Foodscapes, Finance and Faith: A Qualitative Investigation of Multi-Sectoral Stakeholder Perspectives on a New Mall and Supermarket in Kenya

Abstract IntroductionThe nutritional transition is fuelling a concerning rise in Non-Communicable Diseases (NCDs) in Low and Middle-Income Countries (LMICs). These countries lack strong health infrastructure capable of supporting the long-term and expensive medical treatment for those living with NCDs. It is important to identify stakeholders involved in influencing food retail and dietary choices as part of a population-level strategy to reduce the burden of NCDs in LMICs. The aim of this study is to explore stakeholder perspectives on the impacts of new and existing food retail on local diets in Kenya.MethodsRegulatory and local community stakeholders from Kisumu and Homabay Counties of Western Kenya in this study responded to a semi-structured, open-ended interview schedule. We sought their perspectives on the impact of a proposed new mall and supermarket in Kisumu and existing supermarkets in Homabay on local dietary practices. Digital voice recorders captured the responses, which were transcribed verbatim then translated from Kiswahili or Dholuo languages into English. NVivo12 PRO software was used to analyse the coded responses using a thematic discourse analysis approach. FindingsBoth regulatory and local community stakeholders were similarly concerned that supermarkets make unhealthy food items (including fast food) more accessible and therefore easily incorporated into local diets, with the result that more people develop diet-related NCDs. At the same time, both groups of stakeholders indicated the usefulness of supermarkets as a reliable food source, albeit requiring that the shopper discern healthy from unhealthy food items. Overall, they were unsure whether such aspects as the pricing and convenience of supermarkets would be sufficient to cause the local population to stop patronising their usual small-scale food vendors, and had similarly mixed views on wider impacts on the local economy and livelihoods.ConclusionThe prominent themes identified in our analysis were fear of fast food and health implications, supermarkets as reliable (but selective) food outlets, and uncertainty and differences of opinion about the potential mixed impacts of supermarkets on local communities. We found evidence of a multi-sectoral approach with a widely held interest in potential impacts on health.