use four rounds of nationally representative data from Ethiopia to examine changes in household food consumption patterns over a period of unprecedented economic growth. We find that while there is a general decline in the share of food in the total consumption basket of households in Ethiopia, food quantities and intake of calories have increased considerably over the period 1996 to 2011. This was mostly driven by improvements in household incomes, as shown using decomposition analysis. Furthermore, the content of the food basket is changing with a gradual shift towards high-value foods, such as animal products, fruits and vegetables, and processed foods. However, irrespective of the level of income, a heavy focus on starchy staples in the Ethiopian diet remains. Overall, this diet transformation has important implications for the food security debate and for agricultural and food policy in the country.

Costs of healthy diets are worryingly rising in a number of developed and emerging economies. However, less is known on these costs for developing countries. Using price data from a large number of markets in Ethiopia, we find that real prices of all nutritionally-rich food groups increased significantly (between 19 and 62 percent) over the period 2007 to 2016. This contrasts with (1) staple crops (grains, roots, and tubers), which did not show any price increase, and (2) oils, fats, and sugar, the prices of which decreased substantially. Using detailed nationwide datasets and relying on time series methods, we link these price increases to changes in local markets, demand and supply factors, transaction costs, and international trade. We find that prices of nutritionally-rich food groups – compared to cereals – are relatively less affected by international trade and exchange rate changes but more so by rapidly increasing local and city demand. This rising demand is likely due to recent income growth and rapid urbanization and the high-income elasticities for nutritious foods in Ethiopia. Moreover, we find that local production changes affected prices of nutritious items little, but national price rises were found to have been significantly linked with food price rises in commercial clusters in the country. Changes in transaction costs – fuel and transport costs – explained relatively little of the observed food price changes.

Given the high prevalence of undernutrition among children in low income countries and the associated high human and eco-nomic costs (Hoddinott et al. 2013), improving nutritional out-comes must be an urgent priority. Improving nutrition is high on the policy agenda of the government of Ethiopia, as stated in the Growth and Transformation Plan II, which aims to reduce young child stunting levels from 40 percent in 2014/15 to 26 percent in 2019/2020. Lack of access to diverse diets is one of the underlying factors contributing to chronic undernutrition (Arimond and Ruel 2004, UNICEF 1998). Despite recent improvements, child stunting in Ethiopia remains widespread (CSA and ICF International 2017). Moreover, Ethiopian children consume one of the least diverse diets in sub-Saharan Africa (Hirvonen 2016). At the household level, food consumption baskets are dominated by cereals and pulses, while the consumption of animal-source foods and fruits and Vitamin A-rich vegetables is rare, especially in rural areas.1 Such monotonous diets are regarded as a major contributor to non-communicable diseases in Ethiopia (Melaku et al. 2016). Recent research suggests that the poor dietary diversity in ru-ral areas can be explained, at least partly, both by limited knowledge about the health benefits of diverse diets and by poor access to food markets. Households in areas in which food crop production is not very diverse but which have good access to mar-kets are found to have more diverse diets than do households in such areas but which have poor access to markets and, so, de-pend primarily on own-production for the food they consume.2 Yet, even with sufficient access to markets and knowledge on the benefits of diverse diets, poor households may simply be un-able to afford nutritionally rich foods (Warren and Frongillo 2017). Indeed, prices and affordability of nutritious foods remains a neglected area of research in efforts to understand poor dietary diversity in Ethiopia and elsewhere.3 In the analysis described here, we explore how prices and, consequently, the affordability of nutritious food have changed over the last decade in Ethiopia.