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FOOD SECURITY

AND NUTRITION

IN THE WORLD

THE STATE OF

URBANIZATION, AGRIFOOD SYSTEMS

TRANSFORMATION AND HEALTHY DIETS

ACROSS THE RURAL–URBAN CONTINUUM

2023

THAILAND. Green sprouts with a city backdrop – urban and peri-urban agriculture in action.

COVER PHOTOGRAPH ©Dreamstime.com/Manop Lohkaew

This flagship publication is part of The State of the World series of the Food and Agriculture Organization

of the United Nations.

Required citation:

FAO, IFAD, UNICEF, WFP and WHO. 2023. The State of Food Security and Nutrition in the World 2023.

Urbanization, agrifood systems transformation and healthy diets across the rural–urban continuum. Rome, FAO.

https://doi.org/10.4060/cc3017en

The designations employed and the presentation of material in this information product do not imply the expression of any

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FOOD SECURITY

AND NUTRITION

IN THE WORLD

THE STATE OF

URBANIZATION, AGRIFOOD SYSTEMS

TRANSFORMATION AND HEALTHY DIETS

ACROSS THE RURAL–URBAN CONTINUUM

ISSN 2663-8061

Food and Agriculture Organization of the United Nations

International Fund for Agricultural Development | United Nations Children’s Fund

World Food Programme | World Health Organization

Rome, 2023

/316

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2023THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLDURBANIZATION,AGRIFOODSYSTEMSTRANSFORMATIONANDHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMThisflagshippublicationispartofTheStateoftheWorldseriesoftheFoodandAgricultureOrganizationoftheUnitedNations.Requiredcitation:FAO,IFAD,UNICEF,WFPandWHO.2023.TheStateofFoodSecurityandNutritionintheWorld2023.Urbanization,agrifoodsystemstransformationandhealthydietsacrosstherural–urbancontinuum.Rome,FAO.https://doi.org/10.4060/cc3017enThedesignationsemployedandthepresentationofmaterialinthisinformationproductdonotimplytheexpressionofanyopinionwhatsoeveronthepartoftheFoodandAgricultureOrganizationoftheUnitedNations(FAO),theInternationalFundforAgriculturalDevelopment(IFAD),theUnitedNationsChildren’sFund(UNICEF),theWorldFoodProgramme(WFP)ortheWorldHealthOrganization(WHO)concerningthelegalordevelopmentstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Thementionofspecificcompaniesorproductsofmanufacturers,whetherornotthesehavebeenpatented,doesnotimplythatthesehavebeenendorsedorrecommendedbyFAO,IFAD,UNICEF,WFPorWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.ThedesignationsemployedandthepresentationofmaterialinthemapsdonotimplytheexpressionofanyopinionwhatsoeveronthepartofFAO,IFAD,UNICEF,WFPorWHOconcerningthelegalorconstitutionalstatusofanycountry,territoryorseaarea,orconcerningthedelimitationoffrontiers.AllreasonableprecautionshavebeentakenbyFAO,IFAD,UNICEF,WFPandWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallFAO,IFAD,UNICEF,WFPandWHObeliablefordamagesarisingfromitsuse.ISSN2663-8061(print)ISSN2663-807X(online)ISBN978-92-5-137226-5©FAO,2023Somerightsreserved.ThisworkismadeavailableundertheCreativeCommonsAttribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo).Underthetermsofthislicence,thisworkmaybecopied,redistributedandadaptedfornon-commercialpurposes,providedthatTheWorkisappropriatelycited.Inanyuseofthiswork,thereshouldbenosuggestionthatFAO,IFAD,UNICEF,WFPandWHOendorsesanyspecificorganization,productsorservices.TheuseoftheFAOlogoisnotpermitted.IfTheWorkisadapted,thenitmustbelicensedunderthesameorequivalentCreativeCommonslicense.Ifatranslationofthisworkiscreated,itmustincludethefollowingdisclaimeralongwiththerequiredcitation:“ThistranslationwasnotcreatedbytheFoodandAgricultureOrganizationoftheUnitedNations(FAO),InternationalFundforAgriculturalDevelopment(IFAD),UnitedNationsChildren’sFund(UNICEF),WorldFoodProgramme(WFP)orWorldHealthOrganization(WHO).FAO,IFAD,UNICEFandWHOarenotresponsibleforthecontentoraccuracyofthistranslation.TheoriginalEnglisheditionshallbetheauthoritativeedition.”DisputesarisingunderthelicencethatcannotbesettledamicablywillberesolvedbymediationandarbitrationasdescribedinArticle8ofthelicenceexceptasotherwiseprovidedherein.TheapplicablemediationruleswillbethemediationrulesoftheWorldIntellectualPropertyOrganizationhttp://www.wipo.int/amc/en/mediation/rulesandanyarbitrationwillbeconductedinaccordancewiththeArbitrationRulesoftheUnitedNationsCommissiononInternationalTradeLaw(UNCITRAL).Third-partymaterials.Userswishingtoreusematerialfromthisworkthatisattributedtoathirdparty,suchastables,figuresorimages,areresponsiblefordeterminingwhetherpermissionisneededforthatreuseandforobtainingpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser.Sales,rightsandlicensing.FAOinformationproductsareavailableontheFAOwebsite(www.fao.org/publications)andcanbepurchasedthroughpublications-sales@fao.org.Requestsforcommercialuseshouldbesubmittedvia:www.fao.org/contact-us/licence-request.Queriesregardingrightsandlicensingshouldbesubmittedto:copyright@fao.org.COVERPHOTOGRAPH©Dreamstime.com/ManopLohkaewTHAILAND.Greensproutswithacitybackdrop–urbanandperi-urbanagricultureinaction.ISSN2663-8061THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLDURBANIZATION,AGRIFOODSYSTEMSTRANSFORMATIONANDHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMFoodandAgricultureOrganizationoftheUnitedNationsInternationalFundforAgriculturalDevelopmentUnitedNationsChildren’sFundWorldFoodProgrammeWorldHealthOrganizationRome,2023CONTENTSFOREWORDviiCHAPTER5METHODOLOGYxPOLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODACKNOWLEDGEMENTSxiSYSTEMSTRANSFORMATIONFORHEALTHYDIETSABBREVIATIONSxivACROSSTHERURAL–URBANCONTINUUM1075.1PoliciesandinvestmentsforhealthydietsKEYMESSAGESxviacrosstherural–urbancontinuum110EXECUTIVESUMMARYxviii5.2Technologyandinnovation:akeyenablerCHAPTER1foragrifoodsystemstransformationunderINTRODUCTION1urbanization121CHAPTER25.3Integratedplanningandgovernancemechanismsacrosstherural–urbancontinuum131FOODSECURITYANDNUTRITIONAROUNDTHEWORLD5CHAPTER62.1Foodsecurityindicators–latestupdatesCONCLUSION143andprogresstowardsendinghungerandensuringfoodsecurity6ANNEXES1472.2Costandaffordabilityofahealthydiet252.3Thestateofnutrition:progresstowardsANNEX1Aglobalnutritiontargets31StatisticaltablestoChapter2148CHAPTER3ANNEX1BURBANIZATIONISTRANSFORMINGAGRIFOODMethodologicalnotesforthefoodsecuritySYSTEMSANDAFFECTINGACCESSTOandnutritionindicators180AFFORDABLEHEALTHYDIETSACROSSTHEANNEX2RURAL–URBANCONTINUUM43MethodologiesusedinChapter21943.1Drivers,patternsanddynamicsofurbanization44ANNEX33.2Urbanizationaffectsagrifoodsystems,Updateddataseriesofthecostandcreatingchallengesandopportunitiestoaffordabilityofahealthydiet,2017–2021206ensureaccesstoaffordablehealthydiets53ANNEX4CHAPTER4DataanddefinitionsforChapter3213THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITYOFHEALTHYANNEX5DIETSACROSSTHERURAL–URBANCONTINUUM69DataanddefinitionsforChapter42154.1Understandingfoodsupplyanddemandacrosstherural–urbancontinuum69ANNEX64.2Costandaffordabilityofahealthydiet,URCAmapsshowingpatternsofurbanizationandfoodsecurityandnutritionacrosstheforcountriesanalysedinChapter4222rural–urbancontinuum92ANNEX7SupplementaryresultsfromSection4.1228iiANNEX89Urban–ruralcatchmentareas(URCAs)usedMethodologyusedforthesubnationalestimationinChapter471ofcostandaffordabilityofahealthydietusinghouseholdsurveydataforselectedcountries10Foodbudgets,incomelevelsandhouseholdfoodinAfricainChapter4235consumptionsharesforhigh-andlow-food-budgetcountriesanalysed72ANNEX911Inthe11countriesinAfrica,adiettransitionattheSubnationalcostandaffordabilityofahealthyhouseholdlevelisoccurringacrosstherural–urbandietbyurban–ruralcatchmentareainselectedcontinuumandinhigh-andlow-food-budgetcountriesinAfrica237countries–eveninruralareas,thoughlaggedandtoalesserextentthaninurbanandperi-urbanareas88ANNEX10A1.1ProgresstowardstheSustainableDevelopmentFoodinsecurityandmalnutritionacrosstheGoalsandglobalnutritiontargets:prevalenceofrural–urbancontinuum(URCA)forselectedundernourishment,moderateorseverefoodcountriesinAfrica241insecurity,selectedformsofmalnutrition,exclusivebreastfeedingandlowbirthweight148ANNEX11A1.2ProgresstowardstheSustainableDevelopmentGlossary244Goalsandglobalnutritiontargets:numberofpeoplewhoareaffectedbyundernourishment,moderateorNOTES251severefoodinsecurityandselectedformsofmalnutrition;numberofinfantsexclusivelybreastfedandnumberofbabiesbornwithlowbirthweight163TABLESA1.3Prevalenceofmoderateorseverefood1Prevalenceofundernourishment,2005–20229insecurity,andseverefoodinsecurityonly,bydegreeofurbanizationin20221782Numberofundernourishedpeople,2005–202210A1.4Prevalenceofmoderateorseverefood3Prevalenceoffoodinsecurityatseverelevelonly,insecurity,andseverefoodinsecurityonly,amongandatmoderateorseverelevel,basedontheFoodadultmenandwomenin2022179InsecurityExperienceScale,2015–202220A1.5Dataqualitycategoriesforadministrative4Numberofpeopleexperiencingfoodinsecurityatsources191severelevelonly,andatmoderateorseverelevel,A2.1RangesofPoUandNoUnowcastedin2020,basedontheFoodInsecurityExperienceScale,2021and20221952015–2022215Morethan3.1billionpeoplecouldnotaffordaA2.2Regressioncoefficientsfromthreealternativehealthydietin2021,althoughtherewassomemodelsestimatedonhistoricalCVyvaluesimprovementfrom2020to202127(2000–2018)andcomparisonwiththemodelusedin20221976AllregionsmadesomeprogresstowardstheA2.3Countriesandterritorieswithnutritionoutcomestunting,wastingandexclusivebreastfeeding2030datafromnationalsurveysbetween2015and2021targetsexceptOceaniaexcludingAustraliaandforexclusivebreastfeedingandbetween2016andNewZealand382022forstunting,wastingandoverweightthat7Thethreestagesoftransformationofagrifoodcontributedtotherural–urbananalysis203valuechains58A2.4Rulesforprogressassessmentagainstthe8TheavailabilityoffoodgroupstomeetaHealthyglobalnutritiontargets204DietBasket,byregion(percapitaperday),202062iiiCONTENTSA3.1ThecostandaffordabilityofahealthydietbyA9.3Affordabilityofahealthydietinselectedhigh-region,subregion,countryandcountryincomeandlow-food-budgetcountriesinAfricaacrossthegroup,2017–2021207rural–urbancontinuum(URCA)240A3.2Lower-andupper-boundestimatesoftheA10.1Moderateorseverefoodinsecuritybasedonpercentageandnumberofpeople(inmillions)theFoodInsecurityExperienceScaleacrosstheunabletoaffordahealthydiet,byregion,subregionrural–urbancontinuum(URCA)forselectedhigh-andcountryincomegroupin2021212andlow-food-budgetcountriesinAfrica241A4.1URCAdefinitionofcategoriesacrosstheA10.2SeverefoodinsecuritybasedontheFoodrural–urbancontinuum214InsecurityExperienceScaleacrosstherural–urbanA5.1HouseholdsurveysusedinChapter4216continuum(URCA)inselectedhigh-andlow-food-budgetcountriesinAfrica242A5.2HouseholdsamplesizesbyURCAfortheA10.3PrevalenceofmalnutritioninchildrenundersurveysusedinChapter4217fiveyearsofageacrosstherural–urbancontinuumA5.3NOVAfoodgroupswithdescriptionsand(URCA)forthreecountriesinAfrica243examples218A5.4FoodprocessinglevelaggregatesusedinSection4.1adaptedfromNOVA220FIGURESA5.5FAO/WHOGIFTfoodgrouplevelaggregates2201GlobalhungerremainedvirtuallyunchangedfromA5.6Summaryoffoodgroupaggregatesand2021to2022butisstillfarabovepre-COVID-19-terminologyoffoodgroupsusedinSection4.1221pandemiclevels8A7.1Thenon-pricedeterminantsofpurchasedfood2Progresswasmadetowardsreducinghungerinconsumptionshares(forhomeconsumptionandmostsubregionsinAsiaandinLatinAmerica,butfoodawayfromhome)inselectedhigh-andlow-hungerisstillontheriseinWesternAsia,thefood-budgetcountriesinAfrica230CaribbeanandallsubregionsofAfrica11A7.2Thenon-pricedeterminantsofconsumption3In2022,Asiawashometo55percent(402million)sharesofhighlyprocessedfoodsinselectedhigh-ofthepeopleintheworldaffectedbyhunger,whileandlow-food-budgetcountriesinAfrica231morethan38percent(282million)livedinAfrica12A7.3Thenon-pricedeterminantsofconsumption4Theprevalenceofundernourishment(PoU)isstillsharesofanimalsourcefoodsinselectedhigh-andhigherin2022thanbeforethepandemicinlow-food-budgetcountriesinAfrica23258percentofcountries,andthesituationisworseA7.4Thenon-pricedeterminantsoftheconsumptioninlow-incomecountries(77percent)13sharesoffoodawayfromhomeinselectedhigh-and5Projectednumbersofundernourishedindicatelow-food-budgetcountriesinAfrica233thattheworldisfarofftracktoachieveZeroHungerA7.5Thenon-pricedeterminantsoftheconsumptionby203017sharesofvegetablesinselectedhigh-andlow-food-6ModerateorseverefoodinsecurityremainedbudgetcountriesinAfrica234unchangedatthegloballevelfrom2021to2022,A9.1ComparisonofaveragefoodexpenditureandwithworseningfoodinsecuritylevelsinAfricaandincostofahealthydietbasketforselectedhigh-andNorthernAmericaandEurope,andimprovementsinlow-food-budgetcountriesinAfrica238AsiaandinLatinAmericaandtheCaribbean19A9.2Subnationalcostofahealthydietinselected7Theconcentrationanddistributionoffoodhigh-andlow-food-budgetcountriesinAfricaacrossinsecuritybyseveritydiffergreatlyacrosstheregionstherural–urbancontinuum(URCA)239oftheworld22iv8Foodinsecurity,atbothlevelsofseverity,ishigher22DistributionofpopulationacrosstenURCAinruralareasthaninurbanareasinallregionsexceptcategoriesoftherural–urbancontinuum,NorthernAmericaandEurope23forselectedcountries,2020749Globallyandineveryregion,theprevalenceoffood23Twocontrastingpatternsofurbanization:denseinsecurityishigheramongwomenthanamongmen24metropolitanurbanization(Nigeria)andsmallcity10Globallyin2021,thecostofahealthydietandtowndispersedurbanization(BurkinaFaso)75increasedandmorepeoplewereunabletoaffordthe24Whilehighfoodpurchasesamonghouseholdsdietcomparedto2019inallregionsexceptNorthernlivinginurbanareasareexpected,theyareAmericaandEurope,despiteasmalldeclineinsurprisinglyhighacrosstherural–urbancontinuum,unaffordabilityfrom2020to202129evenforruralhouseholds7711Mostofthepeopleunabletoaffordahealthydiet25Thereisamarkeddropinpurchasedfoodin2021livedinSouthernAsia,andinEasternandconsumptionsharesforlow-andmiddle-incomeWesternAfrica30householdslivinginperi-urbanareas,withlevelssimilartoruralhouseholdsinbothhigh-and12Stuntinginchildrenunderfiveyearsofageandlow-food-budgetcountries79exclusivebreastfeedinghaveimprovedandsome26Inthe11countriesinAfrica,ruralhouseholdsareprogresshasbeenmadeonwasting,whilelowconsumingprocessedfoods,includinghighlybirthweightandoverweightinchildrenunderfiveprocessedfoods,eventhoseliving1to2hoursoryearsofagehavenotchanged33morefromacityortown8413Low-andlower-middle-incomecountriesbear27Inthe11countriesinAfrica,lowprocessedandhighlyprocessedfoodconsumptionsharesarethegreatestburdenofstunting,wastingandlowhigheracrosstherural–urbancontinuuminlow-food-budgetcountries,whilesharesoffoodawaybirthweight,butalsohavethelargestproportionoffromhomearehigherinhigh-food-budgetcountries85exclusivelybreastfedchildren;mostoverweightchildrenliveinlower-middle-orupper-middle-incomecountries3514Theglobaltrendsinstunting,wasting,exclusive28Inthe11countriesinAfrica,theshareofstaplebreastfeedingandlowbirthweightmustbefoodsrepresentsaminorityoftotalhouseholdfoodaccelerated,whileforoverweightinchildrentheywillconsumptioninvalueterms,andrisesasincomefallshavetobereversed,toachievethe2030globalacrosstherural–urbancontinuuminbothhigh-andnutritiontargetslow-food-budgetcountries893729Inthe11countriesinAfrica,animalsourcefoods15Theprevalenceofstuntingandwastingwasandfoodawayfromhomesubstitutestaplefoods,higherinruralcomparedtourbanareas,whileoverweightwasmorecommonlyfoundinurbanareas40movingfromruraltourbanareas9030Inthe11countriesinAfrica,thecostofahealthy16Driversofurbanization45dietinurbanareasismuchhigherthaninperi-urban17Grossdomesticproductpercapitaandlevelareas,anditdecreasesthesmallerthecitysizeandofurbanization46movingclosertoruralareas;thistrendisless18Patternsofurbanization51pronouncedinhigh-food-budgetcountries,whichshowsimilarcostsacrossallurbanareas9519Globalmappinganddistributionofpopulationby31Inthe11countriesinAfrica,thehighercostofrural–urbancontinuum(URCA)in201552animalsourcefoodsdrivesthehighcostofahealthy20Thepathwaysthroughwhichurbanizationaffectsdietacrosstherural–urbancontinuum,especiallyinagrifoodsystemsandaccesstoaffordablehealthydiets54urbanandremoteruralareas9721Challengesandopportunitiesinaccessing32Thecostofahealthydietexceedsaveragefoodaffordablehealthydietsacrosstherural–urbanconsumptionforlow-andmiddle-incomehouseholdscontinuum65inbothhigh-andlow-food-budgetcountriesinthe11countriesanalysedinAfrica98vCONTENTS33Inthe11countriesinAfrica,thepercentageof7InitiativesformorenutritiousfoodawayfromhomethepopulationunabletoaffordahealthydietininSouth-easternAsia112peri-urbanareasishigherthaninurbancentresand8Theroleofurbanproximityinagriculturalsimilartoruralareas99intensification:casestudiesinEthiopiaandIndia11434InmanyoftheninecountriesanalysedinAfrica,9SupportinginclusivefoodvaluechainsinAfrica115theprevalenceofmoderateorseverefoodinsecurity10Strengtheningcapacitiesofsmallandmediuminurbanandperi-urbanareasissimilartothatinruralenterprisestooffersafeandnutritiousfoods117areas,andinsomecases,slightlyhigher,indicating11Territorialfoodmarkets,foodsafetyandthatfoodinsecurityisnotexclusivelyaruralproblemhealthydiets119inmostofthecountriesanalysed10135Theprevalenceofchildstuntinggenerally12EggHuboperatormodel:ascalablewin–winincreasesascitiesbecomesmallerandmovingawaysolutionforsmall-scaleproducersandlow-incomefromurbancentres;childwastingandoverweightareconsumers125lowerandexhibitlessevidenttrendsacrossthe13UrbanFoodSystemsCoalition:aglobalplatformrural–urbancontinuum104toraiseawarenessonthekeyroleofsubnational36Reinforcingagrifoodsystemslinkagesandgovernmentsinagrifoodsystemstransformationrural–urbanconnectivitytomakehealthydietsacrosstherural–urbancontinuum132affordableacrosstherural–urbancontinuum10914Subnationalagrifoodsystemsgovernanceagreementsamongmetropolitan,intermediaryand37ChallengesandopportunitiesforagrifoodsmallcitiesinPeru133systemsarisingfromurbanization,mappedonto15Inclusiveagrifoodsystemsgovernancepoliciesacrosstherural–urbancontinuum144mechanisminKisumuCounty,Kenya,linkingurbanA6.1Urban–ruralcatchmentareas223andruralareas134A7.1Averagesharesoftotalhouseholdfood16Localagrifoodsystemsstrategieslinkinglargeconsumptionvaluesforanimalsourcefoodsandfoodawayfromhomebyurban,peri-urbanandruralareaformetropolitanareaswithruralhinterlandinselectedhigh-andlow-food-budgetcountriesinAfrica228Antananarivo,NairobiandQuito13617TheRapidUrbanFoodSystemsAppraisalTool:A9.1Costcontributionofeachfoodgroupasshareofonepossibletooltoanalyseagrifoodsystemsacrosstotalcostofahealthydietinselectedhigh-andtherural–urbancontinuum137low-food-budgetcountriesinAfricaacrossthe18Strengtheningmultilevelinstitutionalagreementsrural–urbancontinuum(URCA)237throughpublicfoodprocurementinManabíProvince,Ecuador13719ThemultistakeholderparticipatoryprocessforBOXESestablishingmultilevelinstitutionalagreementsfor1HowdoestheevidenceonchronicfoodinsecurityfoodsecurityandnutritioninWesternCapeProvince,alignwiththeevidenceonacutefoodinsecurityinSouthAfrica139foodcrisiscountries?1420TheregionalStrategicFoodPlanforCatalonia2Untanglingtherural–urbancontinuum482021–2026andtheCatalanFoodCouncil,Spain1403Definitionsofurban,peri-urbanandruralareasin21MultilevelpublicfoodprocurementnetworkinDenmark:national,regionalandlocalgovernmentsurban–ruralcatchmentareas(URCAs)50workingtogethertoinitiatetheprocessofestablishingmultilevelagrifoodsystemsgovernance1404Fooddesertsandswamps595ThemythofruralsubsistencefarminginAfrica80A8.1Methodology–Globalandsubnational6Foodsecurityacrosstherural–urbancontinuum:estimationoftheCoAHD236evidencefrom21ruraldevelopmentprojectsworldwide103viFOREWORDThisreportbringsourorganizationsNodoubt,achievingtheSDGtargetofZerotogetheragaintoreaffirmthat,ifwedonotHungerby2030posesadauntingchallenge.redoubleandbettertargetourefforts,ourIndeed,itisprojectedthatalmost600milliongoalofendinghunger,foodinsecurityandpeoplewillstillbefacinghungerin2030.Thismalnutritioninallitsformsby2030willis119millionmorepeoplethaninascenarioremainoutofreach.AlthoughtheworldinwhichneithertheCOVID-19pandemicnorisrecoveringfromtheglobalpandemic,thewarinUkrainehadoccurred,andaroundthisisoccurringunevenlyacrossand23millionpeoplemorethaninascenariowithincountries.Ontopofthis,theworldwherethewarhadnothappened.isgrapplingwiththeconsequencesoftheongoingwarinUkraine,whichhasshakenUnfortunately,ourworriesarenotonlyfoodandenergymarkets.duetohunger.In2022,2.4billionpeople,comprisingrelativelymorewomenandpeopleAgrifoodsystemsremainhighlyvulnerablelivinginruralareas,didnothaveaccesstotoshocksanddisruptionsarisingfromnutritious,safeandsufficientfoodallyearconflict,climatevariabilityandextremes,andround.Thepersistingimpactofthepandemiceconomiccontraction.Thesefactors,combinedonpeople’sdisposableincome,therisingwithgrowinginequities,keepchallengingcostofahealthydietandtheoverallrisethecapacityofagrifoodsystemstodeliverininflationalsocontinuedtoleavebillionsnutritious,safeandaffordabledietsforall.withoutaccesstoanaffordablehealthydiet.ThesemajordriversoffoodinsecurityandMillionsofchildrenunderfiveyearsofagemalnutritionareour“newnormal”.Wehavecontinuetosufferfromstunting(148million),nooptionbuttoredoubleoureffortstowasting(45million)andoverweighttransformagrifoodsystemsandleveragethem(37million).DespiteprogressinreducingtowardsreachingtheSustainableDevelopmentchildundernutrition–bothstuntingandGoal2(SDG2)targets.wasting–theworldisnotontracktoachievetheassociated2030targets,andneitherisGlobalhungerisstillfarabovepre-pandemicanyregionontracktoattainthe2030targetlevels.Itisestimatedthatbetween690andforlowbirthweight,socloselylinkedto783millionpeopleintheworldfacedhungerthenutritionofwomenbeforeandduringin2022.Thisis122millionmorepeoplethanpregnancy.SteadyprogressisonlyseenonbeforetheCOVID-19pandemic.Nonetheless,levelsofexclusivebreastfeeding.theincreaseinglobalhungerobservedinthelasttwoyearshasstalledand,in2022,thereThesenumbersandtrendsmaybeawereabout3.8millionfewerpeoplesufferingconsiderabledisappointmentforus,butforthefromhungerthanin2021.Theeconomicchildrenandpeopleaffected,theyconstituterecoveryfromthepandemichascontributedanunderlyingfactoftheirlives,andthisfuelstothis,butthereisnodoubtthatthemodestourdeterminationtokeepfindingsolutions.progresshasbeenunderminedbyrisingfoodSince2017,whensignsofincreasinghungerandenergypricesmagnifiedbythewarinfirstbegantoappear,ourorganizations,Ukraine.Thereisnoroomforcomplacency,throughthisreport,haveprovidedin-depththough,ashungerisstillontherisethroughoutanalysisofthemajordriversbehindtheseAfrica,WesternAsiaandtheCaribbean.concerningtrendsandevidence-basedpolicyrecommendationstoaddressthem.viiFOREWORDWehaverepeatedlyhighlightedthatthechangesareaffectingpeople’sfoodsecurityintensificationandinteractionofconflict,andnutritioninwaysthatdifferdependingonclimateextremesandeconomicslowdownswheretheyliveacrossthiscontinuum.anddownturns,combinedwithhighlyunaffordablenutritiousfoodsandgrowingToovercomethechallengesandseizetheinequalities,arepushingusofftracktomeetopportunitiesthaturbanizationcreates,theSDG2targets.Whilewemustremainouractions,policyinterventionsandsteadfastintakingboldtargetedactionstoinvestmentswillhavetobeinformedbyabuildresilienceagainsttheseadversities,otherclearunderstandingofhowtherural–urbanimportantmegatrendsmustbeconsidered.continuumandagrifoodsystemsinteract,andhow,givensuchinteraction,urbanizationUrbanization,forexample,isonesuchaffectsaccesstoaffordablehealthydiets,andmegatrendthatfeaturesasthethemeofconsequentlyfoodsecurityandnutrition.thisyear’sreport.By2050,almostseveninThepolicyapproachmustgobeyondruraltenpeopleareprojectedtoliveincities;butorurbansilosandadministrativeborderseventoday,thisproportionisapproximatelyandwillrequirestrongandwell-coordinated56percent.Urbanizationisshapingagrifoodgovernancemechanismsandinstitutions.systemsinwayswecanonlyunderstandthrougharural–urbancontinuumlens,Thethemeofthisyear’sreportisalsotimelyencompassingeverythingfromfoodandrelevantforseveralotherreasons.Theproduction,foodprocessing,andfoodpolicyrecommendationscaninformcountriesdistribution,marketingandprocurement,onwhatprogrammes,investmentsandactionstoconsumerbehaviour.Duetopopulationcanbeeffectiveandinnovativeformeetingthegrowth,smallandintermediatecitiesandSDG2targetsinthecontextofurbanization.ruraltownsareincreasinglybridgingTheyarealsorelevantfortheachievementthespacebetweenruralareasandlargeofotherSDGs,includingnotonlySDG11metropolises.Hence,inoureffortstoend(SustainableCitiesandCommunities),butalsohunger,foodinsecurityandmalnutritionSDG1(NoPoverty),SDG3(GoodHealthandinanurbanizingworld,wecannolongerWell-Being),SDG10(ReducedInequalities)operateonthetraditionalassumptionofaandSDG12(ResponsibleConsumptionrural–urbandivide.andProduction).Astheworldisurbanizing,fooddemandRecentdiscussionsattheUnitedNationsandsupplyarechangingrapidlyacrosstheGeneralAssemblyhaveraisedtheimportancerural–urbancontinuum,challengingourofachievingSustainableCitiesandtraditionalthinking.Insomecontexts,foodCommunities(SDG11),asthisiscloselypurchasesarenolongerhighonlyamongrelatedtootherimportantinterconnectedurbanhouseholdsbutalsoamongruralissues,includingpovertyeradication,climatehouseholdslivingfarfromanurbancentre.action,migration,landdegradation,economicMoreover,consumptionofhighlyprocessedprosperityandcreationofpeacefulsocieties.foodsisalsoincreasinginperi-urbanandNonetheless,therelatedlinksbetweenruralareasofsomecountries,whereasurbanizationandtheaffordabilityofhealthyconsumptionofvegetables,fruits,andfatsdiets,andtheresultingimplicationsforfoodandoilsisbecomingmoreuniformacrosssecurityandnutrition,havenotbeenexploredtherural–urbancontinuum.Theseimportantinthesediscussions,andwehopethisreportviiihelpsbridgethisimportantgap.Thereport’scoalitionsofactionestablishedafterthethemeisalsoalignedwiththeNewUrbanUnitedNationsFoodSystemsSummitasweAgenda,endorsedbytheUnitedNationsmovetowardstheglobalstocktakingmeetingGeneralAssemblyin2016,andrepresentstoreviewprogressinimplementingtheauniquecontributiontocreateawarenessoutcomesoftheSummiton24–26July2023,abouttheimportanceofimprovingaccesstonotleasttheUrbanFoodSystemsCoalition,affordablehealthydietsasacriticalcomponenttheCoalitionofActiononHealthyDietsfrominpursuingsustainableurbanization.SustainableFoodSystemsforChildrenandAll,theSchoolMealsCoalition,andtheZeroFinally,wehopethatthisreportinformsHungerCoalition;aswellastheScalingUpotherongoingefforts,clearlythoseoftheNutritionMovement.nQuDongyuAlvaroLarioCatherineRussellFAODirector-GeneralIFADPresidentUNICEFExecutiveDirectorCindyHensleyMcCainTedrosAdhanomGhebreyesusWFPExecutiveDirectorWHODirector-GeneralixMETHODOLOGYTheStateofFoodSecurityandNutritionintheWorld2023hasbeenpreparedbytheFAOAgrifoodEconomicsDivisionincollaborationwiththeStatisticsDivisionoftheEconomicandSocialDevelopmentstreamandateamoftechnicalexpertsfromtheFoodandAgricultureOrganizationoftheUnitedNations(FAO),theInternationalFundforAgriculturalDevelopment(IFAD),theUnitedNationsChildren’sFund(UNICEF),theWorldFoodProgramme(WFP)andtheWorldHealthOrganization(WHO).AsenioradvisoryteamconsistingofdesignatedseniormanagersofthefiveUNpublishingpartnersguidedtheproductionofthereport.LedbyFAO,thisteamdecidedontheoutlineofthereportanddefineditsthematicfocus.Further,itgaveoversighttothetechnicalwritingteamcomposedofexpertsfromeachofthefiveco-publishingagencies.Backgroundtechnicalpaperswerepreparedtosupporttheresearchanddataanalysisundertakenbythemembersofthewritingteam.Thewritingteamproducedanumberofinterimoutputs,includinganannotatedoutline,firstdraftandfinaldraftofthereport.Thesewerereviewed,validatedandclearedbythesenioradvisoryteamateachstageinthepreparationprocess.ThefinalreportunderwentarigoroustechnicalreviewbyseniormanagementandtechnicalexpertsfromdifferentdivisionsanddepartmentswithineachofthefiveUNagencies,bothatheadquartersanddecentralizedoffices.Finally,thereportunderwentexecutivereviewandclearancebytheheadsofagencyofthefiveco-publishingpartners.xACKNOWLEDGEMENTSTheStateofFoodSecurityandNutritionintheWorld2023wasjointlypreparedbytheFoodandAgricultureOrganizationoftheUnitedNations(FAO),theInternationalFundforAgriculturalDevelopment(IFAD),theUnitedNationsChildren’sFund(UNICEF),theWorldFoodProgramme(WFP)andtheWorldHealthOrganization(WHO).ThepublicationwascarriedoutunderthedirectionofMarcoV.SánchezCantilloandJoséRoseroMoncayo,withtheoverallcoordinationofCindyHolleman,theEditorofthepublication,andtheoverallguidanceofMáximoToreroCullen,allofwhomarefromtheFAOEconomicandSocialDevelopmentstream.ThedevelopmentofthereportwasguidedbyaSteeringCommitteeconsistingofagencyrepresentativesfromthefiveco-publishingpartners:MarcoV.SánchezCantillo(Chair),SaraSavastano(IFAD),VictorAguayo(UNICEF),ArifHusain(WFP)andFrancescoBranca(WHO).TisornSongsermsawas(IFAD),ChikaHayashiandVilmaTyler(UNICEF),EricBranckaert(WFP)andLuzDeRegil(WHO)contributedtothecoordinationandprovidedtechnicalsupport.Valuablecommentsandfinalapprovalofthereportwereprovidedbytheexecutiveheadsandseniorstaffofthefiveco-authoringagencies.Chapter1ofthereportwaswrittenbyCindyHolleman(FAO),withinputsfromMarcoV.SánchezCantillo,AnneKepple,JoséRoseroMoncayo,LynnetteNeufeld,PilarSantacolomaandTrudyWijnhoven(FAO),SarahLowder(IFAD),EricBranckaert(WFP),ChikaHayashi(UNICEF),andKatrinaLundbergandKarenMcColl(WHO).Chapter2ofthereportwascoordinatedbyAnneKepple(FAO).Section2.1waswrittenbyCarloCafiero,AnneKepple,JoséRoseroMoncayoandSaraVivianiwithkeyinputsfromPieroConforti,ValentinaContiandFirasYassin(FAO).Section2.2waswrittenbyValentinaConti,withinputsfromVeronicaBoero,CarloCafiero,AnneKeppleandMicheleVollaro(FAO),andYanBai(WorldBank).OlivierLavagned’Ortigue(FAO)provideddatavisualizationandeditorialsupportforSections2.1and2.2.Section2.3waswrittenbyRobertJohnstonandChikaHayashi(UNICEF),withinputsfromJuliaKrasevec,VrindaMehraandYoshitoKawakatsu(UNICEF),ElaineBorghi,RichardKumapley,KatrinaLundbergandKarenMcColl(WHO),andAnneKepple(FAO).NonaReuter(UNICEF)providedsupportfordatavisualizationinSection2.3.JoséRoseroMoncayoprovidedtechnicalguidanceandeditorialsupporttothesectionsofthischapter.Chapter3ofthereportwaswrittenbyCindyHollemanandSophiedeBruin(FAO),withinputsfromGiovanniCarrascoAzzini,AndreaCattaneo,LuciaLatino,TheresaMcMenomy,PilarSantacoloma,KostasStamoulisandTrudyWijnhoven(FAO),FlorenceA.Benn,AlessandraGarberoandSarahLowder(IFAD),VilmaTyler(UNICEF),SabrinaKuriandIsisNuñezFerrera(WFP),KatrinaLundberg,KarenMcColl,LinaMahyandMarjoleinSmit-Mwanamwenge(WHO),andTomReardonandLenisSawedaOnipedeLiverpool-Tasie(MichiganStateUniversity).MarcoV.SánchezCantilloprovidedtechnicalguidanceandeditorialsupporttothesectionsofthischapter.Chapter4ofthereportwascoordinatedbyCindyHolleman(FAO).Section4.1waswrittenbyCindyHolleman(FAO),withinputsfromMichaelDolislager(MessiahUniversity),andLenisSawedaOnipedeLiverpool-TasieandTomReardon(MichiganStateUniversity).FurtherinputswereprovidedbyAgnieszkaBalcerzak,CarloCafiero,GilesHanley-Cook,BridgetHolmes,AdeebaIshaq,LuciaLatino,AnaMoltedo,LynnetteNeufeld,PilarSantacolomaandTrudyWijnhoven(FAO),SarahLowder,JyotsnaPuriandAlessandroRosi(IFAD),IsisNuñezFerrera(WFP),VilmaTyler(UNICEF),andKatrinaLundbergandKarenMcColl(WHO).Section4.2waswrittenbyLuciaLatinoandCindyHolleman(FAO),withinputsfromCarloCafiero,AdeebaIshaq,AnneKepple,AnaMoltedo,PilarSantacoloma,xiACKNOWLEDGEMENTSSaraVivianiandTrudyWijnhoven(FAO),IsisNuñezFerreraandSabrinaKuri(WFP),ChikaHayashi,RobertJohnston,YoshitoKawakatsuandVilmaTyler(UNICEF),andKatrinaLundberg,KarenMcCollandJasonMontez(WHO).MarcoV.SánchezCantilloprovidedtechnicalguidanceandeditorialsupporttothesectionsofthischapter.Chapter5ofthereportwascoordinatedbyGiovanniCarrascoAzzini(FAO).Section5.1waswrittenbyGiovanniCarrascoAzziniandKostasStamoulis(FAO),withinputsfromCindyHolleman,HajnalkaPetrics,PilarSantacolomaandTrudyWijnhoven(FAO),AslihanArslan,DanielHiggins,SarahLowder,AthurMabiso,RobsonMutandi,JoyceNjoroandVictoriaWise(IFAD),andKaiaEngesveen,CeyhunGungor,KatrinaLundberg,KarenMcCollandSimoneMoraesRaszl(WHO).Section5.2waswrittenbyPreetmoninderLidderandGiovanniCarrascoAzzini(FAO),withinputsfromPilarSantacoloma,KostasStamoulisandTrudyWijnhoven(FAO),IlariaFirmian,MarupHossain,SarahLowderandVibhutiMendiratta(IFAD),andKatrinaLundberg,KarenMcColl,CeyhunGungor,SimoneMoraesRaszl,LinaMahyandMarjoleinSmit-Mwanamwenge(WHO).Thesectionbenefitedfromaninternalcallforagrifoodtechnologiesandinnovationcasestudies,inwhichcontributionswerereceivedfromElenaAguayo,ManuelAnta,VittorioFattori,PatriziaFracassi,PabloGarcíaCampos,ElenaIlie,KeyaMukherjee,JiaNi,CortneyPrice,RosaRolle,AnaRuedaGarcia,TiKianSeow,BeateScherf,EmmaSiliprandiandElviraUccello(FAO),andKalpanaBeesabathuni,KlausKraemerandSrujithLingala(SightandLife).Section5.3waswrittenbyCeciliaMarocchino,AnaPuhacandMarcelloVicovaro(FAO),withinputsfromGiovanniCarrascoAzzini,StepankaGallatova,KostasStamoulisandNyYou(FAO),SarahLowderandTisornSongsermsawas(IFAD),andKatrinaLundbergandKarenMcColl(WHO).Thesectionbenefitedfromaninternalcallforgovernanceexperiencesatsubnationalandlocallevels,inwhichcontributionswerereceivedfromGiaimeBerti,CarmenZuletaFerrari,SaraGranados,GarethHaysom,JoaoIntini,BetinaBergmannMadsen,GuidoSantini,FernandoCastroVerasteguiandRebeccahWanjiru(FAO).MarcoV.SánchezCantilloprovidedtechnicalguidanceandeditorialsupporttothesectionsofthischapter.Chapter6ofthereportwaswrittenbyMarcoV.SánchezCantillo,withinputsfromGiovanniCarrascoAzzini,CindyHolleman,AnneKeppleandJoséRoseroMoncayo(FAO).Numerouscolleaguesfromdifferenttechnicalunitsanddepartmentsacrossthefiveco-publishingagenciesprovidedvaluabletechnicalcommentsandinputtothereport.Anagency-widetechnicalclearanceprocessfacilitatedacomprehensivereviewbymanytechnicalexpertsfromthefiveco-authoringagencies.Listingeachofthecontributionswouldbechallengingandfurthermoreincreasetheriskofimportantomissions.DatainputsFirasYassinandSaraViviani(FAO)wereresponsibleforpreparingundernourishmentandfoodsecuritydata,respectively,inSection2.1andAnnex1A,withinputsfromFilippoGheri,AdeebaIshaq,TalentManyani,AnaMoltedo,MaríaRodríguezandAbdulSattar,andunderthesupervisionofCarloCafiero(FAO).SupportingdatawereprovidedbytheFoodBalanceSheetsteam,ledbySalarTayyiboftheFAOStatisticsDivision.CarloCafieropreparedthe2030projectionsofundernourishment,withtheassistanceofAdeebaIshaqandwithkeyinputprovidedbyDavidLaborde(FAO).ValentinaConti(FAO)wasresponsibleforpreparingtheanalysisofthecostandaffordabilityofahealthydietinSection2.2andAnnex3,withinputsfromVeronicaBoero,CarloCafieroandMicheleVollaro(FAO),andSamuelKofiTettehBaah,YanBai,DanielGerszonMahler,NishantYonzanandChristophLakner(WorldBank).VrindaMehra,RobertJohnston,JuliaKrasevecandChikaHayashi(UNICEF)wereresponsiblefortheanalysesinSection2.3.VrindaMehraandJuliaKrasevec(UNICEF),andRichardKumapleyandMonicaFlores(WHO)wereresponsibleforconsolidatingnutritiondatainAnnex2.ThesystematicxiiliteraturereviewofevidencefromscientificstudiesforSections3.2and5.1wasconductedusinganintegratedresearchtooldevelopedbyFAO’sDataLabforStatisticalInnovationandimplementedbyMarcoScarnò,withCarolaFabi,CraigMatadeenandChristianMongeau(FAO).ThedemandanalysisinSection4.1wasconductedbyMichaelDolislager(MessiahUniversity),withinputsfromLenisSawedaOnipedeLiverpool-TasieandTomReardon(MichiganStateUniversity),andAgnieszkaBalcerzak,GilesHanley-Cook,CindyHolleman,BridgetHolmes,LynnetteNeufeldandTrudyWijnhoven(FAO).CalebReichert(MessiahUniversity)providedgeospatialanalysisandmappingusedinSections4.1and4.2.LuciaLatinoconductedtheanalysisofthesubnationalcostandaffordabilityofahealthydietinSection4.2,withinputsfromCarloCafiero,CindyHollemanandAnaMoltedo(FAO).SaraViviani(FAO)conductedthesurveyanalysisforthecalculationofmoderateorseverefoodinsecuritybasedontheFoodInsecurityExperienceScaleinSection4.2,withinputsfromVaishaliBansal(FAO).YoshitoKawakatsuandRobertJohnston(UNICEF)conductedthesurveyanalysisforthecalculationofthemalnutritionindicatorsinSection4.2.SupportforreportproductioncamefromAndrewPark(consultingeditor)andDanielaVeronaintheFAOEconomicandSocialDevelopmentstream.TheFAOMeetingBranchandLanguageBranchoftheGoverningBodiesServicingDivisioncarriedoutthetranslations,inadditiontothecontributorsmentionedabove.ThetranslationsofthereportbenefitedfromatechnicalreviewbyAhmadSadiddinandFirasYassin(Arabic),LanLi(Chinese),OlivierLavagned'Ortigue,ThibaultMeillandandAurelienMellin(French),EvgeniyaKoroleva(Russian),andVerónicaBoeroandGiovanniCarrascoAzzini(Spanish),allofwhomarefromFAO.TheFAOPublicationsandLibraryBranchoftheOfficeofCommunicationsprovidededitorialsupport,designandlayout,aswellasproductioncoordination,foreditionsinallsixofficiallanguages.xiiiABBREVIATIONSAARRaverageannualrateofreductionFOPfront-of-packageADERaveragedietaryenergyrequirementGDPgrossdomesticproductARIMAXAutoregressiveIntegratedMovingGHS-POPGlobalHumanSettlementAveragewithExternalExplanatoryPopulationBMIVariableGIFTGlobalIndividualFoodconsumptionCEAbodymassindexdataToolCoAHDcontrolledenvironmentagricultureGRFCGlobalReportonFoodCrisescostandaffordabilityofaGWPGallup©WorldPollCONSIALhealthydietHDBHealthyDietBasketFoodSystemCouncilofMetropolitanHICshigh-incomecountriesCPILimaICPInternationalComparisonProgramCVconsumerpriceindexIFADInternationalFundforAgriculturalCVrcoefficientofvariationDevelopmentCVyCVduetoenergyrequirementsIFPRIInternationalFoodPolicyResearchDECCVduetoincomeInstituteDEGURBAdietaryenergyconsumptionILOInternationalLabourOrganizationDESDegreeofUrbanizationIMFInternationalMonetaryFundDHSdietaryenergysupplyIPC/CHIntegratedFoodSecurityPhaseEUROSTATdemographicandhealthsurveyClassification/CadreHarmoniséStatisticalOfficeoftheEuropeanJMEJointChildMalnutritionEstimatesFAOUnionLICslow-incomecountriesFoodandAgricultureOrganizationLMICslower-middle-incomecountriesFBDGsoftheUnitedNationsLSMSLivingStandardsMeasurementFBSfood-baseddietaryguidelinesStudyFIESFoodBalanceSheetLUPPAUrbanLaboratoryofPublicFoodFIES-SMFoodInsecurityExperienceScalePoliciesFoodInsecurityExperienceScaleMDERminimumdietaryenergyFImod+sevSurveyModulerequirementprevalenceofmoderateorsevereMICsmiddle-incomecountriesFIsevfoodinsecurityNCDnon-communicablediseaseFLAGprevalenceofseverefoodinsecurityNoUnumberofundernourishedfoodliaisonadvisorygroupOECDOrganisationforEconomicCo-operationandDevelopmentxivPALphysicalactivitylevelUMICsupper-middle-incomecountriespdfprobabilitydensityfunctionUNUnitedNationsPIPPovertyandInequalityPlatformUN-HabitatUnitedNationsHumanSettlements3PLthird-partylogisticsProgrammePoUprevalenceofundernourishmentUNICEFUnitedNationsChildren’sFundPPPpurchasingpowerparityUPAurbanandperi-urbanagricultureR&DresearchanddevelopmentURCAUrbanRuralCatchmentAreasRUFSATRapidUrbanFoodSystemsURCAsurban–ruralcatchmentareasAppraisalToolWDIworlddevelopmentindicatorsSDstandarddeviationWFPWorldFoodProgrammeSDGsSustainableDevelopmentGoalsWHAWorldHealthAssemblySICTssmallandintermediatecitiesWHOWorldHealthOrganizationandtownsWPPWorldPopulationProspectsSMEssmallandmediumenterprisesWTOWorldTradeOrganizationxvKEYMESSAGESèGlobalhunger,measuredbytheprevalenceèMorethan3.1billionpeopleintheworld–ofundernourishment(SustainableDevelopmentor42percent–wereunabletoaffordahealthydietGoal[SDG]Indicator2.1.1),remainedrelativelyin2021.Whilethisrepresentsanoverallincreaseunchangedfrom2021to2022butisstillfaraboveof134millionpeoplecomparedto2019,beforethepre-COVID-19-pandemiclevels,affectingaroundpandemic,thenumberofpeopleunabletoafforda9.2percentoftheworldpopulationin2022comparedhealthydietactuallyfellby52millionpeoplefromwith7.9percentin2019.2020to2021.