Using the Camera to Gain Perspective on Food Choices

November 8, 2018

Makadara community members show and tell about their food choices

October 30, 2018, Nairobi – A photo exhibition on food choices in Makadara opens today at the Jericho Social Hall. The show, called Why We Eat What We Eat, is comprised of 48 photos taken by some 50 youth and adults from Makadara sub-county who were trained on basic digital photography skills and provided with cameras to take photographs representing what influences their personal decisions about what they eat.

The exhibit is one part of a joint research collaboration between the African Population and Health Research Center (APHRC), the University of Ghana, Kenya’s Ministry of Health, University of Sheffield, the Loughborough University, the, and the University of Liverpool.  The study, which began in July 2017, is part of a wider continental research project that seeks to identify social and physical factors that influence food choices urban dwellers across Africa.

With rapid urbanization taking place across the continent, changing lifestyles are characterized by dietary shifts from whole, healthy foods to sugar- and salt-laden, trans-fat filled, processed meals. These changes are spurring a steady rise in overweight and obesity, particularly among women and children living in urban areas.

Overweight and obesity are risk factors for non-communicable diseases (NCDs) such as some types of cancer, diabetes and high blood pressure, which are on the rise across sub-Saharan Africa. In Kenya, these diseases account for over 55% of hospital deaths and dominate the national health budget.

Researchers asked participants to consider how people and structures influence what they eat.  They reported that family and food vendors influence individual food choices, and researchers believe these should be taken into account when developing strategies and interventions to enhance healthy individual dietary practices. Within the physical environment, street foods are common, so incentivizing vendors to provide healthy and safe foods may be another approach.

Participants noted concerns about poor hygiene, environmental sanitation, and food adulteration. Enforcing legislation to promote healthy and safe foods is essential in lowering these risks.

Henry Otieno, a local community member and a participant in the Photovoice project said that being involved in the exercise empowered him and gave him new insights into his everyday food choices. “Being a part of this project has taught me that we as community members have a responsibility for our health, and this is dependent on the choices we make on what we eat,” he said.

“Photovoice enables us to see things in the eyes of the community. It enables the community to communicate their own experiences in ways most relevant to them. It empowers the community to have their voices heard, including the often neglected and faint voices!” said Dr. Elizabeth Kimani, APHRC’s Head of Maternal and Child Wellbeing Unit, and co-PI on the study.

Photovoice has given the community a voice to tell us about what drives their food choices,” said Professor Paula Griffiths, Loughborough University. “It opens up avenues to help to shape healthier diets by harnessing existing good practices like the use of urban gardens to grow vegetables. It also helps to identify areas to craft solutions to problems such as advocating for legislation to improve food hygiene and safety,” she added.

The study responds to a lack of evidence on how the changing physical and social environment in urban settings is influencing food choices and consumption. To date, policy responses to the double burden of over-nutrition (too much food) and under-nutrition (too little food) have primarily been reactionary with strategies based on experiences of high-income countries. More contextual evidence will fill knowledge gaps and help to inform action to stem ill health and disease.

Researchers will identify the range of factors associated with dietary patterns and practices with the ongoing support of local experts and policymakers. They will compare these factors to current policy approaches to assess which gaps need to be addressed and identify interventions that may be useful. The findings are expected in early 2019.



African Population and Health Research Center (APHRC) is an African-led research institution committed to generating an Africa-owned body of evidence to inform decision making for an effective and sustainable response to the most critical challenges facing the continent. Learn more at


[i] Amugsi D.A., Dimbuene Z.T., Mberu B., et al. (2017). Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991–2014. BMJ Open.7:10. https://doi: 10.1136/bmjopen-2017-017344

[ii] Juma, P., Mohamed S. and Kyobutungi C. (2017). Analysis of Non-communicable Disease Prevention Policies in Kenya. Nairobi: APHRC.