RT Journal Article
SR Electronic
T1 Patterns and Drivers of Packaged (Fortified) Maize Flour Purchase in Urban and Peri-Urban Kenya
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
DO 10.9745/GHSP-D-24-00240
A1 Ngozi, Semeni
A1 Wineman, Ayala
A1 Maredia, Mywish K.
A1 Tschirley, David
A1 Fisher, Ian
A1 Khaled, Nahian Bin
YR 2026
UL http://www.ghspjournal.org/content/early/2026/04/16/GHSP-D-24-00240.abstract
AB Key FindingsTwo of three residents living in and around two major Kenyan cities—Nairobi and Kisumu—are reached by large-scale fortification of maize flour, and both poor and non-poor consumers benefit from Kenya’s fortification mandate.One of three people are not being reached by this mass fortification policy. These are people who reside predominantly in peri-urban Kisumu, in areas with a lower density of food retail outlets offering the fortified product, and where packaged maize flour is sold at a relatively higher price than non-packaged maize flour.Some shopper characteristics—shoppers younger in age, those who are female, and those who notice signs that encourage healthy eating and value fortification as a food attribute—are strongly associated with decisions to purchase packaged maize flour.Key ImplicationsGovernments should target their efforts to promote and expand the availability and affordability of healthy food products, such as packaged (fortified) maize flour, with consideration of geography, age, and gender.Government should collaborate with private companies to raise awareness of the benefits of fortification.Background:Large-scale food fortification is a widely applied strategy to address micronutrient deficiencies, and in Kenya, all industrially processed and packaged maize flour is mandated to be fortified with micronutrients. However, policymakers lack information regarding the population’s readiness to procure fortified foods. This study aims to measure the purchase rate of packaged (and presumably fortified) maize flour among households in two Kenyan cities and assess how food environment, household characteristics, and individual shopper perceptions influence consumption of this product.Methods:We conducted a survey of 1,507 households in urban and peri-urban Kisumu and Nairobi from May to June 2022 to gather information on food purchases, food-shopping behavior, awareness of fortification, and household demographics and socioeconomic status. Between June and August 2022, we conducted a census of food outlets to characterize the households’ home food environment. To analyze the data, we first conducted a descriptive analysis with statistics disaggregated by study-region, household poverty status, and/or status as a consumer of packaged maize flour. We then used a probit regression to determine the differential influence of various factors on the households’ likelihood of purchasing packaged (presumably fortified) maize flour.Results:Across Kisumu and Nairobi, 67% of households purchased packaged maize flour, with higher rates seen in urban and peri-urban Nairobi (68% and 70%, respectively) and lower rates seen in urban and peri-urban Kisumu (50% and 34%, respectively). While almost 100% of households had some access to packaged maize flour in their home food environment, the density of outlets that sell this product varied from 12/km2 in peri-urban Kisumu to 54/km2 in urban Nairobi. Moreover, households that purchased packaged maize flour resided in neighborhoods with approximately 11 more outlets/km2, on average, than other households. The local price premium charged for packaged maize flour compared to unpackaged maize flour was a negative and statistically significant driver of the purchase decision.Conclusions:If the goal is to enhance the population’s uptake of fortified maize meal, the government should encourage the private sector to invest more in food outlets that sell packaged maize flour; reduce the retail cost of packaged maize flour; raise awareness of the benefits of fortification (particularly in peri-urban Kisumu); and make relevant technologies available at the scale of smaller mills.