èItisestimatedthatbetween691and783millionèWorldwidein2022,anestimated148.1millionpeopleintheworldfacedhungerin2022.childrenunderfiveyearsofage(22.3percent)Consideringthemidrange(about735million),werestunted,45million(6.8percent)werewasted,122millionmorepeoplefacedhungerin2022thaninand37million(5.6percent)wereoverweight.2019,beforetheglobalpandemic.Theprevalenceofstuntingandwastingwashigherinruralareas,whileoverweightwasslightlymoreèFrom2021to2022,progresswasmadetowardsprevalentinurbanareas.reducinghungerinAsiaandinLatinAmerica,buthungerisstillontheriseinWesternAsia,theCaribbeanèSteadyprogresshasbeenmadeonincreasingandallsubregionsofAfrica.exclusivebreastfeedingforthefirstsixmonthsoflifeandreducingstuntingamongchildrenunderfiveyearsèItisprojectedthatalmost600millionpeoplewillofage,buttheworldisstillnotontracktoachievethebechronicallyundernourishedin2030.Thisisabout2030targets.Childoverweightandlowbirthweight119millionmorethaninascenarioinwhichneitherhavechangedlittle,andtheprevalenceofwastingisthepandemicnorthewarinUkrainehadoccurred,morethandoublethe2030target.andaround23millionmorethanifthewarinUkrainehadnothappened.ThispointstotheimmenseèIncreasingurbanization,withalmostsevenintenchallengeofachievingtheSDGtargettoeradicatepeopleprojectedtoliveincitiesby2050,isdrivinghunger,particularlyinAfrica.changesinagrifoodsystemsacrosstherural–urbancontinuum.ThesechangesrepresentbothchallengesèTheprevalenceofmoderateorseverefoodandopportunitiestoensureeveryonehasaccesstoinsecurityatthegloballevel(SDGIndicator2.1.2)affordablehealthydiets.remainedunchangedforthesecondyearinarowafterincreasingsharplyfrom2019to2020.èChallengesincludeagreateravailabilityofcheaper,About29.6percentoftheglobalpopulation–2.4billionconvenience,pre-preparedandfastfoods,oftenenergypeople–weremoderatelyorseverelyfoodinsecuredenseandhighinfats,sugarsand/orsaltthatcanin2022,ofwhichabout900million(11.3percentofcontributetomalnutrition;insufficientavailabilityofpeopleintheworld)wereseverelyfoodinsecure.vegetablesandfruitstomeetthedailyrequirementsofhealthydietsforeveryone;exclusionofsmallfarmersèWorldwide,foodinsecuritydisproportionatelyfromformalvaluechains;andlossoflandsandnaturalaffectswomenandpeoplelivinginruralareas.capitalduetourbanexpansion.Moderateorseverefoodinsecurityaffected33.3percentofadultslivinginruralareasin2022èButurbanizationalsopresentsopportunities,comparedwith28.8percentinperi-urbanareasandasitresultsinlonger,moreformalandcomplexfood26.0percentinurbanareas.Thegendergapinfoodvaluechainsthatexpandincome-generatingactivitiesinsecurityatthegloballevel,whichhadwidenedintheinoff-farmemployment,especiallyforwomenandwakeofthepandemic,narrowedfrom3.8percentageyouth,andincreasethevarietyofnutritiousfoods.pointsin2021to2.4percentagepointsin2022.Farmersoftengainbetteraccesstoagriculturalinputsandservicesasurbanareasgrowclosertoruralareas.xvièUnderstandingthechangesoccurringthroughoutèInmanyoftheseAfricancountriesstudied,foodagrifoodsystems(i.e.fromfoodproduction,foodsecurityisnotexclusivelyaruralproblem,asmoderateprocessing,andfooddistributionandprocurement,orseverefoodinsecurityacrossurbanareas(large,toconsumerbehaviour)requiresarural–urbanintermediateandsmallcitiesandtowns)andperi-urbancontinuumlens,reflectingthegrowingconnectivityandareas(lessthan1hourtraveltolarge,intermediateandinterlinkagesacrossurban,peri-urbanandruralareas.smallcities)issimilartoandsometimesevenslightlyhigherthaninruralareas.èWhilealreadyquiteadvancedinAsiaandLatinAmerica,changesinfooddemandandsupplyacrossèTheprevalenceofchildoverweightisatrisktherural–urbancontinuumareacceleratinginAfrica,ofincreasingwiththeemergingproblemofhighwherethesharesofthepopulationthatarefoodconsumptionofhighlyprocessedfoodsandfoodawayinsecureandunabletoaffordahealthydietareamongfromhomeinurbancentres,whichisincreasinglythehighestintheworld.Heretheexpansivegrowthinspreadingintoperi-urbanandruralareas.off-farmemploymentandinterconnectedfoodmarketsandfoodsupplychainsisdrivingadiettransitionacrossèIncreasingaccesstoaffordablehealthydietsandtherural–urbancontinuum.achievingfoodsecurityandnutritionforallrequireapolicyapproachandlegislationthatleveragetheèNewevidencefor11Western,Easternandincreasingconnectivitybetweenruralandperi-urbanSouthernAfricancountrieschallengesthetraditionalareasandcitiesofvarioussizes.thinkingthatfoodpurchasesmakeupasmallshareofruralhouseholds’foodconsumptioninAfrica.èThecloserlinkagesamongagrifoodsystemsFoodpurchasesarehighamongurbanhouseholdssegmentscreateopportunitiesforwin–winsituationsininthesecountries,buttheyarealsosurprisinglyhightermsofgreatereconomicdevelopmentandaccesstoacrosstherural–urbancontinuum,evenamongruralaffordablehealthydiets,whichcanbeseizedthroughhouseholdslivingfarfromanurbancentre.investmentsininfrastructure,publicgoodsandenhancedcapacitiesthatimproverural–urbanconnectivity.èNewevidencealsochallengestheconventionalSuchinvestmentsshouldsupporttheessentialrolethinkingthatpurchasepatternsbetweenurbanandofsmallandmediumenterprisesinagrifoodsystems,ruralareasdiffermarkedly.Inthe11Africancountriesparticularlyinsmallandintermediatecitiesandtowns.studied,althoughconsumptionofprocessedfoods,includinghighlyprocessedfoods,ishigherinurbanèPublicinvestmentinresearchanddevelopmentareas,itonlydeclinesgraduallymovingtoperi-urbanandneedstobeincreasedtodeveloptechnologiesandruralareas.Moreover,consumptionofvegetables,fruits,innovationsforhealthierfoodenvironmentsandforandfatsandoilsisfairlyuniformacrosstherural–urbanincreasingtheavailabilityandaffordabilityofnutritiouscontinuumrelativetototalfoodconsumption.foods.Technologycanbeparticularlyimportanttoboostthecapacityofurbanandperi-urbanagriculturetoèTheaffordabilityofahealthydietisbecomingmoresupplynutritiousfoodsincitiesandtowns.criticaltohouseholdslivinginperi-urbanandruralareasbecausetheyrelymoreonfoodpurchases.IntheèLeveragingconnectivityacrosstherural–urban11Africancountriesstudied,despitethelowercostofcontinuumwillrequireadequategovernancemechanismsahealthydietintheseareas,affordabilityisstilllowerandinstitutionstocoordinatecoherentinvestmentbeyondthaninurbancentres.Low-incomehouseholdslivinginsectoralandadministrativeboundaries.Tothisend,peri-urbanandruralareasareespeciallydisadvantaged,subnationalgovernmentscanplayakeyroleindesigningastheywouldneedtomorethandoubletheirfoodandimplementingpoliciesbeyondthetraditionalexpendituretosecureahealthydiet.top-downapproach.Approachestoagrifoodsystemsgovernanceshouldensurepolicycoherenceamonglocal,regionalandnationalsettingsthroughtheengagementofrelevantagrifoodsystemsstakeholdersatalllevels.xviiEXECUTIVESUMMARYThisyear,theupdatetotheglobalassessmentofBuildingontheseinsights,thereportidentifiesfoodsecurityandnutritionreflectsaparticularpolicies,investmentsandnewtechnologiestomomentinhistory.Whilethepandemic,theaddressthechallenges,andcapitalizeontheensuingeconomicrebound,thewarinUkraine,opportunities,thaturbanizationbringsforandsoaringpricesoffood,agriculturalinputsensuringaccesstoaffordablehealthydietsforandenergyhaveallplayedoutdifferentlyeveryone,acrosstherural–urbancontinuum.acrossregionswithdifferingimpacts,newestimatesindicatehungerisnolongerontheFOODSECURITYANDNUTRITIONriseatthegloballevelbutisstillfaraboveAROUNDTHEWORLDpre-COVID-19-pandemiclevelsandfarofftracktoFoodsecurityindicators–latestachieveSustainableDevelopmentGoal(SDG)2.updatesandprogresstowardsendinghungerandensuringfoodsecurityAspasteditionsofthisreporthavehighlighted,theintensificationofthemajordriversoffoodTheglobalassessmentofthestateoffoodinsecurityandmalnutrition–conflict,climatesecurityandnutritionin2022isasnapshotoftheextremes,economicslowdownsanddownturns,worldstillrecoveringfromaglobalpandemicandgrowinginequality–oftenoccurringinandnowgrapplingwiththeconsequencesofcombination,ischallengingoureffortstoachievethewarinUkraine,whichhasrattledfoodandtheSDGs.Thereisnoquestionthesethreatswillenergymarkets.Encouragingsignsofeconomiccontinue,requiringthatweremainsteadfasttorecoveryfromthepandemicandprojectionsbuildresilienceagainstthem.However,thereofadeclineinpovertyandhungerhavebeenarestillimportantmegatrendsthatmustbetemperedbyrisingfoodandenergyprices.fullyunderstoodwhendevisingpoliciestomeettheSDG2targets.Globalhungerin2022,measuredbytheprevalenceofundernourishmentOnesuchmegatrend,andthefocusofthisyear’s(SDGIndicator2.1.1),remainedfarabovereport,isurbanization.Asurbanizationincreases,pre-pandemiclevels.Theproportionoftheworldruralandurbanareasarebecomingmorepopulationfacingchronichungerin2022wasintertwined,andthespatialdistinctionbetweenabout9.2percent,comparedwith7.9percentthemisbecomingmorefluid.Thechangingin2019.Afterincreasingsharplyin2020inthepatternofpopulationagglomerationsacrossmidstoftheglobalpandemic,andrisingmorethisrural–urbancontinuumisdrivingchangesslowlyin2021to9.3percent,theprevalencethroughoutagrifoodsystems,creatingbothofundernourishmentceasedtoincreasefromchallengesandopportunitiestoensureeveryone2021to2022.Itisestimatedthathungeraffectedhasaccesstoaffordablehealthydiets.between691millionand783millionpeopleintheworldin2022.ConsideringtheprojectedAfterpresentingthelatestupdatesofthefoodmidrange(about735millionin2022),122millionsecurityandnutritionsituationaroundtheworld,morepeoplefacedhungerin2022thanin2019,thereportthenexaminesthedrivers,patternsandbeforethepandemic.dynamicsofurbanizationthrougharural–urbancontinuumlensandpresentsnewanalysisonTheeconomicrecoveryfromthepandemichelpedhowurbanizationischangingfoodsupplyandtostemtherisingtideofhungeratleastatthedemandacrosstherural–urbancontinuum.globallevel.However,thepositiveeffectcouldComplementingthis,furtheranalysesforhavebeenevenlargerwithoutthecountervailingselectedcountriesexploredifferencesinthecostwindscausedbytheglobalrepercussionsofandaffordabilityofahealthydiet,andinfoodthewarinUkraineandrisingpricesoffood,insecurityanddifferentformsofmalnutritionagriculturalinputsandenergy,togetherwithacrosstherural–urbancontinuum.xviiiotherdriversoffoodinsecuritysuchasconflictsTheprevalenceofmoderateorseverefoodandweather-relatedevents.insecurityroseslightlyinAfricaandinNorthernAmericaandEurope,anddecreasedTherelativelackofchangeinhungeratthenon-significantlyinAsiafrom2021to2022.globallevelfrom2021to2022hidessubstantialTheonlyregionshowingencouragingprogressdifferencesattheregionallevel.ProgresswaswasLatinAmericaandtheCaribbean,mainlymadetowardsreducinghungerinmostsubregionsinSouthAmerica,althoughthefoodsecurityinAsiaandinLatinAmerica,buthungerisstillsituationdeterioratedintheCaribbeansubregion.ontheriseinWesternAsia,theCaribbeanandallsubregionsofAfrica.TheproportionoftheAcomparisonoffoodinsecurityinrural,populationfacinghungerismuchlargerinAfricaperi-urbanandurbanpopulationsattheglobal,comparedwiththeotherregionsoftheworld–regionalandsubregionallevelsusingtheDegreenearly20percentcomparedwith8.5percentofUrbanization(DEGURBA)classification,anewinAsia,6.5percentinLatinAmericaandtheinternationalstandard,showsthatattheglobalCaribbean,and7.0percentinOceania.level,foodsecurityimprovesasthedegreeofurbanizationincreases.ModerateorseverefoodUpdatedprojectionsshowthatalmost600millioninsecurityaffected33.3percentofadultslivinginpeoplewillbechronicallyundernourishedinruralareasin2022comparedwith28.8percentin2030,pointingtotheimmensechallengeofperi-urbanareasand26.0percentinurbanareas.achievingtheSDGtargettoeradicatehunger.Thisisabout119millionmoreundernourishedPersistentgenderinequalitiesarerevealedbypeoplethaninascenarioinwhichneitherthethenewFIESdata.FoodinsecurityismorepandemicnorthewarinUkrainehadoccurred,prevalentamongadultwomenthanmenineveryandaround23millionmorethaninascenarioinregionoftheworld,althoughthegapnarrowedwhichthewarhadnothappened.considerablyatthegloballevelfrom2021to2022.In2022,27.8percentofadultwomenwereSDGTarget2.1challengestheworldnotonlytomoderatelyorseverelyfoodinsecure,comparedendhunger,butalsotoworktoensureaccesswith25.4percentofmen,andtheproportionforallpeopletosafe,nutritiousandsufficientofwomenfacingseverefoodinsecuritywasfoodallyearround.SDGIndicator2.1.2–the10.6percentcomparedwith9.5percentofmen.prevalenceofmoderateorseverefoodinsecurityinthepopulation,basedontheFoodInsecurityCostandaffordabilityofahealthydietExperienceScale(FIES)–tracksprogresstowardsthisambitiousgoal.Therevisedanalysispresentedinthisyear’sreportshowsthatalmost3.2billionpeopleNewestimatesoftheprevalenceoffoodworldwidecouldnotaffordahealthydietin2020,insecuritybasedontheFIESconfirmthatforwithaslightimprovementin2021(adecrease2022noprogresswasmadeonfoodinsecurityof52millionpeople).Thecostofahealthydietatthegloballevel.Followingasharpincreaseincreasedgloballyby6.7percentbetween2019from2019to2020,theglobalprevalenceofand2021,withanotablesingle-yearincreasemoderateorseverefoodinsecurityremainedof4.3percentin2021.Thecostincreasedbyunchangedforthesecondyearinarow,farmorethan5percentbetween2020and2021inabovepre-COVID-19-pandemiclevels.In2022,anAfrica,Asia,LatinAmericaandtheCaribbean,estimated29.6percentoftheglobalpopulation–andOceania,butonlymarginallyinNorthern2.4billionpeople–weremoderatelyorseverelyAmericaandEurope.foodinsecure,meaningtheydidnothaveaccesstoadequatefood.Thisisstill391millionmoreInmanycountries,theincreaseinthecostofpeoplethanin2019,beforethepandemic.ahealthydietoccurredincombinationwithxixEXECUTIVESUMMARYadeclineindisposableincomefollowingthefrom8.7percentin2000to6.8percentinpersistingeffectsofthepandemic.Lockdowns,2022.Theestimatednumberofchildrenwitheconomicdownturns,andotherpandemic-relatedwastingdeclinedfrom54.1millionin2000todisruptionsin2020ledtojoblossesandreduced45.0millionin2022.incomesformanypeople,affectinglow-incomehouseholdsthemostastheyspendahighershareChildrenwhoareoverweightorobesefacebothofincomeonfood.immediateandpotentiallylong-termhealthimpacts,includingahigherriskofNCDslaterinAslightturnaroundoccurredin2021,whenthelife.Childoverweighthasbeenontheriseinmanynumberofpeopleunabletoaffordahealthydietcountries,hastenedbyincreasinglyinadequatedeclinedby52millioncomparedto2020,butthislevelsofphysicalactivityandincreasedaccesstoisstill134millionmorepeoplethanin2019beforehighlyprocessedfoods.Globally,theprevalencethepandemic.Mostofthepeopleunabletoaffordofoverweightamongchildrenunderfiveyearsahealthydietin2021livedinSouthernAsia,andofageshowedanon-significantincreasefrominEasternandWesternAfrica.5.3percent(33.0million)in2000to5.6percent(37.0million)in2022.Thestateofnutrition:progresstowardsglobalnutritiontargetsThelatestestimateforlowbirthweightrevealedthat14.7percentofnewborns(19.8million)wereNutritionismentionedspecificallyinSDG2bornwithlowbirthweight(lessthan2500g)butiscentraltotheachievementofall17SDGs.in2020,anon-significantdeclinefromtheThissectionpresentsanassessmentofprogress16.6percent(22.1million)in2000.Infantsborntowardsglobalnutritiontargetsforstunting,weighinglessthan2500gareapproximatelywastingandoverweightamongchildrenunder20timesmorelikelytodiethanthosewithfiveyearsofage,exclusivebreastfeedingandlowadequatebirthweight,andthosewhosurvivefacebirthweight.Updateddatawerenotavailablelong-termdevelopmentandhealthconsequences.foranaemiainwomenaged15to49yearsandforadultobesity.Optimalbreastfeedingpractices,includingexclusivebreastfeedingforthefirstsixmonthsStunting,theconditionofbeingtooshortforoflife,arecriticalforchildsurvivalandtheone’sage,underminesthephysicalandcognitivepromotionofhealthandcognitivedevelopment.developmentofchildren.StuntingandotherGlobally,theprevalenceofexclusivebreastfeedingformsofundernutritionearlyinlifemayamonginfantsundersixmonthsofagehasalsopredisposechildrentobeingoverweightrisenfrom37.0percent(24.3million)in2012toanddevelopingnon-communicablediseases47.7percent(31.2million)in2021.Worldwide,(NCDs)laterinlife.Globally,theprevalenceofoverhalfofallinfantsundersixmonthsofstuntingamongchildrenunderfiveyearsofagedidnotreceivetheprotectivebenefitsofagehasdeclinedsteadily,fromanestimatedexclusivebreastfeeding.33.0percent(204.2million)in2000to22.3percent(148.1million)in2022.Low-andlower-middle-incomecountriesbearthegreatestburdenofstunting,wastingandlowChildwastingisalife-threateningconditionbirthweightbutalsohavethelargestproportioncausedbyinsufficientnutrientintake,poorofexclusivelybreastfedchildren.Mostoverweightnutrientabsorptionand/orfrequentorprolongedchildrenliveinthesecountryincomegroups.illness.AffectedchildrenaredangerouslyAtthegloballevel,theprevalenceofstuntingandthin,withweakenedimmunityandahigherwastingwashigherinruralareasthaninurbanriskofmortality.Theprevalenceofwastingareaswhileoverweightwasmorecommonlyamongchildrenunderfiveyearsofagedeclinedfoundinurbanareas.xxTheresultsfromtheseanalyseshelptoidentifyAnotherfactorthatmaycontributetourbanizationvulnerablepopulationgroups,contributingtoisclimatechangeand/orenvironmentalevidencetoinformdecision-makingandeffectivedegradation,whichcanaffectrural-to-urbanactionthroughtheappropriatetargetingandmigrationmovements.Populationsthatdependdesignofpoliciesandprogrammes.SoundonnaturalresourcesfortheirlivelihoodscanbenutritionisfundamentaltotheachievementofcompelledtomigratetourbanareasinsearchoftheSustainableDevelopmentGoalsandmustwork,duetotheeffectsofclimatechangeandbecentralingovernmentpolicyandsupportedbiodiversityloss.Thereisalsoanincreasingbykeystakeholders,includingcivilsocietyandoccurrenceofforceddisplacementfromruraltheprivatesector.areastourbanareas,oftenasaresultofdisastersand/orconflict.URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMSANDAFFECTINGWithurbanexpansionandimprovingroadandACCESSTOAFFORDABLEHEALTHYcommunicationinfrastructureacrosslargerpartsDIETSACROSSTHERURAL–URBANofruralareas,thedistinctionbetweenruralCONTINUUMandurbanareasisincreasinglyblurred.AlargeDrivers,patternsanddynamicsshareofthenewurbandwellersareexpectedtoofurbanizationliveinperi-urbanareas,aswellasinsmallcitiesandinterconnectedtowns.Increasingly,ruralUrbanizationistheresultofurbanpopulationandurbanareasarelessseparatespacesintheirgrowth,urbanexpansion(i.e.reclassificationownright,butrathertwoendsofaspectrum,ofruralareastoperi-urbanorurban)andconnectedvianumerouslinkagesacrossamigrationfromruraltourbanareas.Thisprocessrural–urbancontinuum.isfast-changing,contextspecificanddrivenbyintertwinedfactors.Almosthalfoftheglobalpopulation(47percent)liveinperi-urbanareas(lessthan1hourtolarge,Manypartsoftheworldhaverapidlyurbanized,intermediateandsmallcitiesortowns)andruralwiththeurbanshareoftheworld’spopulationareas(1to2hoursormoretoanurbancentre).risingfrom30percentin1950to57percentinGiventheincreasingconnectivityofperi-urban2021.Itisprojectedtoreach68percentby2050.andruralareasandtheconvergenceofhighfoodInmostregions,thishasbeenlargelydrivenpurchasesinboth,itisclearthatperi-urbanandbystructuraltransformation,whichentailsruralmarketsaresignificantdriversofagrifoodaneconomictransformationfrommainlysystemstransformation.agriculturetoamorediversifiednationaleconomy,intheprocessattractingruralpeopleThedegreeofconnectivitybetweenruralandtourbanareas.urbanareasshapesagrifoodsystems,andthustheavailabilityofaffordablehealthydiets,andtheWhileurbanizationoftengoeshandinhandwithlivelihoodsofurbanandruralprimaryproducers,economicgrowthandstructuraltransformation,processorsandtraders.Dependingonwhereurbanthisdoesnotholdforallcountriesandregions.growthtakesplace,whetherinlarge,intermediateUrbanizationwithouteconomicgrowthcanbeandsmallcitiesortowns,therewillbedifferentlinkedtopoorrurallivingconditions,includingeffectsonruralpopulations’accesstoservices,poverty,lackofemploymentorunderemployment,marketsandinputs.Arural–urbancontinuumlackofinfrastructure,lackofaccesstoservices,frameworkisthereforecriticaltounderstandtheandfoodinsecurity.linksbetweenurbanizationandagrifoodsystemschangesandhowthesechangesareaffectingtheavailabilityandaffordabilityofhealthydiets,andinturn,foodsecurityandnutrition.xxiEXECUTIVESUMMARYUrbanizationaffectsagrifoodsystems,Urbanizationisalsoleadingtochangesincreatingchallengesandopportunitiestomidstreamanddownstreamfoodsupplyensureaccesstoaffordablehealthydietschains,whichhavebecomelonger,moreformalandmorecomplexfollowingrisingconsumerUrbanization,combinedwithothercontextualdemandandincreasedregulationofagrifoodfactorssuchasrisingincomes,growingsystems.Importantly,growingmidstreamemploymentandchanginglifestyles,isdrivinganddownstreamactivitiesprovideimportantchangesthroughoutagrifoodsystemsacrossoff-farmemploymentopportunities,whichcantherural–urbancontinuum.Increasesinprovidesteadyandliveableincomes,increasingfooddemandinurbanareasareoccurringtheaffordabilityofhealthydiets.simultaneouslywithincreasesintheamountoffoodthatagrifoodsystemshavetoproduce,Supply-sidefactors,coupledwithanincreaseprocessanddistribute,which,togetherwithindemandforreadilyavailablefoods,havechangesinconsumerbehaviour,arebeingcontributedtoasubstantialexpansionofseenacrosstherural–urbancontinuum.Thesesupermarketsandhypermarketsthatusemodernchangesmayalsoleadtodisparitiesacrossthefoodtechnology.Whilethesemarketscanberural–urbancontinuum,withbothpositivelinkedtoincreasedaccesstonutritiousfoodsandnegativeeffectsontheavailabilityand–throughreducedwaste,enhancedsanitationaffordabilityofhealthydiets,andinturn,onandreducedadverseeffectsofseasonality,forfoodsecurityandnutritionoutcomes.example–theyhavealsobeenassociatedwithincreasedsupplyofenergy-denseandhighlyOneofthemostimportantpathwaysthroughprocessedfoods.whichurbanizationisdrivingchangesinagrifoodsystemsisthroughashiftinconsumerbehaviourUrbanization,inparticular,byincreasingtheanddiets.Higheraverageincomes,combinedconnectivityofruralandurbanareas,alsowithchanginglifestylesandemployment,areaffectsagrifoodsystemsthroughchangesindrivingadiettransitioncharacterizedbychangesagriculturalproduction.Whileurbanizationinthetypesandquantitiesoffoodconsumed,isoftenassociatedwithadiversificationofwithdietsshiftingbeyondtraditionalgrainsdiets,theavailabilityofvegetablesandfruits,intodairy,fish,meat,vegetablesandfruits.inparticular,isinsufficienttomeetthedailyThereisadiffusionoffoodpurchasesinruraldietaryrequirementsinalmosteveryregionofareas,moresothaniscommonlyunderstood.theworld.Thedietintheseareashasshiftedfrommainlyhome-producedfoodstoincreasinglyAsurbanareasbecomebetterconnectedtoruralmarket-purchasedproducts.areas,ruralproducersmayalsohavebetteraccesstoagriculturalinputsandservices,allowingforHowever,urbanizationhasalsocontributedimprovedproductivitythattypicallyincreasestothespreadandconsumptionofprocessedincomelevels.However,urbanexpansioncanandhighlyprocessedfoods,whichareleadtoland-usechange.Insomecountries,increasinglycheaperandmorereadilyavailablefarmersreceivehighcompensationforsellingandmarketed.Changesinthelifestylesandtheirland,whereasinothers,dispossessionofemploymentprofilesofbothwomenandmen,agriculturallandisnotcompensated,resultingaswellasincreasingcommutingtimes,areinlossoflivelihoodsandpotentialissuesresultingingreaterdemandforconvenience,aroundlandrights.pre-preparedandfastfoods.Thediettransitionisalsooccurringinruralareas,thoughlaggedAccesstoaffordablehealthydietsisgenerallyandtoalesserextentcomparedtourbanandbetterandfoodsecurityandnutritionlevelsareperi-urbanareas.higherincitiesthaninruralareasbecauseofxxiithebetteravailabilityoffood,higheraveragewithgeoreferenceddatafromnationallypurchasingpowerinurbanareas,andbetterrepresentativeLivingStandardsMeasurementaccesstohealthcare,educationandotherservicesStudy(LSMS)surveys.Forreasonsofdatathatareessentialforhealthandnutrition.availability,thesurveysusedcoveredtheperiodHowever,thisdoesnotalwaysholdtruegiventhe2018/19forBenin,BurkinaFaso,Côted’Ivoire,transformationsunderwayinagrifoodsystems,Ethiopia,Guinea-Bissau,Mali,theNiger,Nigeria,thestarkinequalitiesthatexistwithinurbanSenegalandTogo,and2019/20forMalawi.populations,andtheincreasinglyspatialandfunctionalconnectivitybetweencities,townsandGivenitisexpectedthatdietsbecomeruralcatchmentareas.morediversifiedwithhigherlevelsoffoodconsumption,incomeandemployment,theTHEINTERPLAYOFFOODSUPPLYAND11countrieswereclassifiedintotwogroupsDEMANDANDTHECOSTANDaccordingtotheirfoodbudget(i.e.themarketAFFORDABILITYOFHEALTHYDIETSvalueoftheirtotalfoodconsumptionperACROSSTHERURAL–URBANcapitaperday):high-food-budgetcountriesCONTINUUM(average2.3PPPdollarspercapitaperday)andlow-food-budgetcountries(average1.6PPPUnderstandingfoodsupplyanddemanddollarspercapitaperday).acrosstherural–urbancontinuumNewempiricalevidencefromthisanalysis,Urbanization,combinedwithrisingincomes,challengestraditionalthinkingandrevealsincreasesintheopportunitycostoftimerelatedimportantfoodconsumptionpatterns,includingtowork,lifestylechangesanddemographicshifts,dietaryconvergenceacrosstherural–urbanischangingfooddemand.Thesefactorstogethercontinuum.Forexample,acrossthe11countries,withmanysupply-sideconsiderations,includingfoodpurchasesformthemajorityoftotalfoodfoodpricing,marketingandpromotion,amongconsumptioninvalueterms,includingfoodforothers,inturnarechangingagrifoodsystems,sohomeconsumptionandfoodawayfromhome.thereisareinforcingcompoundingeffectonthefoodproduced,suppliedandconsumed.Whilehighsharesoffoodpurchasesinurbanareasaretobeexpected(78–97percent),sharesMostnotably,rapidurbanizationisleadingaresurprisinglyhighevenforruralhouseholdstorisingandchangingfooddemand,andliving1to2hoursfromasmallcityortownshiftsinpatternsoffoodsupply–especially(56percentonaverage)andforthoselivingmoreinsub-SaharanAfricaandSouthernAsia,thethan2hourstraveltoanyurbancentre(52percenttworegionsexhibitingthehighesturbanizationonaverage).Thefindingthatinmostoftherates.Projectionsofoverallfoodexpenditurecountriesanalysed,the"majority"ofhouseholdestimateanapproximate2.5-foldincreaseinfoodconsumptioninruralhouseholdscomessub-SaharanAfricaanda1.7-foldincreaseinfrompurchasesisamajordeviationfromtheSouthernAsiaby2050.traditionalimageofruralsubsistencehouseholds.Analysisoffooddemand,definedashouseholdOwnproductionneverbecomesthemainsourcefoodconsumption(atmarketvalue),acrosstheforfood–noteveninruralareas.Inruralrural–urbancontinuuminselectedcountriesareas,theaverageshareofownproductionwasconductedandrevealedinterestingrepresentsonly37percentand33percentofpatterns.Thiswasmadepossiblebyapplyingtotalconsumptioninhigh-andlow-food-budgetthenewlyavailablegeospatialUrbanRuralcountries,respectively.GiventhatruralCatchmentAreas(URCA)datasetcombinedhouseholdsinthe11AfricancountriesdonotproducethemajorityofthefoodvaluetheyxxiiiEXECUTIVESUMMARYconsume,theaffordabilityofhealthydietsisThecostofahealthydietexceedsaverageequallycriticalacrosstherural–urbancontinuum.foodexpenditureforlow-andmiddle-incomehouseholdsinbothhigh-andlow-food-budgetWhilethediffusionofprocessedfoods,includingcountriesinthe11countriesanalysed.highlyprocessedfoods,isalreadyadvancedinLow-incomehouseholdslivinginperi-urbanandAsiaandLatinAmerica,itisspreadingquicklyruralareasareespeciallydisadvantaged,astheyinAfricaaswell.Inthe11Africancountrieswouldneedtomorethandoubletheircurrentstudied,theanalysisclearlyshowsadiffusionexpenditureonfoodtosecureahealthydiet.ofpurchasesofprocessedfoodsacrosstherural–urbancontinuum.WhilehighlyprocessedAlthoughthecostofahealthydietinperi-urbanfoodsareasmallproportionoftotalpurchasesareasislowerthaninurbanareas,thisdoesnotandtheirconsumptionishigherinurbanareas,translateintoamoreaffordablehealthydietintheresultshighlightthepenetrationofhighlytheformer.Onaverage,thepercentageoftheprocessedfoodsinruralareas,eventhosepopulationunabletoaffordahealthydietinliving1to2hoursormorefromacityortown.peri-urbanareasis1.5timeshigherthaninurbanTheeconometricanalysisindicatesthathighercentresandsimilartoruralareas.levelsofhouseholdincomeandmorenon-farmemploymentareassociatedwithahigherAnanalysisoffoodinsecuritybasedontheconsumptionvalueshareofhighlyprocessedFIESfor9ofthe11Africancountriesshowsthatfoodsinthe11Africancountries.inmanyofthesecountries,theprevalenceofmoderateorseverefoodinsecurityinurbanandInthe11Africancountries,lookingathouseholdperi-urbanareasissimilartothatinruralareas,foodcompositionintermsofthevaluesharesofandinsomecases,slightlyhigher,indicatingthatfoodconsumptionbyfoodgroup,adiettransitionfoodinsecurityisnotexclusivelyaruralproblem.isclearlyoccurringacrosstherural–urbancontinuum,withincreasesintheconsumptionTheprevalenceofmalnutritionacrossthetenofmoreexpensivefooditems,likeanimalsourceURCAcategorieswasonlyestimatedfor3offoodsandfruits.Theeconometricanalysisthe11countries,duetodatalimitations.Intheindicatesthatanimalsourcefoodconsumptionthreecountries(Benin,NigeriaandSenegal),valuesharesarestronglydrivenbyincomegenerallytheprevalenceofstuntinginchildrenacrosstherural–urbancontinuum,whiletheunderfiveyearsofagegraduallyincreasesasconsumptionvaluesharesoffruitsandvegetablescitiesbecomesmallerandasonemovesawayaredrivenmorebyaccessandavailability.fromurbancentres.Costandaffordabilityofahealthydiet,Theprevalenceofwastinginchildrenunderandfoodsecurityandnutritionacrossthefiveyearsofageislowerthanthatofstuntingrural–urbancontinuuminallthreecountriesandexhibitslessevidenttrendsacrosstherural–urbancontinuum.Onaverage,acrossthe11countriesinAfricaNevertheless,therearehintsofincreasedanalysed,thecostofahealthydietinurbanwastinginsomeperi-urbanandruralareasincentresismuchhigher(onaverage1.2timesNigeriaandSenegal.Similarly,theprevalencehigher)thaninperi-urbanareasanditthenoverweightamongchildrenislowinalldecreasesthesmallerthecitysizeandmovingcountriesanddoesnotpresentacleartrendclosertoruralareas.Thehighercostofanimalacrosstherural–urbancontinuum.However,sourcefoods,comparedtotheotherfoodgroups,itisworthnotingthereisasuggestiontowardsdrivesupthecostofahealthydietacrosstheloweroverweightinperi-urbanareasandhigherrural–urbancontinuum,especiallyinurbanandoverweightinsomeruralareascomparedtoremoteruralareas.urbanareas.xxivPOLICIESANDSOLUTIONSTOLEVERAGEGiventhatone-fourthoftheglobalpopulationAGRIFOODSYSTEMSTRANSFORMATIONliveinperi-urbanareasofsmallandFORHEALTHYDIETSACROSSTHEintermediatecitiesandtowns(SICTs),investingRURAL–URBANCONTINUUMinthesecanhaveamoresignificantimpactonhealthydietsfortheirpopulationscomparedtoTheincreasedlinksacrosstherural–urbanthebenefitsthattrickledownfromgrowthincontinuumcoupledwithcloserinteractionslargecities.AddressingsomeofthechallengesbetweenthecomponentsofagrifoodsystemsfacedbySICTscanallowagrifoodsystemstobecreateanumberofopportunitiesandchallengesthedriverofinclusiveruraldevelopment,andfortheavailabilityandaffordabilityofhealthycreatedevelopmentopportunitiesforsmallanddiets.Suchinteractionsalsocreateanumberofmediumenterprises(SMEs).policyandprogrammeentrypointstosupportagrifoodsystemstransformationtowardsThepresenceofprocessedfoodsinhouseholdaffordablehealthydiets.dietsacrossthewholerural–urbancontinuumconstitutesadrivingforcefortheexpansionofPoliciesandinvestmentsforhealthydietstheservicesprovidedbySMEs.Strengtheningacrosstherural–urbancontinuumtheirefficiencyandexpansioncanalsocontributetogainsinproductionofnutritiousSupportinghealthierfoodoutletswillbekeyfoods,andaparallelreductioninthecostofforenablingaccesstohealthydiets,asthishasfoodforconsumers.shownpositiveimpactsondietaryquality.PolicyincentivesarenecessarytoencourageBuildingruralinfrastructure,includingqualityshopstostockandsellgreateramountsoffreshruralandfeederroadstoconnectremoteandminimallyprocessedfoods,forinstance,byfarmsandenterprisestomainroadnetworks,improvingtheircoldstoragefacilities,whiletheisessentialforunlockingtheproductiveavailabilityofhealthierfoodoutletsinparticularpotentialofSICTsandtheircatchmentareas.areasacrosstherural–urbancontinuumcanOtherpublicinvestmentstosupportlinkagesbeimprovedthroughland-useplanningandbetween(mainlysmall)farmsandSMEszoningregulations;taxcreditsorexemptions;couldincludewarehousing,coldstorage,andlicensingagreements.dependableelectrification,accesstodigitaltoolsandwatersupply.Inurbanandperi-urbansettings,anestimated2.5billionpeopleworldwideconsumestreetfoodsFinally,consideringthattheavailabilityoffruitseveryday,whichareespeciallyconvenientforandvegetablespercapitaperdayisinsufficientlow-incomeworkersandhouseholdswhomaytomeettherequirementsofahealthydietinnothavetheresources,facilitiesand/ortimetomostpartsoftheworld,itisessentialtoboostpreparedishesathome.However,streetfoodsdotheproductionofnutritiousfoodsand,innotalwayscontributetohealthydiets.Therearegeneralterms,supportthediversificationofmultipleinfrastructureandregulatorygapsthatfoodproduction.needtobeaddressedtoimprovethenutritionalqualityandsafetyofthesefoods.TheseincludeTechnologyandinnovation:akeyenablerensuringasupplyofwaterofacceptablequalityforagrifoodsystemstransformationforfoodpreparation,cleanplacesforpreparationunderurbanizationandconsumptionoffood,sanitaryfacilitiesforworkers,trainingforstreetvendorsandInanurbanizingworld,thestrategicdeploymentconsumereducation.oftechnologyandinnovationcanbeacriticalcatalystofagrifoodsystemstransformation.xxvEXECUTIVESUMMARYCountrieshavevariedneedsandcapacities,andrequiresonlyasmallplotoflandandcanbewhilethereisaplethoraoftechnologiesandcarriedoutindoors,allowingforthecultivationinnovationsavailable,nosingle“silverbullet”offoodinurbanandindustrialspaces,andtechnologyorinnovationwillmeetallneedsinleadingtoshortersupplychains.allcontextsacrosstherural–urbancontinuum.IntegratedplanningandgovernanceWhetherthesetechnologiesandinnovationsmechanismsacrosstherural–urbanareinclusiveforalldependsnotonlyontheircontinuumadoptionandimpact,butalsoonhowresearchanddevelopment(R&D)isshaped.Between1981Transformativepolicies,technologiesandand2016,therewasadoublingofglobalpublicinnovationsrequireadequategovernanceinvestmentinagriculturalR&D,withsignificantmechanismsthat,whileengagingmultipleincreasesinlargermiddle-incomecountriesactors,cancoherentlyaddressthechallenges(MICs);however,smallerlower-middle-incomeandleveragetheopportunitiescreatedincountries(LMICs)continuetohaveinsufficientagrifoodsystemsunderurbanization.investmentcomparedtoothercomponentsofgeneralservicessupportsuchasDuetothemultisectoralnatureofthechallengesinfrastructureinvestments.andopportunitiesthaturbanizationcreatesacrosstherural–urbancontinuum,subnationalInurbanizingcontexts,whereconsumersaregovernmentsareimportantactorsforformulatingincreasinglyexposedtohighlyprocessedandimplementingcoherentpoliciesthatgofoods,differenttechnologicalandinnovativebeyondagrifoodsystemsandoutsidenormalfoodenvironmentsolutionscancontributeadministrativeborders.Thesegovernmentstoreducingtheirconsumption.Forinstance,areinclosecontactwithlocalstakeholdersbehaviouralscienceisanessentialinnovationandcanensurethatpoliciesareadaptedtothatenablesgovernments,scientistsandlocalconditionsbypromotingadvantagesandthepublictoworktogethertodevelopaddressingbottlenecks.evidence-basedapproachestoincreaseaccesstoaffordablehealthydiets,aswellasempowerAnimportantstartingpointtowardsstreamliningconsumerstochoosehealthydiets.governanceacrosstherural–urbancontinuumisthedevelopmentoflocallybasedagreementsAsalreadynoted,urbanizationisleadingtoabetweenmultipleadministrativezonesandgrowingdemandforpackagedandpre-preparedmultistakeholderplatformsandnetworks.foods.InnovationsinfoodpackagingcanAmongsuchmechanisms,foodpolicymaintainthequality,safetyandnutritionalcouncilsserveasadvisorybodiestolocalorvalueoffoodproducts,meetconsumerneedssubnationalgovernments,supportpolicydesignandpreferences,reducefoodlossandwaste,andimplementation,promotestakeholderandreducethecostofnutritiousfoods,especiallyengagement,andfacilitatemonitoringandacrosslongerdistributionchains.evaluationofprogressinpolicyimplementation,effectiveness,efficiencyandimpact.Finally,therearenumeroustechnologiesandinnovationsthatcanbeleveragedforenhancingThedesignandimplementationoflocalagrifoodproductivityinrural,urbanandperi-urbansystemspolicies,investmentsandlegislationforareas,aswellasforclosingtheproductivityaddressingmultipleagrifoodsystemschallengesgapinLMICs,especiallyinthefaceoftheandopportunitiesrequiresworkingoutsideclimatecrisisandthedisappearanceofnatural“silos”andbridgingthegapsbetweenpolicyresources.Forexample,verticalfarmingareasinordertoachievesystemicchanges.xxviPolicycoherenceatnationalandsubnationalmegatrendisshapingagrifoodsystemsand,asalevelsremainsakeychallengeinestablishingtheconsequence,theircapacitytodeliveraffordableappropriateenablingenvironment.Therefore,healthydietsforallandtohelperadicatethesepoliciesandinvestmentswillrequirestronghunger,foodinsecurityandmalnutrition.multilevelgovernanceacrossnationalandregionalagrifoodsystemspolicies.TheestablishmentofAkeyconclusionisthatthewaysinwhichnationalnetworksengagingvariouslevelsofurbanizationisshapingagrifoodsystemscanonlygovernmentsappearsanimportantstartingpointbeunderstoodthrougharural–urbancontinuumtoinitiatesuchmultilevelgovernancemechanisms.lens;thesimpleconceptofarural–urbandivideisnolongerusefultounderstandthegrowingCONCLUSIONlinksacrossurban,peri-urbanandruralareas.Thisgrowingconnectivityacrosstherural–urbanHungeratthegloballeveldidnotworsencontinuumisakeyaspecttodaytounderstandbetween2021and2022,buttherearemanyplacesthefunctioningofvaluechains.Onlythenintheworldwherehungerisontherise–wherecanthechallengesandtheopportunitiesthatpeoplearestillstrugglingtorecoverincomeurbanizationcreatesforagrifoodsystemslossesinthewakeoftheCOVID-19pandemic,beclearlymappedontoappropriatepolicy,orhavebeenhitbyclimbingfoodandenergytechnologyandinvestmentsolutions.prices,orwhoselivesandlivelihoodshavebeendisruptedbyconflictsorextremeweatherImplementingthesesolutionsrequiresthattheevents.Progressonimportantindicatorsofchildagrifoodsystemsgovernancemechanismsandnutritionistobecelebrated,andsomeregionsareinstitutionscrosssectoralandadministrativeontracktoachievesomeofthenutritiontargetsboundariesandrelyonsubnationalandlocalby2030.However,risingoverweightandobesitygovernments.Localgovernmentsinparticularareinmanycountriesportendsgrowingburdensoffundamentalactorsinleveragingmultilevelandnon-communicablediseases.multistakeholdermechanismsthat,asshownwithconcreteexamplesinthisreport,haveprovedUrbanizationhasfeaturedasthethemeofeffectiveinimplementingessentialpoliciesandthisyear’sreport.Withalmostsevenintensolutionsformakinghealthydietsavailableandpeopleprojectedtoliveincitiesby2050,thisaffordableforall.nxxviiUZBEKISTANAwomanstreetvendorsellingdifferentvarietiesofapplesalongtheroadintheruralJizzakhregion.