Action research spotlight: Healthy school meals in Nairobi

School feeding programmes are a vital safety net for vulnerable children, providing them with healthy and nutritious meals that they might otherwise miss out on.

Such initiatives are not new and have run in Kenya in different forms for decades; in Nairobi, for example, the county government has an existing school feeding programme in public schools. But the current programme does not apply to informal private schools, meaning that the majority of children living in the city’s informal settlements have been excluded from the government initiative. An ACRC action research project aims to fill this gap.

In this episode, Veronica Mwangi, researcher and lecturer of economic geography at the University of Nairobi, joins Chris Jordan to talk about the issue of healthy diets and nutrition in African cities – particularly among children living in Nairobi’s informal settlements. They discuss the various economic, market-related and household-level factors hindering access to nutritious diets in these settlements – such as low incomes, high food prices and cultural practices – highlighting malnutrition and food insecurity as major concerns. They explore the potential that expanding the existing school feeding programme has to address these issues and improve the nutrition of children living in informal settlements, outlining how the action research team is working closely with the community to co-create an affordable, sustainable school feeding model that can be rolled out across informal schools.

> Read more about ACRC’s school feeding programme action research project

Veronica Mwangi is a researcher and lecturer of economic geography in the Department of Geography, Population and Environmental Studies at the University of Nairobi.

Chris Jordan is communications and impact manager for the Global Development Institute at The University of Manchester, and ACRC's communications manager.

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Music: Brighter Days | Broke in Summer

Sounds: Zapsplat

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Transcript

Chris Jordan Welcome to the African cities podcast. My name is Chris Jordan, I'm the communications manager at ACRC and today I'm joined by Dr Veronica Mwangi. Veronica is based at the department of geography and environmental studies at the University of Nairobi and she's been closely involved with the research around health, nutrition, wellbeing, since the start of ACRC. So Veronica, thank you very much for joining us. 

Veronica Mwangi Thank you, Chris. It's my pleasure to join you for this discussion.

Chris Jordan Great. So I just wanted to start off, I think when people think about urban issues, generally across African cities, I think for lots of people, healthy diets or nutrition maybe wouldn't be top of their mind. But is it a big issue in cities like Nairobi and across the continent? 

Veronica Mwangi Yes, the issue of healthy diets, as we call it now, generally, we could also refer to it as nutrition, has been a main or a major concern in African cities, as well as in the global South. Most developing countries are still grappling with issues of malnutrition. And African governments have consistently put it as an agenda to try and get to zero malnutrition and to get all populations food secure. 

Chris Jordan And do you see any particular issues around nutrition and healthy diets in urban areas as opposed to more rural areas? What's different about cities? 

Veronica Mwangi Well, previous literature has always pointed out to food insecurity and malnutrition being particularly high in the rural areas. But what we find is that as African cities expand, we have a majority of the population settling in informal settlements. And informal settlements are areas that are basically characterised by significantly higher levels of poverty, food insecurity, lack of basic services and infrastructure compared to other areas in the city. Currently it is estimated that at least 60 to 80% of the population in African cities such as Nairobi is based at the informal settlements. Now, with that kind of dense population, you also find that we are having an increase of the urban poor in the informal settlements. So yes, the issue of nutrition and healthy diets is now of concern because of the rising number of urban poor in the urban cities. 

Chris Jordan So you were part of the team that undertook some deep dive research around the health, wellbeing and nutrition domain in the foundation phase of the ACRC work, with a focus on Nairobi. Could you just tell me a bit about that research, how did you go about it and what sort of new insights did it generate? 

