Patterns and Drivers of Packaged (Fortified) Maize Flour Purchase in Urban and Peri-Urban Kenya.

Abstract

Background: Large-scale food fortification is a widely applied strategy to address micronutrient deficiencies, and in Kenya, all industrially processed and packaged maize flour is mandated to be fortified with micronutrients. However, policymakers lack information regarding the population's readiness to procure fortified foods. This study aims to measure the purchase rate of packaged (and presumably fortified) maize flour among households in two Kenyan cities and assess how food environment, household characteristics, and individual shopper perceptions influence consumption of this product.

Methods: We conducted a survey of 1,507 households in urban and peri-urban Kisumu and Nairobi from May to June 2022 to gather information on food purchases, food-shopping behavior, awareness of fortification, and household demographics and socioeconomic status. Between June and August 2022, we conducted a census of food outlets to characterize the households' home food environment. To analyze the data, we first conducted a descriptive analysis with statistics disaggregated by study-region, household poverty status, and/or status as a consumer of packaged maize flour. We then used a probit regression to determine the differential influence of various factors on the households' likelihood of purchasing packaged (presumably fortified) maize flour.

Results: Across Kisumu and Nairobi, 67% of households purchased packaged maize flour, with higher rates seen in urban and peri-urban Nairobi (68% and 70%, respectively) and lower rates seen in urban and peri-urban Kisumu (50% and 34%, respectively). While almost 100% of households had some access to packaged maize flour in their home food environment, the density of outlets that sell this product varied from 12/km² in peri-urban Kisumu to 54/km² in urban Nairobi. Moreover, households that purchased packaged maize flour resided in neighborhoods with approximately 11 more outlets/km², on average, than other households. The local price premium charged for packaged maize flour compared to unpackaged maize flour was a negative and statistically significant driver of the purchase decision.

Conclusions: If the goal is to enhance the population's uptake of fortified maize meal, the government should encourage the private sector to invest more in food outlets that sell packaged maize flour; reduce the retail cost of packaged maize flour; raise awareness of the benefits of fortification (particularly in peri-urban Kisumu); and make relevant technologies available at the scale of smaller mills.