Nutritious Food Procurement in Cities in Low- and Middle-income Countries

Public food procurement refers to how governments purchase and provide food to defined populations. Institutional food procurement refers to food purchasing and provision by organisations like schools, hospitals, care homes, youth clubs, prisons, and workplaces. Local governments often manage public food procurement at these institutions, serving food to students, patients, employees, and their families. Nutritious food procurement (also commonly referred to as healthy food procurement) refers to designing food procurement to prioritise the purchase and provision of safe and nutritious food. Nutritious food procurement represents an opportunity to promote nutrition and improve the experience at that institution for a high volume of people, whilst reshaping the broader food system to be healthier and more sustainable. Policymakers are increasingly recognising institutional food procurement as an opportunity to address malnutrition. City governments often play a large role in managing and financing local institutions like schools, hospitals, and workplaces. As part of this role, city governments can use institutional food procurement to improve nutrition, particularly when doing so based on the sharing of experiences and best practices among different stakeholders in low- and middle-income countries (LMICs).

This paper presents two case studies from cities in LMIC settings to explore enabling factors for and barriers to nutritious food procurement: the city-run Students Feeding Agency in Addis Ababa, Ethiopia and Sassoon General Hospital Meal Programme in Pune, India. The Addis Ababa City Administration Students Feeding Agency aims to address undernutrition and improve educational outcomes by feeding all 351,000 public school students from preschool to eighth grade. The Agency also provides uniforms, books, and menstrual pads. The Sassoon General Hospital programme, run by a state-run hospital with 1,400 inpatient beds, provides medically tailored meals for all admitted patients. The programme helps support patient recovery and reduces pressure on families to bring outside food to hospitalised family members. Both programmes are important examples for their respective urban areas and beyond, as both Addis Ababa and Pune are increasingly facing challenges relating to rapid urbanisation and the double burden of malnutrition.