Veronica Mwangi Okay, in the foundation phase of our ACRC research project, we were interested in looking at the health, wellbeing and nutrition of the populations in the informal settlements. And we had about two, three questions that we sought to answer. And the first was that we wanted to establish the patterns of food insecurity and ill health in the informal settlements. Then another major question was that we wanted to find out what are the main characteristics of access to nutritious diets and health services. And we were also interested in looking at the processes and the policies that influence access to healthy diets. So in summary, we were trying to establish what are the factors that either enable or inhibit access to healthy diets in the informal settlements. And so, having undertaken data collection, analysis, we were able to have insights into the perceptions of healthy diets by the community. We were also able to establish some of the factors that inhibit uptake of healthy diets by the communities and also some of the factors that also enable the uptake of diets. So perhaps I could just highlight some of the findings of that phase one of the study. Key among our findings is that we established a set of economic constraints to uptake of healthy diets. These included low levels of income that compromise on the purchasing power of households. We also established that unemployment was a hindrance towards access to healthy diets. In fact, previous studies have also found that unemployment levels are relatively high in the informal settlements compared to other areas in the cities where we have the middle and the high income households. Another barrier that we clustered under the economic constraint was issues such as poverty and households were still suffering from the effects of Covid-19, especially in terms of employment and income. Now we also had some market-related constraints, such as high cost of food, particularly those foods that are considered to be healthy. Issues such as high prices of cooking fuel, clean cooking fuel such as LPG [liquefied petroleum gas], were also raised by community members during our discussions. We have issues surrounding food safety and hygiene. Food environments in the informal settlements tend to be compromised by lack of good infrastructure. So issues such as food adulteration, poor food handling, low access to water, poor sanitation, were some of the issues that are barriers to uptake of healthy diets. We also have some household dynamics that we found to be a hindrance towards the uptake of healthy diets. Characteristics like household size; families that are large tend to struggle to have sufficient healthy food options for everyone. We have issues such as cultural and religious practices that also hinder uptake. We also found out something that has also been pointed out by previous studies: the issue of maternal and child feeding practices. Issues such as alcoholism seem to be raising serious concerns in terms of how households make dietary choices and how children are raised. So alcoholism seems to now be a concern in the community, with even young mothers suddenly getting into such behaviours that compromise on the feeding of children. So those were just some of the findings that came up during our phase one project and those relate to various, we also were interested in finding out whether they are factors that enable uptake of their healthy diets. 

Chris Jordan Okay, so it's quite a complex and systematic issues that you found and as you were talking, there's obviously clear overlaps with other areas of ACRC work around housing and informal settlements, around livelihoods and employment, around mental health and youth opportunities, so it's interesting to see them all coming together a little bit through through this lens of food and diets. So, as you're saying, you did all this initial scoping research, you mapped out a huge number of sort of problems and issues. Where were you able then to take things and to look more at the solutions for some of these issues? 

Veronica Mwangi We held several meetings and workshops with community members to try and find out what would be most ideal or a priority in terms of addressing some of the challenges related to healthy diets. And initially we had about four ideas that came out from the several workshops that we had. I remember some of the ideas revolved around in social protection to improve food access. So we thought about integration of food security, nutrition and health in social protection programmes. Then we thought about school feeding programmes as a safety net, in terms of social protection to improve food access for children who may have been identified as among the vulnerable populations in the informal settlements, in terms of access to healthy diets. Then we had an idea around food safety and hygiene. Given the growing importance of street foods in the informal settlements and the concerns around health and safety of the street foods, then we thought that perhaps it's an area that we could delve into to try and see what could be done in terms of improving food safety and hygiene. We also had a third idea on energy, how to improve access to affordable clean energy. And a fourth idea revolved around primary and preventive and healthcare, to try to strengthen some of the programmes that are existing in the community, such as the community health volunteer programme, in order to upscale or enhancing awareness and education on nutrition. Well, when we thought through the four ideas, we settled on one. And we thought perhaps we could focus on the school feeding programmes so that we benefit children who we viewed to be more impacted by the negative outcomes of poor nutrition. So... By the end of phase two, we thought that one of the most important priority complex problems was on nutrition of children. So we thought that improving the health and nutrition conditions of children in the informal settlements, through a sustainable and affordable school feeding programme, would be of impact to a vulnerable group of persons in the informal settlements. 