©FAO/LazizkhonTashbekovCHAPTER1INTRODUCTIONThisreportregularlymonitorsglobal,groupswerenotbuoyedupbytheeconomicregionalandnationalprogressrecoveryorwerebearingthebruntofhighertowardsthetargetsofendingbothpricesoffood,inputsandenergy–orboth.hungerandfoodinsecurity(SustainableForthesereasons,wearestillfarofftracktoDevelopmentGoal[SDG]Target2.1)andallmeettheSDG2targets.formsofmalnutrition(SDGTarget2.2)inthecontextofthe2030AgendaforSustainableBeyondtheglobalassessmentoffoodsecurityDevelopment.Thisyear,theglobalassessmentandnutritionin2022,thisreportprovidesofthestateoffoodsecurityandnutritioninin-depthanalysisofthemajordriversbehind2022reflectsaparticularmomentinhistory.thesetrendswhicharechallengingoureffortsIn2022,theworldwasbeginningtorecovertoachievetheSDGsinthecontextofthefromtheCOVID-19pandemicwhenthewar2030Agenda.PasteditionshaverepeatedlybrokeoutinUkraine,shakingcommodityandhighlightedtheintensificationofthemajorenergymarkets.Thepandemic,theensuingdriversoffoodinsecurityandmalnutrition–economicrebound,thewarinUkraine,andtheconflict,climateextremes,economicslowdownssoaringpricesoffood,agriculturalinputsandanddownturns,andgrowinginequality–oftenenergydueinparttothewarhaveallplayedoccurringincombination,whichhavepushedoutdifferentlyacrossregionsandpopulations,usofftracktomeettheSDG2targets.Therewithdifferingimpactsonhungerandfoodisnoquestionthesethreatswillcontinue,insecurity.WhilenewestimatespresentedinrequiringthatweremainsteadfastintakingChapter2indicatehungerwasnolongerontheboldactionstobuildresilienceagainstthem.riseatthegloballevelin2022,thisindicatorwasHowever,therearestillimportantmegatrendsstillfarabovepre-COVID-19-pandemiclevels.thatmustbefactoredintotheanalysistofullyMoreover,foodcriseswerestillunfoldinginunderstandthechallengestoandopportunitiesmanypartsoftheworld.ManypopulationformeetingtheSDG2targets.1CHAPTER1INTRODUCTIONOnesuchmegatrend,andthethematicfocusofTheareascurrentlyexperiencingthemostthisyear’sreport,isurbanization.Asurbanizationrapidurbanizationarethosewherethelinkincreases,ruralandurbanareasarebecomingbetweenurbanization,economicgrowthandmoreintertwined,andthespatialdistinctionstructuraltransformationisweaker–regionslikebetweenthemisbecomingmorefluid.Populationsub-SaharanAfricaandSouthernAsia,whichgrowthinsmallandmedium-sizedcitieshavesomeofthehighestnumbersofindividualsandruraltownsnowincreasingly“bridges”whoarehungry,foodinsecureandmalnourished.thespacebetweentheruralhinterlandandThesetwosubregionsareprojectedtoexperiencelargemetropolises.1,2Thechangingpatternthemostrapidincreasesinurbanization,whileofpopulationagglomerationsacrossthisatthesametimefacingthebiggestchallengesrural–urbancontinuumisdrivingchangesregardingpoverty,foodinsecurityandaccesstothroughoutagrifoodsystems,creatingbothaffordablehealthydiets.Sub-SaharanAfrica’schallengesandopportunitiestoensureeveryoneurbanpopulationisprojectedtoalmostquadruplehasaccesstoaffordablehealthydiets.Overcominginsizeby2050,reaching1.3billion,comparedthechallengesandleveragingtheopportunitieswith306millionin2010.4Atthesametime,thewillrequireactionsandpolicyinterventionsruralpopulationisprojectedtoincreaselessthatareinformedbyaclearunderstandingofrapidlybutstillprofoundly,from540millioninhowtherural–urbancontinuumandagrifood2010to909millionin2050.InAsia,theurbansystemsinteract.populationisprojectedtoincreaseby83percent,from1.9billionto3.5billion,whiletheruralWhileratesofurbanizationvaryacrosscountries,populationisprojectedtodeclineby540million,withtherateofanygivencountryoftenlinkedfrom2.3billionto1.8billion.ButinSoutherntoitsstageofstructuraltransformation,Asia,theurbanpopulationisprojectedtomoreurbanizationoverallisaccelerating.By2050,thandouble,increasingby120percent,fromalmostsevenintenpeopleareprojectedto555millionto1.3billion.liveincities;buteventodaythisproportionisalreadyapproximately56percent.aInlow-andUrbanizationarisesfromacombinationofmiddle-incomecountries,theurbanpopulationruralpushfactors(e.g.poverty,inequitableisgrowingmorethanthreetimesfasterthanthelanddistribution,environmentaldegradation,ruralpopulation(3.08percentcomparedwithandforceddisplacementduetodisastersor0.89percentannually,from2015to2020).3conflict)andurbanpullfactors(e.g.urbanBy2030,theurbanpopulationinthesecountriesemployment,higherwages,bettersocialservicesisprojectedtoexceed4billion;thatis,itwillandeducationalopportunities),whichvaryhavemorethandoubledinsizesincetheyeardependingonthecountryandspecificcontext.2000.Incontrast,theruralpopulationoflow-Thisleadstoincreasedfoodsupplyanddemand,andmiddle-incomecountriesisprojecteddirectandindirectland-usechange,andmoretoincreasemuchless,toatleast3billionbycomplexagrifoodmarketlinkagesamong2050–onlyslightlyhigherthanthe2.95billionproducers,midstreamsupplychainprocessorsfigureof2000.Whileruralpopulationsarestillanddistributors,andconsumers.5WhilelivinginincreasingrapidlyinsomeregionssuchastheurbanareashasoftenbeenassociatedwithhigherAfricandrylands,inmostotherregionsruralstandardsoflivingoverall,theseareasmayalsopopulationsaredeclining,includinginLatinhavepocketsofabjectpovertycomparedtoruralAmericaandEurope.areas,andtheirservicesareoftenstretchedtothelimit.ThiscanresultinlackofaccesstoaTheUnitedNationsDepartmentofEconomicandSocialAffairsaffordablehealthydiets,aswellasincreasesin(UNDESA)doesnotapplyitsowndefinitionof“urban”population,butpovertyandfoodinsecurityandmultipleformsinsteadfollowsthedefinitionusedineachcountry.Thedefinitionsareofmalnutrition.generallythoseusedbynationalstatisticalofficesincarryingoutthelatestavailablecensus.EachcountryappliesitsownpopulationcriteriaAcrosstheentirerural–urbancontinuum,theforclassifyingcitiesasurban.3majorityoffoodconsumedispurchasedfrommarkets.Hence,thetypeofdietthathouseholdsconsumeisdeterminedbycostandaffordability,2THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023whichinturndependonthestructureofagrifoodAreas(URCA)globaldatasetcombinedwithsystems,includingfoodsupplyandvalue-addedgeoreferencedhouseholdsurveydata.Thisischains.Thesefactorsmustbetakenintofollowedbyadditionalanalysisforselectedconsiderationindesigningeffectivepoliciesandcountriesexploringdifferencesinthecostandinvestmentstoensurerural,peri-urbanandurbanaffordabilityofahealthydiet,andinfoodpopulationshaveaccesstoaffordablehealthyinsecurityanddifferentformsofmalnutritiondiets.Apolicyapproachthatgoesbeyondsectoralacrosstherural–urbancontinuum.silosandadministrativeborderswillbeneededtoshapehowregionsurbanizeandaffectagrifoodFinally,buildingontheinsightsfromthesystemsacrosstherural–urbancontinuum.previouschapters,Chapter5identifiesthepolicies,newtechnologies,andassociatedAfterpresentingthemaintrendsintheglobalinvestmentsthatcanbeadaptedtoaddresstheassessmentoffoodsecurityandnutrition,andthechallenges–andcapitalizeontheopportunities–costandaffordabilityofahealthydietaroundthethaturbanizationbringsforensuringaccesstoworld(Chapter2),thisreportexploresthelinkagesaffordablehealthydietsforeveryone,acrossthebetweenurbanizationandchangingagrifoodrural–urbancontinuum.Thechapterdescribessystemsacrosstherural–urbancontinuum.thegovernancemechanismsandinstitutionsthatareneededtoachieveamorecoherentandTobegin,Chapter3examinesthedrivers,integratedapproachforimplementingthesepatternsanddynamicsofurbanizationthroughpoliciesandsolutions.arural–urbancontinuumlens.ItpresentsaconceptualframeworkshowingthepathwaysSuchtimelyevidenceandrecommendationsarethroughwhichurbanizationisaffectingagrifoodrelevanttotheNewUrbanAgenda,endorsedsystems,andinturnenablingorhamperingaccessbytheUnitedNationsGeneralAssemblyintoaffordablehealthydiets,withimplicationsfor2016,aswellasotherglobalprocessessuchasfoodsecurityandmalnutritioninallitsforms.theUnitedNationsFoodSystemsSummitandtheestablishmentoftheUrbanFoodSystemsLookingatthisprocess,oneofthekeytransitionsCoalitionin2021.Theyarealsoconsideredthatstandsoutoccursthroughtheinterplayofhighlyrelevantfortheeffortstowardsachievingfoodsupplyanddemand,aswellastheresultingSDGsbeyondZeroHunger,notleastSDG11changesinwhatpeopleareeatingacrossthe(SustainableCitiesandCommunities),butalsorural–urbancontinuum.TobetterunderstandSDG1(NoPoverty),SDG3(GoodHealthandthis,Chapter4presentsnewanalysispreciselyWell-being),SDG10(ReducedInequalities)onhowurbanizationischangingfooddemand,andSDG12(ResponsibleConsumptionutilizingauniqueUrbanRuralCatchmentandProduction).n3KENYAFreshvegetablesforsaleinLimuruvegetablemarket–addressingtherootcausesofmigrationbycreatingemploymentopportunitiesinagribusiness.©FAO/LuisTatoCHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDTheglobalassessmentofthestateofnutritionin2022ispresented.Encouragingsignsfoodsecurityandnutritionin2022ofeconomicrecoveryfromthepandemicandpresentedinthiseditionofthereportprojectionsofadeclineinpovertyandhungerisasnapshotoftheworldstillrecoveringfromhavebeentemperedbyrisingpricesoffood,aglobalpandemicandnowgrapplingwiththeagriculturalinputsandenergy.consequencesofthewarinUkraine,whichhasfurtherrattledfoodandenergymarkets.TheThischapterpresentsanannualupdateoftheimpactoftheCOVID-19pandemiconlivesandglobalassessmentoffoodsecurityandnutritionlivelihoodswasdevastating,producingaglobaluptotheyear2022andareportonprogresseconomicrecessionthatendedthreedecadesoftowardsmeetingSustainableDevelopmentglobalprogressinpovertyreduction,contributingGoal(SDG)2withaspecialfocusonSDGtoanestimatedincreaseofcloseto90millionTargets2.1and2.2:endhungerandensureaccesspeoplefacinghungerinjustoneyear(from2019byallpeopletosafe,nutritiousandsufficientto2020).Theyear2021markedapartialrecoveryfoodallyearround;andendallformsoffromthepandemic-inducedcontractionsthatmalnutritionby2030.washighlyuneven,acrosscountriesandwithincountries;thepaceofrecoverywasmuchslowerSection2.1presentsanassessmentofprogressinlow-andlower-middle-incomecountries,towardsachievingtheSDG2targetsforhungeranddisadvantagedsegmentsofthepopulationandfoodinsecurity.Itincludesglobal,regionaleverywherewerestillstrugglingtorecoverfromandsubregionalupdatesofthetwoTarget2.1theincomelossessufferedduringthepeakofindicators:theprevalenceofundernourishmentthepandemicthepreviousyear.Thiscontributed(PoU)andtheprevalenceofmoderateorseveretoafurtherincreaseofabout38millioninthefoodinsecuritybasedontheFoodInsecurityestimatednumberofpeopleexperiencinghungerExperienceScale(FIES),revisedupto2022basedin2021.InFebruary2022,justastheweightofonthemostrecentdataavailabletoFAOatthethepandemicwasbeginningtolift,thewarintimeofwritingthisreport.UpdatedprojectionsUkraineeruptedinvolvingtwomajorproducersofwhattheglobalPoUmaybein2030arealsoofagriculturalcommoditiesintheworld,sendingprovided.Acomparisonofthefoodinsecurityshockwavesthroughcommodityandenergystatusofmenandwomenispresented,aswellmarkets,weakeningtherecoveryandaddingevenas,forthefirsttime,alookatdifferencesingreateruncertainty.1foodinsecurityamongrural,peri-urbanandurbanpopulations.ItisinthiscontextofcontinuedslowandunevenrecoveryfromthepandemicandglobalSection2.2presentsupdatedestimatesoftherepercussionsofthewarinUkrainethatthisindicatorsofthecostandaffordabilityofaassessmentofthestateoffoodsecurityandhealthydiet(CoAHD).Theseindicatorsprovide5CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDevidenceregardingpeople’seconomicaccesstorecoveryofemploymentandincomesofthemostdiverse,nutritiousfoods,whichisonecriticalvulnerablepeople,hinderingadeclineinhunger.aspectofachievinghealthydiets.Inthisyear’seditionofthereport,thecostandaffordabilityèTherelativelackofchangeinhungerbetweenindicatorsareupdatedto2021.Lackofrecentdata2021and2022atthegloballevelhidessubstantialonestimatedincomedistributions,purchasingdifferencesattheregionalandsubregionallevels.powerparities(PPPs),anddetailedfoodpricesatWhileprogresswasmadetowardsreducinghungerinthecountrylevelpreventsanupdateto2022.AsiaandinLatinAmerica,hungerwasstillontheriseinWesternAsia,theCaribbeanandallsubregionsSection2.3presentsanassessmentofthestateofAfrica.ofnutritionandprogresstowardstheglobalnutritiontargetsdefinedbytheWorldHealthèThePoUinAfricarosefrom19.4percentin2021Assembly(WHA)in2012andthe2030Agendato19.7percentin2022,drivenmostlybyincreasesinforSustainableDevelopment(SDG2.2).UpdatesNorthernandSouthernAfrica.Thenumberofpeopleareprovidedforfivenutritiontargets:lowfacinghungerinAfricahasincreasedby11millionbirthweight,exclusivebreastfeeding,andpeoplesince2021andbymorethan57millionpeoplestunting,wastingandoverweightinchildrensincetheoutbreakofthepandemic.underfiveyearsofage.èThePoUinAsiafellfrom8.8percentin20212.1to8.5percentin2022–adecreaseofmoreFOODSECURITYthan12millionpeople,mostlyinSouthernAsia.INDICATORS–LATESTHowever,thisisstill58millionabovepre-pandemicUPDATESANDPROGRESSlevels.TherewereimprovementsineverysubregionTOWARDSENDINGexceptWesternAsia,wherethePoUincreasedfromHUNGERANDENSURING10.2percentin2021to10.8percentin2022.FOODSECURITYèAturnaroundalsooccurredinLatinAmericaandKEYMESSAGEStheCaribbean,wherethePoUfellfrom7.0percentin2021to6.5percentin2022–adecreaseofèGlobalhunger,measuredbytheprevalence2.4millioninthenumberofpeoplefacinghunger,ofundernourishment(PoU)(SDGIndicator2.1.1),butstill7.2millionmorethanin2019.Thedecreaseremainedrelativelyunchangedfrom2021to2022wasdrivenbySouthAmericaandmasksanotablebutisstillfarabovepre-COVID-19-pandemiclevels,increaseintheCaribbean,from14.7percentin2021affectingaround9.2percentoftheworldpopulationto16.3percentin2022.in2022comparedwith7.9percentin2019.èAmuchlargerproportionofthepopulationinèItisestimatedthatbetween691and783millionAfricafaceshungercomparedtotheotherregionspeopleintheworldfacedhungerin2022.oftheworld–nearly20percentcomparedwithConsideringthemidrange(about735million),8.5percentinAsia,6.5percentinLatinAmericaand122millionmorepeoplefacedhungerin2022thanintheCaribbean,and7.0percentinOceania.2019,beforethepandemic.èItisprojectedthatalmost600millionpeoplewillèTheeconomicrecoveryfromthepandemicbechronicallyundernourishedin2030,pointingtoobservedin2021slowedin2022.RisingpricesoftheimmensechallengeofachievingtheSDGtargetfood,agriculturalinputsandenergy,magnifiedbytoeradicatehunger.Thisisabout119millionmoretheimpactofthewarinUkraine,underminedthethaninascenarioinwhichneitherthepandemicnorthewarinUkrainehadoccurred,andaround23millionmorethanifthewarinUkrainehadnothappened.MostprogressisexpectedtooccurinAsia,whereasnoprogressisforeseeninLatinAmericaandtheCaribbean,andhungerisprojectedtoincreasesignificantlyinAfricaby2030.6THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023èFollowingasharpincreasefrom2019to2020,additionalchallengesfortheassessmentofthetheprevalenceofmoderateorseverefoodinsecuritystateoffoodinsecurityintheworldandinducingatthegloballevel(SDGIndicator2.1.2)remainedgreateruncertaintyaroundtheestimates.Whileunchangedforthesecondyearinarowbutwasstillthemaineffectsofthepandemichavereceded,farabovethepre-pandemiclevelof25.3percent.anddatacollectionactivitieshavebeguntoAbout29.6percentoftheglobalpopulation–normalize,datareportingbycountrieswas2.4billionpeople–weremoderatelyorseverelyfoodstillnotfullybackuptospeedby2022.Thus,insecurein2022,391millionmorethanin2019.estimatesoftheglobalPoU(SDGIndicator2.1.1)arepresentedasrangesbeginninginèTheprevalenceofseverefoodinsecurityat2020toreflecttheadditionaluncertaintythegloballeveldeclinedslightlyfrom11.7percentsincethepandemic.in2021to11.3percentin2022,theequivalentof27millionfewerpeople.However,thenumberAsalways,thePoUestimatesforthemostrecentofseverelyfood-insecurepeoplewasstillaboutyear(2022)areobtainedbynowcastingthevalues900millionin2022,whichis180millionmorethanofthethreeneededparametersusingthemostin2019.recentinformationavailabletoFAOregardingthefoodsupplyandbasedonreasonableassumptionsèTheprevalenceofmoderateorseverefoodontheextentofinequalityinaccesstofoodinsecurityroseslightlyinAfricaandinNorthern(Annex2,SectionA).AmericaandEurope,anddecreasednon-significantlyinAsiafrom2021to2022.TheonlyregionshowingTheassessmentsoftheprevalenceofmoderateencouragingprogressisLatinAmericaandtheorseverefoodinsecuritybasedontheFIESCaribbean,wheremoderateorseverefoodinsecurity(SDGIndicator2.1.2)areinformedbyofficialdecreasedfrom40.3percentin2021to37.5percentestimatesasreportedbycountries,wheneverin2022,theequivalentof16.5millionfewerpeopleinavailable,andbyFAOestimatesbasedononeyear,mainlyinSouthAmerica.datacollectedannuallybytheOrganizationthroughdatacollectionserviceprovidersinoverèAcomparisonoffoodinsecurityamongrural,140differentcountries(seeAnnex1B).peri-urbanandurbanpopulationsrevealsthatglobalfoodinsecurity,atbothlevelsofseverity,islowerSDGIndicator2.1.1inurbanareas.ModerateorseverefoodinsecurityPrevalenceofundernourishmentaffected33.3percentofadultslivinginruralareasin2022comparedwith28.8percentinperi-urbanareasTheassessmentofglobalhungerin2022,and26.0percentinurbanareas.measuredbythePoU(SDGIndicator2.1.1),revealsthatitremainedfarabovepre-pandemiclevels.èFoodinsecurityaffectswomenmorethanmeninTheproportionoftheworldpopulationfacingeveryregionoftheworld.However,thegendergapinchronichungerin2022wasabout9.2percent,foodinsecurityatthegloballevel,whichhadwidenedcomparedwith7.9percentin2019(Figure1).AfterinthewakeoftheCOVID-19pandemic,narrowedincreasingsharplyin2020inthemidstofthefrom3.8percentagepointsin2021to2.4percentageglobalpandemic,andrisingmoreslowlyinpointsin2022,suggestingthatthedisproportionate2021to9.3percent,thePoUceasedtoincreaseimpactsofthepandemiconwomen’sfoodinsecurityfrom2021to2022,providingsomehopeofahaveeasedgloballyandinsomeregions.Thegenderpossibleturnaround.bgapdiminishednotablyinAsiaandinLatinAmericaandtheCaribbean,butwidenedinAfricaandinItisestimatedthathungeraffectedbetweenNorthernAmericaandEurope.691and783millionpeopleintheworldin2022.EstimatesofhowmanypeoplearefacingbTheentireseriesofPoUvaluesisrevisedwitheachneweditionofhungerintheworldarealwaysthebestpossiblethisreporttoreflectnewdataandinformationthatFAOhasobtainedapproximationsgiventheinformationavailable.sincethereleaseofthepreviousedition.AsthisprocessusuallyimpliesTheCOVID-19pandemicdisruptednormaldatabackwardrevisionsoftheentirePoUseries,readersshouldrefrainfromcollectionactivitiesin2020and2021,creatingcomparingseriesacrossdifferenteditionsofthisreportandshouldalwaysrefertothecurrentedition,includingforvaluesinpastyears.7CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDFIGURE1GLOBALHUNGERREMAINEDVIRTUALLYUNCHANGEDFROM2021TO2022BUTISSTILLFARABOVEPRE-COVID-19-PANDEMICLEVELS1890016743.7796.9783.1800793.4701.4738.914656.6735.1612.87001212.1%690.6674.6106008597.8588.910.1%9.8%50068.6%563.99.3%9.2%7.7%7.9%8.5%8.7%400PERCENTAGEMILLIONS9.5%8.9%8.4%7.9%3004200210000200520062007200820092010201120122013201420152016201720182019202020212022Prevalenceofundernourishment(percentage,leftaxis)Numberofundernourished(millions,rightaxis)NOTES:Projectionsbasedonnowcastsfor2022areillustratedbydottedlines.Barsshowlowerandupperboundsoftheestimatedrange.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSConsideringtheprojectedmidrange(aboutandnearly57millionmoresincetheoutbreak735millionin2022),122millionmorepeoplefacedofthepandemic.Moreover,hungerincreasedhungerin2022thanin2019,beforethepandemic.throughoutallsubregionsofAfricain2022.ThePoUinNorthernAfricarosefrom6.9percenttoTherelativelackofchangeinhungeratthe7.5percent,equivalenttonearly2millionmoregloballevelfrom2021to2022hidessubstantialpeoplefacinghungerin2022.Insub-Saharandifferencesattheregionallevel(Table1,Table2andAfrica,hungerincreasedfrom22.2percenttoFigure2).Manyplacesintheworldarestillfacing22.5percent,whichtranslatesinto9millionmoreseriousfoodcrises(Box1).Hungerhasbeenonthepeoplecomparedto2021.ThelargestincreaseinriseinAfricasince2010,withasharpincreaseinPoUoccurredinSouthernAfrica,at1.1percentageallsubregionsin2020followedbyagentlerrisepoints,followedbyMiddleAfricawithanin2021.In2022,thePoUinAfricacontinuedtoincreaseof0.6percentagepoints.Marginalrisefrom19.4percentin2021to19.7percent–theincreasesof0.1percentagepointsoccurredinequivalentof11millionmorepeopleinoneyearWesternandEasternAfricafrom2021to2022.8THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLE1PREVALENCEOFUNDERNOURISHMENT,2005–2022Prevalenceofundernourishment(%)2005201020152016201720182019202020212022WORLD12.18.67.97.87.57.67.98.99.39.2AFRICA19.215.115.816.616.516.617.018.719.419.7NorthernAfrica6.24.75.45.76.06.05.86.06.97.5Sub-SaharanAfrica22.517.618.219.118.919.119.521.622.222.5EasternAfrica31.723.824.626.226.226.026.728.128.428.5MiddleAfrica31.922.523.324.723.724.424.827.628.529.1SouthernAfrica5.17.29.38.37.87.78.39.510.011.1WesternAfrica12.210.810.610.710.611.111.013.714.514.6ASIA13.99.38.07.57.07.17.48.58.88.5CentralAsia13.86.64.03.83.53.12.83.33.23.0EasternAsia6.8<2.5<2.5<2.5<2.5<2.5<2.5<2.5<2.5<2.5South-easternAsia17.311.17.56.55.85.55.35.35.35.0SouthernAsia20.215.414.012.912.212.313.315.616.415.6WesternAsia7.96.59.110.09.810.310.310.510.210.8WesternAsiaand7.15.77.48.08.18.38.28.48.79.2NorthernAfricaLATINAMERICA9.36.25.36.15.85.95.66.57.06.5ANDTHECARIBBEANCaribbean18.414.713.213.513.214.014.215.214.716.3LatinAmerica8.65.64.75.55.25.34.95.96.45.8CentralAmerica8.16.86.76.26.16.15.14.85.05.1SouthAmerica8.85.13.95.24.95.04.96.37.06.1OCEANIA6.96.56.26.16.16.46.46.06.67.0NORTHERNAMERICA<2.5<2.5<2.5<2.5<2.5<2.5<2.5<2.5<2.5<2.5ANDEUROPENOTES:Projectedvaluesarebasedontheprojectedmidranges.Thefullrangesofthe2020,2021and2022valuescanbefoundinAnnex2.Forcountrycompositionsofeachregional/subregionalaggregate,seeNotesongeographicregionsinstatisticaltablesattheendofthereport.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSIntermsofnumbersofpeoplefacinghunger,than12millionpeople,mostlyinSouthernthesepercentage-pointincreasesareequivalentAsia.However,thisisstill58millionabovetoabout1millionmorepeopleinSouthernpre-pandemiclevels.EverysubregionexceptAfrica,3millionmoreinMiddleAfricaandalsoWesternAsiaexperiencedaturnaround,withinEasternAfrica,and2millionmoreinWesternthelargestimprovementinSouthernAsia,theAfrica.AllsubregionsinAfricaregisteredeitherasubregionwiththehighestPoU(15.6percentprevalenceoranumberofundernourishedpeoplein2022).InWesternAsia,morethan2millionwellabovepre-pandemiclevels.additionalpeoplewerefacinghungerin2022comparedto2021–anincreaseof0.6percentageThePoUestimateforAsiafor2022pointstoapoints,from10.2percentto10.8percent.turnaroundinthetrendofhunger,whichhadbeenontheriseintheregionsince2017.AturnaroundalsooccurredinLatinAmericaThePoUfellfrom8.8percentin2021toandtheCaribbean,wherethePoUfellfrom8.5percentin2022–adecreaseofmore7.0percentin2021to6.5percentin2022–9CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDTABLE2NUMBEROFUNDERNOURISHEDPEOPLE,2005–2022Numberofundernourishedpeople(millions)2005201020152016201720182019202020212022WORLD793.4597.8588.9586.4571.8586.8612.8701.4738.9735.1AFRICA178.2159.2189.6204.1207.9215.6225.1254.7270.6281.6NorthernAfrica11.79.812.313.414.414.614.415.117.619.5Sub-SaharanAfrica166.5149.5177.3190.7193.5201.0210.6239.6253.0262.0EasternAfrica94.281.596.8106.1108.6110.8116.9126.4131.2134.6MiddleAfrica36.330.136.740.139.842.344.451.054.257.0SouthernAfrica2.84.25.95.35.15.15.56.46.87.6WesternAfrica33.233.637.939.240.142.943.855.860.862.8ASIA551.9392.8357.8336.0319.3325.2343.9396.2414.1401.6CentralAsia8.24.22.82.62.52.22.02.52.42.3EasternAsia104.2n.r.n.r.n.r.n.r.n.r.n.r.n.r.n.r.n.r.South-easternAsia97.666.747.941.637.436.535.035.236.034.1SouthernAsia325.4267.9260.3242.8232.2236.2258.6307.7326.0313.6WesternAsia16.615.424.127.027.028.729.130.029.631.6WesternAsiaand28.325.236.340.441.343.343.645.147.251.2NorthernAfrica51.936.732.938.236.637.936.042.345.643.2LATINAMERICAANDTHECARIBBEANCaribbean7.46.15.65.85.76.16.26.76.57.2LatinAmerica44.630.627.332.430.931.829.835.639.136.0CentralAmerica11.710.611.210.510.410.59.08.58.99.1SouthAmerica32.820.016.121.920.521.320.827.130.326.8OCEANIA2.32.42.52.52.52.72.82.72.93.2NORTHERNAMERICAn.r.n.r.n.r.n.r.n.r.n.r.n.r.n.r.n.r.n.r.ANDEUROPENOTES:Projectedvaluesarebasedontheprojectedmidranges.Thefullrangesofthe2020,2021and2022valuescanbefoundinAnnex2.n.r.=notreported,astheprevalenceislessthan2.5percent.Regionaltotalsmaydifferfromthesumofsubregions,duetoroundingandnon-reportedvalues.Forcountrycompositionsofeachregional/subregionalaggregate,seeNotesongeographicregionsinstatisticaltablesattheendofthereport.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSadecreaseofmorethan2.4millionintheregionsoftheworld–nearly20percentcomparednumberofpeoplefacinghunger,thoughstillwith8.5percentinAsia,6.5percentinLatin7.2millionmorecomparedto2019.TherewasAmericaandtheCaribbean,and7.0percentinasharpincreaseintheCaribbeansubregionOceania(Table1).from14.7percentin2021to16.3percentin2022.However,notableimprovementsoccurredinWhiletheregionalprevalenceestimatesrevealSouthAmericainthesameperiod,wherethethemagnitudeoftheburdenofhungerineachPoUdecreasedfrom7.0percentto6.1percent,region,convertingthemintonumbersofpeopleequivalentto3.5millionpeople,butstillindicateswheremostofthepeoplefacinghunger6millionabove2019levels.intheworldlive(Table2andFigure3).WhilethePoUinAsiaislessthanhalfthatinAfrica,TheproportionofthepopulationfacinghungerAsiaisneverthelesshometothemajorityofismuchlargerinAfricacomparedtotheotherpeoplefacinghunger–402million,representing10THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE2PROGRESSWASMADETOWARDSREDUCINGHUNGERINMOSTSUBREGIONSINASIAANDINLATINAMERICA,BUTHUNGERISSTILLONTHERISEINWESTERNASIA,THECARIBBEANANDALLSUBREGIONSOFAFRICALATINAMERICAWORLDANDREGIONSAFRICAASIAANDTHECARIBBEAN302520PERCENTAGE15105020152019202020212022201520192020202120222015201920202021202220152019202020212022WorldAfricaAsiaLatinAmericaandtheCaribbeanAfricaEasternAfricaCentralAsiaCaribbeanAsiaMiddleAfricaSouth-easternAsiaCentralAmericaLatinAmericaNorthernAfricaSouthernAsiaSouthAmericaandtheCaribbeanSouthernAfricaWesternAsiaWesternAfricaNOTES:EasternAsiaisnotshownbecausetheprevalenceofundernourishmenthasbeenconsistentlybelow2.5percentsince2010.Valuesarebasedontheprojectedmidranges.Thefullrangesofthe2020,2021and2022valuescanbefoundinAnnex2.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS55percentofthetotalnumberofundernourishedanunequaleconomicrecoveryafteradramaticpeoplein2022.About38percent(282million)decreaseineconomicactivityobservedinofundernourishedpeopleliveinAfricaand2020,andrisingfood,fuelandtransportationabout6percent(43million)inLatinAmericapricesproducedbytherecoveryitself,thwartedandtheCaribbean.progressinfoodsecurity.EconomicrecoveryhamperedbynewchallengesJustasglobaleconomicconditionsappearedtotofoodsecuritybemorefavourablefor2022andtheprospectsAttheendof2021,globalfoodsecuritywasonofareductioninhungerandfoodinsecurityhighalertduetolingeringeffectsoftheCOVID-19towardspre-pandemiclevelsseemedpossible,pandemicaswellasnewandongoingconflictstheoutbreakofthewarinUkrainesentanotherandweather-relatedshocks.Acombinationofshockthroughtheglobaleconomy.Asaresult,11CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDFIGURE3IN2022,ASIAWASHOMETO55PERCENT(402MILLION)OFTHEPEOPLEINTHEWORLDAFFECTEDBYHUNGER,WHILEMORETHAN38PERCENT(282MILLION)LIVEDINAFRICANOTUNDERNOURISHEDUNDERNOURISHEDASIALATINAMERICA7240million735million402millionANDTHECARIBBEANAFRICA43million282millionOCEANIA3millionNORTHERNAMERICAANDEUROPEn.r.NOTES:Projectedvaluesarebasedontheprojectedmidranges.Thefullrangesoftheprojected2022valuescanbefoundinAnnex2.n.r.=notreported,astheprevalenceislessthan2.5percent.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FStherecoveryobservedin2021slowedfurtherinAlthoughglobalfoodcommoditypriceswere2022andglobalgrossdomesticproduct(GDP)risingsteadilyevenbeforethewar,theaddedgrewin2022by3.4percent,onepercentageuncertaintyinducedbythewarcontributedpointmoreslowlythanpredictedatthetoasurgeinfoodprices.TheFAOFoodPricebeginningof2023.3Indexjumpedtoanall-timehighinMarch2022,andalthoughtheindexsteadilydeclinedTheshockcausedbythewaractedmainlythroughouttheyear,itremainedmuchhigherthroughtheglobalfoodandagriculturalthanbeforethepandemic.5Asaresultofthemarkets,asitinvolvedtwomajorglobalhighinternationalfoodprices,importcostsofproducersofagriculturalcommodities:thefoodrose,affectingespeciallycountriesthatareRussianFederationandUkraine.In2021,eitherhighlydependentonfoodimports.TheworldtheRussianFederationorUkraine(orboth)foodimportbillwasestimatedtohavereachedrankedamongthetopthreeglobalexportersofanall-timehighin2022ofnearlyUSD2trillion,wheat,maize,rapeseed,cakeofsunflowerseed,anincreaseof10percent(nearlyUSD181billion)andsunfloweroil.c,4TheRussianFederationisfromthe2021level,drivenmostlybyhigheralsoaprominentexporteroffertilizers.Inthisprices.6Worldfertilizerpricesalsosoared,context,oneofthemainimpactsofthewarhasmainlyasaresultofrisingenergyandnaturalbeentoincreaseinternationalpricesoffood.gasprices.Theglobalagriculturalinputimportbillwasestimatedtoincreaseby48percentincThetwocountriescombinedaccountedfor19percentofglobal2022toUSD424billion.7Allofthesefactorsoutputofbarley,14percentofwheat,and4percentofmaize,havecontributedtohigherpricesoffoodatthebetween2016/17and2020/21.Theircontributiontothegloballocalandnationallevels,whichinturnhaveproductionofoilseedswasparticularlyimportantforsunfloweroil,contributedheavilytooverallinflation.Inflationwithjustoverhalfofworldoutput,onaverage,originatinginthetworosethroughout2022inalmostalleconomies,countriesduringthisperiod.12THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE4THEPREVALENCEOFUNDERNOURISHMENT(PoU)ISSTILLHIGHERIN2022THANBEFORETHEPANDEMICIN58PERCENTOFCOUNTRIES,ANDTHESITUATIONISWORSEINLOW-INCOMECOUNTRIES(77PERCENT)SHAREOFCOUNTRIES(PERCENTAGE)1009080LOW-INCOMECOUNTRIESLOWER-MIDDLE-INCOMECOUNTRIESUPPER-MIDDLE-INCOMECOUNTRIES70PoUhigherthanin20196050403020100WORLDPoUlowerthanorequalto2019SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSandglobalheadlineinflationexceeded9percentcountries(LMICs)thaninupper-middle-incomeinthesecondhalfoftheyear,thehighestcountries(UMICs)andhigh-incomecountrieslevelsince1995.8(HICs).Concomitantly,globalunemploymentdeclinedsignificantlyin2022to205million,Inthiscontext,globaltrendsinhungerreflectdownfrom216millionin2021and235millioninthecombinationoftwofactorsinterplaying2020,butstillaboveits2019level.9atthehouseholdlevel.First,anincomeeffectproducedbytheeconomicrecoveryin2022Thesecondfactoraffectingthetrendinhungerlikelycontributedtoanincreaseinhouseholdisthepriceeffect.Increasesinfoodpricesanddisposableincomeandimprovedaccesstogeneralinflationcanerodeincomegainsandfood,particularlyforthepooresthouseholdsworsenaccesstofood.Intheshortterm,thisthatsufferedheavyincomelossesduringtheisparticularlytrueforthepoorestsegmentspandemic.Globally,employmentincreasedbyofthepopulationwhospendalargershareof2.3percentin2022fromameagreannualgrowththeirincomeonfood.Inthelongterm,however,of0.2percentintheperiodfrom2020to2021.9somehouseholdsmaymanagetoadapttheirEmploymentgrowthwasfasterinlow-incomeconsumptionpatternstolessentheimpacts,countries(LICs)andlower-middle-incomeandpoorruralpopulationsengagedin13CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDBOX1HOWDOESTHEEVIDENCEONCHRONICFOODINSECURITYALIGNWITHTHEEVIDENCEONACUTEFOODINSECURITYINFOODCRISISCOUNTRIES?Theevidencepresentedinthisreportpointstothefactand,therefore,potentiallyinneedofhumanitarianthat,althoughtheprevalenceofundernourishmentassistance.Theseassessmentsarenotstatistical(PoU)atthegloballevelremainedrelativelyunchangedmeasurements,butrathertheresultofaprocessfrom2021to2022,hungerwasontheriseinmanyofconvergenceofevidencereachedbyacountrypartsoftheworld.Thenegativeimpactsonfoodteamofanalysts,basedonthemostrecentavailablesecurityofthewarinUkraine(andotherconflicts),informationfromvarioussources.Withinacountry,soaringfoodpricesandextremeweathereventswereroughestimatesofthenumberofpeoplefacingcrisisfeltmorestronglyinsomeplacesthaninothers.levelsofacutefoodinsecurityarepresentedthatreferConsistentwiththis,themostrecenteditionofthetothespecificpopulationscoveredbytheanalysis,GlobalReportonFoodCrises(GRFC)2reinforcesandnotnecessarilytothewholepopulationatthetheseconclusions.nationallevel.TheGRFCandthisreportarebothmultipartnershipBecauseoftheseconceptualandmeasurementeffortsthatprovideinternationalassessmentsoffooddifferences,adirectcomparisonoffiguresfromsecurity;however,theirobjectivesandgeographicalbothreportsisnotpossible.However,acuteandscopearedistinct,andtheyrelyondifferentdataandchronicfoodinsecurityarenotunrelatedphenomena.methodologies.Ontheonehand,thisreporthastheRepeatedshocksandpersistentcrisescanprovokebroadobjectiveofmonitoringchronicfoodinsecuritysituationsofchronicfoodinsecurity.Becauseofthis,intheentireworld,onaregularbasis,byreportingoneexpectssomealignment,atleastintrends,oftheonSDGIndicators2.1.1and2.1.2.Chronicfoodresultsofthetworeports.insecurityisdefinedasastructural,long-termsituationoffooddeprivation.ThePoU,forexample,measuresHavingthisinmind,the2023GRFC2pointstoanhunger(chronicundernourishment)definedastheincreaseofaround37millionpeoplefacingacutefoodlong-termorpersistentinabilitytomeetminimuminsecurity(IPC/CHPhase3orabove)from2021todietaryenergyrequirementsand,withinacountry,2022inthesame48countriesanalysedinbothyears.itisestimatedtoberepresentativeofthewholeThatisequivalenttoanincreaseintheprevalenceofpopulation.TheGRFC,ontheotherhand,focusesacutefoodinsecurityfrom21.8percentto22.5percentmorenarrowlyonacutefoodinsecurityincountriesoftheanalysedpopulation.Ananalysisofhunger(PoU)experiencingfoodcrisesforthepurposeofguidingrestrictedtothesamegroupof48countriesanalysedimmediatehumanitarianresponse.AcutefoodbytheGRFCshowsanincreaseof14millionintheinsecurityreferstoashort-term(possiblytemporary)numberofpeoplefacingchronicundernourishment,inabilitytomeetdietaryenergyrequirements,relatedequivalenttoanincreaseinthePoUfrom20.8percenttosporadiccrisesthatmaysometimesbeprotractedto21.3percentofthecombinedpopulationsofthoseandareofaseveritythatthreatenslivesorlivelihoods.48countries(FigureA).ThisrevealsconvergenceintheAssessmentsoffoodinsecurityprioritizetheuseofassessmentsofthetrendsandpointstotheexistencetheIntegratedFoodSecurityPhaseClassification/ofpersistentfoodcrisesinmanypartsoftheworld,CadreHarmonisé(IPC/CH),appliedinasetofreinforcingtheneedtobetterunderstandthenexuscountriesthataresusceptibletofoodcrisissituationsbetweenacuteandchronicfoodinsecurity,particularlyinfoodcrisiscountries.NOTES:WhenrecentIPC/CHisnotavailable,alternativesourcesareusedsuchastheConsolidatedApproachforReportingIndicatorsofFoodSecurityortheFamineEarlyWarningSystemsNetwork.Theseareusedtoapproximatepopulationsfacingcrisisorworse(IPC/CH3+).Inthe48countriesanalysedinbothyearsintheGRFC,thereweredifferencesinanalysiscoverageatthecountrylevel,resultingina15.5percentincreaseintheanalysedpopulationbetweenthetwoyearsinthesecountries.agriculturemayevenbenefitfromhigherpricesThestalledsituationinglobalhungerobservedfortheiragriculturalproducts.d,10for2022isthustheresultoftheinteractionofthesetwofactors.TheeconomicrecoverydPovertyassessmentsconductedduringthefoodpricecrisesofhelpedtostemtherisingtideofhungerat2008and2011demonstratedthathigherfoodpriceshavethepotentialleastatthegloballevel.However,thepositivetoboostagriculturalincomegrowthandwages.10effectcouldhavebeenevengreaterwithoutthecountervailingwindscausedbytheglobal14THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX1(Continued)FIGUREAESTIMATESOFACUTEFOODINSECURITYFROMTHEGRFCANDOFCHRONICUNDERNOURISHMENTBASEDONTHEPoUINTHESAME48COUNTRIESSHOWSIMILARTRENDSFROM2021TO20222520.821.322.521.820PERCENTAGE1510502021202220212022PREVALENCEOFIPCPHASE3ORABOVEACUTEFOODINSECURITYPREVALENCEOFUNDERNOURISHMENT(GLOBALREPORTONFOODCRISES)(THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD)SOURCES:FoodSecurityInformationNetwork&GlobalNetworkAgainstFoodCrises.2023.GlobalReportonFoodCrises(GRFC)2023.Rome.www.fsinplatform.org/global-report-food-crises-2023;FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSrepercussionsofthewarinUkraineandthepricefromfoodinflationandincreasingfoodimportinflationforfood,agriculturalinputsandenergy,bills,aswellasextremeclimateevents,whichtogetherwithotherdriversoffoodinsecurityhavecounteractedthepositiveeffectsofeconomicsuchasconflictsandweather-relatedevents.growth,drivenbybuoyantoilexportrevenuesinAsaresult,hungerremainsfarabovesomecountries.11pre-pandemiclevelsgloballyandinallregions.InWesternAsia,manycountriesbenefitedfromAttheregionallevel,thisdynamicofincomeincreasedoilrevenues,butthesedidnotalwaysandpriceeffectisvisibleinmultiplesubregions,translateintolowerlevelsofhungerin2022.withvaryingresults.InSouthernAfrica,forPoliticalinstabilityinsomecountriesandconflictsinstance,theuptickofhungerin2022stemmedhavecontinuedtodisruptfoodsupplies,marketsfromincreasinginflation,followingtheupsurgeanddistributionsystems,resultinginhigherfoodininternationalcommodityprices,aswellaspricesandfoodshortages.Inaddition,domesticdomesticchallengessuchaspersistentlyhighinflationhassoaredinseveralcountries,makinglevelsofunemploymentandvulnerabilitytoaccesstofoodmoredifficult.12InSouthernAsia,shocks.11AlthoughtherewassustainedGDPontheotherhand,theoutcomeofsustainedgrowthin2022,thisoftendidnottranslateintoeconomicgrowth,especiallyinagriculture,hasimprovedsocioeconomicconditionsforthelikelyprevailedoverinflation,thuscontributingpoor.Agriculturalproduction,atthesametime,toanoverallimprovementinfoodsecuritysufferedfromseveredroughtsandfloods,andtheconditions.Morethanonecountryintheregionsurgeininternationalfertilizerprices.InMiddlehasalsoenactedpolicymeasuresthathaveAfrica,theincreaseinhungerhasmainlyresultedcontributedtothisoverallimprovement,including15CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDsupplyingfertilizerstofarmers,providingcerealTowardsendinghunger(SDGTarget2.1):subsidiestovulnerablepopulationgroups,andprojectionsto2030reducingcustomsdutiesonimportedcereals.13Asinpreviouseditionsofthereport,anexercisewasconductedtoprojecthowmanyIntheCaribbean,morethanonesmallislandpeoplemaybefacinghungerin2030basedondevelopingstatehassufferedfromhighfoodwhatcanbeinferredfromavailableforecastsinflationandincreasedimportbills,giventheoffundamentaldemographicandeconomicwidespreaddependenceofthesubregiononvariables.Theprojectionswereobtainedbyimportedfoodandagriculturalproducts.Attheseparatelyprojectingeachoftheparameterssametime,exportrevenueshavebeendecliningthatinformthemodelusedtoestimatethePoUinkeysectors,includingtourism,resulting(seeAnnex2,SectionB).inreduceddisposableincomeandincreasedfoodinsecurity.14Onthecontrary,theobservedTrajectoriesarepresentedunderthreescenarios:declineinhungerin2022inSouthAmerica,a“currentprospects”,whichaimstocapturenetexporteroffoodandagriculturalproducts,currentprojectionsofthePoUin2030basedonstemmedlargelyfrompositivedevelopmentintheworldeconomicprospectspresentedinthelabourmarkets,whichcounteractedthesurgeApril2023editionoftheInternationalMonetaryininflation,aswellasfromsocialprotectionFundWorldEconomicOutlookdatabase;3policies.14Additionally,somecountriesinthe“projectionsbeforeCOVID-19”,calibratedtoregionhavebenefitedfromthesurgeinoilandreflectthesituationoftheworldeconomygaspricesthatboostedexportrevenues.Thishasbeforethepandemic,asdescribedbytheWorldtranslatedintoimprovedpublicbudgetresourcesEconomicOutlookpublishedinOctober2019;15(whichcouldbeusedtofinancesocialprotectionand“projectionsbeforethewarinUkraine”,programmes)andinvestmentinagricultureandwhichdoesthesamebutconsideringtheOctoberfooddistributionsystems.2021editionofthesamepublication16beforetheoutbreakofthewar.Atthecountrylevel,thesecountervailingforceshaveplayedoutindifferentwayswithunequalThecurrentscenarioshowsthatalmostimpactsontrendsinhunger.Acomparison600millionpeoplewillbechronicallyacrosscountryincomegroupsofchangesinundernourishedin2030,pointingtothethePoUbetween2019and2022showsthatimmensechallengeofachievingtheSDGLICsarestillstrugglingthemosttorecover.targettoeradicatehunger(Figure5).ThisisGlobally,58percentofcountrieshadaPoUinabout119millionmoreundernourishedpeople2022thatwasstillabovepre-pandemiclevels.thaninthescenarioinwhichneithertheHowever,thepercentageismuchhigherinLICs;pandemicnorthewarinUkrainehadoccurred77percentofLICshavenotreturnedtoPoU(the“projectionsbeforeCOVID-19”scenario)levelsobservedin2019,incontrastto47percentandaround23millionmorethanintheofUMICs(Figure4).scenariowherethewarhadnothappened(the“projectionsbeforethewarinUkraine”scenario).ThehaltintheriseinglobalhungerobservedinThelatterprovidesanindicationoftheadditional2022isalsoconsistentwithnowcastsofpovertysetbackthewarmayhavecausedintheglobalavailablefor2022.10Projectionsfor2022arethat,fightagainsthunger.despiteanexpectedreductioninpovertybetween2021and2022,thepaceofreductionwillfurtherFigure5alsoshowshowthesituationiscurrentlystallgiventhedownwardrevisedprospectsofexpectedtoevolveinAsia,Africa,andLatinglobalgrowthin2022andhigherpricesoffood,AmericaandtheCaribbean.Thedifferentagriculturalinputsandenergy.Itisestimatedtrajectoriesareevident,demonstratingthatthatthenumberofpeopleinextremepovertywillpracticallyalltheprogressinthefightagainsthavedecreasedby5millionfrom2021to2022,hungerisexpectedtobemadeinAsia,wherebasedonascenariothattakesintoconsiderationthenumberofundernourishedisprojectedtotherelativelygreaterimpactofhighfoodfallfromthecurrent402millionto242millioninflationamongthepoor.peopleby2030.Thenumberofundernourished16THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE5PROJECTEDNUMBERSOFUNDERNOURISHEDINDICATETHATTHEWORLDISFAROFFTRACKTOACHIEVEZEROHUNGERBY2030WORLD800738.9735.1700668.8MILLIONS600612.8617.6590.3500567.6471.8400202020212022202520302015298.2AFRICA297.6350271.9300281.6290.02030270.6242.0223.4MILLIONS273.4280.0164.3203025044.5225.140.520029.6150202020212022202520302015450414.1ASIA400401.6350MILLIONS300343.9328.9250292.620020202021202215020252015LATINAMERICAANDTHECARIBBEAN5045.643.243.040MILLIONS3041.72039.11036.0020152020202120222025CurrentprospectsProjectionsbeforeCOVID-19ProjectionsbeforethewarinUkraineNOTE:The2020,2021and2022valuesarebasedontheprojectedmidrangeswhichcanbefoundinAnnex2.SOURCE:Authors’(FAO)ownelaboration.17CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDisexpectedtoremainconstantinLatinAmericapre-pandemiclevels–equivalentto180millionandtheCaribbeanandtoincreasesignificantlymorepeoplecomparedto2019(Table3andTable4).inAfrica,whereitisprojectedthatclosetoAtthegloballevel,theslightdecreaseinsevere300millionpeoplemaybefacinghungerin2030.foodinsecurity,andunchangedprevalenceofMuchstrongereffortsareneededtoaddressthemoderateorseverefoodinsecurity,suggestthatfundamentalstructuralproblemsthatafflictthethegravityofthefoodinsecuritysituationofAfricancontinent.somepeoplemayhavetransitionedfromseveretomoderatefrom2021to2022.SDGIndicator2.1.2PrevalenceofmoderateorseverefoodAsexpected,theglobaltrendsintheprevalenceinsecurityinthepopulation,basedontheofseverefoodinsecurityaresimilartotheFoodInsecurityExperienceScaletrendsforthePoU(Table1).ThisisbecausepeopleexperiencingseverefoodinsecurityareunlikelySDGTarget2.1challengestheworldnotonlytotobeabletoacquireenoughfoodtocontinuouslyendhunger,butalsotoworktoensureaccessfulfiltheirdietaryenergyrequirements,andforallpeopletosafe,nutritiousandsufficientthusmaybecomechronicallyundernourished.foodallyearround.SDGIndicator2.1.2–theBothindicatorsprovideevidenceregardingprevalenceofmoderateorseverefoodinsecuritytheproportionofthepopulationfacingsevereinthepopulation,basedontheFIES–tracksconstraintsonfoodaccess,albeitbasedonveryprogresstowardsthisambitiousgoal.differentmethodologiesandsourcesofdata(seeAnnex1B).NewestimatesoftheprevalenceoffoodinsecuritybasedontheFIESconfirmthatforDespitethelackofchangeintheprevalence2022noprogresswasmadeonfoodinsecurityoffoodinsecurityatthegloballevel,thereatthegloballevel.Followingasharpincreaseweredivergenttrendsattheregionallevel.from2019to2020,theglobalprevalenceofImprovementsinsomeregionswereoffsetmoderateorseverefoodinsecurityremainedbyworseningsituationsinothers(Figure6,unchangedforthesecondyearinarow,farTable3andTable4).abovepre-COVID-19-pandemiclevels(Figure6andTable3).In2022,anestimated29.6percentofTheprevalenceofmoderateorseverefoodtheglobalpopulation–2.4billionpeople–wereinsecurityinAfricaincreasedbyonepercentagemoderatelyorseverelyfoodinsecure,meaningpointinoneyearto60.9percentin2022.theydidnothaveaccesstoadequatefood(Table3TheincreaseismuchsmallercomparedtotheandTable4).Thisisstill391millionmorepeoplepreviousyear,whenitroseby4percentagepoints.thanin2019,beforethepandemic,and745millionFrom2021to2022,theprevalenceofmoderatemorecomparedto2015whenthe2030SustainableorseverefoodinsecurityroseinEasternAfrica,DevelopmentAgendawaslaunched.MiddleAfricaandSouthernAfricaby2.4,3.0and1.2percentagepoints,respectively.TheprevalenceMorethanone-third(38percent)ofpeoplein2022rangedfrom25.9percentinSouthernfacingmoderateorseverefoodinsecurityintheAfricato78.4percentinMiddleAfrica.Theworldin2022–over900million–wereseverelyincreaseinmoderateorseverefoodinsecurityfoodinsecure,indicatingthattheyhadrunoutinAfricafrom2021to2022ismostlyduetooffoodattimesduringtheyearand,atworst,morepeoplefacingmoderatefoodinsecurity,asgoneanentiredayormorewithouteating.Thetheriseinseverefoodinsecurityintheregionprevalenceofseverefoodinsecurityattheglobalwasmarginal.Nevertheless,nearlyoneinfourlevelshowedamarginaldeclinefrom11.7percentpeopleinAfrica(24.0percent)wasfacingseverein2021to11.3percentin2022,theequivalentoffoodinsecurityin2022.Theprevalenceofsevere27millionfewerpeople(Figure6,Table3andTable4).foodinsecurityroseinNorthernAfrica,MiddleWhileitisencouragingthattheupwardtrendinAfrica,SouthernAfricaandWesternAfricabyseverefoodinsecurityofthepastsixyearshasnot0.8,1.3,1.5and0.3percentagepoints,respectivelycontinued,theglobalprevalenceisstillfarabove–theequivalentof2.4millionmorepeopleinNorthernAfrica,4.8millionmoreinMiddle18THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE6MODERATEORSEVEREFOODINSECURITYREMAINEDUNCHANGEDATTHEGLOBALLEVELFROM2021TO2022,WITHWORSENINGFOODINSECURITYLEVELSINAFRICAANDINNORTHERNAMERICAANDEUROPE,ANDIMPROVEMENTSINASIAANDINLATINAMERICAANDTHECARIBBEAN7059.960.96056.051.552.35045.436.136.940.3PERCENTAGE4033.639.337.531.532.133.031.529.429.629.628.227.33022.423.824.025.724.524.226.826.425.320.020.221.223.917.217.718.924.921.720152017201920202021202216.014.214.62018.617.918.3AFRICA13.123.321.911.212.420.016.115.76.66.58.19.610.49.714.220152017201920202021202210ASIA12.513.912.69.38.47.17.87.78.07.39.79.77.68.29.310.811.711.38.07.26.26.66.26.62015201720192020202120221.41.20.91.21.51.50LATINAMERICA201520172019202020212022201520172019202020212022WORLDANDTHECARIBBEANNORTHERNAMERICAANDEUROPESeverefoodinsecurityModeratefoodinsecurityNOTE:Differencesintotalsareduetoroundingoffigurestothenearestdecimalpoint.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSAfrica,1.1millionmoreinSouthernAfrica,andslightlyinWesternAsia.Moderateorsevere3.6millionmoreinWesternAfricafacingseverefoodinsecurityremainedvirtuallyunchangedfoodinsecurityin2022comparedto2021.intheothersubregionsofAsia,althoughtherearestilllargedifferencesinprevalenceAnon-significantdecreaseinfoodinsecuritybetweensubregions.ThepercentageofpeoplewasregisteredinAsia,where24.2percentofthefacingmoderateorseverefoodinsecuritypopulationwasfacingmoderateorseverefoodrangedfrom6.2percentinEasternAsiatoinsecurityin2022comparedwith24.5percent40.3percentinSouthernAsia,whichishometoin2021.Thesituationimprovedsomewhatmorethanone-thirdoftheworld’smoderatelyinCentralAsiaandWesternAsia,wheretheorseverelyfood-insecurepopulation–aboutprevalenceofmoderateorseverefoodinsecurity809millionpeople.SouthernAsiaalsohasthefellby2.7and3.2percentagepoints,respectively,highestprevalenceofseverefoodinsecurityevenasseverefoodinsecurityincreasedonthecontinent,althoughthisdiddecrease19CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDTABLE3PREVALENCEOFFOODINSECURITYATSEVERELEVELONLY,ANDATMODERATEORSEVERELEVEL,BASEDONTHEFOODINSECURITYEXPERIENCESCALE,2015–20222015Prevalenceofsevere20222015Prevalenceofmoderateorsevere2022foodinsecurity(%)foodinsecurity(%)20172019202020212017201920202021WORLD7.68.29.310.811.711.321.723.925.329.429.629.6AFRICA17.220.020.222.423.824.045.451.552.356.059.960.9NorthernAfrica9.010.58.79.511.212.026.233.128.830.234.032.4Sub-SaharanAfrica19.122.222.825.426.626.649.855.857.761.865.767.2EasternAfrica22.026.125.028.128.727.756.864.663.566.566.869.2MiddleAfrican.a.n.a.n.a.36.037.839.1n.a.n.a.n.a.70.175.478.4SouthernAfrica9.09.49.311.011.012.521.722.122.124.724.725.9WesternAfrica11.414.316.619.921.722.039.846.251.759.066.766.4ASIA6.66.58.19.610.49.717.718.921.225.724.524.2CentralAsia1.42.82.34.85.04.69.113.913.517.820.117.4EasternAsia0.81.71.32.01.01.05.910.07.47.86.16.2South-easternAsia1.92.01.82.12.62.614.515.714.515.516.916.8SouthernAsia13.211.816.318.821.019.427.726.134.343.140.640.3WesternAsia9.09.68.99.610.210.330.930.929.935.138.735.5WesternAsiaand9.010.08.89.510.711.128.731.929.432.836.534.1NorthernAfrica7.39.79.712.513.912.627.333.031.539.340.337.5LATINAMERICAANDTHEn.a.n.a.n.a.32.425.728.2n.a.n.a.n.a.65.459.560.6CARIBBEANCaribbeanLatinAmerica5.58.18.211.113.011.524.830.929.437.538.935.9CentralAmerica6.76.37.37.38.08.630.327.928.234.234.134.5SouthAmerica5.08.98.512.715.112.722.632.129.938.840.936.4OCEANIA2.64.13.82.64.53.410.014.413.612.113.013.0NORTHERN1.41.20.91.21.51.59.38.47.17.87.78.0AMERICAANDEUROPE1.61.41.01.41.91.98.88.36.97.57.88.2EuropeEasternEurope1.51.10.81.41.72.011.710.38.310.210.510.9NorthernEurope1.82.21.01.21.82.06.86.05.14.24.56.6SouthernEurope1.72.01.62.42.81.69.610.68.79.38.67.5WesternEurope1.40.90.70.81.71.85.04.64.33.94.95.7NorthernAmerica1.00.80.80.70.70.710.38.67.68.37.57.7NOTES:n.a.=notavailable,asdataareavailableonlyforalimitednumberofcountries,representinglessthan50percentofthepopulationintheregion.TheestimatesforLatinAmericaandtheCaribbeanfrom2014to2019includeCaribbeancountrieswhosecombinedpopulationsrepresentonly30percentofthepopulationofthatsubregion,whilethe2020,2021and2022estimatesincludeCaribbeancountrieswhosecombinedpopulationsrepresentbetween60percentand65percentofthesubregionalpopulation.Thecountriesincludedinthe2022estimatefortheCaribbeansubregionare:AntiguaandBarbuda,Bahamas,Barbados,Dominica,DominicanRepublic,Grenada,Haiti,Jamaica,SaintKittsandNevis,SaintLucia,SaintVincentandtheGrenadines,andTrinidadandTobago.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS20THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLE4NUMBEROFPEOPLEEXPERIENCINGFOODINSECURITYATSEVERELEVELONLY,ANDATMODERATEORSEVERELEVEL,BASEDONTHEFOODINSECURITYEXPERIENCESCALE,2015–20222015Numberofseverely20222015Numberofmoderatelyorseverely2022food-insecurepeople(millions)food-insecurepeople(millions)20172019202020212017201920202021WORLD561.5623.8719.8850.7927.3900.11612.41817.01966.42307.22342.52356.9AFRICA206.3252.2268.1305.0331.1341.8544.8650.6695.0761.7834.5868.3NorthernAfrica20.525.021.523.828.731.159.978.871.275.986.984.3Sub-SaharanAfrica185.8227.2246.6281.2302.4310.6484.9571.9623.7685.8747.6783.9EasternAfrica86.6108.2109.3126.2132.1130.9223.5267.9277.9298.8308.2327.4MiddleAfrican.a.n.a.n.a.66.571.976.7n.a.n.a.n.a.129.4143.5153.7SouthernAfrica5.76.16.27.47.58.613.814.314.716.616.817.8WesternAfrica41.053.966.181.190.894.4142.7174.5205.7240.8279.1285.1ASIA293.7295.0377.3449.5486.1456.9791.0857.4981.81196.81151.51144.9CentralAsia1.02.01.73.63.83.56.39.99.913.315.313.4EasternAsia12.427.921.433.417.016.095.7164.3123.0129.0102.3103.4South-easternAsia11.913.312.213.917.717.892.5101.996.0104.0114.2114.4SouthernAsia244.7225.4316.9371.3417.9389.2514.7496.6668.1849.8807.6809.2WesternAsia23.826.425.127.429.730.381.884.684.8100.7112.1104.444.351.446.651.258.461.4141.7163.4156.0176.6199.0188.7WesternAsiaandNorthernAfrica45.361.762.581.891.183.4169.8209.7203.8256.4264.3247.8n.a.n.a.n.a.14.211.412.5n.a.n.a.n.a.28.726.326.9LATINAMERICAANDTHECARIBBEANCaribbeanLatinAmerica32.048.249.367.579.770.8144.0183.1177.6227.7238.0220.8CentralAmerica11.210.912.812.914.315.450.747.849.360.360.661.9SouthAmerica20.837.336.554.765.555.493.3135.3128.3167.4177.4159.0OCEANIA1.11.71.71.12.01.54.06.05.95.35.85.9NORTHERN15.113.210.313.317.016.5102.893.379.887.086.490.0AMERICAANDEUROPE11.610.47.310.514.313.865.661.751.556.158.161.1EuropeEasternEurope4.53.22.44.04.95.734.330.324.429.930.631.4NorthernEurope1.92.21.01.31.92.17.06.35.44.44.77.1SouthernEurope2.53.12.43.64.32.414.716.213.414.213.111.4WesternEurope2.71.81.41.63.23.69.68.98.37.79.611.2NorthernAmerica3.52.93.02.72.72.837.231.528.430.928.328.9NOTES:n.a.=notavailable,asdataareavailableonlyforalimitednumberofcountries,representinglessthan50percentofthepopulationintheregion.TheestimatesforLatinAmericaandtheCaribbeanfrom2014to2019includeCaribbeancountrieswhosecombinedpopulationsrepresentonly30percentofthepopulationofthatsubregion,whilethe2020,2021and2022estimatesincludeCaribbeancountrieswhosecombinedpopulationsrepresentbetween60percentand65percentofthesubregionalpopulation.Thecountriesincludedinthe2022estimatefortheCaribbeansubregionare:AntiguaandBarbuda,Bahamas,Barbados,Dominica,DominicanRepublic,Grenada,Haiti,Jamaica,SaintKittsandNevis,SaintLucia,SaintVincentandtheGrenadines,andTrinidadandTobago.SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS21CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDFIGURE7THECONCENTRATIONANDDISTRIBUTIONOFFOODINSECURITYBYSEVERITYDIFFERGREATLYACROSSTHEREGIONSOFTHEWORLDTotalpopulation7975millionNUMBER(MILLIONS)IN2022Totalpopulation4723millionTotalpopulationTotalpopulationTotalpopulation1427million1120million660million23571145900868342901724883457WORLDASIAAFRICANORTHERNAMERICALATINAMERICAANDEUROPEANDTHECARIBBEANTotalpopulationModerateorseverefoodinsecuritySeverefoodinsecuritySOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSby1.6percentagepointsfrom2021to2022,remainedunchanged.Moderateorseverefoodtheequivalentof28.7millionpeople.insecurityincreasedbyapproximately2percentagepointsinNorthernEurope,reaching6.6percentinLatinAmericaandtheCaribbeanshowed2022,whereastheprevalenceofmoderateorsevereencouragingprogressin2022,astheproportionfoodinsecuritydecreasedbyabout1percentageofthepopulationfacingmoderateorseverefoodpointinSouthernEuropeto7.5percent.insecuritydecreasedfrom40.3percentin2021to37.5percentin2022,theequivalentof16.5millionItisinterestingtocomparehowtheregionsfewerpeopleinoneyear.TheimprovementwashavefaredinthefightagainsthungersincedrivenbyadecreaseinSouthAmerica,fromthepandemicemergedinlate2019.Three40.9percentin2021to36.4percentin2022.yearslater,partsofAsiaandLatinAmericaTheprevalenceofseverefoodinsecurityalsoappeartoberebounding,whereasAfricaisstilldeclinedinSouthAmerica,from15.1percentinstrugglingtoturnthingsaround.Regardless,2021to12.7percentin2022.InCentralAmericafoodinsecuritylevelsinallregionsarestillfarandtheCaribbean,ontheotherhand,thefoodabovepre-pandemiclevels.securitysituationdeterioratedfrom2021to2022.IntheCaribbean,whichisthesubregionmostFigure7showsthat,ofatotalof2.4billionpeopleaffectedbyfoodinsecurity,theprevalenceofintheworldfacingfoodinsecurityin2022,moderateorseverefoodinsecurityincreasednearlyhalf(1.1billion)wereinAsia;37percentfrom59.5percentto60.6percent,andsevere(868million)wereinAfrica;10.5percentfoodinsecurityincreasedfrom25.7percent(248million)livedinLatinAmericaandtheto28.2percent.Caribbean;andaround4percent(90million)wereinNorthernAmericaandEurope.TheInOceania,theprevalenceofmoderateorseverefigurealsoillustratesthedifferentproportionsfoodinsecuritywas13.0percentin2022.ofseverefoodinsecurityinrelationtomoderateAnestimated3.4percentofthepopulationinorseverefoodinsecurityacrossregions.SevereOceaniawasfacingseverefoodinsecurityin2022,foodinsecurityrepresentsalargershareofthedownfrom4.5percentin2021.combinedtotalofmoderateplusseverefoodinsecurityinAfrica,Asia,andLatinAmericaInNorthernAmericaandEurope,theprevalenceandtheCaribbean–39.4percent,39.9percentofmoderateorseverefoodinsecurityroseslightlyand33.5percent,respectively–comparedwithin2022to8.0percent,whileseverefoodinsecurity18.8percentinNorthernAmericaandEurope.22THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE8FOODINSECURITY,ATBOTHLEVELSOFSEVERITY,ISHIGHERINRURALAREASTHANINURBANAREASINALLREGIONSEXCEPTNORTHERNAMERICAANDEUROPE8071.071.563.77064.560.36054.25041.142.5PERCENTAGE4038.540.438.639.242.737.232.138.034.136.726.033.325.926.023.122.13028.820.224.814.412.621.626.026.525.110.122.221.820.517.916.414.516.114.12017.213.519.016.610.311.08.314.811.830.029.013.924.510.7106.86.57.58.27.77.48.212.811.69.45.65.26.16.25.66.51.21.31.45.13.64.21.51.71.80RuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanRuralPeri-urbanUrbanWORLDAFRICAASIALATINAMERICANORTHERNLOW-INCOMELOWER-UPPER-HIGH-INCOMEMIDDLE-MIDDLE-COUNTRIESANDAMERICACOUNTRIESINCOMEINCOMECOUNTRIESCOUNTRIESTHECARIBBEANANDEUROPESeverefoodinsecurityModeratefoodinsecuritySOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FSDifferencesinfoodinsecurityacrossrural,iii)cities(urbanareas),basedonpopulationperi-urbanandurbanareasdensityandsize,inagloballycomparableway.f,17TheavailabilityofgeoreferencedFIESdataTheprevalenceoffoodinsecurityamongadultscollectedbyFAOin2022hasmadeitpossiblewithineachgroupwasthencalculated.topresent,forthefirsttime,acomparisonoffoodinsecurityinrural,peri-urbanandResultsshowthatatthegloballevel,foodsecurityurbanpopulationsattheglobal,regionalandimprovesasthedegreeofurbanizationincreasessubregionallevels.eTheDegreeofUrbanization(DEGURBA)classification,anewinternationalfTheDEGURBAclassificationwasdevelopedbytheStatisticalOfficestandard,wasusedtodistinguishamongoftheEuropeanUnion(EUROSTAT),theInternationalLabourpopulationslivingin:i)ruralareas;ii)townsOrganization(ILO),FAO,theOrganisationforEconomicCo-operationandsemi-denseareas(peri-urbanareas);andandDevelopment(OECD),theUnitedNationsHumanSettlementsProgramme(UN-Habitat)andtheWorldBankandwasapprovedattheeSeeAnnex2,SectionCfordetailsonthemethodsusedtoobtain51stsessionoftheUNStatisticalCommissioninMarch2020(seeBox2disaggregatedestimates.inChapter3).17ThisdiffersfromtheUrbanRuralCatchmentAreas(URCA)criteriausedfortheanalysesofsubsetsofcountriesinChapter4(seeBox3).23CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDFIGURE9GLOBALLYANDINEVERYREGION,THEPREVALENCEOFFOODINSECURITYISHIGHERAMONGWOMENTHANAMONGMEN706050PERCENTAGE4030201002015201720192021202220152017201920212022201520172019202120222015201720192021202220152017201920212022WORLDAFRICAASIALATINAMERICANORTHERNAMERICAANDTHECARIBBEANANDEUROPEMen−moderateorsevereMen−severeWomen−moderateorsevereWomen−severeSOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS(Figure8).gModerateorseverefoodinsecuritymovingfromurban,toperi-urban,toruralareas.affected33.3percentofadultslivinginruralInAsiaandLatinAmericaandtheCaribbean,areasin2022comparedwith28.8percentinfoodinsecurityissignificantlyhigherinruralperi-urbanareasand26.0percentinurbanareas.areascomparedtourbanareas,atbothlevelsofTheprevalenceofseverefoodinsecuritywasseverity,butthedifferencesbetweenperi-urban12.8percentinruralareas,11.6percentamongandruralareasarelessclear.InNorthernperi-urbanresidents,and9.4percentamongAmericaandEurope,ontheotherhand,foodurbanresidents.insecurity,atbothlevelsofseverityisworseinurbanareasthaninruralareas.Attheregionallevel,thedifferencesacrossregionsareinteresting.AfricaclearlyfollowstheThesedifferencesinregionalpatternsmaybeglobalpatternofworseningfoodsecuritywhenpartiallyexplainedbylookingatrural–urbandifferencesinfoodinsecuritybyDEGURBAgSeeTableA1.3inAnnex1Aforprevalenceofmoderateorseverefoodthroughacountryincomegrouplens(Figure8).insecurity,andseverefoodinsecurityonly,bydegreeofurbanizationinInLICs,ruralandperi-urbanpopulations2022byregionandsubregion.24THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023aremorefoodinsecurecomparedtourbanTherewereencouragingimprovementsinthepopulations,whereasinLMICs,foodinsecurityisgendergapinbothAsiaandLatinAmericahighestinruralareasbutonlymarginallyworseandtheCaribbeanfrom2021to2022.Thegapinperi-urbanthaninurbanareas.Thesituationnarrowedbymorethan2percentagepointsismarkedlydifferentinUMICsandHICs.AmongformoderateorseverefoodinsecurityinbothUMICs,theprevalenceoffoodinsecurity,atbothregions,andbyabout2and1.3percentagepointslevelsofseverity,ishighestinruralareasandforseverefoodinsecurityinAsiaandinLatinlowestinperi-urbanareas.InHICs,ontheotherAmericaandtheCaribbean,respectively.hand,itistheurbanpopulationthatisathigherInAfricaandinNorthernAmericaandEurope,riskofmoderateorseverefoodinsecurity,withhowever,thegapincreasedmarginallyforvirtuallynodifferenceforseverefoodinsecurity.moderateorseverefoodinsecurityandremainedaboutthesameforseverefoodinsecurity.nGenderdifferencesinfoodinsecurityPersistentgenderinequalitiesarerevealedbythe2.2newFIESdata.FoodinsecurityismoreprevalentCOSTANDAFFORDABILITYamongadultwomenthanmenineveryregionofOFAHEALTHYDIETtheworld.Thegendergapinfoodinsecurityatthegloballevelwidenedconsiderablyin2020and2021KEYMESSAGESinthewakeoftheCOVID-19pandemic,aswomenweremoreaffectedbyjobandincomelossesandèThecostofahealthydietrosegloballyby4.3percentborealargerresponsibilityforadditional,unpaidincomparisonto2020,andby6.7percentcomparedtocaregivingduties.18,19Womenlivinginruralareasthepre-COVID-19-pandemiclevels,in2019.Thisincreasewereevenmorelikelytobefoodinsecure,20asjobisduetotheoverallriseininflationin2020and2021,andincomelossesweremuchhigherforwomendriveninpartbythepersistingeffectsofthepandemic.thanformenparticularlyinagrifoodsystems.21In2021,thegendergapreached3.8percentageèWorldwidein2021,theaveragecostofahealthypoints,with28.6percentofwomenintheworlddietwas3.66PPPdollarsperpersonperday.ThecostbeingmoderatelyorseverelyfoodinsecurewashigherinLatinAmericaandtheCaribbeancomparedwith24.8percentofmen(Figure9).(4.08PPPdollars)comparedtoAsia(3.90PPPdollars),Africa(3.57PPPdollars),NorthernAmericaandEuropeFor2022,thefoodinsecuritygapbetweenmenand(3.22PPPdollars),andOceania(3.20PPPdollars).womenappearstohavenarrowedconsiderablyatthegloballevel,whichmaypartiallyreflectèInAfrica,Asia,andLatinAmericaandtheareturnofwomentoeconomicactivitiesasCaribbean,thecostofahealthydietincreasedbypandemic-relatedrestrictionswereeased,andamorethan5percentfrom2020to2021,negativelyweakeningofthedisproportionateimpactsoftheaffectingallsubregionsexceptforNorthernAfrica,pandemiconwomen’sfoodinsecurity.In2022,wherethecostfellby2.8percent.Inthesameperiod,27.8percentofadultwomenweremoderatelyorthecostofahealthydietroseinOceania(5.2percent)severelyfoodinsecure,comparedwith25.4percentandinNorthernAmericaandEurope(marginally,ofmen,andtheproportionofwomenfacingsevereby0.6percent).Thesurgehitlower-middle-incomefoodinsecuritywas10.6percentcomparedwithcountriesmorethanhigh-incomecountries.9.5percentofmen.ThedifferenceintheprevalenceofmoderateorseverefoodinsecuritybetweenèMorethan3.1billionpeopleintheworld–menandwomendecreasedfrom3.8percentageor42percent–wereunabletoaffordahealthydietinpointsin2021to2.4percentagepointsin2022,and2021,representinganincreaseof134millionpeoplethegapforseverefoodinsecuritynarrowedfromcomparedto2019,beforethepandemic.Thisreflects2.4to1.1percentagepoints(Figure9).htheincreaseinthecostofahealthydietthat,inmanycountries,occurredincombinationwithadeclineinhSeeTableA1.4inAnnex1Aforprevalenceofmoderateorseverefooddisposableincome.insecurity,andseverefoodinsecurityonly,amongadultmenandwomenin2022byregionandsubregion.SeeAnnex2,SectionCforthemethodology.25CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDèWhileAsiahadthelargestnumberofpeoplewho2022.SeeAnnex2,SectionDfordetailsonthewereunabletoaffordahealthydiet(1.9billion)inmethodologyandimportantupdates.2021,Africareportedthehighestproportionofthepopulationunabletoaffordit(78percent)comparedThisyear,affordabilityindicatorsreflectnottoAsia(44percent),LatinAmericaandtheCaribbeanonlypriceshocksbutalsoincomeshocks(23percent),Oceania(3percent),andNortherninducedbythepandemic,bettercapturingAmericaandEurope(1percent).theglobalsituationin2020and2021.Thiswaspossiblebecauseincomedistributions–derivedèSouthernAsiashowsthehighestnumber(1.4billion)fromthePovertyandInequalityPlatformtoandproportion(72percent)ofthepopulationunabletoestimateaffordability–havenowbeenupdatedaffordahealthydietinAsia,withtheprevalencealmosttoincludetheyears2020and2021foralltwicetheregionalaverage.EasternandWesternAfricacountries(seeAnnex2,SectionD).iFollowingreportthehighestproportion(85percent)intheAfricatherecentreleaseofnewPPPsfor2017,theregion,aswellasthehighestnumber(712million),WorldBankadoptedthelatestconversionwhenconsideredtogether.factorstopresentitsmonetaryindicatorsin2017PPPterms,includingincomedistributions.26HealthydietsareessentialforachievingfoodConsequently,theindicatorsofaffordabilityaresecuritygoalsandimprovingnutritionalexpressedin2017PPPratherthan2011PPP,asinoutcomes.Ahealthydietiscomposedofavarietypreviousyears(seeAnnex2,SectionD).ofnutritiousandsafefoodsthatprovidedietaryenergyandnutrientsintheamountsneededforThecostandaffordabilityofahealthyahealthyandactivelife.Ahealthydietisbaseddietin2021onawiderangeofunprocessedorminimallyprocessedfoods,balancedacrossfoodgroups,Therevisedanalysispresentedinthisyear’swhileitrestrictstheconsumptionofhighlyreport–whichaccountsforupdatedincomeprocessedfoodsanddrinkproducts;itincludesdistributionsin2020and2021–showsthatwholegrains,legumes,nuts,anabundanceandalmost3.2billionpeopleworldwidecouldvarietyoffruitsandvegetables,andcanincludenotaffordahealthydietin2020,withaslightmoderateamountsofeggs,dairy,poultryandimprovementin2021(adecreaseof52millionfish,andsmallamountsofredmeat.22,23Eatingapeople).Foodpricescontinuedtoclimbhealthydietthroughoutthelifecycleiscriticalforthroughout2021,pushinguptheaveragecostofpreventingallformsofmalnutrition,includingahealthydietglobally.However,areboundinchildstuntingandwasting,micronutrienteconomicgrowthinmanycountries,particularlydeficienciesandoverweightorobesity.ItalsoinAsia,mayhavetranslatedintolargerfiscalhelpsreducetheriskofnon-communicablespaceforstimuluspackages,socialtransfersdiseases(NCDs)suchascardiovasculardiseases,andimprovedlabourmarkets.27,28Theseeffortsdiabetesandcertaintypesofcancer.24helpedtocountertheeffectsofhighfoodinflation,therebyreducingthenumberofpeopleFAO,withsupportfromtheWorldBankDataunabletoaffordahealthydietatthegloballevel,Group,systematicallymonitorsthecostandlargelydrivenbyAsia.affordabilityofahealthydiet(CoAHD)indicatorsandrecentlybegantodisseminatetheupdatedTable5presentstheCoAHDindicatorsattheseriesontheFAOSTATdatabase.25Theseglobalandregionallevels,andbycountryindicatorsprovideevidenceregardingpeople’sincomegroup,for2019,2020and2021.Estimatedeconomicaccesstothelowest-costhealthydietrangesofaffordabilityindicatorsarepresentedinagivencountry,usinglocallyavailablefoodsinTableA3.2for2021,whereloweranduppertomeetnutritionalrequirements.Inthisyear’sboundsreflectdifferentassumptionsaboutthereport,theCoAHDindicatorsareupdatedtoshareofincomereservedforfood.Country-level2021.LackofupdatedincomedistributionatthecountrylevelandofdetailedfoodpricesandiInlastyear’sreport,affordabilityin2020wasobtainedbyapplyingpurchasingpowerparity(PPP)conversionfactorsthecostofahealthydietin2020toincomedistributionsin2019,hencemakesitimpossibletoupdatetheseestimatesforaccountingforpriceshocksinducedbythepandemic,butnotforincomeshocks.26THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLE5MORETHAN3.1BILLIONPEOPLECOULDNOTAFFORDAHEALTHYDIETIN2021,ALTHOUGHTHEREWASSOMEIMPROVEMENTFROM2020TO2021CostofahealthydietProportionoftheNumberofpeopleunable(PPPdollarsperpersonperday)populationunabletotoaffordahealthydietaffordahealthydiet(%)(millions)2019202020212019–2020change(%)2020–2021change(%)2019202020212019202020212019–2020change(millions)2020–2021change(millions)WORLD3.433.513.662.34.341.243.342.23005.53191.93139.5186.4-52.4AFRICA3.313.383.572.25.677.477.977.5989.41020.71040.531.319.8NorthernAfrica3.603.573.47-0.6-2.854.754.051.7131.3131.9128.50.6-3.4Sub-SaharanAfrica3.283.363.582.66.682.683.383.4858.1888.8912.130.723.3EasternAfrica3.013.093.292.76.784.284.784.6341.3352.7361.911.49.2MiddleAfrica3.303.373.552.25.382.182.281.9145.7150.5154.54.84.0SouthernAfrica3.713.844.063.45.865.467.467.043.445.345.61.90.3WesternAfrica3.373.453.712.57.684.185.185.4327.6340.3350.112.79.8ASIA3.573.703.903.75.243.246.444.21877.42031.41949.9154.0-81.5CentralAsia2.913.103.326.77.221.324.624.47.38.68.71.30.1EasternAsia4.454.674.875.14.111.214.510.0177.8230.9159.453.1-71.5South-easternAsia3.863.994.193.64.852.354.054.9335.1349.0357.413.98.4SouthernAsia3.663.824.084.26.970.273.872.21340.61425.91408.585.3-17.4WesternAsia3.153.223.362.24.59.79.79.016.717.015.90.3-1.1LATINAMERICAAND3.783.884.082.75.320.820.922.7120.0121.9133.41.911.5THECARIBBEANCaribbean4.064.204.413.35.051.655.257.013.714.815.41.10.6LatinAmerica3.493.553.751.95.619.319.321.1106.3107.1118.00.810.9CentralAmerica3.453.483.620.84.123.625.422.235.738.734.23.0-4.5SouthAmerica3.503.593.822.46.417.717.020.670.668.483.8-2.215.4OCEANIA2.963.043.202.85.22.62.72.90.70.70.80.00.1NORTHERN3.193.203.220.60.61.71.61.418.117.214.9-0.9-2.3AMERICAANDEUROPECOUNTRYINCOMEGROUPLow-income3.143.223.372.54.786.786.986.1456.8471.0480.014.29.0countriesLower-middle-income3.553.653.882.96.268.371.070.22180.72296.82299.6116.12.8countriesUpper-middle-income3.653.723.912.05.114.416.614.1350.5406.4345.555.9-60.9countriesHigh-income3.293.363.432.12.11.51.51.317.417.614.30.2-3.3countriesNOTES:Thecostofahealthydietisexpressedinpurchasingpowerparity(PPP)dollarsperpersonperday.Theshareofpeopleunabletoaffordahealthydietisaweightedaverage(%)estimatedusingpopulationdata.The2022WorldBank’sincomeclassificationisusedtoidentifycountryincomegroups.Thecalculationoftheannualchange(%)inthecostofahealthydietisbasedonthecostroundedtothreedecimalplaces.SOURCE:FAO.2023.FAOSTAT:CostandAffordabilityofaHealthyDiet(CoAHD).In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/CAHD27CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDestimatesfortheentire2017–2021seriescanbetheCaribbean,thecostincreaserangedfromfoundinTableA3.1.6.4percentinSouthAmericato4.1percentinCentralAmerica.In2021,theaveragecostofahealthydietgloballywas3.66PPPdollarsperpersonperday(Table5).TheCOVID-19pandemichasexacerbatedexistingThecostwashigherinLatinAmericaandtheinequalitiesacrossallregionsintheworld.Low-Caribbean(4.08PPPdollars)comparedtoAsiaandmiddle-incomecountrieshavefacedgreater(3.90PPPdollars),Africa(3.57PPPdollars),challengesrelatedtoincreasesinfoodpricesNorthernAmericaandEurope(3.22PPPdollars),andfoodinsecuritycomparedtohigh-incomeandOceania(3.20PPPdollars).countries.29Thisisalsoreflectedintheincreasedcostofahealthydietfrom2020to2021,whichThecostofahealthydiethasbeenontherisewasmuchlargerinLMICs(6.2percentincrease),since2019.Itincreasedgloballyby6.7percentUMICs(5.1percent)andLICs(4.7percent),between2019and2021,withanotablesingle-yearcomparedtoHICs(2.1percent)(Table5).increaseof4.3percentin2021(Table5andFigure10A).ThesurgeinthecostofahealthydietAbout3.14billionpeopleintheworld–orreflectsanoverallriseinfoodinflationthat42percent–wereunabletoaffordahealthyhiteveryregionfollowingtheoutbreakofthedietin2021;thisfigureisdownsomewhatfrompandemic.Soaringpricesweremostlydriven3.19billionpeople–or43percent–in2020(Table5bylockdownsandbydisruptionsintheglobalandFigure10B).Inmanycountries,theincreaseinsupplychainandtransportationsystems,asthecostofahealthydietoccurredincombinationwellaslabourshortageshittingespeciallythewithadeclineindisposableincomefollowingtheagriculturesector.8persistingeffectsofthepandemic.Lockdowns,economicdownturns,andotherpandemic-relatedThecostofahealthydietincreasedbymorethandisruptionsin2020ledtojoblossesandreduced5percentbetween2020and2021inAfrica,Asia,incomesformanypeople,affectinglow-incomeLatinAmericaandtheCaribbean,andOceania,householdsthemostastheyspendahighersharebutonlymarginallyinNorthernAmericaandofincomeonfood.30TheimpactofescalatingEurope(0.6percent).Theincreaseincostinprices,coupledwithareductionindisposableAfrica,LatinAmericaandtheCaribbean,andincomeinmanycountries,resultedinanOceaniawasnearlydoublethatwhichoccurredadditional186millionpeopleunabletoaffordabetween2019and2020,whilethecostrosetoahealthydietin2020comparedto2019.lesserextentinAsiaandinNorthernAmericaandEurope(Table5andFigure10A).Aslightturnaroundoccurredin2021,whenthenumberofpeopleunabletoaffordahealthydietBetween2020and2021,soaringcostsaffectedalldeclinedby52millioncomparedto2020(Table5subregionsinAfrica,Asia,andLatinAmericaandFigure10B),butthisisstill134millionmoreandtheCaribbean,exceptforNorthernAfrica,peoplecomparedtopre-pandemiclevelsin2019.wherethecostdeclinedby2.8percent.TheAreboundinglobalGDPgrowthto6percentcostofahealthydietclimbedby7.6percentinin2021,followingthepandemicthatplungedWesternAfrica,athreefoldincreasecomparedmostcountriesintorecessionin2020,3likelytotheperiodbetween2019and2020(Table5).alleviatedtheburdenofunaffordability,owingEasternAfricaalsoexperienceda6.7percenttoseveralfactors,includinggovernmentstimulusriseinthecostofahealthydiet,followedprogrammes,socialprotectionmeasures,andbySouthernAfrica(5.8percent)andMiddleemploymentrecovery,insomeinstances.31Africa(5.3percent).InAsia,thehighestsurgeHowever,theunequalpatternofeconomicwasseeninCentralAsiaandSouthernAsiarecoveryacrossandwithincountries,coupled(7.2percentand6.9percent,respectively).withincreasingpricesandinequalities,hasmadeEasternAsiareportedthesmallestincreaseinahealthydietlessaffordableespeciallyinsomethecostbetween2020and2021(4.1percent)andregions,placinganadditionalburdenontheshowedaslowdownincostinflationcomparedmostvulnerablehouseholds.tothepreviousperiod.InLatinAmericaand28THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE10GLOBALLYIN2021,THECOSTOFAHEALTHYDIETINCREASEDANDMOREPEOPLEWEREUNABLETOAFFORDTHEDIETCOMPAREDTO2019INALLREGIONSEXCEPTNORTHERNAMERICAANDEUROPE,DESPITEASMALLDECLINEINUNAFFORDABILITYFROM2020TO2021A)CHANGEINTHECOSTOFAHEALTHYDIET109+9.1+8.1+7.9+8.18+5.2+2.87+6.7OCEANIAPERCENTAGE6+5.6+5.2+5.3+3.75+4.3ASIA43+2.7+2.3+2.221+1.2+0.6+0.60AFRICALATINAMERICANORTHERNAMERICAWORLDANDTHECARIBBEANANDEUROPEB)CHANGEINTHENUMBEROFPEOPLEUNABLETOAFFORDAHEALTHYDIET200+186.4+154.0150+134.0MILLIONS100+11.5+13.4+72.5+1.9+51.1−0.9−2.3−3.250NORTHERNAMERICA+31.3ANDEUROPE+19.82019and20210−50−81.5−52.4−100−150AFRICAASIALATINAMERICAWORLDANDTHECARIBBEANChangebetween:2017and20182018and20192019and20202020and2021SOURCE:FAO.2023.FAOSTAT:CostandAffordabilityofaHealthyDiet(CoAHD).In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/CAHD29CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDFIGURE11MOSTOFTHEPEOPLEUNABLETOAFFORDAHEALTHYDIETIN2021LIVEDINSOUTHERNASIA,ANDINEASTERNANDWESTERNAFRICATOTALTOTALTOTALTOTAL133.4MILLION3139.5MILLIONOceania1949.9MILLIONCentralAsia1040.5MILLIONCaribbean1000.88.715.4LatinAmericaandSouthernAfrica45.6CentralAmericatheCaribbean133.4NorthernAmerica34.2andEuropeEasternAsiaWesternAsia14.9159.415.9NorthernAfrica90128.580AfricaSouth-easternAsia357.41040.5MiddleAfrica154.57060PERCENTAGE50WesternAfrica350.140SouthernAsia1408.5AsiaSouthAmerica83.8301949.920EasternAfrica361.9100WORLDASIAAFRICALATINAMERICAANDTHECARIBBEANSOURCE:FAO.2023.FAOSTAT:CostandAffordabilityofaHealthyDiet(CoAHD).In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/CAHDComparedto2019,thenumberofpeopleunableincreasesthepreviousyearinthenumbertoaffordahealthydietwashigherin2021inallofpeopleunabletoaffordthisdiet.EasternregionsexceptNorthernAmericaandEurope,AsiaistheonlysubregioninAsiareportingwherethenumberofpeopleunabletoaffordtheanoverallimprovementin2021comparedtodietdecreasedby2.3milliondespitetheprice2019,asthenumberofpeopleunabletoaffordaandincomeshocksinducedbythepandemichealthydietdecreasedby18.4million.InAfrica,(Figure10B).InAsia,thenumberofpeoplewhounaffordabilitycontinuedtoworsen:51.1millioncouldnotaffordahealthydietincreasedbymorepeoplecouldnotaffordahealthydiet154millionfrom2019to2020,butthendecreasedin2021comparedto2019,withthehighestby81.5millionfrom2020to2021(Figure10B).increaseoccurringfrom2019to2020(31million).Anotableimprovementoccurredfrom2020toSub-SaharanAfricareportedthelargestincrease2021inEasternAsia,whereahealthydietwasinthenumberofpeopleunabletoaffordaoutofreachforfewerpeople(71.5millionfewerhealthydietfrom2019to2021(54millionpeoplecouldnotaffordit),andinSouthernmorepeople),whilethesituationimprovedinAsia(17.4millionfewerpeople),followingsharpNorthernAfrica,wherethedietwasoutofreach30THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023foralmost3millionfewerpeople(Table5).Finally,“average”costandaffordabilitysituationattheinLatinAmericaandtheCaribbean,13.4millionglobal,regionalandcountrylevels.However,morepeoplecouldnotaffordahealthydiettheydonotfullycapturetheheterogeneousin2021comparedto2019,withthelargestcharacteristicsofapopulationthatdeterminetheincreaseinSouthAmerica(13.3millionpeople)abilitytoaffordahealthydietwithinacountryduetoasharpjumpfrom2020to2021(Table5oraregion.AffordabilityisaffectednotonlybyandFigure10B).theaveragecostofahealthydietandpeople’sincomes,butalsobyfactorssuchasplaceofOfthepeopleintheworldwhowereunableresidence,proximitytofoodmarkets,orfoodtoaffordahealthydietin2021,1.9billion,orproductionforownconsumption.Duetodata62percent,werefoundinAsia(Figure11).Intermslimitations,affordabilityestimatescannotcontrolofproportion,however,Africawastheregionforthesefactorsandmayoverestimate,insomewiththehighestproportionofthepopulationinstances,thecostofahealthydietforspecificthatcouldnotaffordahealthydietin2021populationsubgroups,andhencethenumber(78percent)comparedtoAsia(44percent),LatinofpeoplewhoseincomefallsbelowthecostAmericaandtheCaribbean(23percent),Oceaniathresholdforahealthydiet.n(3percent),andNorthernAmericaandEurope(1percent)(Table5).2.3THESTATEOFNUTRITION:Almost70percentofthepeopleinAfricawhoPROGRESSTOWARDSwereunabletoaffordahealthydietlivedinGLOBALNUTRITIONEasternandWesternAfrica.Consideredtogether,TARGETSthetwosubregionsreportedthehighestnumber(712million)andproportion(85percent)ofKEYMESSAGESpeoplewhowereunabletoaffordahealthydietinAfricain2021(Table5andFigure11).AhighèWorldwidein2022amongchildrenunderfiveyearsproportionwasalsofoundinMiddleAfricaofage,anestimated148.1million(22.3percent)were(82percent)in2021,followedbySouthernAfricastunted,45million(6.8percent)werewastedand(67percent)andNorthernAfrica(52percent),37million(5.6percent)wereoverweight.whosepercentagewaslowerthantheregionalaverage(78percent).èGlobalstuntingprevalencewas1.6timeshigherandwastingprevalence1.4timeshigherinruralversusInAsia,SouthernAsiashowedthehighesturbanareas.Theprevalenceofoverweightwasonlynumber(1.4billion)andproportion(72percent)slightlyhigherinurbanchildren(5.4percent)comparedofpeopleunabletoaffordahealthydietin2021,toruralchildren(3.5percent).farabovetheregionalaverageof44percent.InSouth-easternAsia,around55percentofèTherehasbeensteadyprogressinreducingstuntingpeoplecouldnotaffordthisdiet,andthenumbersince2012,buttheworldisstillnotontracktoachievehasbeenincreasingsince2019.the2030targetof13.5percent(50percentreductioninthenumberofchildrenwithstuntingfromthebaseline).Finally,inLatinAmericaandtheCaribbean,Inthetenyearssince2012,thenumberofchildrenwith63percentofthepeopleunabletoaffordahealthystuntingdeclinedbynearly30million.dietlivedinSouthAmerica,andonly12percentlivedintheCaribbean(Figure11).TheCaribbeanèReductioninwastingismakingsomeprogresswasthesubregionwiththelowestabsolutebutglobalprevalenceismorethantwicethe2030numberofpeople(15million)butthehighesttarget.Wastingamongchildrenwashighestinlow-proportionofthepopulation(57percent)unableandlower-middle-incomecountries(94percentofthetoaffordahealthydiet–morethantwicetheglobalburden).regionalaverage.TheindicatorsdescribedinthissectionandinAnnex2andAnnex3provideasnapshotofthe31CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDèGlobally,themajorityofoverweightchildrenwasadoptedbytheWHAaspartoftheGlobal(77percent)livedinlower-middle-andActionPlanforthePreventionandControlofupper-middle-incomecountriesin2022.IntermsofNCDsin2013.Onlytheindicatorsforstunting,progresstowardsthe2030targetoflessthan3percentwasting,overweight,exclusivebreastfeedingandprevalence,noregionswereontrackandonlyNorthernlowbirthweightwillbepresentedinthiseditionAmericaandEuropemadesomeprogresstowardsofthereport,asupdateddatawerenotavailablethetarget.foranaemiainwomenaged15to49yearsandadultobesity.èGlobally,therehasbeennosignificantchangeinlowbirthweightoverthelasttwodecades–16.6percentGlobaltrendsandburdenofmalnutritionin2000comparedwith14.7percentin2020–andnoregionisontracktoattainthe2030targetConflict,climatechangeandtheenduringofa30percentreductionsincethe2012baseline.secondaryeffectsoftheCOVID-19pandemicDatagapspresentachallengetotheglobalmonitoringcontinuetoaffectmalnutrition,birthweightsandoflowbirthweight,asnearlyoneinthreenewbornsincaringpracticeslikeexclusivebreastfeeding.theworldwerenotweighedatbirthin2020.The2022editionofthisreportpresentedmultiplepathwaysforthepandemictoimpactchildèSteadyprogresshasbeenmadeonexclusivenutritionalongwithpotentialrisksstemmingbreastfeeding,with47.7percentofinfantsundersixfromthewarinUkraine.Althoughtheeffectsmonthsofageexclusivelybreastfedworldwideinofthecurrentcrisesonmalnutritionarenotyet2021,upfrom37.0percentin2012.Anestimatedfullyreflectedintheupdatespresentedinthis75percentofexclusivelybreastfedinfantsliveinlow-editionofthereport,dueeithertodatasparsityororlower-middle-incomecountries.tothelong-termimpactofsomeofthenutritionaloutcomes,negativeimpactsonvariousformsèConflict,climatechangeandrisingfoodprices,ofmalnutritionareexpectedatthegloballevel.alongwiththepersistingeffectsoftheCOVID-19Anypotentialglobalconsequencesofthewarpandemic,allthreatenprogresstowardsachievingtheinUkraineonmalnutritionarealsoyettobe2030globalnutritiontargets.Coordinatedeffortsaremeasuredcomprehensively.Theglobaltrendsneededtoeliminatemalnutritioninallitsforms.inprevalenceandabsolutenumbersforfivenutritionindicatorsaresummarizedinFigure12.TheimportanceofnutritionandreportingontheSustainableDevelopmentGoalsThelatestestimateforlowbirthweightrevealsthat14.7percentofnewborns(19.8million)wereNutritionismentionedspecificallyinSDG2butbornwithlowbirthweight(lessthan2500g)initiscentraltotheachievementofall17SDGs,2020,anon-significantdeclinefrom16.6percentspecificallythoserelatedtohealth,education,(22.1million)in2000.Infantsbornweighinggenderequalityandtheclimate.32Thissectionlessthan2500gareapproximately20timespresentsanassessmentofglobalandregionalmorelikelytodiethanthosewithadequatelevelsandtrendsforglobalnutritiontargets.birthweight,33andthosewhosurvivefaceThereareupdatesonfiveofthesixnutritionlong-termdevelopmentandhealthconsequences,targetsinitiallyendorsedbytheWorldHealthincludingahigherriskofstunting,adiminishedAssembly(WHA)in2012tobeachievedbyintelligencequotient,andincreasedriskof2025,forwhichextended2030targetswereobesityanddiabetesasadults.34subsequentlyproposedbytheWorldHealthOrganization(WHO)andtheUnitedNationsOptimalbreastfeedingpractices,includingChildren’sFund(UNICEF).Fouroutofthesixexclusivebreastfeedingforthefirstsixmonthsindicatorswerealsoselectedtomonitorprogressoflife,arecriticalforchildsurvivalandthetowardsSDGTarget2.2,namelystunting,wastingpromotionofhealthandcognitivedevelopment.35andoverweightinchildrenunderfiveyearsofGlobally,theprevalenceofexclusivebreastfeedingage,andanaemiainwomenaged15to49years.amonginfantsundersixmonthsofagerosefromAseventhtargettohalttheriseinadultobesity37.0percent(24.3million)in2012to47.7percent(31.2million)in2021.Worldwide,overhalfofall32THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE12STUNTINGINCHILDRENUNDERFIVEYEARSOFAGEANDEXCLUSIVEBREASTFEEDINGHAVEIMPROVEDANDSOMEPROGRESSHASBEENMADEONWASTING,WHILELOWBIRTHWEIGHTANDOVERWEIGHTINCHILDRENUNDERFIVEYEARSOFAGEHAVENOTCHANGED60200022.150201221.640Low202019.833.047.7birthweight30201224.32016.6Exclusive202131.2108.75.337.0breastfeeding0(<6months)2000PERCENTAGE2000148.1177.9204.220122022Stunting(<5years)22.3200054.1201250.745.014.7Wasting2022(<5years)6.8200033.0201237.05.6Overweight202237.0(<5years)2012202020220255075100125150175200225MILLIONSNOTES:Wastingisanacuteconditionthatcanchangefrequentlyandrapidlyoverthecourseofacalendaryear.TheUNICEF-WHO-WorldBank:Jointchildmalnutritionestimatesdonotcurrentlyadjustforseasonalvariationthatcanaffectwastingprevalenceestimates.Theglobalestimatesofthenumberofchildrenwithwastingarebasedonnational-levelprevalencedatawhichcapturethecasesofwastingatagivenmomentintime.Assuch,thereportedestimatesdonotreflectthecumulativecasesofwastingovertheyear.SOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited24April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding;dataforlowbirthweightarefromUNICEF&WHO.2023.Lowbirthweightjointestimates2023edition.[Cited12July2023].https://data.unicef.org/topic/nutrition/low-birthweight;www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-low-birthweight-estimates.Theburdenestimatesbyindicatorarebasedondifferentdenominatorsincludingchildrenunderfiveyearsofageforstunting,wastingandoverweight,childrenundersixmonthsofageforexclusivebreastfeedingandlivebirthsforlowbirthweight.PopulationdataarebasedonUnitedNationsPopulationDivision.2022.WorldPopulationProspects2022.[Cited27April2023].https://population.un.org/wppinfantsundersixmonthsofagedonotreceivetheunderminethephysicalandcognitiveprotectivebenefitsofexclusivebreastfeeding.developmentofchildrenandincreasetheirriskofdyingfromcommoninfections.StuntingandStunting,theconditionofbeingtooshortforotherformsofundernutritionearlyinlifemayone’sage,isamarkerforlonger-termchronicalsopredisposechildrentooverweightandmalnutrition.ItiscausedbyacombinationofNCDslaterinlife.36Globally,theprevalenceofnutritionalandotherfactorsthatsimultaneouslystuntingamongchildrenunderfiveyearsof33CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDagehasdeclinedsteadily,fromanestimateddistributionoftheburdenbasedonthelatest33.0percent(204.2million)in2000to22.3percentclassificationofacountry’sincomegroup.(148.1million)in2022.ThedistributionsoftheglobalburdenforfiveChildwastingisalife-threateningconditionnutritionindicatorsbycountryincomegroupcausedbyinsufficientnutrientintake,poorarepresentedinFigure13.Foreachindicator,nutrientabsorptionand/orfrequentorprolongedthedistributionsin2012andintheyearforwhichillness.Affectedchildrenaredangerouslythemostrecentdataareavailablearepresentedtothin,withweakenedimmunityandahighershowchangesovertime.riskofmortality.37TheprevalenceofwastingamongchildrenunderfiveyearsofagedeclinedLICsandLMICstogethercarriedthebruntofthenon-significantlyfrom8.7percentin2000tolowbirthweightburdenamongnewbornsinboth6.8percentin2022.Theestimatednumberof2012and2020–atotalof84percentoftheglobalchildrenwithwastingdeclinedfrom54.1millionburdenoflowbirthweightin2020–whilethetwoin2000to45.0millionin2022,butitisimportantcountryincomegroupstogetherrepresentedonlytonotethatthesearepointestimatesandnot70percentofglobalannualbirths.Overall,therepresentativeofthecumulativenumberofdistributionoftheburdenacrossincomegroupscasesofwastingovertheyear.Theglobalremainedsimilarbetween2012and2020.Theprevalence-basedestimatesofchildrenunderproportionoflowbirthweightinLICsincreasedfiveyearsofageaffectedbywastingfromthefrom15percentto18percent,inparallelwiththeUNICEF-WHO-WorldBank:Jointchildmalnutritionfastestglobalpopulationgrowth.estimatesshouldbeconsideredunderestimatesoftheannualburden.WastingisanacuteWorldwide,thelargestproportionofexclusivelyconditionthatcanchangerapidlyandisaffectedbreastfedinfantsliveinLICsorLMICs,andthebyseasonalchangesinmanycontexts.38,39combinedestimatedidnotchangefrom2012Thismakesreliablenationaltrendsovertimeto2021(75percent).Thegreatestproportionofchallengingtoestimateandinterpret.exclusivelybreastfedchildrenisfoundinLMICs(55percent),whilethesecountriesrepresentChildrenwhoareoverweightorobesefaceonly52percentoftheoveralltargetpopulation.bothimmediateandpotentiallylong-termForHICs,therewereinsufficientdatatoexaminehealthimpacts.Immediateimpactsincludetheportionofexclusivelybreastfedinfants;respiratorydifficulties,increasedriskoffractures,thus,theproportionalcontributionofHICstohypertension,earlymarkersofcardiovasculartheglobaltotalispresentedas“estimatesnotdisease,insulinresistanceandpsychologicalavailable”inFigure13.effects.40AffectedindividualsalsohaveahigherriskofNCDslaterinlife.ChildoverweighthasTheproportionofstuntinginchildrenunderfivebeenontheriseinmanycountries,hastenedyearsofageincreasedinLICsfrom21percentinbyincreasinglyinadequatelevelsofphysical2012to26percentin2022,whiletheproportionofactivityandincreasedaccesstohighlyprocessedchildrenunderfiveyearsofageinthesecountriesfoods,whichtendtobehighinenergy,fats,freeincreasedfrom14percentto17percent.ForLICssugarsand/orsalt.23Globally,theprevalenceandLMICscombined,theproportionofstuntedofoverweightamongchildrenunderfiveyearschildrenincreasedfrom88percentin2012toofageshowedanon-significantincreasefrom90percentin2022,whilethesecountryincome5.3percent(33.0million)in2000to5.6percentgroupsonlyrepresented64percentofallchildren(37.0million)in2022.Thepersonal,communityunderfiveyearsofagegloballyin2012andandsocietalcostsofoverweightandobesityare68percentin2022.heavyandareincreasingglobally.41Astheydoforlowbirthweightandstunting,NutritionacrosscountryincomegroupsLICsandLMICsalsobearthegreatestburdenTheglobalburdenofmalnutritionvariesofwasting.Thesegroupscomprisedacombinedsubstantiallyacrosscountryincomegroupstotalof92percentin2012and94percentin2022andovertime.Theseanalysesexaminetheofallwastedchildrenunderfiveyearsofage,34THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE13LOW-ANDLOWER-MIDDLE-INCOMECOUNTRIESBEARTHEGREATESTBURDENOFSTUNTING,WASTINGANDLOWBIRTHWEIGHT,BUTALSOHAVETHELARGESTPROPORTIONOFEXCLUSIVELYBREASTFEDCHILDREN;MOSTOVERWEIGHTCHILDRENLIVEINLOWER-MIDDLE-ORUPPER-MIDDLE-INCOMECOUNTRIESPopulationdistributionofchildrenunderﬁveyearsofageDistributionofannualbirthsbycountryincomegroup,bycountryincomegroup,global2012and2022global2012and2020POPULATION201214%50%26%10%201215%50%26%9%DISTRIBUTION(675M)(144M)202217%51%22%9%202018%52%21%9%(663M)(135M)Distributionofchildrenunderﬁveyearsofageaectedbystunting,Distributionoflowbirthweightbirthsbycountryincomegroup,wastingandoverweight,bycountryincomegroup,2012and2022global2012and2020STUNTING201221%67%10%2%LOW201267%13%5%(178M)26%64%BIRTHWEIGHT(21.6M)15%SHAREOFCHILDRENAFFECTED8%2%BYNUTRITIONSTATUS2022202018%66%12%5%(148M)(19.8M)OVERWEIGHTWASTING201275%8%(51M)17%202276%6%1%Distributionofexclusivelybreastfedinfantsundersixmonths(45M)18%ofage,bycountryincomegroup,global2012and2021201210%39%38%14%EXCLUSIVE201221%54%16%n.a(37M)42%BREASTFEEDING(22.5M)202211%35%13%55%16%n.a.(37M)202120%(28.7M)020406080100020406080100PERCENTAGEPERCENTAGELow-incomecountriesLower-middle-incomecountriesUpper-middle-incomecountriesHigh-incomecountriesNOTES:n.a.=estimatesnotavailable.Thepercentagesinthebargraphsrefertotheproportionofthepopulation/affectedpopulationinthefourcountryincomegroupsfromthefiscalyear2023WorldBankincomeclassificationwhilethenumbersinmillions(depictedbeloweachyear)arealignedwithglobalestimates.Thedistributionofaffectedpopulationisrelativetothetotalnumberaffectedacrossthefourcountryincomegroupsexceptforexclusivebreastfeeding;thisvariesfromtheglobaltotals(depictedbeloweachyear),whicharealignedwithglobalestimatesusedelsewhereinthisreport.Thesumsofthefourcountryincomegroupsareasfollows:stunting2012=177.4million,2022=147.7million;wasting2012=47.7million,2022=42.8million;overweight2012=36.9million,2022=36.8million;lowbirthweight2012=21.6million,2020=19.8million.Thepercentagesfordistributionofchildrenunderfiveyearsofage(2022),wasting(2022),overweight(2012and2022)andlowbirthweight(2020)donotaddupto100percentduetorounding.Duetospacelimitations,thepopulationdistributionforinfantsundersixmonthsofagein2012and2021isnotshown,butthedistributionsarethesameasforannualbirthsin2020andonlyvaryfrom2012birthsinhigh-incomecountriesforwhichtheproportionforinfantsundersixmonthsofagewas10percentin2012.Exclusivebreastfeedingestimatesarenotavailableforhigh-incomecountries,sotheircontributiontotheglobaltotalispresentedasn.a.andthesumsrepresentthreecountryincomegroups.SOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited24April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding;dataforlowbirthweightarefromUNICEF&WHO.2023.Lowbirthweightjointestimates2023edition.[Cited12July2023].https://data.unicef.org/topic/nutrition/low-birthweight;www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-low-birthweight-estimates.PopulationdataarebasedonUnitedNationsPopulationDivision.2022.WorldPopulationProspects2022.[Cited27April2023].https://population.un.org/wppdespiterepresentingonly68percentoftheglobalacrosscountryincomegroupsoftheburdenofpopulationunderfiveyearsofagein2022.overweightamongchildrenunderfiveyearsofagechangedmarginallybetween2012and2022,TheproportionofoverweightchildreninLICswithasmallincreaseinthenumberofoverweightandLMICscombinedincreasedfrom49percentchildrenresidinginLMICsandasmalldeclinein2012to53percentin2022.WhilethesechangesinnumbersofoverweightchildreninUMICs.weremarginal,theyillustratetherisingthreatsThemajorityofoverweightchildren(77percent)ofoverweightandobesityamongpopulationsofliveinLMICsandUMICs.lowercountryincomegroups.Thedistribution35CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDTheanalysispresentedindicatesthatLICsandtargetofa13.5percentstuntingprevalenceLMICsarehometothemajorityofinfantswhoin2030,however,theprevalenceneededtobenefitfromexclusivebreastfeeding.Italsoreach18.2percentin2022.StrongprogresshighlightsthatLICsandLMICscombinedcarryhasbeenmade,butlargerinvestmentsinthegreatestburdenforlowbirthweight,stunting,nutrition-appropriatepoliciesandactionsacrosswastingandoverweight.multiplesystemswillberequiredtoensuregreaterstridesaremadeinreducingstunting.Progresstowardsendingallformsofmalnutritionby2030TheglobalprevalenceofwastingamongchildrenunderfiveyearsofagedidnotchangeGlobalprogresssignificantlyfrom2012to2022,decliningfromGlobalprogresstowardsthefivenutrition7.5percentto6.8percent.The2022estimateis2030targetsforwhichindicatorshavebeenmorethandoublethe2030targetoflessthanupdatedissummarizedinFigure14.The2020low3percent.Theseresultssignalthatgreaterbirthweightprevalenceof14.7percenthasnottargetingofresourcesisneededtowardsthosedeclinedquicklyenoughtobeontrackforthecountrieswiththehighestburdentoincrease2030targetofa30percentreductionfromthetheiraccesstoessentialactionsfortheprevention2012baseline.Theavailablelowbirthweightofchildwastingacrossmultiplesystems,datasufferfromdataqualityissues,especiallyincludinghealth,waterandsanitation,education,amongcountriesthataremostlikelytohaveandsocialpolicy.Toensureachievementofthehighprevalence,andnearlyoneinthreeglobaltargets,scalingupofearlydetection,newbornsintheworldwerenotweighedatoptimizedtreatments,andmonitoringandbirthin2020.Improvementsinlowbirthweightdeliveryofeffectiveservicesforreducingchilddataqualityandrepresentativenessareneededwastingareneeded,aspertheGlobalActiontoassesstheseverityandmagnitudeofthePlanonChildWasting.44problemmorereliably.Toachievethe2030targetof3percentforchildTheproportionofexclusivelybreastfedinfantsoverweight,ashiftisrequiredinthedirectionofundersixmonthsofageincreasedfromtheglobaltrend.Theprevalenceofoverweight37.0percentin2012to47.7percentin2021.remainedstagnantat5.5percentin2012andAlthoughthisisclosetothe50percenttarget5.6percentin2022.Toaddressoverweightandfor2025,theworldisnotontracktoachieveobesityintheyoungestagegroups,itiscriticalthe2030targetofatleast70percent.Toachievetoinvestineffectivepromotionandadoptionofthistarget,sustainedinvestmentisneededinpositivehabitsincludinghealthyfeedingpatterns,effectiveinterventionsthatpromotetheadoptionavoidingeasyaccesstofoodshighinsugars,andcontinuationofexclusivebreastfeeding(suchsaltandfats,aswellasactiveplayandotherasadequatepaidmaternityleaveandworkplacetypesofphysicalactivity.45policiestoensurenearbyaccesstoqualitychildcare,breastfeedingbreaksanddedicatedRegionalprogressnursingspaces),alongwithgreaterprotectionThissectionpresentsanassessmentoftheandsupportforbreastfeedinginemergencyprogresstowardsthe2030globalnutritiontargetscontexts.Enactmentandenforcementoftheattheregionalandsubregionallevels.TheInternationalCodeofMarketingofBreastmilkregionalandsubregionalanalysisisbasedonSubstitutes,42institutionalizationofthetheannualaveragerateofreduction46observedBaby-friendlyHospitalInitiative,43andscalingfromtrendsbetweenthebaselineandthemostupofantenatalandpostnatalbreastfeedingrecentyearoftheindicator,comparedtotheratecounsellingwillalsohelpcountriestoreachtheirofreductionneededbetween2012and2030toindividualtargets.reachtheglobaltargets.ProgressiscalculatedastheprogressachievedversusthechangeStuntinginchildrenunderfiveyearsofrequiredtobringtheindicatorstothedesiredagedecreasedfrom26.3percentin2012tolevels(Table6).(Themethodologyisdescribedin22.3percentin2022.TobeontrackfortheAnnex2,SectionF.)36THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE14THEGLOBALTRENDSINSTUNTING,WASTING,EXCLUSIVEBREASTFEEDINGANDLOWBIRTHWEIGHTMUSTBEACCELERATED,WHILEFOROVERWEIGHTINCHILDRENTHEYWILLHAVETOBEREVERSED,TOACHIEVETHE2030GLOBALNUTRITIONTARGETS802025WHAGlobalNutritionTargets70.02025targetsextendedto2030tobe70alignedwiththeSDGtimeline6050.05047.7PERCENTAGE4037.0201220203026.3202522.32030201216.4202113.520252030201220222025203020122022202520302012202220252030207.56.85.05.515.014.73.010.510.5105.55.63.00LowExclusiveStuntingWastingOverweightbirthweightbreastfeeding(<5years)(<5years)(<5years)(<6months)NOTE:WHA=WorldHealthAssembly.SOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited24April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding;dataforlowbirthweightarefromUNICEF&WHO.2023.Lowbirthweightjointestimates2023edition.[Cited12July2023].https://data.unicef.org/topic/nutrition/low-birthweight;www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-low-birthweight-estimates.Thetargetsaredrawnfrom:UNICEF&WHO.2017.Methodologyformonitoringprogresstowardstheglobalnutritiontargetsfor2025–technicalreport.NewYork,USAandGeneva,Switzerland.https://data.unicef.org/resources/methodology-for-monitoring-progress-towards-the-global-nutrition-targets-for-2025;andUNICEF&WHO.2019.Theextensionofthe2025Maternal,InfantandYoungChildnutritiontargetsto2030.NewYork,USAandGeneva,Switzerland.https://data.unicef.org/resources/who-unicef-discussion-paper-nutrition-targetsForlowbirthweight,noregionisontracktoreachbirthweight,itistheregionwheresomeprogressthe2030targetsandglobalprogressisofftrackisbeingachievedinthreeoutoffivesubregions.(noprogressorworsening).OnlyAfricamademodestprogress(offtrack–someprogress)andAtthegloballevel,therehasbeensomeprogresstheremainingregionshavemadenoprogress(offtrack–someprogress)towardsreaching(offtrack–noprogressorworsening)towardsthe2030targetforexclusivebreastfeeding.the30percentreductioninprevalenceoflowAttheregionallevel,Africa,Asia,andLatinbirthweight.DespiteAfricabeingoneoftheAmericaandtheCaribbeanhaveallachievedtworegionswiththehighestprevalenceoflowsomeprogress(offtrack–someprogress).37CHAPTER2FOODSECURITYANDNUTRITIONAROUNDTHEWORLDTABLE6ALLREGIONSMADESOMEPROGRESSTOWARDSTHESTUNTING,WASTINGANDEXCLUSIVEBREASTFEEDING2030TARGETSEXCEPTOCEANIAEXCLUDINGAUSTRALIAANDNEWZEALANDChildChildChildLowExclusivestuntingoverweightwastingbirthweightbreastfeeding(%)(%)(%)(%)(%)20122022203020122022203020222030201220202030201220212030WORLD26.322.35.55.66.815.014.737.047.7AFRICA34.430.05.04.95.814.513.935.444.3NorthernAfrica23.521.711.812.36.314.014.140.8n.a.Sub-SaharanAfrica36.231.33.83.75.714.513.934.445.138.630.63.93.65.014.714.048.659.1EasternAfrica37.937.44.54.65.612.812.228.444.4MiddleAfrica23.422.812.311.43.516.416.4n.a.32.8SouthernAfrica34.530.02.32.46.714.914.322.135.1WesternAfrica28.222.34.85.19.317.217.239.051.5ASIA39.329.42.92.913.725.423.546.559.4CentralAsiaandSouthernAsia14.78.25.02.129.244.9CentralAsia40.37.72.72.814.36.36.047.260.2SouthernAsia16.030.56.58.04.226.124.430.341.5EasternAsiaandSouth-easternAsia13.96.68.31.528.435.3EasternAsia7.76.47.47.88.18.733.448.3South-easternAsia30.44.99.17.23.55.55.531.931.7WesternAsia19.126.410.49.84.912.812.537.2n.a.WesternAsiaandNorthernAfrica21.214.012.212.2LATINAMERICAAND17.91.413.113.1THECARIBBEAN12.7Caribbean11.57.48.62.99.59.634.342.6CentralAmerica13.01.0SouthAmerica18.211.36.56.61.411.411.729.431.4OCEANIAEXCLUDINGAUSTRALIA10.116.96.66.710.910.921.737.7ANDNEWZEALAND7.99.78.342.246.8AustraliaandNewZealand40.99.08.68.8NORTHERNAMERICAANDEUROPEn.a.NorthernAmerica3.444.09.313.9n.a.17.417.956.659.5Europe4.20.22.63.412.419.3n.a.6.46.4n.a.n.a.5.13.89.07.67.47.4n.a.n.a.3.68.68.28.08.125.525.84.09.27.37.17.0n.a.n.a.Legendforstunting,wastingandoverweightLegendforlowbirthweightandexclusivebreastfeedingOntrackOntrackOfftrack–someprogressOfftrack–someprogressOfftrack–noprogressOfftrack–noprogressorworseningOfftrack–worseningAssessmentnotpossibleAssessmentnotpossibleNOTES:DetailsonthemethodologytoassessprogresscanbefoundinAnnex2,SectionF;n.a.iswherepopulationcoverageisunder50percent.ThecombinedregionsofNorthernAmericaandEuropehadalowerboundconfidenceintervalof3.1percentforstuntingin2022andwereprojectedtohavealowerboundconfidenceintervalbelow3percentby2030;theywerethereforecategorizedas“ontrack”.SOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited24April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding;dataforlowbirthweightarefromUNICEF&WHO.2023.Lowbirthweightjointestimates2023edition.[Cited12July2023].https://data.unicef.org/topic/nutrition/low-birthweight;www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-low-birthweight-estimates.Thetargetsaredrawnfrom:UNICEF&WHO.2017.Methodologyformonitoringprogresstowardstheglobalnutritiontargetsfor2025–technicalreport.NewYork,USAandGeneva,Switzerland.https://data.unicef.org/resources/methodology-for-monitoring-progress-towards-the-global-nutrition-targets-for-2025;andUNICEF&WHO.2019.Theextensionofthe2025Maternal,InfantandYoungChildnutritiontargetsto2030.NewYork,USAandGeneva,Switzerland.https://data.unicef.org/resources/who-unicef-discussion-paper-nutrition-targets38THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Considerableimprovementshavebeenmadecouldbeunderestimatedduetovariousfactors,inEasternAfricaandSouthernAsiawithasmentionedatthebeginningofthissection.exclusivebreastfeeding,bothofwhichareonAchievingthe2030globalnutritiontargetstracktoreachtheirtargets.Subregionsthatrequiresstrongerandmoreconcertedeffortsarenotprogressing(offtrack–noprogressortopreventglobalsetbacks.Theglobaltrendsworsening)includetheCaribbean,Oceaniainstunting,wasting,exclusivebreastfeedingexcludingAustraliaandNewZealand,Northernandlowbirthweightmustbeaccelerated,AmericaandWesternAsia.Thesubregionswhileforoverweightinchildrentheywillwithinadequatedata(assessmentnotpossible)havetobereversed,toachievethe2030globalincludeAustraliaandNewZealand,Europe,nutritiontargets.NorthernAfricaandSouthernAfrica.Urban–ruraldifferencesinGlobalestimatesshowsomeprogress(offtracknutritionindicators–someprogress)towardsreachingthestuntingreductiontarget.NorthernAmericaandEuropeInthepast,urbanchildrenheldadistinctareontrack.AllotherregionsexceptOceaniaadvantageofbeingbetternourishedthanruralexcludingAustraliaandNewZealandachievedchildren.47Thehigherincomesandimprovedsomeprogress(offtrack–someprogress)onfoodaccessandavailabilityassociatedwithurbanstuntingreduction.ThesubregionsconsideredresidenceallowedchildrentoobtainmoreregularontrackforstuntingincludeAustraliaandNewanddiversedietsaswellasaccesstohealthZealand,CentralAsia,EasternAsia,Europeandservices,potablewaterandsanitation.ButwithNorthernAmerica.Theremainingsubregionscontinuedurbanizationandtherapidriseinaremakingsomeprogressonstuntingwiththeurbanpoor,thereisnowalargerpopulationexceptionofMiddleAfricaandSouthernAfrica.dependentonthemosteasilyavailableandinexpensivefoodswhichareoftennotnutritiousForwastingatthegloballevel,someprogressorhygienic,increasingtheriskofmalnutrition.(offtrack–someprogress)hasbeenachieved,withLatinAmericaandtheCaribbeanontrackRuralpopulationsoftendependonagriculturefortoreachthe2030target.Amongthesubregions,theirlivelihoods.Atthesametime,thepoorestthoseontrackaretheCaribbean,CentralpopulationsaretypicallyfoundinagriculturalAmerica,CentralAsia,EasternAsia,Northernregionsacrossandwithincountries.Hence,whenAmericaandSouthAmerica.AfricaandAsiahaveotherlabouropportunitiesarise,peopleoftenmadesomeprogress(offtrack–someprogress)tomoveawayfrompoorlycompensatedagriculturaladdressthisdangerousconditioninregionswithwork,whichreinforcestheparadoxthatinthehighestprevalence.agriculturalregions,thepopulationandnotablyitschildrenaremorelikelytobemalnourished.48TherehasbeennoprogressinreducingInfact,ithasbeendemonstratedthatproximityoverweightinchildrentomeetthe2030targettoagriculturalfoodproductiondoesnottranslateatthegloballevel(offtrack–noprogress).intohealthierdietsforchildren.The2022reportTheprevalenceofoverweightisworseninginonchildfoodpovertyfoundahigherprevalenceAsia,AustraliaandNewZealand,LatinAmericaofseverefoodpoverty(consumingfoodsfromandtheCaribbean,andOceaniaexcludingonlytwofoodgroupsorlessperday)amongAustraliaandNewZealand.Thesituationischildrenlivinginruralareas.49comparativelybetterinAfrica;theregionisstillofftrack(noprogress),butwithanon-significantUrban–ruraldifferencesinstuntingandreductioninoverweightinchildrenunderwastingariseinpartfromdisparitiesinaccessfiveyearsofage.tohealthcare,water,sanitationandahygienicenvironment.50ImplementationofkeypublicGreatachievementshavebeenmadeinpromotinghealthinterventionsacrossthecontinuumofexclusivebreastfeedingandreducingstunting,carehelpstoimprovethehealthandnutritionalbuttheresultsvaryacrossregions.Malnutritionstatusofchildrenandmothers,throughprovisioninallitsformsisfoundacrossallregionsandofcareatfirst-linehealthfacilities.Improved39CFHIGAUPRTEE1R52TFHOEODPRSEEVCAULREITNYCAENODFNSUTUTRNITTIINOGNAANRODUWNADSTTHINEGWWOARSLDHIGHERINRURALCOMPAREDTOURBANAREAS,WHILEOVERWEIGHTWASMORECOMMONLYFOUNDINURBANAREASExclusivebreastfeedingStunting(<6months)(<5years)AfricaAfricaAsiaAsiaLatinAmericaLatinAmericaandandtheCaribbeanNorthernAmerica,theCaribbeanEurope,AustraliaNorthernAmerica,andNewZealandEurope,AustraliaOceaniaexcludingandNewZealandAustraliaandNewZealandOceaniaexcludingAustraliaandWorldNewZealand30World4050607001020304050PERCENTAGEPERCENTAGEWastingOverweight(<5years)(<5years)AfricaAfricaAsiaAsiaLatinAmericaandLatinAmericaandtheCaribbeantheCaribbeanNorthernAmerica,NorthernAmerica,Europe,AustraliaEurope,AustraliaandNewZealandandNewZealandOceaniaexcludingOceaniaexcludingAustraliaandAustraliaandNewZealandNewZealandWorldWorld05101520024681012PERCENTAGEPERCENTAGERuralUrbanNOTES:Theregionalestimatesforurbanandruralareaspresentedarebasedonapopulation-weightedanalysisofasubsetofcountrieswithdisaggregateddataavailableonplaceofresidenceusingthelatestavailabledatafromnationalsurveysbetween2015and2021forexclusivebreastfeedingandbetween2016and2022forstunting,wastingandoverweight.Regionswithlessthan50percentpopulationcoveragearenotconsideredrepresentativeandresultsaresupressed.IntheurbanestimatesforAsia,stuntingandwastingarebasedon49percentpopulationcoverage.LatinAmericaandtheCaribbeanexcludingBrazil.SOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited24April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding.PopulationdataarebasedonUnitedNationsPopulationDivision.2022.WorldPopulationProspects2022.[Cited27April2023].https://population.un.org/wpp.Rural/urbandataarefromUnitedNationsPopulationDivision.2018.WorldUrbanizationProspects2018.