Roy Anne-Sophie, Mazaniello-Chézol Maud, Rueda-Martinez Maria, Shafique Sohana, Adams Alayne M
School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.
Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.
Soc Sci Med. 2023 Apr;322:115804. doi: 10.1016/j.socscimed.2023.115804. Epub 2023 Feb 24.
Increasing food and nutritional inequities are apparent in urban settings across Low- and Middle-Income Countries (LMICs), along with nutrition transition towards ultra-processed diets high in fat, sugar, and salt. In urban informal settlements, characterized by insecurity and inadequate housing and infrastructure, food systems dynamics and their nutritional implications are poorly understood.
This paper explores the food system determinants of food and nutrition security in urban informal settlements in LMICs with the goal of identifying effective approaches and entry points for policy and program.
Scoping review. Five databases were screened spanning the period 1995 to 2019. A total of 3748 records were assessed for inclusion based on title and abstract followed by 42 full text reviews. At least two reviewers assessed each record. Twenty-four final publications were included, coded, and synthesized.
Factors influencing food security and nutrition in urban informal settlements can be organized into three interconnected levels. Macro-level factors include globalization, climate change, transnational food corporations, international treaties and regulations, global and national policies such as SDGs, insufficient social aid programs, and formalization or privatization. Meso-level factors include gender norms, inadequate infrastructure and services, insufficient transportation, informal food retailers, weak municipal policies, marketing strategies, and (lack of) employment. Micro-level factors comprise gender roles, cultural expectations, income, social networks, coping strategies, and food (in) security.
Greater policy attention should focus at the meso-level, with priority investments in services and infrastructure within urban informal settlements. The role and engagement of the informal sector is an important consideration in improving the immediate food environment. Gender is also crucial. Women and girls have a central role in food provisioning but are more vulnerable to various forms of malnutrition. Future research should include context-specific studies in LMIC cities as well as promoting policy change using a participatory and gender transformative approach.
在低收入和中等收入国家（LMICs）的城市地区，粮食和营养不平等现象日益明显，同时营养结构也在向高脂肪、高糖和高盐的超加工饮食转变。在以不安全、住房和基础设施不足为特征的城市非正规住区，人们对粮食系统动态及其营养影响知之甚少。
本文探讨了低收入和中等收入国家城市非正规住区粮食和营养安全的粮食系统决定因素，目的是确定政策和项目的有效方法及切入点。
范围综述。对1995年至2019年期间的五个数据库进行了筛选。根据标题和摘要对总共3748条记录进行了纳入评估，随后进行了42篇全文综述。至少两名评审员评估每条记录。纳入了24篇最终出版物，进行编码和综合分析。
影响城市非正规住区粮食安全和营养的因素可分为三个相互关联的层面。宏观层面的因素包括全球化、气候变化、跨国食品公司、国际条约和法规、全球和国家政策（如可持续发展目标）、社会援助项目不足以及正规化或私有化。中观层面的因素包括性别规范、基础设施和服务不足、交通不便、非正规食品零售商、市政政策薄弱、营销策略以及（缺乏）就业。微观层面的因素包括性别角色、文化期望、收入、社会网络、应对策略以及粮食（不）安全。
政策应更多地关注中观层面，优先投资于城市非正规住区内的服务和基础设施。非正规部门的作用和参与是改善当前粮食环境的重要考虑因素。性别问题也至关重要。妇女和女孩在粮食供应中发挥着核心作用，但更容易受到各种形式营养不良的影响。未来的研究应包括在低收入和中等收入国家城市开展针对具体情况的研究，并采用参与性和性别变革性方法促进政策变革。