Chris Jordan And school feeding programmes aren't a new idea, either in Kenya or indeed in the UK or in other countries. In Nairobi, what's been sort of blocking progress so far? Why have they not taken off up until now? 

Veronica Mwangi Yeah, yeah, very, very true, Chris. School feeding programmes is not a new idea globally. Even in Kenya, school feeding programmes have existed since the 19… even before 1980s, there was still a school feeding programmes, though some of the most impactful ones are traced back to the 1980s and 90s. What there is is that informal settlements have both public and private schools, and majority of the children in the informal settlements attend private informal schools, which fill up a gap in the absence of sufficient public schools in the settlements. There are few public schools in the informal settlements. cannot cater for the majority of the children. Now, currently, the county government has a school feeding programme in the public schools. And the same is not running in informal private schools. So it means that majority of the children in the informal settlements have been excluded from the government's school feeding programme. And so, we thought that... That is a gap that the project can fill in. We also found that most of the informal schools in the informal settlements are not able to afford provision of school meals to the children. So, again, that confirms the gap in terms of providing school meals in the private informal schools. 

Chris Jordan And I presume that the Nairobi county government are aware of this gap and the fact that children who are going to school in informal settlements aren't able to access any decent food at lunchtime. Are they trying to do something about it? Is it something they're aware of, or is it just a lack of resources or focus? What's behind that decision? 

Veronica Mwangi Well, the school feeding programme by the city county government is relatively new. It's been running for about, say, two years or less now. And true, the county government is aware that they are not providing school meals to all school children in Nairobi County. There may be plans in the future to provide the meals to the informal schools. But currently, the county government has not yet extended the programme to the informal schools. After all, in most African countries, we grapple between the divide of formal versus informal. And what you find is that government services tend to be limited to formal institutions, with most state governments sort of ignoring or shying away from provision of services to informal institutions, basically due to their informality. And... You also acknowledge that most informal institutions tend not to be protected under the legal framework. So then there would need to be consideration or discussions around how the government extends such services to informal institutions. So we can only hope that there are such discussions going on so that in the future all these informal schools are able to benefit from such programmes because one project alone cannot be sufficient or cannot have the resources and muscle to cover all the informal schools. 

Chris Jordan So I believe part of the current phase of action research that you're undertaking at the moment is looking at different models and different ways in which informal schools could be brought into the feeding programmes. How are you going about that research and what's the progress so far? 

Veronica Mwangi Well, let me say we have made quite some progress and one key lesson that I have learned with action-oriented research is that it tends to drag its feet because the action-oriented research gives priority or precedence to the community to generate the solutions. And so far, I would say that we are at the stage at which we are evaluating the existing school feeding programme together with the community core structures. So, what will happen is that we shall have a look at the existing feeding programmes in some of the schools that have them. And the community core researchers will pick up lessons from the existing school feeding programmes and sort of tease out what would work for their schools. And this is a process in which now we co-create the school feeding programme. So once we have visited schools with existing school feeding programmes, we shall then converge and then sort of design what works for each of the schools or all of the schools and then test it and implement. 

Chris Jordan I know you've said that working very closely with the community and community researchers is a slower process than just doing it yourself, but do you think it's been an effective approach so far? 

Veronica Mwangi Yes, and it's effective and also different from some of the research that we have undertaken before, because in this kind of scenario, we as researchers would like to benefit from the community knowledge. So, we get together with the community members who will be the beneficiaries of the project. So it's slow because also in the process we as researchers learn from the community. We are able to understand their needs in order to know their priority. The community can express what is pressing for them, what is priority for them, and also suggest what would possibly work for them. So in this case, as researchers, we act as technical persons, sort of guiding in terms of how to proceed and how to design, but most of the ideas will come from the community, whom in this case we co-opt as for researchers into the project. 

Chris Jordan And do you think as a result of that, do you think different ideas or different priorities emerge than if researchers or academics had just led the project and come up with the solutions? Does it feel like it generates different results? 