[Cited27April2023].https://population.un.org/wup40THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023sanitationandhygienepracticescanmakeForstunting,therearemajorrural–urbansignificantdifferencesinhaltingthecycleofdifferencesgloballyandinthreeofthefiveinfectiousdiseaseandundernutrition.regions.InAfrica,Asia,andLatinAmericaandtheCaribbean,theprevalenceofstuntinginruralSince2000,asurbanpopulationshaveundergoneareasis9to15percentagepointshigherthaninthenutritiontransition,nutrition-relatedNCDs–urbanareas.Globally,theprevalenceofstuntingincludingobesity,diabetesandhypertension–ishigherinruralareas(35.8percent)thaninhavecausedalargerproportionofdeathurbanareas(22.4percent).anddisabilitycomparedtoundernutrition.51Worldwide,ruralpopulationsarenowWastingpresentedasimilardistribution,withundergoingthesametransition,andinsometheglobalprevalencesignificantlyhigherinareasarebeginningtoshowhigherprevalenceofruralareas(10.5percent)thaninurbanareasoverweightandobesitycomparedtourbanareas.52(7.7percent).InAsia,thereisasignificantTheunfinishedagendastoreducestunting,differenceinwastingbetweenrural(14.3percent)wastingandmicronutrientdeficiency,alongandurban(11.8percent)areas.Norural–urbanwithrisingoverweightandobesity,representdifferenceswerefoundinAfricaorLatinAmericathecurrentchallengetoaddressmultipleformsandtheCaribbean.ofmalnutrition.Malnutritioninallitsformsisrelatedtopoordiets,theriseoflow-costForchildoverweight,therearesmallbutnutrient-poorfoodsandtheincreasingavailabilitysignificantdifferencesbyrural–urbanresidenceofhighlyprocessedfoodsinruralareas.53,54thatserveasanimportantalert.InAsiaandglobally,overweightprevalencewasnearlyFigure15presentstheprevalenceoffournutritiontwopercentagepointshigherinurbanareasindicatorsinruralandurbanareas.(5.3percentinAsiaand5.4percentglobally)thaninruralareas(3.5percentinboth).TheThedefinitionsofruralandurbanresidenceusedhighestreportedregionalprevalencein2022wasintheanalysisarebasedonnationaldefinitionsamongchildrenresidinginurbanareasofLatinrecordedinnationalmastersampleframesAmericaandtheCaribbean(9.1percent).Currentemployedtogeneratesurveysamples.jThecriteriaresultswerenotavailableinthemosturbanizedarecommonlybasedonpopulationsize,rangeofsubregions,namelyAustraliaandNewZealand,economicactivitiesundertaken,whethertheareaEuropeandNorthernAmerica.hasbeenassignedanadministrativefunction,oracombinationofthesecharacteristics.ForTheresultsfromtheseanalyseshelptoidentifymoreinformationonrural–urbanclassification,vulnerablepopulationgroups,contributingtoseeBox3inChapter3.evidencetoinformdecision-makingandeffectiveactionthroughtheappropriatetargetingandTheprevalenceofexclusivebreastfeedingisdesignofpoliciesandprogrammes.SoundsignificantlyhigherinruralAsia(58.6percent)nutritionisfundamentaltotheachievementofthaninurbanAsia(50.2percent).NosignificanttheSustainableDevelopmentGoalsandmustbedifferenceswerefoundinexclusivebreastfeedingcentralingovernmentpolicyandsupportedbybyareaofresidenceinAfrica,LatinAmericakeystakeholders,includingcivilsocietyandtheandtheCaribbean,andOceaniaexcludingprivatesector.nAustraliaandNewZealand.Globally,exclusivebreastfeedingishigherinruralareas(53.9percent)thaninurbanareas(45.3percent)withthedifferencesborderingonstatisticalsignificancebutclearlyindicatingpublichealthsignificanceforthemillionsofchildrenwhobenefitfromexclusivebreastfeeding.jTherefore,therural–urbanclassificationsarenotentirelycomparableacrosscountries,asaretheDEGURBAclassificationsusedinSection2.1andtheURCAclassificationusedinChapter3(seeBox3).41PALESTINEAmantendstothevegetablegardenontherooftopofhishome–increasingaccesstofoodbyimprovinghousehold-levelproduction.©FAO/MarcoLongariCHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMSANDAFFECTINGACCESSTOAFFORDABLEHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMKEYMESSAGESèUrbanizationisoftenassociatedwithadiversificationofdiets,includingincreasedconsumptionèGrowingurbanizationisamegatrendthat,combinedofdairy,fish,meat,vegetables,fruitsandlegumes–withchangesinincomes,employmentandlifestyles,foodsthatcancontributetoahealthydiet.isdrivingchangesthroughoutagrifoodsystemsacrosstherural–urbancontinuum,fromfoodproduction,èButtherearechallenges:i)theavailabilityoffoodprocessing,fooddistributionandprocurement,tovegetablesandfruits,inparticular,isinsufficientconsumerbehaviour.tomeetthedailyrequirementsofahealthydietinalmosteveryregionoftheworld;andii)urbanizationèThesechangesrepresentbothchallengesandcontributestothespreadofconvenience,pre-preparedopportunitiestoensureeveryonehasaccesstoandfastfoods,oftenenergydenseandhighinfats,affordablehealthydiets.Challengesincludethesugarsand/orsalt,whichareincreasinglyabundantandincreasingavailabilityofcheap,energy-denseandalsocheaper.highlyprocessedfoodsandtheexclusionofsmallfarmersfromformalizingvaluechains.ButthereareèTheincreaseddemandforhigh-valuecrops,suchasalsoopportunitiesforincreasedemploymentalongthefruitsandvegetablesandprocessedproducts,includingfoodvaluechainsandimprovementsinthevarietyofinruralareas,hasledtosignificantgrowthinlonger,nutritiousfoods.moreformalandcomplexfoodvaluechains,providinggreaterincomeopportunitiesforoff-farmemployment,èThecentralityoflargecitiestothetransformationespeciallyforwomenandyouth.ofagrifoodsystemsischallengedbythefactthat,duetourbanization,nowadaysone-fourthoftheglobalèSupply-sidefactors,includingglobalizedtechnologypopulationliveinperi-urbanareasofintermediateandinfoodproduction,transportationandmarketing,smallcitiesandtowns,whichcanserveasimportantcoupledwithanincreaseindemandforreadilyavailablenodesinstrengtheningrural–urbanlinkagesandthefoods,havecontributedtoasubstantialexpansionfunctioningofvaluechains.ofsupermarkets,hypermarkets,fooddeliveriesandotherconvenienceretailers.However,theseareèMoreover,withtheconvergenceofhighfoodalsoassociatedwithincreasedsupplyandspreadofpurchasesinbothperi-urbanandruralareas,whereenergy-denseandhighlyprocessedfoods.almosthalfoftheglobalpopulationlive,marketsintheseareasareasignificantdriverofagrifoodsystemstransformation.43CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>èAsurbanareasandruralareasbecomemoreFigure16.Thisprocessisfast-changing,contextinterlinked,ruralproducersoftenhavebetteraccessspecificanddrivenbyintertwinedfactors,toagriculturalinputsandservices,allowingforincludingdiverseeconomicdevelopmentsimprovedproductivity,whichtypicallyincreasesincome(e.g.increasingagriculturalproductivity),levels.However,therearealsorisksthatsmall-scalepolicychoices,availabilityofnaturalresources,producersinperi-urbanareasmaylosetheirlandstoandexternalstressorssuchasconflict,climateurbanexpansion.extremesorenvironmentaldegradation.èOverall,accesstoaffordablehealthydietsandManypartsoftheworldhaverapidlyurbanizedfoodsecurityarebetterincitiesthaninruralareas,sincetheSecondWorldWar,withtheurbansharealthoughthisgeneralizationiscomplicatedbytheoftheworld’spopulationrisingfrom30percentinsocioeconomicdisparitiesindietaffordabilityandfood1950to57percentin2021.Itisprojectedtoreachsecuritythatexistwithinurbanareasandacrossthe68percentby2050.1Inmostregions,thishasrural–urbancontinuum.beenlargelydrivenbystructuraltransformation,whichentailsaneconomictransformationfromUrbanization,combinedwithothercontextualmainlyagriculturetoamorediversifiednationalfactorssuchasrisingincomes,employmentandeconomy,intheprocessattractingruralpeoplechanginglifestyles,isdrivingchangesthroughouttourbanareas.2agrifoodsystemsacrosstherural–urbancontinuum,includingfoodproduction,foodThestructuraltransformationofeconomiesisprocessing,fooddistributionandprocurement,characterizedbyimprovementsinproductivity,andconsumerbehaviour.Thesechangesmayespeciallyoflabour,andchangesintherelativealsoleadtodisparitiesacrossthiscontinuum,importanceofsectorsthroughthereallocationwithbothpositiveandnegativeeffectsontheofproductionfactorssuchaslabourandcapital.3availabilityandaffordabilityofhealthydiets,andThisentailsfourinterrelatedprocesses:i)ainturn,onfoodsecurityandnutritionoutcomes.decliningshareofagricultureingrossdomesticproduct(GDP)andemployment,andagradualThischapterfirstexaminesthedrivers,patternsshiftofjobsfromtheprimaryagriculturesectoranddynamicsofurbanization,throughatosecondaryandtertiarysectorjobs,typicallyrural–urbancontinuumlens.Itthenpresentslocatedinurbanareas;ii)rural-to-urbanaconceptualframeworktounderstandthemigration;iii)theriseofamodernindustrialandpathwaysthroughwhichurbanizationisserviceeconomy;andiv)ademographictransitionaffectingagrifoodsystemsacrosstherural–urbanfromhightolowratesofbirthsanddeaths.2,4,5,6continuum.Last,thechaptersummarizesthechallengesandopportunitiesthaturbanizationAstherelationshipbetweenagricultureandtheandtheassociatedagrifoodsystemschangescanrestoftheeconomychanges,ruraltransformationposeforaccesstoaffordablehealthydiets.noccurs.Thelatterreferstotheprocessofinclusiveandsustainableimprovementsinrural3.1livelihoodsfollowingrisingproductivityofDRIVERS,PATTERNS(smallholder)agriculture,increasingmarketableANDDYNAMICSOFsurpluses,risingoff-farmemploymentURBANIZATIONopportunitiesinruralareas,betteraccesstoservicesandinfrastructurealsoinruralareas,Driversofurbanizationandthecapacitytoinfluencepolicy,embeddedinnationalprocessesofeconomicgrowthandUrbanizationistheresultofurbanpopulationstructuraltransformation.7Thisprocessinvolvesgrowth,urbanexpansion(i.e.reclassificationofastrengtheningofrural–urbanlinkages,whichruralareastoperi-urbanorurban)andmigrationconnectagricultureandotheractivitiesinthefromruraltourbanareas,asconceptualizedinruraleconomytothemanufacturingandservicesectorsastheyexpandintourbancentres.3Growthinnon-farmsectorsandshiftsinthelabourforceoutoffarmingarethenexpectedto44THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE16DRIVERSOFURBANIZATIONECONOMICANDSTRUCTURALReduceddemandURBANEXPANSION:TRANSFORMATIONforgoodsandservicesreclassiﬁcationinruralareasofruraltourbanDecliningIncreasingagriculturalruralemploymentRuraloutmigrationproductivitytopursue(perceived)opportunitiesurbanemploymentAND/ORopportunitiesURBANIZATIONIMPACTSONAGRIFOODSYSTEMSPOOR/DECLININGRURAL+Remittances,knowledge,LIVINGCONDITIONSsocialnetworksURBANPOPULATION–DecreasinglabourforceGROWTHEnvironmentaldegradation,highpopulationgrowth,availabilitypoverty,unemployment,foodinsecurity,climateextremes,conﬂictSOURCE:deBruin,S.&Holleman,C.2023.Urbanizationistransformingagrifoodsystemsacrosstherural–urbancontinuumcreatingchallengesandopportunitiestoaccessaffordablehealthydiets.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-08.Rome,FAO.graduallycontributetolandconsolidationandsmalllandlockedcountries,havelowerlevelsrisingfarmsizes.ImprovementsinagriculturalofurbanizationthanexpectedconsideringtheirproductivityareanecessaryconditionforsuchrelativelyhighGDPpercapita.aprocesstoresultinreductionsinruralpovertyandoverallimprovementsinlivingstandards.UrbanizationwithoutstructuraltransformationandeconomicgrowthoccurredinsomeoftheHowever,thetheorythaturbanizationgoeshandpoorestcountriesinthelatetwentiethcentury.9inhandwitheconomicgrowthandstructuralAsinthecasesabove,theincreaseinshareoftransformationdoesnotholdforallcountriespopulationincitiesdoesnotnecessarilyindicateandregions.Althoughcountrieswithahighhigheconomicgrowth.Ratherurbanizationisshareofurbanpopulationareoftenmoreassociatedwithother“atypical”developments.prosperousthancountrieswithalargeruralFirst,overallpopulationgrowthleadstopopulation,thisisnottrueinallcases.8Figure17growthinbothurbanandruralareas.Withoutshowsthatalthoughatrendcanbeseenbetweenincreasesinagriculturalproductivity,ruralGDPpercapitaatpurchasingpowerparity(PPP)populationgrowthresultsinlandsubdivision,andlevelofurbanization(measuredbytheshareunviablefarmingplotsandalackoflivelihoodoftheurbanpopulation),thereisnoone-to-oneopportunitiesinruralareas.Ruralinhabitantsassociation.Forexample,in2019,91percentofthenmigratetocitieswhereopportunitiesmayJordan’spopulationwasurban,butthiscountry’sbelimited(becauseofthelackofeconomicGDPpercapitawasrelativelylowatalmostgrowth),resultinginincreasesinurbanpoverty.10000PPPdollarsperyear.Likewise,inGabon,Second,urbanpopulationgrowthstretchesthe90percentofthepopulationwaslivingincitiescapacityofurbaninfrastructureandsocialandin2019,butthecountry’sGDPpercapitawasotherservicestothelimit.Thisisparticularlyaround15000PPPdollarsperyear.Smallislandthecaseforrapidlygrowingurbanareas,countriesandterritories(AntiguaandBarbuda,whereinvestmentshavenotkeptpacewithSaintKittsandNevis,andAruba),aswellasurbanexpansion.45CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>FIGURE17GROSSDOMESTICPRODUCTPERCAPITAANDLEVELOFURBANIZATION140000120000GDPPERCAPITAPERYEAR(PPP)100000Ireland8000060000Austria4000020000ArubaStKittsandNevisAntiguaandBarbudaDjiboutiArgentina80GabonJordan001020304050607090100URBANPOPULATION(PERCENTAGEOFTOTALPOPULATION)AfricaAsiaLatinAmericaandtheCaribbeanOceaniaNorthernAmericaandEuropeNOTES:GDP=grossdomesticproduct;PPP=purchasingpowerparity.Eachdotrepresentsacountry/territory.SOURCE:WorldBank.2023.DataBank.In:WorldBank.[Cited23May2023].https://databank.worldbank.orgUrbanizationwithouteconomicgrowthcantookplaceinthemidstoflaggingperformancesbelinkedtopoorrurallivingconditions–inagricultureandthebroadereconomy.kincludingpoverty,lackofemploymentorInthelate1990s,percapitaincomegrowthinunderemployment,lackofinfrastructure,lackofthissubregionbegantoincreasesignificantly,accesstoservicesandfoodinsecurity–and/oroutpacingmanycountriesaroundtheworld;stillenvironmentaldegradation.10,11,12Southernhowever,aspectsoftheeconomictransformationAsiaandsub-SaharanAfricaaretworegionsshowsignificantdivergencesfromurbanizationwherestructuraltransformationislaggingdrivenbystructuraltransformationelsewhere.15behind,asaresultofthelowproductivityofForexample,ruralpopulationscontinuetosubsistenceagricultureand,aboveall,therapidgrowasmostAfricancountriesareurbanizingratesofpopulationgrowthandurbanization.3andfarmlabourisnotnecessarilymovingtoInsub-SaharanAfrica,thereislesspovertyreductionalongsideurbanizationthaniskInsub-SaharanAfrica,theurbanpopulationsharerosebyafactorofhistoricallyobservedinotherregions.13Through3.2,from11percentin1950to36percentin2010.Incomparison,thelate1990s,sub-SaharanAfricahadthehighestAsia’surbanpopulationshareduringthisperiodincreasedonlyrateofurbanizationintheworld;however,this2.5times(from18percentto44percent),andLatinAmerica’s1.9times(from41percentto79percent).1446THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023off-farmsectorsoftheeconomy.15Moreover,1960and2000,nearly50percentofnetmigrationlurban-basedhouseholds,manyofwhomare(estimatedat5millionpeople)wasduetochangesmedium-scaleinvestorfarmers,controlasizeableintemperatureandrainfall,whichaffectedshareofnationalagriculturallandandcontinueagriculturalproductionandbroughtaboutatoinvestthere.reductioninfarmincomesandruralwages,thusspurringrural-to-urbanmovements.23AnotherfactorthatmaycontributetourbanizationisclimatechangeandenvironmentalSendingoneormorefamilymembersintocitiestodegradation,whichcanaffectrural-to-urbanworkinsectorsotherthanagriculture,especiallymigrationmovements.16,17Generally,inforpoorruralhouseholds,isoftenimportantinlow-incomeruralregions,thelowerthepercapitaordertoreducetherisksofhungerandextremeincome,thelargertheshareofthelabourforcepoverty,andtocopewithpossibleadverseemployedinagriculture,forestryandfisheries.18shocksthehouseholdmightface.Forexample,ThismeansthatmorepeopleintheseregionsevidencefromtheSidamaDistrictinsoutherndependonnaturalresourcesfortheirlivelihoods,Ethiopiashowsthathouseholdswhosemembersandarethereforemorevulnerabletoclimatewereanxiousaboutadecreaseinqualityandchangeandenvironmentaldegradation.19Ifquantityoffoodweremorelikelytodecidethattheagriculture,forestry,fisheriesandland-useanadultshouldmigrateinsearchofemploymentsectorsareweakenedfromtheeffectsofclimatetosupportbetterlivesforthemselvesandthechangeandbiodiversityloss,thesepopulationsfamily.24Additionalevidencefromthesamemaybecompelledtomigratetourbanareasincountryconfirmedtheseresults:forhouseholdssearchofwork.20Withthegrowingmagnitudewithoutamigrantmember,theinabilitytofeedofclimatechangeimpacts,futurerural-to-urbanthefamilycomparedtoneighbouringhouseholdsmigrationmaybeincreasinglyaffected.withmigrantmembersincreasedbyfourtimesthepropensitytosendoutamigrantforwork.25However,migrationmaybeneitherpossiblenordesirableforallaffectedpopulations.SomeThereisalsoanincreasingoccurrenceofofthepoorestandmostvulnerablegroupsforceddisplacementfromruralareastourban(includingwomen,childrenandtheelderly)canareas,oftenasaresultofdisastersand/orbecometrappedinruralareas,theirmobilityconflict.Displacedpopulationsareincreasinglyconstrainedbyinsufficientresourcesorsocialconcentratingincities,with61percentofthenorms.Evidencealsoindicatesthatothersmay26millionrefugees,26andtwooutofthreechoosetoremaininhigh-riskareasduetoainternallydisplacedpersons,residinginurbanstrongattachmenttotheirancestrallandandareasin2019.27livelihoods.21Whilemigrationtocitiespresentsrisksandopportunities,thosewhoremaininPatternsanddynamicsofurbanizationruralareas,whetherwillinglyorunwillingly,aredisproportionatelyvulnerabletoclimatechangeWithurbanexpansionandimprovingroadandimpacts,whichwillhaveadverseimplicationsfortheirfuturelivelihoodsandfoodsecurity.communicationinfrastructureacrosseverlargerWheretherearerecurrentclimateshocks,partsofruralareas,thedistinctionbetweenruralpatternsofmovementcanbecomecyclical,pre-emptiveandpermanentbecauseofperceivedandurbanareasisincreasinglyblurred.Alargefuturerisk.Forexample,evidencefromBangladeshsuggeststhataround22percentofshareofthenewurbandwellersareexpectedruralhouseholdsaffectedbytidal-surgefloods,and16percentofthoseaffectedbyriverbanktoliveinperi-urbanareas,aswellasinsmallerosion,havemigratedtourbanareas.22Evidencefromsub-SaharanAfricashowsthat,betweencitiesandinterconnectedtowns.Increasingly,ruralandurbanareasarelessseparatespacesintheirownright,butrathertwoendsofaspectrum,connectedvianumerouslinkagesacrossarural–urbancontinuum(Box2),whichareimportantforagrifoodsystems.»lThedifferencebetweenimmigrationtoandemigrationfromtheareaduringtheyear.47CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>BOX2UNTANGLINGTHERURAL–URBANCONTINUUMGlobalpopulationsareregularlycategorizedasdifferencesinSDGIndicator2.1.2(prevalencelivingeitherinurbancentresorinruralareas.ofmoderateorseverefoodinsecurityintheThisdistinctionisoftenattributedtodatalimitationspopulationbasedontheFoodInsecurityExperiencebutalsotothepracticalityofthecategorization,Scale[FIES])amongrural,peri-urbanandurbanforexampleinnationalministrieswhicharepopulationsaroundtheworld.usuallydividedbyruralandurbanmandates.28,29Thisapproachalsotendstofocusontherural–urbanToexplorehowurbanizationshapesagrifooddivide,withtheconclusionthatruralareastypicallysystems,amoregranularlensoftherural–urbanlagbehindtheirurbancounterparts.30,31However,continuumisuseful.Forthisreasonanotherthisdivideischallengedbothinscienceandinpublicallyavailableglobalgeospatialdataset–policy,duetotheincreasinginterconnectednessUrbanRuralCatchmentAreas(URCA)–isusedbetweenvarioustypesofpopulationagglomerations.forthecountrycasestudyanalysisinChapter4.ThisnewlyavailableglobalgeospatialdatasetThereisnocommonlyagreedupondefinitionprovidesaglobalmappingoftherural–urbanoftheterm“urban”acrosscountries,andthuscontinuum,28,38basedontheGlobalHumancomparabilityof“urbanareas”acrosscountriesSettlementLayer.39LiketheDEGURBAclassification,andregionsisnotalwaysstraightforward.32itplacesurbancentresonagradientbasedonThislimitationcarriesoverdirectlytogloballypopulationsizeanddensity,wherebycitysizeisareportedurbanpopulationstatisticsbytheUnitedproxyforthebreadthofservicesandopportunitiesNationsDepartmentofEconomicandSocialAffairs,providedbyanurbancentre.Butitalsoaddsawhichclassifiesareasasurbanaccordingtotheseconddimension:rurallocationsareassignedacriteriausedbyeachcountryorterritory.33Criteriagradientoftheirown,usingtheshortesttraveltimemaybebasedonpolitical/administrativeaspects,tourbancentresofvarioussizesasaproxyforthestructuraland/orfunctionalcharacteristicsrelatedcostofaccessinggoods,servicesandemploymenttopopulationdensityandsizeorthefunctionsthatopportunities(FigureA).Thus,theURCAdatasetcitieshavefortheirinhabitants.34disaggregatesruralareasintomultiplecategories;distinguishing,forexample,betweenlocationsthatRecently,importantadvancesweremadeinarelessthan1hourfromanurbancentre(inyellow)developingamethodologyfordelineatingurbanandandthosethatarefartheraway.ruralareasforinternationalandregionalstatisticalcomparisons.35TheUNStatisticalCommissionTheURCAmethodologyfordefiningurban–ruralendorsedtheDegreeofUrbanization(DEGURBA)catchmentareasprovidesaspatialandfunctionalinMarch2020–amethodologydevelopedbyarepresentationoftheconnectionbetweenruralconsortiumoftheEuropeanUnionandinternationalareasandurbancentres,givingnewinsightsintotheagencies(OrganizationforEconomicCo-operationdegreeofconnectivitybetweenruralandurbanareasandDevelopment[OECD],WorldBank,FAO,andthediversityofpatternsinrural–urbanlinkagesUnitedNationsHumanSettlementsProgrammearoundtheworld.Spatialrepresentationrefersto[UN-Habitat]andInternationalLabourOrganizationthegeographicalandlocationaldistributionofthe[ILO]).Thismethodologyclassifiestheentireterritorypopulation(i.e.whatareaitoccursinandhowspreadofacountryacrossarural–urbancontinuum,36outitis).Functionalrepresentationentailshowbydegreeofurbanization.Theclassificationtheseareasrelatetoeachotherintermsofactivitiessystemconsistsofthreeclasses–cities,townsandpurpose(i.e.accessofrurallocationstourbanandsemi-denseareas,andruralareas–andsevenservicesandopportunities,capturedbythesizeofsubclassesfortheruralandsemi-denseareas,basedtheclosesturbancentreandtheassociatedtravelonpopulationsizeanddensity,usingthesametimefromtherurallocation).Thiscategorization,thresholdsacrosstheglobe,andthusensuringglobalwhencombinedwithhouseholdsurveydata,allowscomparability.37Theoutcomeisanopen-accessforamoredetailedanalysisregardingconsumptiongeospatialdataset.Thisofficialclassificationsystemandproductionacrosstherural–urbancontinuumisusedforthefirsttimeinChapter2,tolookat(seeChapter4).48THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX2(Continued)FIGUREARURAL–URBANCONTINUUMBASEDONTHEURBANRURALCATCHMENTAREAS(URCA)DATASETTWO-DIMENSIONALTRAVELTIMETOURBANRURAL–URBANCENTREOFREFERENCECONTINUUM(URCA)>3hours2–3hours1–2hours0–1hour0ONE-DIMENSIONALRURAL–URBANCONTINUUMRURALTOWNSSMALLCITIESINTERMEDIATECITIESLARGECITIESNOTES:ThefigureisastylizedrepresentationoftheURCA-definedrural–urbancontinuumwhichhasatwo-dimensionalgradientandthemorecommonone-dimensionalconceptualizationofarural–urbancontinuum.ThesizeofthebubbleroughlyexpressespopulationsizesbasedontheURCAdatasetofglobalpopulationdistributionacrosstherural–urbancontinuumin2015(seeFigure19B).SeeAnnex4forfulldefinitionanddescription.SOURCE:AdaptedfromFAO.2021.GlobalUrbanRuralCatchmentAreas(URCA)Grid–2021.In:FAO.[Cited12June2023].https://data.apps.fao.org/?share=g-3c88219e20d55c7ce70c8b3b0459001a»Figure18conceptualizestwodivergentpatternsofperi-urbanandruralareasforfoodandecosystemservices.Forexample,inmanypartsofAfrica,urbanizationandtheirmajorimpacts(seeBox3agricultureoftenflourishesincloseproximitytofordefinitionsofcitysizes),whichultimatelyurbancentresthroughmoreintensiveproductiondeterminetheavailabilityandaffordabilityofofhigh-valuecropssuchasfruitsandvegetables,healthydiets.3Thedegreeofconnectivitybetweenwhicharehighlyperishable.Inthiscase,farmersruralandurbanareasshapesagrifoodsystems,cantakeadvantageofthisproximitytomarketsandthustheavailabilityofaffordablehealthyforbothinputsandpost-harvestproductsdiets,andthelivelihoodsofurbanandruralandservices.3,40primaryproducers,processorsandtraders.3WhetherurbangrowthtakesplaceinlargeorRuralagriculturallivelihoodsoftendependonintermediateandsmallcitiesortownswillaffecttheirconnectiontoperi-urbanandurbanfoodruralpopulations’accesstoservices,marketsandspaces,whilecitiesdependonsurrounding49CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>BOX3DEFINITIONSOFURBAN,PERI-URBANANDRURALAREASINURBAN–RURALCATCHMENTAREAS(URCAs)ThedefinitionofcitysizeandtypedifferswidelyLargecities:>1millionpeople.amongcountries.NumerousdesignationsaregivenIntermediatecities:0.25–1millionpeople.indicatingsizeandfunction,suchasprimary,Smallcities:50–250thousandpeople.secondaryortertiarycities,indicatingtheroleofaTowns:20–50thousandpeople.citywithinanationalcontext.Furthermore,basedonURCAsubcategories,Thereisalsonostandarddefinitionofperi-urban,peri-urbanandruralareasaredefinedasfollows:andthetermisappliedtoadiversemixofinformalandformalsettlementsaroundurbanareas.41,42Peri-urbanareasconsistofthreeURCAIngeneral,however,peri-urbanreferstothesubcategories:<1hourtoalargecity;<1hourtoangeographicaledgeofacity–the“urbanfringe”intermediatecity;<1hourtoasmallcity.outsidetheformalcitylimits.ItisoftendescribedasthelandscapeinterfaceortransitionzonebetweenRuralareasalsoconsistofthreeURCAurbanandruralareas.subcategories:<1hourtoatown;1–2hourstoacityortown;>2hourstoacityortown.ForthepurposesofthediscussionandanalysisinChapters3,4and5ofthisreport,theterminologySeeAnnex4forfurtherdetailsontheURCAutilizesURCAdefinitionstodefineurban,peri-urbanmethodology.andruralareas.BasedoncombinedURCAurbanareasubcategories,urbanareasaredefinedaccordingtothefollowingpopulationsizes:inputs(Figure18).Thisisbecauseintermediateandinlargecitiesseemstohavelittleeffectonsmallcities,alsoreferredtoas“secondarycities”,mpovertyreduction,andevenincreasespovertyplayapivotalroleinprovidinginputandoutputinsomecases,whiledecreasinglevelsofurbanmarketopportunitiesforruralpopulationsnotfoodsecurity.50Forthesereasons,severallocal,residingclosetothelargecities.Infrastructurenationalandinternationalpolicieshaveexplicitlyandfacilitiesinintermediateandsmallcitiesarepromotedthegrowthofsuchintermediateandimportantforconnectingdifferenturbancentressmallcities.51witheachotherandwithruralareas,therebyfacilitatingaccesstomoredispersedpatternsAsruralandurbanareasrepresenttwoendsofaofpre-harvestandpost-harvestfacilitiessuchspectrum,arural–urbancontinuumframeworkascollectionhubs,(cold)storagefacilities,andisthereforecriticaltounderstandthelinksdistributionandprocessingcentres.45,46betweenurbanizationandagrifoodsystemschangesandhowthesechangesareaffectingtheSeveralstudiesfindthatthegrowthofavailabilityandaffordabilityofhealthydiets,intermediateandsmallcitiesmaymatterevenandinturn,foodsecurityandnutrition.Withmorethanthegrowthoflargecitiesinreducingthisinmind,theglobalUrbanRuralCatchmentpovertynationally.47,48,49PopulationgrowthAreas(URCA)datasetsuggeststhatthebreadthofservicesandopportunitiesavailable,aswellasmSecondarycitiesaregeographicallydefinedurbanjurisdictionsortheiraccessibilitytorurallocations,areoftenacentresperformingvitalgovernance,logisticalandproductionfunctionsfunctionofthesizeofnearbyurbancentresandatasubnationalorsubmetropolitanregionallevelwithinasystemoftheassociatedtraveltimefromrurallocationscitiesinacountry.Secondarycitiesrangeinsizefrom100000to(seeBox2andAnnex4forafulldescriptionofthe1000000peopleormoreinsomeofthemorepopulatedcountries,anddataandthedefinitionofURCAcategories).theyarecentresofsubnationalgovernment,logistics,employmentandservices.43,4450THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE18PATTERNSOFURBANIZATIONB)DISPERSEDSMALLCITYANDTOWNURBANIZATIONA)DENSEMETROPOLIZATIONAROUNDLARGEANDINTERMEDIATECITIES▪Centralizedmarketsanddemand▪Decentralizedmarketsanddemand▪Morecentralizedeconomicgrowth▪Scatteredcentresofeconomicgrowth▪Higherlevelsofeconomicinequality▪Moredispersednon-farmemployment▪Increasedriskofslumsandurbanpoverty▪MoreinclusivegrowthLargecityIntermediatecitySmallcityTownSphereofinﬂuenceConnectivitySOURCE:AdaptedfromdeBruin,S.,Dengerink,J.&vanVliet,J.2021.Urbanisationasdriveroffoodsystemtransformationandopportunitiesforrurallivelihoods.FoodSecurity,13:781–798.https://doi.org/10.1007/s12571-021-01182-8Figure19AshowsaglobalmappingoftheURCA(asconceptualizedinFigure18).Similarly,categoriesaroundtheworldandFigure19Binlow-incomecountries,64percentoftheshowstheglobalpopulationdistributionofpopulationliveeitherinsmallcitiesandtownsURCAcategoriesbycountryincomegroupandorwithintheircatchmentareas(i.e.locationsregionalgroup.TheURCAmappingrevealsthatgravitatearoundaspecificurbancentredisparitiesinaccesstoservices,witharoundintermsofaccesstomarkets,servicesand3.4billionpeoplelivinginperi-urbanandruralemploymentopportunities).Alltold,almostlocations(Figure19)(seeBox3forspecificURCAs).halfoftheglobalpopulation(47percent)liveAroundone-fourthoftheglobalpopulationinperi-urbanareas(lessthan1hourtolarge,liveinperi-urbanareas(lessthan1hourtoanintermediateandsmallcitiesortowns)nandurbancentre)ofintermediateandsmallcitiesruralareas(1to2hoursormoretoanurbanandtowns,whichchallengesthecentralityofcentre).Giventheincreasingconnectivityoflargecitiestodevelopment,aswellastothetransformationofagrifoodsystems(Figure19B).peri-urbanandruralareasandtheconvergence»IntermediateandsmallcitiesappeartoprovidecatchmentareasforproportionatelymorenNoteforthepurposesoftheselectedcountryanalysesinChapter4,peoplegravitatingaroundthemcomparedtosmallcitiesandtownsaresplitintotwoseparatecategoriesandperi-largercities,emphasizingtheirimportanceurbanareasaredefinedaslessthan1hourtraveltoacityofanysize(i.e.townsareexcluded).ThisfacilitatesrepresentationoftheanalysisoftheselectedcountriesinAfricastudiedinChapter4.51CFHIGAUPRTEE1R93GULROBBAANLIZMAATIPOPNINISGTARNADNSDFISOTRRMIIBNUGTAIOGNRIOFOFOPDOPSYUSLTAETMIOSN<.B..Y>RURAL–URBANCONTINUUM(URCA)IN2015A)GLOBALMAPOFRURAL–URBANCONTINUUM(URCA)IN2015B)GLOBALPOPULATIONDISTRIBUTIONACROSSTHERURAL–URBANCONTINUUM(URCA)IN2015,BYCOUNTRYINCOMEGROUPANDREGIONALGROUPGlobal(7.3billion)22131013221134COUNTRYLow-income(0.6billion)114873312210INCOMEGROUPSLower-middle-income(2.9billion)2113121325122Upper-middle-income(2.6billion)23141113218124High-income(1.2billion)3116912214112EasternAsiaandPaciﬁc(2.3billion)2517914216123Europeand15131216317164CentralAsia(0.8billion)REGIONALGROUPSLatinAmericaand297137220126theCaribbean(0.6billion)281213824102NearEastand3216289311114NorthernAfrica(0.5billion)NorthernAmerica(0.4billion)201312162610SouthernAsia(1.8billion)15687229209Sub-SaharanAfrica(1.0billion)1020304050607080901000PERCENTAGELargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlandsSOURCE:AdaptedfromCattaneo,A.,Nelson,A.&McMenomy,T.2021.Globalmappingofurban–ruralcatchmentareasrevealsunequalaccesstoservices.PNAS(ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica),118(2):e2011990118.https://doi.org/10.1073/pnas.201199011852THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023»ofhighfoodpurchasesinboth(seeSection3.2),logistics,processing,wholesaleanddistribution);ruralinputmarkets;agriculturaltechnology;anditisclearthatperi-urbanandruralmarketsthesizedistributionoffarms.14,56Thus,agrifoodaresignificantdriversofagrifoodsystemssystemsaretransformed,fromtraditionalandtransformation.nmostlyruralsystemsbasedonlocalmarketlinkagesandfarmingemployment,tosystems3.2withgreaterconnectivitybetweenruralareas,URBANIZATIONAFFECTSandbetweenrural,peri-urbanandurbanAGRIFOODSYSTEMS,areas.Thisentailsmorecomplexrural–urbanCREATINGCHALLENGESmarketlinkagesacrossaspatialandfunctionalANDOPPORTUNITIESrural–urbancontinuum,andmorediverseTOENSUREACCESSemploymentopportunitiesalongthefoodvalueTOAFFORDABLEchain,includingprocessing,marketingandtrade.HEALTHYDIETSItalsoentailsmoredependenceonincomeandfoodpricing(affordability)fordietarychoices,asUrbanizationcontributestothetransformationthereisagreaterdependenceonpurchasedfoods.ofagrifoodsystemsbyreshapingspatialpatternsoffooddemandandaffectingconsumerOfspecificconcernagainstthisbackdroparethepreferences,changinghow,whereandwhatchangesinthesupplyanddemandofnutritiousfoodisproduced,suppliedandconsumed.foodsthatconstituteahealthydiet;theircostThesechangesareaffectingagrifoodsystemsrelativetofoodsofhighenergydensityandinwaysthatarecreatingbothchallengesandminimalnutritionalvalue,whichareoftenhighinopportunitiestoensureeveryonehasaccesstofats,sugarsand/orsalt;andtheircostrelativetoaffordablehealthydiets.people’sincome(i.e.theiraffordability).Withurbanizationandrisingincomes,Figure20presentsaconceptualframeworkforhouseholdsofteneatgreaterandmorediverseunderstandingthedifferentpathwaysthroughquantitiesoffood,includingdairy,fish,meat,whichurbanizationisdrivingchangesinagrifoodlegumes,freshfruitsandvegetables,aswellassystemsacrosstherural–urbancontinuum,andis,moreprocessedfoods.52,53,54,55This,togetherinturn,affectingaccesstoaffordablehealthydiets.withpopulationgrowth,impliessubstantialTheorangetextthroughoutthissectionrefersincreasesintheproductionandsupplyofsometospecificelementsinFigure20foremphasistypesoffoods(i.e.meat,dairy,freshfruitsandandtoeasecross-referencingwiththefigure.vegetables,wheatandwheatproducts,aswellTheframeworkwasdevelopedbasedonaashighlyprocessedfoods)tosatisfyincreasedsystematicreviewandmeta-analysisofevidencedemand.This,inturn,asurbanpopulationsfromscientificstudiesoandinformedbynewgrow,translatesintovastincreasesinthetotalanalysispresentedinChapter4onchangesinamountoffoodthatagrifoodsystemshavetofooddemandandsupplyacrosstherural–urbanproduce,processanddistributeovertime.Therecontinuum.Figure20recognizesthaturbanizationmayalsobeslowergrowthorevendeclinesinisnotanagrifoodsystemsdriverinisolationbutdemandforotherfoodproductssoldsuchasthatitchangesagrifoodsystemsininteractiontraditionalgrains,maize,rootsandtubers.withotherdriversincludingincomegrowth,employment,lifestyles,economicinequality,policiesandAdjustmentsinthequantityandqualityoffoodinvestments.demandandsupplybringaboutchangesinmarketsandretailtrade;midstreamfoodsupplyoThedesignofthisreviewisbasedonthedesignassuggestedinthechains(changesinpost-harvestsystemsforPreferredReportingItemsforSystematicReviewsandMeta-analysis(PRISMA)guidelines,butisadaptedmakinguseofFAO’sDataLab,whichautomatizessearchesofscientificarticlesandidentifiesthemostrelevantonesthroughanartificialintelligencemethodthatlearnsfromusers’selectionsandextendstheassessmenttootherarticles.AdescriptionofthetoolandapproachisavailableinAnnex4.53CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>FIGURE20THEPATHWAYSTHROUGHWHICHURBANIZATIONAFFECTSAGRIFOODSYSTEMSANDACCESSTOAFFORDABLEHEALTHYDIETSUrbanizationdrivingchangesinagrifoodsystemsOtherdriversofagrifoodsystemschangealongsideurbanization:incomegrowth,aectingaccesstoaordablehealthydietsemployment,lifestyles,economicinequality,policiesandinvestmentsAGRIFOODSYSTEMSRURAL–URBANCONTINUUMFOODSUPPLYCHAINSFOODENVIRONMENTSPRODUCTIONMIDSTREAMDOWNSTREAMCONSUMERBEHAVIOUR(logistics,processing(marketing,retailANDDIETSandwholesale)andtrade)DietsDemandProfocoedsssedfFrooomdhaowmayeDiversiﬁcationProductionLandNaturalValueMarketsTradeFoodchainsdesertsandproductivityfactorsusecapitalProductdiversiﬁcationandmoreproductivefarmsGrowingemploymentinlonger,moreformalandMorediversiﬁeddiets:higher-valueandmorewellconnectedtourbanmarkets.complexfoodvaluechains:transport,processing,nutritiousfoods,butalsoincreasinglyofminimalpackagingandtrade.nutritionalvalueandhighinfats,sugarsand/orsalt.Increasingaccesstoproductionfactorsforfarmerswellconnectedtourbanmarkets.Increasingnumberandsizeof(peri-)urbanfoodmarketsUrbanpoorandricheatingmorehighlyprocessed(formalandinformal)andretailoutlets.foods,conveniencefoodsandfoodawayConversionofagriculturallandtourbanlanduse,fromhome.increaseofagriculturallandelsewhere.Substantialexpansionofsupermarketsandincreaseintypesandquantitiesofhighlyprocessedfoods.Widespreaddiusionoffoodpurchasesinruralareas.Riskstonaturalcapitalneededforagriculture,especiallywaterresources.Urbanfooddeserts:limiteddistributionofnutritiousDiettransitionoccurringinruralareas,thoughlaggedfoodsinsomepoorareasandneighbourhoods.andlower.ACCESSTOAFFORDABLEHEALTHYDIETSSOURCE:deBruin,S.&Holleman,C.2023.Urbanizationistransformingagrifoodsystemsacrosstherural–urbancontinuumcreatingchallengesandopportunitiestoaccessaffordablehealthydiets.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-08.Rome,FAO.Thisconceptualframeworkstipulatesthatinalongsidetheagrifoodsystemscontinuum;additiontoruralareas,foodcanalsobeproduceditisabroadercontinuuminwhichagrifoodinurbanandperi-urbanareas.Inmanycountries,systemscanbeplaced.thecomponentsofagrifoodsystemsaremoreinterconnected.TherearealsobothshortandFigure20depictsthewaysinwhichurbanizationlongfoodsupplychains,andtherecanbeaisaffectingthreemajorcomponentsofagrifooddislocationofmidstreamprocessingawayfromsystems:i)consumerbehaviouranddiets;ii)midstreamurbanareasaspartofverylongsupplychains.