Transforming Food System Evaluation in Mozambique

Overview

Global Alliance for Improved Nutrition (GAIN)'s "Transforming Food Systems to Improve Diet Quality and Resilience for the Most Vulnerable" program seeks to improve consumption of healthy foods by improving supply, increasing demand, and improving the enabling environment for different targeted foods in 4 countries by operating at multiple levels - individuals, households, markets, producers, and policies. RTI and local partners propose to conduct impact and process evaluations of GAIN's program tailored to the theory of change and the target foods for Mozambique. The evaluation in Mozambique will include a mix of quantitative and qualitative methods and will be guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) implementation research framework.

To increase consumption of animal source foods (ASFs) by Bottom of Pyramid (BoP) consumers, the Global Alliance for Improved Nutrition (GAIN) will implement the Transforming Food Systems to Improve Diet Quality and Resilience for the Most Vulnerable program, which will use a market-based approach to improving diets through food systems. The set of interventions proposed is based on characteristics and challenges of the food environments of bottom of BoP consumers in Mozambique. GAIN will focus on elements of the food environment related to accessibility, affordability, and desirability of animal source foods (ASFs) in Mozambique. GAIN's program will improve accessibility (physical distance that consumers travel to procure food) by developing sustainable last mile ASF delivery systems. This will involve developing an efficient and integrated private sector-led delivery system of fish (fresh and dry), chicken cuts (tails, heads, feet, necks, guts), and eggs from consolidation points/aggregators to last-mile retailers by facilitating logistics services (including on-demand backhaul trucks) and strengthening the linkages along the ASF supply chain. Accessibility will also be increased through improvement of fish drying technology and practices using solar tent dryers to enhance the quality and shelf life of dried fish, improve food safety, and decrease salt content. GAIN intends to improve affordability of ASF by focusing on improving the value chains of the most affordable ASF options (fish, chicken cuts, and eggs) and will support accessibility by investing in enhanced cold chain systems and stronger distribution channels to underserved areas. GAIN's program will improve desirability through a demand generation campaign to increase the frequency of ASF consumption among BoP consumers by focusing on key messages that are expected to drive behavior change. The campaign will focus on promoting ASFs as a food group for the whole family, using a short and catchy slogan. Messages will be disseminated through provincial and community radio via drama-based radio messages with new spots every 2 weeks, a musical jingle, and interactive call-in shows. Complementary channels will include television (cooking shows showing preparation of promoted foods), radio messages, social media campaigns, and illustrative point of sale materials (e.g., posters, danglers). This evaluation of GAIN's Transforming Food Systems to Improve Diet Quality and Resilience for the Most Vulnerable program in Mozambique will use a mixed-methods quasi-experimental parallel group before-after cross-sectional design to assess effectiveness on increasing frequency of animal source food (ASF) consumption by bottom of the pyramid (BoP) consumers. The evaluation will be carried out in 4 intervention and 4 comparison districts, purposefully selected. It will include both impact and process evaluation components. Data will be collected through household surveys, market actor surveys and observations, in-depth interviews (IDIs), and focus group discussions (FGDs). Cross-sectional population-based household surveys with men and women in BoP households will be conducted at baseline (N=1,472) and endline (N=1,472) to assess the impact of the intervention on their ASF consumption frequency and dietary diversity using difference-in-differences analysis. Market actor surveys and observations will be conducted with retailers of fish, chicken, and eggs in both study arms at baseline and endline (N=800 at each time point). The baseline-endline market actor data will be analyzed using difference-in-difference analysis to assess improvements in availability, food safety, and prices of fish, chicken, and eggs. Process evaluation data will include IDIs with food transporters, traders, large-scale retailers, and other stakeholders (N=16 at each timepoint); FGDs with retailers of the target foods (N=16 FGDs at each time point); and FGDs with BoP households (N=16 FGDs at each time point). These will be conducted at midline and endline in the intervention districts only. Qualitative data will be analyzed using thematic content analysis methods. We will link the process and impact data through a program impact pathway analysis to document the pathways through which the program achieved its effects.