Dietary transitions in Ghanaian cities: mapping the factors in the social and physical food environments that drive consumption of energy dense nutrient-poor (EDNP) foods and beverages, to identify interventions targeting women and adolescent girls throughout the reproductive life course 



Project objectives:  

To examine factors in social and physical food environments of African cities that drive consumption of EDNP foods and beverages, and harness this understanding to develop interventions to reduce their consumption.    


Setting: Two Ghanaian cities of different stages of transition: provincial city (Ho- population>270,000); capital city (Accra- population>1.8 million).  

Study population: Women/adolescent girls living in lower wealth quintile neighborhoods at four key stages of the reproductive life course: i. Early adolescence (13-14y) not pregnant or breastfeeding; ii. Pregnancy (15-49y); iii. Breastfeeding (15-49y); and iv. Women/older adolescents not breastfeeding or pregnant (15-49y). Community informants and national stakeholders will also be interviewed.  

Proposed methods: A combination of qualitative and quantitative methods to examine factors in the social and physical food environments that drive consumption of EDNP foods and beverages: longitudinal qualitative interviews with women/adolescent girls including 24hr recall and Photovoice; Geographic Information System (GIS) mapping; and a photography exhibition. We will integrate these findings into developing priorities for context-specific gender interventions to reduce consumption of EDNP foods of women and adolescent girls to reduce the gender gap: Community Readiness Model (CRM), policy documentary analysis, Multi-Criteria Mapping (MCM) and stakeholder deliberation with local community informants and national stakeholders. Widespread dissemination will include webinars in Ghana and beyond, to build momentum for future implementation of interventions.  


Lead Institution 

University of Sheffield, UK 


Collaborating Institutions 

Department of Population, Family and Reproductive Health, University of Ghana, Accra, Ghana 

Department of Family and Community Medicine, University of Health and Allied Sciences, Ghana 

Centre for Global Health and Human Development, Loughborough University 

The French Agricultural Research & International Cooperative Organization (CIRAD) 

Department of Geography and Planning, University of Liverpool, UK 


Principal Investigator(s) 

> Michelle Holdsworth, RD, PhD, Professor of Public Health, University of Sheffield, UK 

> Amos Laar, MPH, MA, PhD, Senior Lecturer, School of Public Health, University of Ghana, Accra, Ghana 

> Francis Zotor, PhD, Senior Lecturer, University of Health and Allied Sciences, Ghana 



> Robert Akparibo, MPH, PhD, Lecturer/Researcher, University of Sheffield, UK 

> Paula Griffiths, PhD, Reader in Biosocial Science, Loughborough University 

> Mark Green, PhD, Lecturer, University of Sheffield, UK 

> Nicolas Bricas, MSc, Senior Researcher & UNESCO Chair of World Food Systems, Agricultural Research & International Cooperative Organization 

> Kobby Mensah, PhD, Lecturer, University of Ghana Business School