(e.g.logistics,processingandwholesale)andForthesereasons,theconceptualframeworkdownstream(e.g.markets,retailandtrade)fooddoesnotvisualizetherural–urbancontinuumsupplychains;andiii)foodproduction.Thefigure54THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023presentsthesethreecomponentsinthestandardplacestobuyfoodinurbanfoodenvironments,orderforconceptualizingagrifoodsystemsandrangingfromsupermarketstoinformalmarkets,foodsupplychains.However,thefollowingfoodstreetvendorsandrestaurants.61Thesectionsstartattheotherendwithconsumerincreasedavailabilityoftheseoptionsoftenbehaviouranddiets,asthisisoneofthemostresultsinincreasedfoodconsumptionanddietaryimportantpathwaysthroughwhichurbanizationdiversity.Dietarypreferencesarealsoshapedisdrivingchangesinagrifoodsystems.Changesbymarketingandothersupplyfactors,withacrossagrifoodsystemsalsoimpactfoodareinforcingcompoundingeffectonthefoodenvironmentswhichhererefertophysical,produced,suppliedandconsumed.economic,socioculturalandpolicyconditionsthatshapeaccess,affordability,safetyandfoodHowever,urbanizationhasalsocontributedtopreferences.57,58,59,60thespreadandconsumptionofprocessedandhighlyprocessedfoods,whichareincreasinglycheap,Moreover,asillustratedinFigure20andexpandedreadilyavailableandmarketed,withprivateonbelow,foodenvironmentsreflectacomplexsectorsmallandmediumenterprises(SMEs)interplayamongsupply-sidedriversincludingandlargercompaniesoftensettingthenutritionfoodpricing,productplacementandpromotion,landscape.Costcomparisonsofindividualfoodanddemand-sidedriversincludingconsumeritemsand/orfoodgroupsfromexistingstudiespreferencesandpurchasingpower.Togetherindicatethatthecostofnutritiousfoods–suchthiscomplexinterplayofsupplyanddemandasfruits,vegetablesandanimalsourcefoods–isconsiderationsiskeytounderstandhowtypicallyhigherthanthecostofenergy-denseurbanizationisdrivingchangesinagrifoodfoodshighinfats,sugarsand/orsalt,andofsystemsacrosstherural–urbancontinuum,staplefoods,oilsandsugars.62,63,64,65Therelativeaffectingaccesstoaffordablehealthydiets.pricesofnutritiousfoodsandfoodsofhighenergydensityandminimalnutritionalvalueConsumerbehaviouranddietshavealsobeenshowntodiffersystematicallyacrossincomelevelsandregions.62,66,67OneofthemostimportantpathwaysthroughwhichurbanizationisdrivingchangesinagrifoodWithurbanization,purchasesfromsupermarkets,systemsisthroughashiftinconsumerbehaviourandfastfoodtakeawayoutlets,homedeliveriesanddiets(Figure20).Higheraverageincomes,combinede-suppliersandotherconvenienceretailerswithchanginglifestylesandemployment,areincreasing.68,69,70InLatinAmericaandthearedrivingadietarytransition.WhilethisisCaribbean,forexample,therehasbeenaprofoundoccurringincountriesandregionsatdifferentshiftinthelast20yearstowardsfoodsofhighspeedsandwithvariations,itishappeningenergydensityandminimalnutritionalvalue,aroundtheworld.Thistransitionischaracterizedincludingsugar-sweetenedbeverages.Whilethisbychangesinthetypesandquantitiesoffoodphenomenonoccurspredominatelyinurbanandconsumed,withdietsshiftingbeyondtraditionalperi-urbanareas,itisspreadingtoruralareasgrainsintodairy,fish,meat,vegetablesandfruits,andIndigenousPeoples’lands.Therehasalsobutalsointoconsumptionofmoreprocessedbeenashifttowardsincreasedconsumptionfoodspandconveniencefoodsorfoodawayfromoffoodawayfromhomeandsnacking,whichhome.Thesechangingpreferencesarereinforcedcorrespondstohighlevelsofoverweightandbythegreaterdiversityofbothfoodproductsandobesityamongallages,alongwithhighburdensofstuntinginsomecountries.69SuchchallengespFoodprocessingcanfacilitatethepromotionofhigh-qualitydiets,arenotuniquetotheLatinAmericaandtheasitcanmakefoodmoreavailableaswellassafer.However,highlyCaribbeanregion,andmanysettingsnowfaceprocessedfoodscancontainveryhighdensitiesofsalt,freesugarsandmultiple,simultaneousburdensofdifferentformssaturatedortransfats,andtheseproducts,whenconsumedinhighofmalnutrition.71,72amounts,canunderminedietquality.Freesugarsareallsugarsaddedtofoodsordrinksbythemanufacturer,cookorconsumer,aswellasAnotherreasonforthespreadofprocessedsugarsnaturallypresentinhoney,syrups,fruitjuicesandfruitjuicefoodsisconvenience.Urbanizationisassociatedconcentrates.Forfurtherinformation,seeAnnex5,SectionCwithchangesinthelifestylesandemployment(“Explanatorynoteonprocessedfoodsandfoodprocessingclassificationsystems”).55CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>profilesofbothwomenandmen,aswellasChapter4alsoshowsthatfoodpurchasesformincreasingcommutingtimes,resultingingreaterthemajority(average56percent)ofthefoodsdemandforconvenience,pre-preparedandfastfoods.consumed(invalueterms)byruralhouseholdsWomen,whooftenbearresponsibilityforfoodin11countriesinsub-SaharanAfrica.Thisispreparation,areincreasinglyworkingoutsidetrueevenforthosehouseholdsliving1to2hoursthehome,andthusmayhavelesstimetoshop,fromasmallcityortown(average56percent),processandpreparefood.Atthesametime,menandthoselivingmorethan2hoursfromacityorareincreasinglyworkingfarfromhomeinothertown(average52percent).cities.Thesetrendsaredrivingthepurchaseofpre-preparedorready-to-eatcerealssuchasriceStudiesshowthatwhileconsumptionofandwheat,73,74alongwithmoreprocessedfoodsprocessedfoods(ofalltypes)ishigherinurbanandfoodawayfromhomepreparedbyrestaurants,areas,intermsoftheproportionofexpenditurecanteens,retailers,etc.18Thefoodprocessingonfood,ruralconsumptionofprocessedfoodssectorandfastfoodsegmenthavegrownquicklyisnotmuchlower.54,79InEasternandSouthernasaresult.Forexample,eatingpatternsofAfrica,forexample,29percentoftotalfoodTanzanianmigrantschangewhentheymovefromoutlaysarespentonsuchfood,andoftheseruraltourbanareas,awayfromtraditionalstaple17percentarespentonpurchasedmilledfoodssuchascassavaandmaize,andtowardsgrainsclassifiedasminimallyprocesseditems,convenience,ready-to-eatorpre-preparedfoods48percentonnon-grainminimallyprocessedsuchasrice,breadandfoodawayfromhome.75foodsand35percentonhighlyprocessedIncreasingly,thistrendisalsooccurringinruralfoods.77,80RecentevidencefromthreeAfricanareasasatime-savingmeasureforoff-farmcountriesshowsthatthesharesofprocessedlabourersandwomenworkingoutsidethehome,foodsofalltypesaresurprisinglyhighamongfacilitatedbyincreasedruralincomes,increasedthepoorandeventheultra-poor,inbothruralsupplyofthesefoodsfromurbanandotherruralandurbanareas.52,53,54However,thereareareas,andreducedtransportationcostsbecausedifferentpatternsofconsumptionofvariousofbetterroads.typesofprocessedfoodsacrosstherural–urbancontinuum,withhighlyprocessedfoodandThediettransitionisalsooccurringinruralareas,foodawayfromhomesharesshowingastrongthoughlaggedandtoalesserextentcomparedcorrelationwithtotalfood-budgetsharestourbanandperi-urbanareas.Newstudiesandurbanareasinthe11sub-SaharanAfricainthelasttwoyears,52,53,76includingthenewcountriesanalysed(seeChapter4).54,79analysispresentedinChapter4,underscoretheextentofthediettransitionacrosstheMidstreamanddownstreamfoodrural–urbancontinuumandtheabsenceofstarksupplychainsdifferencesbetweenurbanandruralareaswithincountriesanalysed.AnotherpathwaythroughwhichurbanizationisaffectingagrifoodsystemsischangesinThereisalsoadiffusionoffoodpurchasesinruralmidstreamanddownstreamfoodsupplychainsareas,moresothaniscommonlyunderstood.(Figure20).ThesechangesareoftentheresultofThedietintheseareashasshiftedfromincreasedinvestmentsininfrastructuresuchasmainlyhome-producedfoodstoincreasinglyroads,warehousesandcoldstoragefacilities.market-purchasedproducts.TheruralpoorThemidstreamconsistsofthepost-farmgateareheavilyengagedinpurchasingfoodfromactivitiesrelatedtothelogistics,processingmarketsandare,ingeneral,netfoodbuyers.Inandwholesaleoffood.Thisincludescleaning,EasternandSouthernAfrica,researchshowssorting,packaging,transportation,storageruralhouseholdsbuy44percent(invalueandwholesalingofagriculturalandfoodterms)ofthefoodtheyconsume.77Astudyofproducts.DownstreamfoodsupplychainsBangladesh,Indonesia,NepalandVietNaminvolvethosesegmentsmoredirectlyrelatedtoshowsruralhouseholdsbuyanevenhigherconsumerpurchases,thatisretailmarketsandproportionoftheirfood–73percent(invaluesales,andtrade.terms).78Moreover,newresearchpresentedin56THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FoodsupplychainsAsiaandLatinAmerica.88,89ModernfoodsupplyUrbanizationcancontributetolonger,moreformalchainsbasedaroundsupermarketsandlargeandmorecomplexfoodsupplychains,followingrisingprocessorstendtobelongaswell,stretchingconsumerdemandandincreasedregulationoffromruralareastourbanareas,buttheyalsoagrifoodsystems.81,82Ascitiesgrowanddietsincludeinternationalelements.Suchlongsupplyofurbandwellerschange,urbanpopulationschainsaccountforapproximately20percentincreasinglymustlookbeyondlocalproductionofagrifoodsystemsinAfricaandSouthernfortheirfoodsupply.Onlyaround30percentAsia,and45percentinSouth-easternAsiaofurbanresidentsworldwideareestimatedtoandLatinAmerica.fulfiltheirdemandforspecificcropslocally(approximately100kmradius).83,84ThemajorityofMidstreamfoodsupplychainsurbanfooddemand,about80percent,issuppliedMidstreamfoodsupplychainshavebecomemajorregionally(withina500kmradius).85supplychaingrowthenginesasaresultoftheoverallriseinurbanfooddemandandmoreAlthoughsomeofthefoodsconsumedinurbanspecificallythehigherdemandforhigh-valueareasmusttravelfartoreachtheirdestination,andprocessedproducts.90Thesesupplychainsmostareproducedwithinnationalbordersandhavegrownquicklyoverseveraldecadesandnowtradeddomestically(forexample,thisshareconstituteasignificantshareofthetotalvalueis90–95percentinAsia).80Exceptionsaretheaddedandcostsinfoodvaluechains.Inlow-entireNearEastandNorthAfricaregion,someandlower-middle-incomecountries,midstreamcountriesinsub-SaharanAfrica,aswellasthefoodsupplychainsform30to40percentoftheSmallIslandDevelopingStates.Accordingtovalueaddedinfoodvaluechains.80Additionally,thelatestWorldTradeOrganizationreport,duetotheembeddednessinlocaleconomies,thereare32netfood-importingdevelopingthemidstreamsegmentscanprovidelocallycountries.86Forthesecountries,foodimportsadaptedservicesandmarketlinkagestofarmerscanbesubstantial.Forexample,accordingtocontributingtoenhancingfoodsupplyandtheOECD–FAOAgriculturalOutlook,roughlyruraleconomies.9170percentofallfoodcommoditiesconsumedintheNearEastandNorthAfricaareimported.87ThepastseveraldecadeshavewitnessedaFormostothercountries,importsarealowrapidproliferationofSMEs,whichnowplayshareoffoodsupply,andmainlyconsistofaanimportantroleinthetransformationoffewproducts,suchthatdomesticsupplychainsagrifoodvaluechainsinAfrica,Asiaandreallydrivefoodsupply.55ThisisconsistentLatinAmerica.91,92ThespreadofSMEsismostacrossregionsandmostfoodgroups(exceptoilsrapidduringthetransitionalstageofthisandfats),andisparticularlythecaseforfruits,transformation,whenagrifoodvaluechainsvegetablesandanimalsourcefoods,whicharedevelopandgrowlongerasurbanizationimportantfoodgroupsforhealthydiets.progresses,butremainsfragmented(seeTable7formoredetailonthetransformationofagrifoodDomesticfoodsupplychainsareusuallylongvaluechains).Theabsenceofappropriateandcriss-crossacountryfromsupplyzonestopolicieshasbeenafactorhinderingthecitiesandruralareas.88Shortrurallocalsupplyproliferationof“formal”SMEs,particularlyinchains,ortraditionalfoodsupplychainsbasedtheprocessingsector.91aroundsubsistenceagriculture,onlyaccountforapproximately10percentofthefoodeconomyInsub-SaharanAfrica,SMEsoperatingininAfricaandSouthernAsia,and5percentinthemidstreamfoodvaluechainsprocureSouth-easternAsiaandLatinAmerica.76,88,8995percentofthetotalsupplyforsmallfarmsOntheotherhand,longsupplychainsconnectingandhavebecomethelargestinvestorsinruralproducerstourbanconsumersthroughagriculturalproducemarketsintheregion.93aweboflabour-intensiveagrifoodSMEsareTheproductivityofthismidstreamis,therefore,moreprevalent,accountingforapproximatelyasimportantasfarmyieldsforfoodsecurityin70percentofthefoodeconomyinAfricaandpoorcountries.Thepost-farmgatesegmentsofSouthernAsia,and50percentinSouth-easternthesupplychain–themidstream(processing57CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>TABLE7THETHREESTAGESOFTRANSFORMATIONOFAGRIFOODVALUECHAINSModernagrifoodvaluechainsTraditionalagrifoodvaluechainsTransitionalagrifoodvaluechainsSupermarketsMainenterprisetypein:Fastfoodchains,supermarketsandRetailHomeenterpriseSmallandmediumenterpriseshypermarkets,(SMEs),wetmarketsindependentrestaurantsLargeprocessorsandfoodFoodserviceNone(homecooking)Streetvendors,independentmanufacturersrestaurantsProcessingNone(homeprocessing)SMEssuchassmallmillsWholesaleBrokersbasedinruralWholesalersbasedinurbanOff-marketdistributionvillagesmarketscompaniesLogisticsOwnlogisticsbybrokersSMEsinthird-partylogistics(3PL)Large3PLcompaniesandSupplychainlengthShort,localLong,rural–urbanfreightforwardersLong,rural–urban,internationalExchangearrangementsNocontracts,nostandardsNocontracts,publicstandards,Emergingcontracts,Labourintensivesomeverticalintegrationprivatestandards,verticalTechnologyNoneintegrationForeigndirectLabourintensiveinvestmentCapitalintensiveEmergingSignificantSOURCE:AdaptedfromBarrett,C.B.,Reardon,T.,Swinnen,J.&Zilberman,D.2022.Agri-foodValueChainRevolutionsinLow-andMiddle-IncomeCountries.JournalofEconomicLiterature,60(4):1316–1377.https://doi.org/10.1257/jel.20201539andwholesale/transport)anddownstreamcurrentlygrowingmorerapidlythanemployment(retailandfoodstalls)segments–togetherinfarmingitself45–aclearmanifestationofcomprise40to70percentoffoodcostsforurbanagrifoodsystemstransformation.EmploymentAfricans.94Ruralareasnearertocitiestendtoinoff-farmactivities,mostofteninSMEs,experienceamorerapidtransformationoffoodincludespost-farmgatejobsinfoodprocessing,valuechains,includingthedevelopmentofthewholesale,logistics,retail,andfoodservice,asmidstream.80However,insomelow-incomeandwellasnon-agrifoodsystemsjobs.Studiesshowurbanizingcountries,themidstreamsegmentsthatSMEemploymentinagrifoodsystemsinofagrifoodsystemsarestillatanearlystageofprocessing,wholesale,transportandretailcantransformation.Forexample,inmanycountriesbeespeciallyimportanttotheemploymentofinsub-SaharanAfrica,mostcitiesstillhaveonlywomenandyouth.36,98Whileestimatesoftheanarrowrangeofpackagedandprocessedfoods,numberofemployedpeopleinfoodsupplychainswiththegreatestdiversityofproductsavailablearescarce,anumberofstudieshaveestimatedinthecapitalorlargecities.95,96,97employmentinagrifoodsystemsasawholeforspecificregionsandsubpopulations.Forexample,Importantly,growingmidstreamanddownstreamonestudyestimatesthatinAfrica,AsiaandLatinactivitiesprovideimportantoff-farmemploymentAmerica,youthemploymentratesinagrifoodopportunities,whichcanprovidesteadyandsystemsare61percent,39percentand48percent,liveableincomes,increasingtheaffordabilityofrespectively.99AnotherstudyinWesternAfricahealthydiets.Forexample,insub-SaharanAfrica,estimatesthatagrifoodsystemsaccountforemploymentinoff-farmagrifoodsystemsis66percentoftotalemploymentandthatprocessing58THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX4FOODDESERTSANDSWAMPSalreadywellestablishedinpoorerneighbourhoodsinhigh-incomecountries.Urbanizationandchangingagrifoodsystemshavegivenrisetotwonewtypesoffoodenvironments:Forexample,therapidgrowthofWindhoek,fooddesertsandfoodswamps.FooddesertsthecapitalofNamibia,hasgonehandinhandwitharegeographicareaswhereresidents’accesstotherapidgrowthofinformalperi-urbanandurbandiverse,freshornutritiousfoodsislimitedorevensettlements.Thesesettlementscanbedefinednon-existent,duetotheabsenceorlowdensityasfooddesertsduetothelackofnutritiousfoodsof“foodentrypoints”withinapracticaltravellingformostinhabitants.111IntheMexicancityofdistance.FoodswampsareareaswherethereisanMazatlán,incontrast,low-andmiddle-incomeoverabundanceoffoodsofhighenergydensityandneighbourhoods,withaveryhighdensityofveryminimalnutritionalvalue.Theyofferfewoptionsforsmall,informalbusinessessellingenergy-denseaffordable,nutritiousfoods.snacks,quickmealsandsugarydrinks,canbeconsideredfoodswamps.112InRiodeJaneiro,Brazil,Althoughbothconceptshavebeencriticizedforastudyfoundthatfooddesertsandswampsweretheirnarrowandinappropriatemeaningincertainsimultaneouslymoreprevalentinthelowest-incomecontexts,110urbanizationcanaffecttheaccessibilityneighbourhoods,whichhadhighlevelsofdeprivationofbothhealthyandunhealthydiets,especiallyinandsegregation.113expandinginformalneighbourhoods.Whileanewandgrowingphenomenoninurbanslumsoflow-andmiddle-incomecountries,thisproblemwasandfoodvending/servicesaredisproportionatelyoftradeandtransportationjobshasthefemale,withwomencomprisingover80percentbiggestimpactinAfrica,wheretheshareofofworkersinthosesectors.45Inthefisheriesandnon-agriculturaljobsinagrifoodsystemsisaquaculturesector,womenrepresent50percentofbetween5percentand14percent.Acrossallthoseemployedintheentireaquaticvaluechainotherregions,thesharerangesfrom8percentin(includingpre-andpost-harvest).100Europeto14percentinAfrica.104,105Furthermore,severalstudieshighlightChangingurbanfoodmarkets:theriseofthatespeciallyinlow-andmiddle-incomecountries,whereagrifoodsystemsemploythesupermarketsandhighlyprocessedfoodslargestnumberofworkers,agrifoodsystemstransformationoffersthepromiseofnewjobsUrbanizationresultsinanincreaseinthenumberbothdownstreamandmidstream,particularlyforlarge,youngpopulations.101,102,103Anewstudyandsizeofurbanfoodmarkets.Bothformalestimatesthattotalemploymentinagrifoodsystemswas1.23billionpeopleworldwideinandinformalfoodmarketoutletshavebeen2019.104,105TotalagrifoodsystemsemploymentinAfricaisestimatedat62percent,comparedexpandingwithcitygrowth,owingtothewith40percentinAsiaand23percentintheAmericas.Whilethestudydoesnotdisaggregatedemandandpurchasingpowerofurbanemploymentbythedifferentcomponentsofagrifoodsystems,itdoesseparateoutemploymentresidentsaswellastopublicandprivaterelatedtofoodsupplytradeandtransportation.Ofthe1.23billionpeopleemployedinagrifoodinvestmentsinthesemarkets.AstudyinEasternsystems,375millionareinjobsrelatedtofoodsupply,tradeandtransportation.TheinclusionandSouthernAfricaestimatesthegrowthofurbanmarketsinthetworegionsatbetween600percentand800percentoverthelastfourdecades.90AstudyofSouth-easternAsiaplacesgrowthatroughly1000percentinthesameperiod.106Urbanizationandchangingagrifoodsystemshavealsogivenrisetobothfooddesertsandswamps,whicharecharacterizedbymarketsthatprovidepooraccesstoorlimitedavailabilityofdiverseandnutritiousfoods(Box4).»59CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>DEMOCRATICREPUBLICOFTHECONGOAwomanharvestingpotatoleaves.©FAO/OlivierAsselinTHESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023»Theformalfoodsectorischaracterizedbymoremoreprofoundlylinkedtoprivatizationandliberalizationofagrifoodsystems.69InAsiaontheformalizedsupermarketsandchains;theyareotherhand,supermarketdevelopmentwascloselyregulatedandtaxedbygovernmentsatvariouscorrelatedwithurbanization.Ultimately,thescales,and–unlikeinformalmarkets–areshifttowardsmoresupermarketshasbeendrivenabletoaffordfinancialandtechnicalservices.byarangeoffactorsincludingrisingincomes,Incontrast,theinformalfoodsectorcanbechanginglifestyles,marketingandincreasingbroadlydefinedasallfood-relatedeconomicawarenessoffoodsafetyandquality.115,116,117activitiesthattakeplaceinindependent,smalland/orunregisteredenterprises.Mostly,Whilesupermarketscanbelinkedtoincreasedthereislimitedcoveragebyformalauthoritiesaccesstonutritiousfoods,118andmodernfoodformonetary,regulatoryandinstitutionaltechnologyhasprovidedbenefitsintermsarrangementssuchastaxation.ofreducingwaste,enhancingsanitationandreducingadverseeffectsofseasonality,109Supply-sidefactors,coupledwithanincreasetheyhavealsobeenassociatedwithincreasedindemandforreadilyavailablefoods,havesupplyofenergy-denseandhighlyprocessedcontributedtoasubstantialexpansionofsupermarketsfoods.81,119,120,121,122,123Thesubstantialexpansionandhypermarkets.107,108,109Thesesupplyfactorsinthetypes,varietiesandquantitiesofhighlyincludepolicyliberalizationandprivatizationprocessedfoodssoldworldwidecanbeassociatedinthe1980sand1990sleadingtocompetitivewiththeexpansionofsupermarketsanddomesticinvestments,publicinfrastructurehypermarkets,theindustrializationofagrifoodinvestmentsthatreducedtransactioncostsforsystems,technologicalchange,andglobalizationsupplychaindevelopment(e.g.procurementincludingmarketgrowthandthepoliticalsystems),andglobalizeddistributionofactivitiesoftransnationalfoodcorporations.moderntechnologyrelatedtofoodproduction,Whiletherearewidevariationsbetweentransportationandmarketing,massmedia,andregionsandcountries,salesofhighlyprocessedtheflowofcapitalandservices.SupermarketsfoodsarehighestinOceaniaandthePacific,havebeenabletoattaineconomiesofscaleinNorthernAmerica,EuropeandLatinAmerica,procurement,andeconomiesofscaleandscopebutarealsogrowingrapidlyinAsia,theNearinmarketing,whichhasallowedthemtoincreaseEastandAfrica.119overtimetheirshareofretailcomparedtosmallshopsandwetmarkets(marketplacessellingDespitethegreaterpenetrationofformalmarketsfreshfoodssuchasmeat,fish,produceandothersuchassupermarketsandhypermarkets,openconsumption-orientedperishablegoodsinaandwetmarkets,aswellasinformalkiosksnon-supermarketsetting),especiallyinAsiaandandstreetvendors,arestillimportantforlocalLatinAmerica.108,109urbanfoodculturesinmanycountriesaroundtheworld,particularlyinAsiaandAfrica.117Increasingly,supermarketsandhypermarketsHere,thelowaverageannualincomeperrepresentthemajorforcecontributingtothepersonisseenasanimportantlimitationfordiettransitioninanycountryorregion.Theirsupermarketstoexpand.124establishmenthasbeenfacilitatedbytheincreaseinlargeurbanfoodmarkets,whichbothbringPoorurbandwellersespeciallybuymosttogetherpotentialconsumersandattractforeignoftheirfoodatinformalmarketsorstreetinvestments.114Thesemarketsareoftenpartofshops.Forexample,supermarketsaccountmultinationalchainsor,incountriessuchasforonly3percentand0.4percentofallfoodSouthAfricaandChina,domesticchainsthatexpenditureofslumdwellersinNairobiandfunctionlikeglobalchains.Kampala,respectively.125InZambia,theshareofsupermarketsislowerinsmallcitiesthaninTherelationshipbetweenurbanizationandthelargercities.126Despiteagreaterpenetrationofgrowthofsupermarketsdifferswidelybyregionformalmarkets,informalfoodretailers–suchandcitysize.InLatinAmericaandtheCaribbean,asstreetandmarkettradersandsmall-scaleurbanizationoccurredinthe1980s,beforetheriseshops–remainabundantacrosstheAfricanofsupermarkets,andtheprocesswasactually61CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>TABLE8THEAVAILABILITYOFFOODGROUPSTOMEETAHEALTHYDIETBASKET,BYREGION(PERCAPITAPERDAY),2020AfricaAsiaLatinAmericaandNorthernEuropeWorldtheCaribbeanAmerica(%)Staplefoods188108684473111Animalsourcefoods−334014333125871(exceptoils)Pulses,nutsandseeds−38−37−42−43−67−41Vegetables−5525−63−20−27−4Fruits−40−31−2−13−24−29Fatsandoils−21−3671008212NOTES:YellowhighlightsemphasizewhereamountsoffoodavailableareinsufficienttomeetaHealthyDietBasket(HDB).FoodavailabilityisbasedonFAOFoodBalanceSheetsdataandhealthydietrequirementsbyfoodgrouparethoseoftheHDBusedinthecostandaffordabilityofahealthydietinChapter2.SOURCE:Dolislager,M.J.,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuumforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.continentaswellasinmanyAsiancountries.117fruits,inparticular,qisinsufficienttomeettheInLatinAmericaandtheCaribbean,streetdailydietaryrequirementsinalmosteveryregionmarketsandwholesalemarketsarealsostilloftheworld(Table8).Particularlyconcerningistherelevant,especiallyforfreshfoods.127,128,129insufficientavailabilityofallfoodgroupsapartInplaceswheresupermarketsareexpanding,fromstaplefoodsinAfrica.Thereare,however,thisprocessaffectsprices,qualityandsafetynotabledifferencesacrosscountriesandwithinstandards,oftenrestrictingaccesstosalesregions.Forexample,thesupplyofvegetablesischannelsforsmallproducers.130,131morethanadequateinAsia.55FoodproductionUrbanizationaffectsagriculturalproductionindifferentwaysacrosstherural–urbancontinuum.Urbanization,inparticular,byincreasingtheInruralandperi-urbanregionsthatarewellconnectivityofruralandurbanareas,alsoconnectedtoexpandingurbanmarketsorstorageaffectsagrifoodsystemsthroughchangesinandprocessingfacilities,small-andlarge-scaleagriculturalproduction(Figure20).Asconsumerfarmersareincreasinglycommercialandbehaviouranddietschange,thisinfluencesrelativelywellservedbyagribusinessesprovidingagriculturalproductionanddiversification,withinputsandfarmoutputmarketingservices.133shiftsinintensityandtypeofproductionfactorsFarmerslocatedclosetourbanmarketsoften(i.e.labour,landandothernaturalresources).receivehigherreturnsontheiragriculturalFurthermore,asalreadyhighlighted,thishasaproductsandbenefitmostfromgrowingmarketsreinforcingcompoundingeffect–asfoodsupplyfordiversifiedhigh-valueproducts.134,135changesinturninfluenceconsumerbehaviourandchoices,whichfurtheraffectfoodproduction.Asurbanareasbecomebetterconnectedtoruralareas,ruralproducersmayalsohavebetteraccessFoodproduction,productionfactorsandtoagriculturalinputsandservices,allowingforimprovedagriculturalservicesproductivitythattypicallyincreasesincomelevels,136Urbanizationisoftenassociatedwithadiversificationofdiets,includingdairy,fish,meat,qThisfindingisalignedwithananalysisinthe2020editionofthisvegetables,fruitsandlegumes–foodsthathelpreport,62whichshowedthattheavailabilityoffruitsandvegetablesforconstituteahealthydiet,asalreadyhighlightedhumanconsumptionwasbelow400gpercapitaperday,whichistheabove.However,theavailabilityofvegetablesandrecommendedamountinFAOandWorldHealthOrganizationguidingprinciplesofahealthydiet.132Furtherresearchisneededtodeterminethereasonsbehindtheseresults.62THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023whichiskeytoincreaseaccesstonutritiousoftenmovefartherawayfromcitiesandconvertfoods.Forinstance,inMeru,UnitedRepublicmoreremotenaturalareas(mostlyforestsandofTanzania,urbanizationhasstimulatedthescrublands)intonewfarmland,negativelydemandformilk,providingareliablesourceaffectinghabitatqualityandbiodiversity,ofincomeforsmallholdersinaregionfacingandcausingenvironmentaldegradationandascarcityof(fertile)land.137Improvedaccessdeforestation.144,145,146,147Insomecases,farmerstoinputsandthesupportofstableinstitutionsaredriventouselessproductivelandsinmorewereimportantconditionsthatfacilitatedthisremotevillages,orarerestrictedtounauthorizedintensification,resultinginhigherincomes.publicspaces.148,149Whatismore,convertedlandsarelessfertilethanarablelandsaroundcities,Theeffectsofurbanizationcanspreadtoleadingtoalossinagriculturalproductivitythatagriculturalzonesquitefarfromtownsandcities,ishigherthantheabsolutelossofland.150Meetingdependingontheconnectivitybetweenruralandfoodproductionanddemandforanurbanizingurbanareas,whichisshapedbytheproximitypopulationwhenlandavailabilityandqualityaretocitiesandbyexistingtransportroutes.138reducedrequiresagriculturalintensification;thisThiscanbeseenintheruralregionsaroundimpliesintensiveuseofenergy,landandwater,Delhi,India.Vegetablesanddairyproductsarewhichifnotmanagedtomitigateagainstclimatebecomingincreasinglyimportantcomponentschange,canleadtoanincreaseingreenhousegasofconsumptionnotonlyinhigh-incomeurbanemissions.151,152,153,154households,butalsoinlow-andmiddle-incomeurbanhouseholds.AsaresultofthesechangesWithurbanizationcontinuing,theresultantlossinurbanconsumption,theruralareasaroundofcroplandisexpectedtobe3percentintheDelhi,whichusedtobecultivatedwithcereals,wholeofAsiaandAfricaby2030.Theproductionarenowincreasinglybeingdiversifiedtoloss,however,is6and9percent(respectively),vegetableproductionandlivestockkeeping,because(asstatedabove)agriculturallandaroundandproductivityisrising.139Thefar-reachingcitiesisoftenmorefertile–animportantreasoninfluenceofurbanizationisalsoseeninfisheries,whycitieshistoricallydevelopedwheretheydid.whereithasimpactedfishers'abilitytomeettheAdditionally,farmersclosetocitiesareoftenrisingcostoflivinginfishingcommunities.140moreproductiveduetohigherinputuseandknowledgelevels.150Therefore,theproductivityAtthesametime,millionsofsmallholdersinlesslossishigherthantheabsolutelossofland.Inaccessibleordetachedhinterlandsremaincutmostcountries,productionisrelocated,althoughofffromtheopportunitiesthatgrowingurbanthisisnotpossibleeverywhere–inEgypt,foodmarketscanbring.141Inmoreisolatedruralforinstance,theamountofarableandfertileareas,agriculturalgrowthislimitedduetolowlandislimited.155productivityandhightransportationcosts.138FarmerswithlimitedaccesstourbanmarketsUrbanizationcanalsoaffectfarmsizeinvarioushavefewopportunitiestoprofitfromurbanways.Impactsdependonlandtenuresecurity,development.Forexample,insub-SaharanAfrica,non-farmopportunities,andthemagnitudeandtheadoptionofhigh-inputtechnologyandcropimpactoflandpurchasesbyurbanbuyers.133,138productivityisfoundtobenegativelycorrelatedInlow-incomecountries,farmsizeshavewithtraveltimetourbancentres.142decreasedfromanaverageof2.1hectaresin1960to1.3hectaresin2010,duetoruralpopulationAnotherimportantdirectimpactofurbangrowth(andsubsequentoutmigrationaspartofexpansionisland-usechange.Insomecountries,urbanization).156Ingeneral,farmsizesdecreasefarmersreceivehighcompensationforsellinguntiloff-farmopportunities,oftenincities,theirland,143whereasinothers,dispossessionofexpandsufficientlytoabsorbnewworkers.Asiaagriculturallandisnotcompensated,resultinghasnowpassedthisturningpointsoitsaverageinalossoflivelihoodsandissuesaroundlandfarmsizescanrise,whileinAfricaaveragerights.Asfarmsinperi-urbanareasmakefarmsizesareexpectedtocontinuetofallinvoluntaryorinvoluntaryroomforurbanmanycountries138–althoughinsomeareastheyexpansionandassociatedinfrastructure,theyarerising.Insub-SaharanAfrica,thegrowing63CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>acquisitionoffarmlandbyurbanbuyershastoaffordablehealthydietsthroughouttheincreasedaveragefarmsizescomparedtootherrural–urbancontinuumasaresultofanumberofAfricancountries.15structuralchallenges.62,157TheseincludeeconomicchallengesrelatedtothehighcostofnutritiousHowurbanizationaffectsaccesstofoods(Figure21),whichvarieswithincountriesaffordablehealthydiets,foodsecurityandcanbeevenhigherinpoorneighbourhoods.andnutritionForurbanpopulationslivinginpoverty,themosteasilyavailableandaffordabledietstendUrbanizationcanhavebothpositiveandtobeunhealthy.158Accesstonutritiousfoodsisnegativeimpactsonaccesstoaffordableoftenlimited,asthesetypesoffoodsaremorehealthydietsandonfoodsecurityandexpensive,orinsomecasesunavailable,inmorenutritionacrosstherural–urbancontinuum.urbanizedareas.PoorerhouseholdsareinclinedLinkagesbetweenurbanizationandaccesstotoprioritizemeetingdietaryenergyrequirementsaffordablehealthydietsarenotunequivocal:overnutritionalquality,spendingtheirresourcesobservationsdependhighlyonlocalornationalonmoreaffordablefoods,whichtendtobeofcontext-specificdynamics,includinginvestmentshighenergydensityandminimalnutritionalinagrifoodsystemsaswellasinruralandvalue.158,159Otherstructuralbarriersarefoundinurbaninfrastructure,trainingandeducation,agrifoodsupplysystemsandmarkets,impedingandeconomicpolicies.Therearehoweverphysicalaccesstohealthydiets(resultinginfoodsomeimportantoverarchingchallengesanddesertsandswampsinurbanareas,forexample).opportunitiesconcerningurbanizationacrosstherural–urbancontinuum.Figure21summarizesForotherincomegroupsofurbandwellers,themostimportantofthese,drawingfromanimportantchallengetoaccesstoaffordabletheprevioussectionsonhowurbanizationishealthydietsisthaturbancentreshavemoreaffectingagrifoodsystems,aswellasfurthersupermarketsandespeciallyfastfoodchains,empiricalevidenceandstudies.Althoughtheincludingmultinationaloutlets,offeringachallengesoutnumbertheopportunities,thisreadyandabundantsupplyofhighlyprocessedisnotpersethecaseforthemagnitudeofthefoods,aswellasenergy-densesnacks,sweets,impactsonaccesstoaffordablehealthydiets.andsugar-sweetenedbeverages(Figure21).ThesedevelopmentshavenegativelyaffectedInrecentyears,manystudieshavefocusedobesitylevelsandhealthconditionsofurbanonurbanizationandagrifoodsystemsdwellers.160,161Itisimportanttonotethatwhiletransformation;neverthelessthereislimitedsupermarketshaveanadvantageinsellinghighlycommonunderstandingofhowthenexusprocessedfoodsbecauseofeconomiesofscale,aofthesetwoprocessesaffectsbothaccesstogrowingnumberofsmallshopsarealsosellingaffordablehealthydietsandfoodsecurityandtheseproducts.54,69Therapidlyincreasingsharenutrition,andevenfewerstudieshaveappliedofhighlyprocessedfoodsofhighenergydensityarural–urbancontinuumlens.Datatosupportandminimalnutritionalvalue,especiallyinsuchadisaggregatedrural–urbancontinuumurbanconsumptionpatterns,islinkedtotheriseanalysisareextremelylimited;theanalysisinobesityandnon-communicablediseases.54requireshouseholdsurveydatawithgeospatialInmanycountries,obesitylevelshaverisenlocationaldata,andformostcountriesinthealongsideurbanization.NewevidenceforAfricaworldsuchdataarenotreadilyavailable.suggeststhatconsumptionofhighlyprocessedChapter4exploresthisquestionthroughanewfoodsandhigh-caloriesnacksandbeveragesanalysisonvariationsinfooddemand,economicisspreadingacrossthefullspectrumoftheaccesstohealthydiets,andfoodsecurityandrural–urbancontinuum,evenamongtheruralnutritionacrosstherural–urbancontinuum,poor–atrendofgreatconcern(seeSection4.1).usingselectedcountrycasestudiesasfarasdataavailabilityallowed.RecentempiricalstudiesshowthattheriskoffoodinsecuritycanevenbehigherinurbanWhatwedoknowisthatempiricalevidenceareasthaninruralareas,duetotheintra-urbanrevealssocioeconomicdisparitiesinaccessinequalitiespresentinmanyrapidlyurbanized»64THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE21CHALLENGESANDOPPORTUNITIESINACCESSINGAFFORDABLEHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMCONSUMERBEHAVIOURANDDIETSMorediversiﬁeddiets,includingdairy,ﬁsh,meat,vegetables,fruitsandlegumesWidespreaddiusionoffoodpurchasesinruralareasGreaterdemandforconvenience,pre-prepared,ready-to-eatandfastfoodsHighcostofnutritiousfoodsrelativetothecostofprocessed,energy-densefoodshighinfats,sugarsand/orsaltAGRIFOODSYSTEMSFOODSUPPLYCHAINS–DOWNSTREAM(marketing,retailandtrade)SpreadofprocessedfoodsofhighenergydensityandminimalnutritionalvaluethatarereadilyavailableandcheapMoreemploymentopportunitiesindownstreamfoodsupplychainsIncreasedsupplyofdiversenutritiousfoodsbutataveryhighcostthatisunaordableforthepoorLarge-scaleexpansionofsupermarketsandhypermarketssupplyingcheaphighlyprocessedfoodsofminimalnutritionalvalueFooddesertsandswamps,andlimitedaccessandaordabilityforlow-incomegroupsFOODSUPPLYCHAINS–MIDSTREAM(logistics,processingandwholesale)Increasedsupplyofconvenience,pre-prepared,ready-to-eatandfastfoodsthatareoftenenergydenseandhighinfats,sugarsand/orsaltGreatero-farmopportunitiesinmidstreamfoodsupplychainsLossofincomeopportunitiesduetoexclusionfromvaluechainsofsmallfarmersduetovaluechainformalizationFOODSUPPLY–PRODUCTIONUrbanandperi-urbanagriculturalproductioncreatingemployment,generatingopportunitiesforsmallbusinessesandincreasingsupplyofnutritiousfoodsRisingincomeforfarmerswellconnectedtocitiesduetoimprovedproductivityanddiversiﬁcationfollowingrisingdemandInsucientproductionandhighpricesforvegetablesandfruitsAsurbanareasgrowclosertoruralareas–betteraccesstoagriculturalinputsandservicesallowingimprovedproductivity,lowerpricesandrisingincomes(Peri-)urbanagriculturallivelihoodsthreatenedbyurbanexpansionRuralareasfarawayfromcitiesRURAL–URBANCONTINUUMLargecitiesTownsandsmallcitiesChallengestoaccessaordablehealthydietsOpportunitiestoaccessaordablehealthydietsSOURCE:deBruin,S.&Holleman,C.2023.Urbanizationistransformingagrifoodsystemsacrosstherural–urbancontinuumcreatingchallengesandopportunitiestoaccessaffordablehealthydiets.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-08.Rome,FAO.65CHAPTER3URBANIZATIONISTRANSFORMINGAGRIFOODSYSTEMS<...