| dc.description.abstract | Background: Food systems are changing due to drivers such as urbanisation, nutrition transition and globalisation. As a result, there is reduced utilisation of traditional and indigenous foods (TIF) towards westernised diets. Food insecurity and all forms of malnutrition co-exist in different regions of the world, including Botswana. Traditional or indigenous foods are believed to provide better quality diets. There is, however, limited information on extent of access to and consumption of (TIF) in Botswana. Aim: The aim of the study was to explore access to and consumption of TIF among rural and urban households in Botswana. In addition, the study sought to investigate the importance of TIF among street vendors of TIF in Gaborone. Methods: The first component of this study determined household access to TIF and their association to household food security (access), household dietary diversity (HDD) and women BMI through a sequential explanatory mixed methods design; including a random household cross-sectional survey on household food insecurity (access), household dietary diversity (HDD) and women's BMI; followed by eight focus group discussions (FGDs) among purposefully selected participants on their perceptions of TIF. The study involved 400 households and 253 women in these households. The second component determined consumption of TIF and their contribution to dietary nutrients intake of energy, protein, iron, zinc and vitamin A among children 2-5 and women 18-49 years old in Botswana. This was part of a cross-sectional study mentioned in the first component of this study. A 30-day quantitative food frequency questionnaire was administered to the sample which comprised of 173 children and 253 women. The last component explored the relationship between vending TIF and vendors' overall household income, vendors' household food security (access) and vendors' household dietary diversity. The study made use of sequential explanatory mixed methods design. Face to face interviews were conducted with purposively selected street vendors of TIF (n=27) in Gaborone, followed by three focus group discussions (FGDs), each with 6 participants (18 participants in total) to get an in-depth insight on the contribution of TIF to household income and perceived challenges in sourcing and vending TIF. Results: Study 1: Almost two thirds of households experienced moderate or severe food insecurity (28.8 and 37.3%, respectively) while more than half of women were overweight or obese (26.9 and 26.9%, respectively). Median HDD score was 6 (5, 7) out of a total of 12 while the majority of households (81.0%) fell into the medium HDD category (5-8 food groups). A positive correlation was found between the number of TIF accessed and HDD scores (r = 0.457; P < 0.001) while a negative correlation between the number of TIF accessed and HFIA scores (r = - 0.272; P < 0.001) was found. TIF were perceived as healthy, yet their consumption was reported to be declining due to convenience, easy accessibility to and a growing preference for modern foods. Study 2: TIF accounted for relatively high percentages of energy intake in children and women (41 % and 36%, respectively). The intake of vitamin A in children was higher from TIF mean 234 (184 - 299) compared to non-TIF mean 176 (138-224) P = 0.0851. In women, the intake of vitamin A and zinc were significantly higher from TIF compared to non-TIF (zinc from TIF mean 4.9 (4.6 - 5.3), non-TIF mean 4.2 (3.9 - 4.5) P = 0.0033, vitamin A from TIF mean 409 (332 - 503), non-TIF mean 295 (240 - 362) P = 0.0286. Across quartiles of increasing TIF energy intake, children in the third quartile consumed a significantly higher intake of energy compared to children in the first quartile P < 0.05. Further, children in the second quartile consumed a significantly higher intake of zinc compared to children in the first quartile P < 0.05. Study 3: It was observed that 74.0% of the vendors' households were food insecure, with 18.5%, 33.3% and 22.2% being mildly, moderately and severely food insecure, respectively. Vendors' median HDD score was 4 (3, 6) out of a total of 12 while slightly more than half of the households (51.9%) fell into the lowest group of HDD score (0-4 food groups). A positive correlation was found between monthly income from sale of TIF and vendors' overall household income (r = 0.594 P = 0.004) and between the number of TIF varieties for sale and vendors' HDD (r = 558, P = 0.002). No correlation was found between the number of TIF varieties for sale and HFIA scores (r = 0.136, P = 0.498). FGDs confirmed that vending of TIF contributed substantially to vendors' household income. A supply chain of TIF crossing boarders also emerged. Conclusion: Food insecurity in terms of access and low diversified diets was found to be highly prevalent in the two urban and two rural areas of Botswana that were under study and among the vendors' households. Large proportions of the study population in the two rural and two urban areas were found to have access to TIF. This study highlights that TIF may present a useful potential to contribute to household food security (access), household dietary diversity and nutrients intake, especially of energy, vitamin A and zinc. In addition, it also highlights that vending of TIF may contribute significantly to vendors' households' income. However, there is a need to explore the potential benefits of optimal use of TIF in contributing to household food security (access), household dietary diversity, improved nutrients intake and vendors' household income. This should also include attention to related energy consumption and physical activity as these factors may influence overall nutrition status outcomes. | en_US |