Veronica Mwangi Yes, it definitely does, because you can only imagine that since the community is involved along the process, from the word go, in the initial, you know, once we have the concepts and it's presented to the community, and the community, you know, picks up what is the priority for them. We develop that idea. Remember we talked about the four priority complex problems that we identified from phase one. And from the workshop discussions with the community, they picked up school feeding as one of the avenues that may be more impactful for them in terms of nutrition for children. So we get together with the community, they own the idea and that is very important in terms of implementation of a project that you get more results first in terms of the community owning up to the idea and being able to really bring out what would work for them. So that kind of approach contributes to let's say the success of such an action-oriented research project. 

Chris Jordan And on a more personal level, is it something that you are enjoying as a process, as an approach? 

Veronica Mwangi Oh, definitely. I have really enjoyed working. Initially, I wondered what do we actually mean by action-oriented research? In fact, I must admit that I've had to do sort of like a mental shift, whereby I have to remind myself that it's the community first, then the researchers, you know. The opposite is that in our academic research projects, we design tools, we collect data, we analyse and make policy recommendations. What is different in this case is that the community is involved in all the processes. We design the ideas with them, we collect data with the community. We analyse the data with them and we design the solutions. And then the beauty is that we actually implement this designed solution. So, in a way, it's been a good learning experience for me. And in terms of the structure of our projects, the fact that it's action-oriented research, but within it, we have structures that are unique. For example, we have the issue of political settlements and city of systems in the projects. And political settlements is particularly important because it gives us that opportunity or that emphasis to really look or reflect on how our systems, especially politically and governance, affect us and what is their place in finding the solutions. So the emphasis of our project on political settlements is unlike others that have worked before. You know, in other projects, we just tend to generate policy briefs. However, there's been deliberate efforts by ACRC to understand how politics influence the current situation and also how we can closely work with government and politicians whose goodwill in terms of project implementation and success is crucial. Another angle to how different this project is, is the issue of coalitions. Our project has had an emphasis on coalitions, what we also tend to term as reform coalitions. And it's quite impressive that in the project, we are several partners working together, so that each partner benefits from the expertise of the other. So you find we have the university, we have the community, the Muungano members, we have SDI-Kenya, and we also have LVCT, which is a research organisation by itself. And so we have formed a coalition that will help us leverage on the strength of each other. And I found that to be very important in terms of addressing our challenges, that one institution cannot work very well alone. And so the issue of coalitions, I think, is something that should be pursued by researchers. And maybe finally, on a personal level, I also want to point out on capacity building. And the project has really taken into consideration and provided opportunities for the different actors within the project to develop. Where I stand as a researcher, this is the first project that has had an initiative of bringing about early career researchers together to train them on writing, to help in dissemination. You'll find that other projects will tend to ask one to identify a training, then pay for that training. But this has been done within. But I've also found that in terms of capacity building for community members, their project has been very deliberate on developing those capacity of community leaders, so that they are able to have the capacity to identify solutions and to be able to integrate also with researchers in developing solutions. So you find the project is keen on developing each actor within the project. Maybe those are some of the issues that I would raise.

Chris Jordan Well, thank you so much for sharing them. It's really fascinating and inspiring to hear how it's all coming together for you. I know the school feeding action research projects are still at a relatively early stage, so we're really interested to keep tabs on it and to see where it goes next, how it evolves, what sort of influence you're able to generate as a result of coming up with new models and working in these coalitions. And so, yeah, I'd be really keen to talk to you again a little bit down the line once you've made some more progress. But for today, thank you so much for sharing all those insights with us, Veronica, and we will see you again soon. 

Veronica Mwangi Thank you, Chris. I'm also excited by what lies ahead. And we hope it will be exciting because the project seems to have a very strong desire towards causing change. So we are just not ticking a box. There's a strong desire from all quarters of the project to really cause change and to see that a solution is implemented. 

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