>»countries.162Indeed,newanalysisfromdesignedtofacilitatefoodaccess–suchasmonetaryorin-kindtransferschemes,communitycountrycasesstudiesinsub-SaharanAfricakitchensandfoodbanks–areofteninsufficient(seeSection4.2)showsthattheprevalenceofbythemselvestofullyresolvefoodinsecuritymoderateorseverefoodinsecuritybasedontheproblems,becausetheydonotaddressbarriersFoodInsecurityExperienceScaleinurbanandsuchaslackofcookingfacilitiesorfoodstorage,peri-urbanareasissimilarto(e.g.Côted’Ivoire,andcompetinghealthorhousingexpenses.Senegal)orsometimesevenhigherthan(e.g.Niger,Nigeria)thatinruralareas.AccessOntheotherhand,inruralareas,urbanizationtofood–nutritiousfoodsinparticular–acrosscanprovideopportunitiesforon-andoff-farmtherural–urbancontinuumiscomplex,withemployment(Figure21),thusincreasingpurchasingmultipledeterminants.Itcannotbeassumedpowerandoptionstoaccesshealthydiets.thatthisaccessisalwaysbetterforpopulationsEspeciallyinruralcommunitieswhereagricultureinurbanareas.Infact,severalstudiesshowcompletelydominatestheeconomy,thegrowththattheso-called“urbanadvantage”doesnotofsmallcitiesandtownscanplayanimportantbenefitthepoorest,who–onthecontrary–roleinprovidingaccesstoinputs,marketsandfacedisproportionatebarrierstoaccessingandnon-farmactivities,thusreducingpovertyandconsumingahealthydietandhaveanincreasedimprovingfoodsecurity.169However,thereareriskoffoodinsecurityandmalnutrition.157alsorisksoflosingordecreasingopportunitiestosustainlivelihoodsduetoformalizationFurthermore,whenmigrationdecisionsreflectprocesses.Forexample,feesforstallsinformalthepushfactorsinruralareas(e.g.conflictormarketsareoftenrelativelyexpensive,whichlackofaccesstoland)ratherthanthepullofdecreasestheaccessibilityofthesemarketsforbetteropportunitiesinurbanareas,foodsecuritymanysmall-scalefarmersandtraders.Nearlyandnutritionoutcomescanbecompromisedallsmallholderfarmers,mosttradersinfood(Figure21).10Challengesaroundaccessingfoodandmarketsandmanymicro-andsmall-scalefoodtheriskoffoodinsecurityamongrural–urbanprocessorsandfoodretailersarenotpartofthemigrantsareintensifiedduringcrises.163,164,165formalfoodeconomyinsub-SaharanAfrica,170Rural–urbanmigrantswhoofteninhabitinformalandimprovementsinformalmarketswillnotsettlementslacksocialprotectioncoverageandbenefittheseactors.Thusthereisariskthattheirneighbourhoodsoftenfalloutsidetheremitsmallholders,small-scalefoodprocessorsandofurbanplanning.TheCOVID-19pandemicisanfoodretailersbeexcludedfromformalizingexampleofasituationinwhichlow-incomeandvaluechains.Understandinghowtobestsustaininformalrural–urbanmigrantsexperiencedfoodinformalvaluechainsiscritical;however,thisinsecurityincities.knowledgeisoftenlacking.171FoodinsecurityinurbanareasisstronglydrivenTherural-to-urbanoutmigrationofyoungbyincomelimitations;low-incomehouseholdspeople,oftenmen,alsoposesbothchallengesneedtoallocateahighproportionoftheirtotalandopportunitiesintermsofimprovingexpendituretofoodandareextremelyvulnerableaccesstoaffordablehealthydiets(Figure21).toexternalshocksincludingunemployment,Insomecontexts,ruraloutmigrationcanresulthealthproblemsandfoodpriceinflation.157insubstantialremittancesthatincreasetheFoodinsecuritycanbefurthercompoundedbyaccessibilityofhealthydietsandimprovepoorhealth,aslow-incomeurbanhouseholdsfoodsecurityinruralareas.172,173Householdstendtohavepoorsanitationandalowstandardthatreceiveremittancescanbebetteroffinofotheressentialhousinginfrastructureandtermsoftotalincome,assets,caloriesupplygoods.166,167,168Urbanpovertyposesdiverseandmicronutrientsupply.174Rural-to-urbanchallengesthatpreventaccesstohealthydietsmigrationcanalsocontributetoresilienceinthe(e.g.unplannedbuiltenvironments),andcommunitiesoforiginandfurtherthetransferofchallengingsocialnetworkstructuresoftenknowledgeandotherresourcesbesidesfinancialpreventlow-incomehouseholdsfromfindingremittances.175However,thereareinstancesstrategiestocopewithfoodinsecurity.Socialwhereremittancesaretoolow(orevenabsent)protectionandfoodassistanceprogrammes66THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023toreplacethelostworkerswithhiredlabour.176Africa,185foundthatruralpopulationsareInsuchcases,thelostlabourandassociatedcharacterizedbyworsenutritionoutcomesthanreductioninincomeoragriculturalproduceurbanpopulations,butitalsoproducedthecanresultindecreasedaccesstohealthydiets,somewhatunexpectedresultthatthenutritionorinlongerworkinghoursfortheleft-behindoutcomesofmoreremoteruralpopulationsarewomeninsubsistencefarmingtomaintainnotsubstantiallyworsethanthoseoflessremotehouseholdfoodsecurity.ruralpopulations.Thisfindingisalsoalignedwithnewanalysis(presentedinSection4.2)ofIntermsofmalnutrition,studiesgenerallyshowchildstuntingandwasting,whichlooksatruralthatruralpopulationsfaceahigherburdenofcatchmentareasofvaryingtraveltimestothechildundernutritionthanurbanpopulations,177,178nearesttownorcityinthreesub-SaharanAfricannotonlybutespeciallyinsub-SaharanAfrica,acountries.Furthermore,andbroadlyinkeepingsubregionwheremanyhouseholdsstillliveinwithpreviousanalysesofrural–urbaninequalityremoteruralareas.Studiessuggeststherearenoinnutrition,itappearsthatthemajorityoffundamentaldifferencesinthecharacteristicsthatthisnutritionaldisadvantageisexplainedbydeterminechildnutritionoutcomesinurbananddifferencesinwealth,education,healthandruralareas.Instead,differencesareexplainedbynon-roadinfrastructureservicesacrossruralthebetterurbanenvironment,greaterchoicesandandurbanareas.185increasedopportunitiesrelatedtosocioeconomiccharacteristics,frommaternalandspousalInconclusion,accesstoaffordablehealthydietsiseducation,wealth,andemployment,tosocialandgenerallybetterandfoodsecurityandnutritionfamilynetworks,aswellasaccesstohealthcarelevelsarehigherincitiesthaninruralareasandotherservices.becauseofthebetteravailabilityoffood,higheraveragepurchasingpowerinurbanareas,andUrbanizationtypicallyentailsimprovedaccessbetteraccesstohealthcare,educationandothertonon-foodmarketsandservicesthatareservicesthatareessentialforhealthandnutrition.importantfornutrition,includingschools,However,thisdoesnotalwaysholdtruegiventhehealthclinicsandnon-farmlabourmarketsthattransformationsunderwayinagrifoodsystems,improveincomestability.177,178,179Furthermore,thestarkinequalitiesthatexistwithinurbanproximitytotownscanalsoweakenthepopulations,andtheincreasinglyspatialandrelationshipbetweenagriculturalshocksandfunctionalconnectivitybetweencities,townsandchildnutrition.180,181Morerecently,studiesruralcatchmentareas.185,186Newevidencefromfindthat“marketaccess”canbeanimportant11countriesinsub-SaharanAfricapresentedindeterminantofdietarydiversityandhencechildSection4.2suggeststhatthe“urbanadvantage”innutritionoutcomes.182,183,184Thereisrelativelyaccessingaffordablehealthydiets,foodsecuritylittleresearch,however,onthedegreetowhichandnutritionmaynotbeasgreatasexpected.ruralpopulationshaveaccesstourbanmarketsThus,itwillbeincreasinglyimportanttoanalyseandservicesandtheassociateddifferencesintheseacrosstherural–urbancontinuum,andnutritionseenacrossruralandurbanpopulations,tounderstandthepatternsofurbanizationandoracrossgradientsofruralremoteness.185connectivityacrosstherural–urbancontinuuminOnesuchstudy,whichexaminedthelinkagesordertoidentifythechallengesandopportunitiesbetweenchildnutritionandurbanizationandforensuringaccesstoaffordablehealthydiets,proximitytolargeurbancentresinsub-Saharantoimprovefoodsecurityandnutritionforall.n67DEMOCRATICREPUBLICOFTHECONGOAmantransportssacksofcabbagestomarketbybicycle.©FAO/OlivierAsselinCHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITYOFHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMAshighlightedinChapter3,athoroughanddifferentformsofmalnutritionacrossunderstandingofhowurbanizationisdrivingtheURCA-definedrural–urbancontinuumchangesinagrifoodsystemsthataffectthe(Section4.2).navailabilityandaffordabilityofhealthydietsisonlypossiblethrougharural–urbancontinuum4.1lens.AsseeninChapter3andillustratedinUNDERSTANDINGFigure20,foodenvironmentsreflectacomplexFOODSUPPLYANDinterplayamongsupply-sidedriversincludingDEMANDACROSSfoodpricing,productplacementandpromotion,THERURAL–URBANanddemand-sidedriversincludingconsumerCONTINUUMpreferencesandpurchasingpower.KEYMESSAGESTogetherthiscomplexinterplayofsupplyanddemandinagrifoodsystemsiskeytoèNewevidencefor11Western,EasternandSouthernunderstandinghowurbanizationisaffectingAfricancountriesshowsthatwhilehighsharesoffoodaccesstoaffordablehealthydietsacrossthepurchasesamonghouseholdslivinginurbancentresarerural–urbancontinuum.Amorenuancedexpected(78–97percent),sharesaresurprisinglyhighgeoreferencedmappingofthespatialandacrosstherural–urbancontinuum.Thisisthecaseevenfunctionalconnectivityacrosstherural–urbanforruralhouseholdsliving1to2hours(56percent)andcontinuum,usingthenewlyavailableFAOUrbanmorethan2hours(52percent)fromanurbancentre.RuralCatchmentAreas(URCA)globaldataset(seeChapter3andBox2),thusbecomesakeytoolèOwnproductionisnotthemainsourceoffoodtoarriveatsuchathoroughunderstanding.inruralareasinthe11Africancountries.Infact,theaverageshareofownproductionrepresentsonlyThischaptercontributesnewevidenceonhow37percentand33percentoftotalhouseholdfoodurbanizationischangingfoodsupplyandconsumptioninhigh-andlow-food-budgetcountriesdemandacrosstherural–urbancontinuum,respectively,dispellingthenotionthatruralpopulationsdrawingfromanalysisutilizingtheURCAinAfricarelyprimarilyonsubsistencefarming.datacombinedwithgeoreferencedhouseholdsurveydata(Section4.1).Thisisfollowedbyadditionalanalysisforselectedcountriesthatexploresdifferencesinthecostandaffordabilityofahealthydiet(CoAHD),foodinsecurity,69CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>èGiventhatruralhouseholdsinthe11AfricanAnunderstandingofthechangesoccurringincountriesdonotproducethemajorityofthefoodvaluefoodsupplyanddemandbasedonempiricaltheyconsume,theaffordabilityofhealthydietsisevidenceiscrucialforpolicymakers.Thisequallycriticalacrosstherural–urbancontinuum.knowledgeisneededtodesignappropriatefood,agriculturalandnutritionpolicies,asèWhilethediffusionofprocessedfoods,includinghighlywellasrelatedsectorpoliciessuchashealth,processedfoods,isalreadyadvancedinAsiaandLatincityandregionalplanning,andeducation.America,itisspreadingquicklyinAfricaaswell.IntheOnlythroughallofthesepoliciescanagrifood11countriesinAfrica,ruralhouseholdsareconsumingsystemsbeleveragedtodeliverhealthydietsprocessedfoods,includinghighlyprocessedfoods,acrossthatareaffordabletoeveryoneacrossthetherural–urbancontinuum,eveninremoteruralareas.rural–urbancontinuum.èHighlyprocessedfoodsareasmallproportionofWhilethereisasubstantialamountofliteraturetotalpurchasesandtheirconsumptionishigherinurbanthatdiscussestheeffectofurbanizationonfoodareas;however,resultsshowthepenetrationofhighlydemand,5soundempiricalevidencethatlooksatprocessedfoodsinruralareas,eventhoseliving1to2thefullspectrumoftherural–urbancontinuumhoursormorefromacityortown.isstillscarceandlimited.Todate,themajorityofexistingresearchisbasedonthedescriptiveèMovingacrossthecontinuumfromurbantocomparisonoffooddemandbetweenruralandruralareasinthesecountries,thereisanincreasingurbanareas.Whilethisresearchisimportant,thishouseholdfoodconsumptionvalueshareofstaplefoodssimplecomparisondoesnotreflecttherealityofandpulses,seedsandnuts,andadecreasingvaluechangingsettlementpatternsanddemographicshareofanimalsourcefoodsandfoodawayfromhome.shiftswithinarural–urbancontinuum.Incontrast,sharesofvegetables,fruits,andfatsandoilsareuniformacrosstherural–urbancontinuum.NewresearchsuggeststhatthedifferencesbetweenurbanandruralfooddemandmaynotèWhileanimalsourcefoodconsumptionvaluesharesbeasacuteaspreviouslythought(seeChapter3).arestronglydrivenbyincomeacrosstherural–urbanHowever,thisresearchdoesnotprovideancontinuum,incontrast,sharesoffruitsandvegetablesunderstandingofthemagnitudeofthedifferencesaredrivenmorebyaccessandavailability.infooddemandacrossthefullspectrumoftherural–urbancontinuum,noranunderstandingofAshighlightedinChapter3,urbanization,thelocation-relatedfactors(i.e.wherehouseholdscombinedwithrisingincomes,increasesintheliveinrelationtovariouspointsacrosstheopportunitycostoftimerelatedtowork,lifestylerural–urbancontinuum),andotherhouseholdchangesanddemographicshifts,ischanging(e.g.socioeconomic)orfoodenvironmentfactorsfooddemand.Thesefactorstogetherwithmanythatmaybedrivingthesedifferences.supply-sideconsiderations,includingfoodpricing,marketingandpromotion,amongothers,Tohelpbridgethisgap,thissectionpresentsaninturnarechangingagrifoodsystems,sothereanalysisoffooddemand,definedashouseholdisareinforcingcompoundingeffectonthefoodfoodconsumption(atmarketvalue)acrosstheproduced,suppliedandconsumed.rural–urbancontinuuminselectedcountries,applyingthenewlyavailablegeospatialURCAMostnotably,rapidurbanizationisleadingtodataset.TheURCAclassificationprovidesarisingandchangingfooddemand,andshiftsmoregranularlenstoexploretheinterplayofinpatternsoffoodsupply1,2–especiallyinfoodsupplyanddemandacrosstherural–urbansub-SaharanAfricaandSouthernAsia,thetwocontinuumthantheDegreeofUrbanizationregionsexhibitingthehighesturbanizationrates.(DEGURBA)classificationusedinChapter2,Projectionsofoverallfoodexpenditureestimatewhichisanofficialmethodologyfordelineatinganapproximate2.5-foldincreaseinsub-SaharanurbanandruralareasforinternationalandAfricaanda1.7-foldincreaseinSouthernAsiaregionalstatisticalcomparisons.by2050.1,3,470THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLE9URBAN–RURALCATCHMENTAREAS(URCAs)USEDINCHAPTER4TenURCAsappliedintheanalysesofChapter4FurtheraggregationintothreecategoriesLargecity(>1millionpeople)Intermediatecity(0.25–1millionpeople)UrbanSmallcity(50–250thousandpeople)Town(20–50thousandpeople)<1hourtoalargecity<1hourtoanintermediatecityPeri-urban<1hourtoasmallcity<1hourtoatown1–2hourstoacityortownRural>2hourstoacityortownSOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TheURCAmethodologydefinesurbancentresanalysis,astherearecurrentlyonlyahandfulofacrossarural–urbangradientbasedonLSMSdatasetsthathavelatitudeandlongitudepopulationsizeanddensity,wherebythecityinformationwhichispubliclyavailable.rAllofsizeisaproxyforthebreadthofservicesandthesedatasetsareforAfrica;hencetheanalysisopportunitiesprovidedbyanurbancentre.inthissectionislimitedtocountrycasestudiesUniquely,theURCAdatasetalsoclassifiesruralinthatregion.However,asananalysisoffoodlocationsusingtheshortesttraveltimetoandemandacrosstheURCA-definedrural–urbanurbancentre,asaproxyforthecostofaccessingcontinuum,itisthefirstofitskindandprovidesgoods,servicesandemploymentopportunitiesinsightsontheimportanceofusingarural–urban(seeChapter3andBox2).Thereare30urban–ruralcontinuumlenswhenanalysingotherregions.catchmentareas(URCAs)categoriesintotal;GiventhatAfricahasthehighestshareofthehowever,forthepurposeoftheanalysisinthistotalpopulationunabletoaffordahealthychapter,thesearefurtheraggregatedintotendiet(77.5percentin2021)(seeChapter2)andiscategories(Table9).Tofacilitatethepresentationlaggingbehindinfoodsecurityandnutrition,anddiscussionofthemorecomplexdata,somefocusingoncountriesofthiscontinentiswithoftheanalysisisfurtheraggregatedintothreemeritinitself,especiallyasithasoneofthecategoriesforurban,peri-urbanandruralhighestratesofurbanizationintheworld.Theareas(seeTable9).analysispresentedbelowalsoservestohighlighttheneedforfurtheranalysiscoveringotherTheURCAglobalgeospatialdatasetismappedregions,whichwilldependonanincreasedagainstlatitudinalandlongitudinaldataavailabilityofgeoreferencedsurveydata.ofhouseholdsfromthemostrecentWorldBankLivingStandardsMeasurementStudyToevaluatehouseholdfoodconsumption(LSMS),makingitpossibletoworkwithbehaviour,georeferenceddatafromnationallydifferentcategoriesofcatchmentareasacrossrepresentativeLSMSsurveyscoveringtheperiodtherural–urbancontinuum–asdefinedin2018/19areusedforBenin,BurkinaFaso,CôteBox3inChapter3.d’Ivoire,Ethiopia,Guinea-Bissau,Mali,theNiger,TheavailabilityofgeoreferencedhouseholdrMostLSMSsurveyscollectlatitudeandlongitudeinformationforsurveydatawasamajorlimitingfactorforeachhousehold.However,almostallcountriesdonotmakethesedataselectionofcountriesforthisfooddemandpubliclyavailableforreasonsofprivacy.71CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>TABLE10FOODBUDGETS,INCOMELEVELSANDHOUSEHOLDFOODCONSUMPTIONSHARESFORHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESANALYSEDFoodbudgetIncomeFoodconsumptionsharesTotalhouseholdfoodTotalhouseholdexpenditureHouseholdfoodconsumptionasaconsumptionpercentageoftotalhouseholdexpenditure(PPPdollarspercapitaperday)(%)High-food-budgetcountries2.344.0458Senegal2.576.1042Ethiopia2.443.8563Côted’Ivoire2.295.0445Mali2.294.5450Nigeria2.263.8159Low-food-budgetcountries1.623.2949Guinea-Bissau2.064.3847Benin2.004.4145Togo1.694.1241BurkinaFaso1.573.7042Malawi1.522.3964Niger1.462.7852NOTES:Allsurveysare2018/19,exceptMalawi(2019/20).PPP=purchasingpowerparity.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.Nigeria,SenegalandTogo,and2019/20forcomprisesallfoodsconsumedawayfromhomeMalawi.sTheLSMSsurveyscapturehousehold(e.g.fromstreetvendorsandinrestaurants).foodconsumptionusingaseven-dayrecall.Forthefooddemandanalysis,reportedfoodsTheclassificationoffooditemsbyleveloffoodareaggregatedintocategoriesbasedonfoodprocessingwasadaptedfromtheNOVAfoodsource,foodprocessinglevelandfoodgroup.classificationsystem,6,7focusingonlyonthoseFoodsourcesaredefinedusingfourcategories,foodsclassifiedaslowprocessed(“processed”inthefirstthreeofwhichareassumedforat-hometheNOVAclassification)andhighlyprocessed.consumption,specificallyfoodfromownSeeAnnex5forafulldescriptionofthedatasetsproduction,foodpurchased,andfoodreceivedasanddefinitionsapplied,includingdescriptionsofagiftorasin-kindpaymentforlabour.Thevaluefoodgroupsanddetailsaboutfoodprocessing.offoodconsumptionfromownfoodproductionandfoodreceivedasagiftorin-kindisvaluedInthefooddemandanalysisthatfollows,theatthemarketpricethathouseholdswouldhave11countrieswereclassifiedintotwogroupshadtopayiftheyhadpurchasedthesameaccordingtotheirfoodbudget,thatisthequantityfromthemarket.27Thefourthcategorymarketvalueoftheaveragetotalhouseholdfoodconsumptionpercapitaperday:high-food-budgetsThesearetheonlycountriesthathavepubliclyavailableLSMScountries(average2.3PPPdollarspercapitapersurveydataidentifyinghouseholdsbylatitudeandlongitudeandanday)andlow-food-budgetcountries(averageexhaustivefoodconsumptionmodule,elementswhicharenecessaryto1.6PPPdollarspercapitaperday)(Table10).carryoutthedemandanalysisbyURCA.OtherspatialidentifierswereCountrieswerefirstrankedbasedonaverageexplored,buttheyprovedtobeinaccurateinidentifyinghouseholdsbyfoodbudgetandthensplitintohigh-andURCA,sothesewerenotapplied.Thefactthat9outofthe11countrieslow-food-budgetcountries.CountrieswerearelocatedinWesternAfricapreventedamorebalancedsubregionalsplitintothetwogroupswithnoreferencetoapproach.72THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023abenchmark,buttheydepictacross-sectionThetwocountryfood-budgetgroupsaddaofAfricancountriesfromtheperspectiveoffurtherdimensiontotheanalysisthatrelatesdifferentlevelsofdevelopmentintermsoftoanongoingdebateaboutwhathappensaveragetotalhouseholdfoodconsumption,incountriesofhighandlowpercapitafoodwhichalsoroughlycorrelateswithaveragetotalconsumption:Arethelatterjusttraditional,orhouseholdexpenditure,aproxyforhouseholdaretheyalsochanging?Oneexpectstofindmoreincome(Table10).Theyfellroughlyintoabovediversifieddietsandprocessedfoodsinurbanandbelow2PPPdollarspercapitaperdayareas,aswellasinplaceswheretherearehigherfoodbudget.t,ulevelsoffoodconsumptionpercapita,but,asweshallseebelow,lookingatfooddemandacrossMoreover,thereisanassumptionthatthetherural–urbancontinuumandcomparinghigh-differencesinfoodbudgetswillleadtodifferentandlow-food-budgetcountries,thismaynotbepatternsofconsumption.Thisisbasedonathecaseasarule.Ifthepatternsoffooddemandwell-establishedeconomiclaw,referredtoasarethesame–betweeneitherurban,peri-urbanBennett’slaw,v,8whichstipulatesthatdietsbecomeandruralareasorlow-andhigh-food-budgetmorediversifiedwithhigherlevelsoffoodcountries–thisinitselfisanimportantfinding.consumption,incomeandemployment.Thus,theIndeed,theinsightsandmessagesarestrongerdifferencesinfoodconsumptionpointtolargerifoneseestheyarehappeningbothacrossfoodbudgetsproviding“room”foradditionstherural–urbancontinuumandinhigh-andbeyondstaplefoodswithincreasingexpenditureonlow-food-budgetcontexts.non-stapleproducts(asBennett’slawpredicts)aswellasonindustrially(ratherthanhome)processedForthe11Africancountriesanalysed,Figure22foodproductsthatreducetheopportunitycostofshowsthecountrypopulationdistributionacrosstimeforwomenandmenengagedinemploymenttencategories(i.e.URCAs)oftherural–urban(seeChapter3).Usuallyhigherfoodbudgetsarecontinuum(seeTable9forspecificcategorycorrelatedwithbothoftheseconsumptionchanges,grouping).Whiletherearecountryexceptionsandthetwosetsofcountriesallowthiscorrelationineachgroup,ingeneral,high-food-budgettobetested.Thisisofparticularrelevancewhencountriestendtohavealargershareoftheseekingtounderstandhowurbanizationisdrivingpopulationlivinginlargeandintermediatechangesinagrifoodsystemsandhowthisislikelycitiesandtheirsurroundingperi-urbanareastoaffectfooddemandandaccesstohealthydiets,(41.5percent)comparedtolow-food-budgetasweshallseenext.countries(34.2percent).tRankingandclassifyingcountriesbyincomeisnotasrelevantforaFurthermore,high-food-budgetcountriesareinfooddemandanalysis,becausesomecountrieshavehighincomesmostcasescharacterizedbydensemetropolitanlinkedtothenon-farmsector,andtheseincomesarespentonnon-foodurbanizationpatterns,whilelow-food-budgetitems.Itisalsonotusefultorankandclassifycountriesbytheshareofcountriestendtohavemoredispersedfoodintotalexpenditure,forasimilarreason:higherincomeusuallyurbanizationpatternsaroundsmallcitiesandleadstolowerfoodshare(Engel’slaw),butthefoodsharecanvaryfortowns.Figure23providesamappingthatrepresentsnon-incomereasons,andthusitdoesnotmatter.twocontrastingpatternsofurbanization:densemetropolitan(e.g.Nigeria)andsmallcityanduThecountry“split”occursatafoodbudgetofroughlyUSD2pertowndispersed(e.g.BurkinaFaso).Themapscapitaperday.Coincidentally,itmaybenoticedthatthissplitpointisprovideausefulvisualfor“unpacking”thetennotfarfromthenewWorldBankextremepovertylineofUSD2.15perURCAcategories(seeAnnex6formapsofothercapitaperday;however,thetwoareinnowayrelated,aspovertylinescountriesanalysed).areincomebased.ThelistofcountriesanalysedforthisreportisbasedonlyonLSMSavailability,andrepresentsneitherarandomsamplenorAshighlightedinChapter3,thespatialpatternsthetotalityofcountriesinAfrica.anddegreeofconnectivityofrural–urbanlinkagesdeterminetheimpactsofurbanizationvInagriculturaleconomicsanddevelopmenteconomics,Bennett’sonagrifoodsystems.Theanalysispresentedlawiswellestablished,basedontheobservationthatasincomesrise,belowattemptstofindempiricalevidencepeopleeatrelativelyfewerstaplesandrelativelymorenon-staplesofa“locationeffect”;thatistosay,totestifincludingsomenutrient-densefoods(e.g.meats,fruitsandvegetables).8Bennett’slawisrelatedtoEngel’slaw,whichconsiderstherelationshipbetweenrisinghouseholdincomesandtotalfoodspending.Engel’slaw,alsowellestablished,isrelatedtotheobservationthatasfamilyincomeincreases,thepercentagespentonfooddecreases;thatspentonclothing,rent,heatandlightremainsthesame;whilethatspentoneducation,healthandrecreationincreases.73CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>FIGURE22DISTRIBUTIONOFPOPULATIONACROSSTENURCACATEGORIESOFTHERURAL–URBANCONTINUUM,FORSELECTEDCOUNTRIES,2020NigeriaHIGH-FOOD-BUDGETCOUNTRIESSenegalEthiopiaLOW-FOOD-BUDGETCOUNTRIESCôted'Ivoire102030405060708090100MaliTogoBeninBurkinaFasoMalawiGuinea-BissauNigerHigh-food-budgetcountriesLow-food-budgetcountries0PERCENTAGELargecity(>1millionpeople)<1hourtoalargecityIntermediatecity(0.25–1millionpeople)<1hourtoanintermediatecitySmallcity(50–250thousandpeople)<1hourtoasmallcityTown(20–50thousandpeople)<1hourtoatown1–2hourstoacityortown>2hourstoacityortownNOTES:Countriesarelistedbasedontherankingofthepercentageoftheirruralpopulationwithineachfood-budgetgroup.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:FAOestimatesbasedon2020GHS-POPdatasetandFAOURCAdataset.thedifferentURCAsacrosstherural–urbancountries.First,foodconsumptionpatternsarecontinuumarecontributingdeterminantsofanalysedintermsofhowhouseholdsacquirefooddemand.Animportantlimitationofthisfood,meaningwhetherthefoodtheyconsumeisanalysis,however,isthatitdoesnotcompletelypurchased,own-produced,acquiredasgiftsorisolatethelocationeffectfromotherdriversin-kindbarter,orpurchasedaspreparedmealssuchasfoodenvironmentconsiderationseatenawayfromhome.Theextentofconsumptionincluding,interalia,theroleofindustryproductofpurchasedfoodsshedslightontheimportanceplacementandpromotion.andreachoffoodsupplychains,movingoutfromurbanareasacrossthecontinuumtomoreInthesectionsthatfollow,weexplorethreeremoteruralareas.Theconventionalviewisthatdifferentaspectsoffoodconsumption,examininghouseholdslivinginorjustoutsideurbanareaspatternsandtheirdriversacrosstherural–urbanpurchasemostoftheirfood,whereashouseholdscontinuumforhigh-andlow-food-budgetinruralareaslargelyproducetheirownfood.»74FIGURE23TWOCONTRASTINGPATTERNSTOHFEUSTRABTAENOIFZAFTOIOODN:SDECEUNRSIETMYAENTRDONPUOTLRITITAINONUIRNBTAHNEIZWAOTRIOLND2023(NIGERIA)ANDSMALLCITYANDTOWNDISPERSEDURBANIZATION(BURKINAFASO)A)DENSEMETROPOLITANURBANIZATIONPATTERN–EXAMPLENIGERIAURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELB)SMALLCITYANDTOWNDISPERSEDURBANIZATIONPATTERN–EXAMPLEBURKINAFASOURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlandsSOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.75CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>»Especiallyinthecontextofsub-SaharanAfrica,Foodpurchasesareamajorcontributortohouseholdfoodconsumptionacrossthethereisapersistentviewthathouseholdslivingrural–urbancontinuum,evenamongtheinruralareasaresubsistentfarmerswhoproduceruralpoortheirownfood,withtheexceptionofthelandlesspoorwhoarereliantonfarmlabourandwhoAcrossthe11high-andlow-food-budgetAfricanpurchaseorbartertomeetsomeoftheirfoodcountries,foodpurchasesformthemajorityofconsumptionneeds.totalhouseholdfoodconsumptioninvalueterms,includingfoodforhomeconsumptionandfoodSecond,foodconsumptionpatternsareanalysedconsumedawayfromhome(Figure24).Whilehighintermsoftheshareoftotalhouseholdfoodsharesoffoodpurchasesrelativetototalfoodconsumptionthatislowprocessedandhighlyconsumptionamonghouseholdslivinginurbanprocessed.Thisanalysiscanshedsomelightonareasaretobeexpected(78–97percent),sharesthemagnitudeandreachofthemidstreamfoodaresurprisinglyhighacrosstherural–urbanvaluechainsandtheassociatedemploymentcontinuum,evenforruralhouseholdsliving1tothatthissectorgenerates(seeChapter3)related2hoursfromasmallcityortown(56percentontobothlowprocessedandhighlyprocessedaverage)andforthoselivingmorethan2hoursfoods.wInaddition,lowprocessedfoodscanfromanyurbancentre(52percentonaverage).providemanyadvantagestohouseholdsthroughThefindingthatinmostofthecountriesanalysedenhancedshelf-life,foodsafety,convenience,the“majority”ofhouseholdfoodconsumptionandinsomecasesnutritionalenhancementinruralhouseholdsiscomingfrompurchases(e.g.fortification).Ontheotherhand,many(56percentonaverageinthe11countrieshighlyprocessedfoodsareenergydenseandanalysed)isamajordeviationfromthetraditionalhighinfats,sugarsand/orsalt,andresearchimageofruralsubsistencehouseholds(Box5).suggeststhattheymaycontributetooverweightandobesityaswellassomenon-communicableIndeed,thediffusionofhighlevelsoffooddiseases(NCDs)(seeChapter3).Asalreadypurchasesacrosstherural–urbancontinuumhighlighted,itisexpectedthattheconsumption(Figure24)confirmsthatfoodmarketsandsupplyofbothlowprocessedandhighlyprocessedchainsareimportanttoruralareasinbothhigh-foodsishigherwithhigherlevelsoffoodandlow-food-budgetcountries.Furthermore,consumptionandespeciallywhereincomeandtheaveragefoodpurchaseshareforpopulationsemploymentarehigher.livinginruralareasisonlyslightlylowerinhigh-food-budgetcountries(55percent)thaninThird,householdfoodconsumptionpatternsarelow-food-budgetcountries(57percent),indicatinganalysedexaminingthemarketvalueofthefoodsaconvergenceacrossdifferentpatternsofconsumedbyfoodgroup,whichprovidesinsightsurbanizationandincomelevels.intothespreadoftheconsumptionofdiversedietsamonghouseholdsacrosstherural–urbanAsexpected,foodpurchasesharesdeclinecontinuum.Urbanizationisgenerallyassociatedmovingfromurbantoruralareasacrossthewithachangeinconsumptionbehaviour,continuum.Thedeclineisslightlysteeperwithurbanhouseholdsusuallyeatingamoreforlow-food-budgetcountriesmovingfromdiversifieddietincludingmoreexpensivefoodsurbantoperi-urbanareas(32percentdecline,suchasanimalsourcefoodsandfruits(seeversus27percentinhigh-food-budgetChapter3).However,somestudiessuggestthatitcountries),whereasmovingfromperi-urbanishigherincome,ratherthanurbanizationperse,toruralareasthedropissignificantlyhigherthatiscausingthesedietshifts.inhigh-food-budgetcountries(18percentonaverage)thaninlow-food-budgetwNoteacomprehensiveoverviewofprocessedfoodsisnotprovided,countries(6percent).asNOVAGroup1(unprocessedandminimallyprocessed)isnotanalysed.Whilethispatternovertherural–urbancontinuumappliesonaverage,therearevariationsbetweencountriesdependingonthedensityof76THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE24WHILEHIGHFOODPURCHASESAMONGHOUSEHOLDSLIVINGINURBANAREASAREEXPECTED,THEYARESURPRISINGLYHIGHACROSSTHERURAL–URBANCONTINUUM,EVENFORRURALHOUSEHOLDSURBANCENTRESPERI-URBANAREASRURALAREAS1009080PURCHASEDFOODCONSUMPTIONSHARE70(PERCENTAGE)6050403020100LargecityIntermediatecitySmallcityTown<1hourto<1hourtoan<1hourto<1hour1–2hours>2hours(>1million(0.25–1million(50–250(20–50alargecityintermediateasmalltoatowntoacitytoacitythousandthousandcityortownortownpeople)people)people)people)cityRURAL–URBANCONTINUUM(URCA)High-food-budgetcountries:SenegalEthiopiaCôted'IvoireMaliNigeriaLow-food-budgetcountries:Guinea-BissauBeninTogoBurkinaFasoMalawiNigerNOTES:Thefigureshowshouseholdfoodpurchasesasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)acrosstherural–urbancontinuum(URCA)bycountryandhigh-andlow-food-budgetcountrygroup.AlthoughURCAisacategoricalvariable,itisconceptualizedasaspatialcontinuum,thustheuseofalinegraph,whichalsofacilitatesthepresentationoftheresults.Allsurveysare2018/19,exceptMalawi(2019/20).SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.urbanizationpatterns.Forexample,thereisaAnotherstrikingfindingisthatforfournotableincreaseinpurchasesinareaslessthancountries,thereisanuptickinfoodpurchases1hourfromatowninEthiopia,Guinea-Bissau,inthemostremoteruralareas(morethanNigeriaandTogo(Figure24).2hourstraveltoacityofanysize):MaliandNigeria(high-food-budgetcountries),and77CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>BeninandTogo(low-food-budgetcountries).high-food-budgetcountries,asitspatternofTheuptickinpurchasesintheseareascanurbanization“straddles”thedividebetweenbeexplainedinseveralways.First,farmers“densemetropolitan”and“smallcityandtowninremoteareastendtobepoorer,meaningdispersed”(seeFigureA6.1inAnnex6),withpoorerhouseholdsoftenneedpurchasesto“smoothoutlierruralareasnotwellconnectedduetoveryconsumption”orcompensateforpoorpoororlimitedroadinfrastructure.11harvests.Second,infurthestoutlyingruralareas(morethan2hourstraveltoacityorFoodpurchasesharesoflow-andmiddle-incometown),localnon-farmemploymentisscarce,householdsareloweroverallthanthesharesofasareservices,andthereforehouseholdshigh-incomehouseholdsacrosstherural–urbanfocusmoreonmigrationtobringinmoney,continuum(Figure25).Thedifferencesaresmallwhichcanbeusedtobuyfood.Thispatterninurbanareas,butbecomemuchbiggerinaffectsbothlow-andhigh-food-budgetcountries.peri-urbanareaslessthan1hourfromeitheralargecityoranintermediatecity.ThissuggestsThetraditionalviewofarural–urbandividethatwhilethesehouseholdsstillrelyonfoodformedafewdecadesago,whenmostruralpurchases,ownfoodproductionisalsoimportantareasinAfricaweremuchpoorerandless(Box5).Thepatternholdsforbothhigh-andconnectedtourbanareas.However,morelow-food-budgetcountries,althoughfoodrecently,theurbanizationoccurringinmanypurchasesharesareslightlylowerforthelatter.Africancountriesisdispersed,withgrowingnetworksofinterconnectedsmallcitiesandInurbanandruralareas,thedispersionoftownsandincreasedconnectivitywithruralfoodpurchasesharesacrosshouseholdincomeareas.Thistranslatesdirectlytoexpansivegroupsissmallerthaninperi-urbanareas,growthinoff-farmemploymentopportunities,indicatingthathouseholdincomeislessofainterconnectedfoodmarketsandfoodsupplyfactordrivingfoodpurchasesharesforurbanchains;lifestylesthuschange,whichinturnandruralhouseholds.Theonlyexceptionisaffectshowhouseholdsacquirefoodandwhatpoorhouseholdsinmoreremoteruralareasfoodstheyeat(seeChapter3).(morethan2hourstraveltoacityortown),whosefoodpurchasesharesare31percentandLookingtootherregions,studiesshowthere15percentlessthanhigh-incomehouseholdsinissubstantialevidenceofhighlevelsoffoodthesameareasofhigh-andlow-food-budgetpurchasesinruralareas,forexampleinAsia,countries,respectively.includingstudiesfromBangladesh,Indonesia,NepalandVietNam.9,10ThesestudiesfindThedescriptiveanalysispresentedupuntilthissimilarpatternsoffoodpurchasesinruralareas,buttheconvergencebetweenurbanandpointisbackedupbyaneconometricanalysisruralfoodpurchasepatternsismoreadvancedthaninAfrica.thatlooksintothedeterminantsoffoodpurchaseWhenhouseholdincomelevelsareconsidered,sharesforthehigh-andlow-food-budgetthenotionthatruralhouseholdsinsub-SaharanAfricarelyprimarilyonsubsistencefarmingcountries.Determinantsincludelocationforfoodstilldoesnothold.Thefindingsshowthatfoodpurchasesrepresent50percentoracrosstherural–urbancontinuum,householdmoreoftotalhouseholdfoodconsumption(includingownproductionvaluedatmarketincome,non-farmemployment,foodprices,xage,prices)acrossallincomegroupsinruralareasofmostofthecountries,whichisbynoeducation,maritalstatusandgenderoftheheadmeanslow.ThemainexceptionisEthiopia,whichdragsdowntheaverageshareoffoodofthehousehold,householdsize,andsizeofpurchasesforhigh-food-budgetcountries(Figure24).Ethiopiaisanoutliercaseamongthecultivatedland,ownershipofassetsandanimalstocks.TableA7.1inAnnex7presentsthefulleconometricresults.Herewehighlightsomeofthekeyfindingsfromthisanalysis.»xWhilethefocusisonnon-pricedeterminants,pricevariablesareaddedascontrolvariablestoshowthelocationeffectacrosstherural–urbancontinuum.Asexpected,themarginaleffectofownpricesisstatisticallysignificant.78THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023PURCHASEDFOODCONSUMPTIONSHAREFIGURE25THEREISAMARKEDDROPINPURCHASEDFOODCONSUMPTIONSHARESFORLOW-AND(PERCENTAGE)MIDDLE-INCOMEHOUSEHOLDSLIVINGINPERI-URBANAREAS,WITHLEVELSSIMILARTORURALHOUSEHOLDSINBOTHHIGH-ANDLOW-FOOD-BUDGETCOUNTRIES100908070605050%line403020100HighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeHighincomeMiddleincomeLowincomeLargecity<1hourtoIntermediate<1hourtoanSmallcity<1hourtoTown<1hour1–2hours>2hours(>1millionalargecitycityintermediate(50–250asmallcity(20–50toatowntoacitytoacitythousandthousandortownortownpeople)(0.25–1millioncitypeople)people)people)RURAL–URBANCONTINUUM(URCA)High-food-budgetcountries:SenegalEthiopiaCôted'IvoireMaliNigeriaLow-food-budgetcountries:Guinea-BissauBeninTogoBurkinaFasoMalawiNigerNOTES:Thefigureshowshouseholdfoodpurchasesasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)acrosstherural–urbancontinuum(URCA)byhouseholdincomegroup,country,andhigh-andlow-food-budgetcountrygroup.Incomelevelsarecalculatedusingtercilesoftotalhouseholdexpenditureperadultequivalentasproxy.AlthoughURCAisacategoricalvariable,itisconceptualizedasaspatialcontinuum,thustheuseofalinegraph,whichalsofacilitatesthepresentationoftheresults.Allsurveysare2018/19,exceptMalawi(2019/20).SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.79CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>BOX5THEMYTHOFRURALSUBSISTENCEFARMINGINAFRICAEspeciallyinthecontextofsub-SaharanAfrica,therestartinginareaslessthan1hourfromalargecityisapersistentviewthathouseholdslivinginrural(FigureA1).areasaresubsistencefarmerswhoproducetheirownfood,yettheanalysisinthisreportindicatesthatthisAndyet,ownproductionneverbecomesthedoesnotholdtrue.Usingmarketprices,thevalueofmainsourceforfood–noteveninruralareas.foodconsumptionfromownproductionisestimatedInruralareas,theaverageshareofownproductionhere,thatisthevaluethathouseholdswouldpayifrepresentsonly37percentand33percentoftotaltheyacquiredthesamequantityofthatfoodfromtheconsumptioninhigh-andlow-food-budgetcountries,market.Findingsshowthat,movingfromurbantorespectively.Thesharesrangefrom8percenttoruralareasacrossthecontinuum,foodconsumption50percentinhigh-food-budgetcountries,andsharesofownproductiongrow,withasharpincreasefrom18percentto47percentinlow-food-budgetcountries(FigureA1).FIGUREAALLHOUSEHOLDSACROSSTHERURAL–URBANCONTINUUMHAVEFOODCONSUMPTIONSHARESFROMOWNFOODPRODUCTIONTHATARELESSTHAN50PERCENTA1)MARKETVALUEDERIVEDHOUSEHOLDFOODCONSUMPTIONSHARESFROMOWNFOODPRODUCTION–ACROSSTHERURAL–URBANCONTINUUMINSELECTEDCOUNTRIESINAFRICAURBANCENTRESPERI-URBANAREASRURALAREAS5045OWNFOODPRODUCTIONCONSUMPTIONSHARE40(PERCENTAGE)35302520151050LargecityIntermediateSmallcityTown<1hourtoa<1hourtoan<1hour<1hour1–2hours>2hours(>1millioncity(50–250(20–50largecityintermediatetoasmalltoatowntoacitytoacitythousandthousandortownortownpeople)(0.25–1millionpeople)people)citycitypeople)RURAL–URBANCONTINUUM(URCA)High-food-budgetcountries:SenegalEthiopiaCôted'IvoireMaliNigeriaLow-food-budgetcountries:Guinea-BissauBeninTogoBurkinaFasoMalawiNiger80THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX5(Continued)Thesesurprisingfindingsholdtrueevenhouseholds(i.e.anaverageof34percentinbothamongpoorruralhouseholds(FigureA2),whohigh-andlow-food-budgetcountries).Giventhatobtainonaverage40percentand36percentofruralhouseholdsdonotproducethemajorityofthefoodconsumptionfromownproductioninhigh-foodvaluetheyconsume,theircapacitytoaffordaandlow-food-budgetcountries,respectively.healthydietisakeyfactortoconsiderregardingtheirFurthermore,thesesharesofownproductionarenotconsumptionofnutritiousfoods.muchhigherthanthesharesfoundforperi-urbanA2)MARKETVALUEDERIVEDHOUSEHOLDFOODCONSUMPTIONSHARESFROMOWNFOODPRODUCTION–FORHOUSEHOLDSLIVINGOUTSIDEURBANAREAS,BYHOUSEHOLDINCOMELEVELINSELECTEDCOUNTRIESINAFRICAOWNFOODPRODUCTIONCONSUMPTIONSHARES60RURAL(URCA)(PERCENTAGE)50NigeriaGuinea-BissauBenin403020100SenegalEthiopiaCôted'IvoireMaliTogoBurkinaFasoMalawiNigerHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESOWNFOODPRODUCTIONCONSUMPTIONSHARES60PERI-URBAN(URCA)(PERCENTAGE)50NigeriaGuinea-BissauBenin403020100SenegalEthiopiaCôted'IvoireMaliTogoBurkinaFasoMalawiNigerHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESHigh-incomehouseholdsMiddle-incomehouseholdsLow-incomehouseholdsNOTES:Thefiguresshowhouseholdconsumptionfromownproductionasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)acrosstherural–urbancontinuum(URCA)(FigureA1)andbyruralandperi-urbanareaandhouseholdincomegroup(FigureA2).AlthoughURCAisacategoricalvariable,itisconceptualizedasaspatialcontinuum,thustheuseofalinegraphinFigureA1,whichalsofacilitatesthepresentationoftheresults.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.81CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>»Forbothcountryfood-budgetgroups,thereisFurthermore,resultsshowthatthelargerthehouseholdsizethelowerthehouseholdfoodstatisticalconfidenceaboutthelocationeffectpurchases,inbothhigh-andlow-food-budgetacrosstherural–urbancontinuum;thatis,thecountries.Thisispresumablybecausehavingfartherfromalargecity,thelowertheshareoftheirownlabourallowshouseholdstosubstitutepurchasesintotalhouseholdfoodconsumption.purchasedfoodwiththeirownproduction,Asobservedinthedescriptiveanalysis,thisforexampleinprocessingandfarming.Thispatternisfairlysmoothandcontinuous.isreinforcedwiththeexpectednegativeeffectonfoodpurchasesofownershipoffarmlandHoldingallotherfactorsconstant,theeffectofandanimalstocks.incomeonthefoodpurchaseshareispositiveinbothsetsofcountries(excludingEthiopia,whichThereisadiffusionofprocessedfoodsshowsanegativeeffect),withasomewhathigherandfoodawayfromhomeacrosstheeffectinlow-food-budgetcountries–accordingrural–urbancontinuum,butitishigherintothesupplementaryeconometricanalysis.Thisurbanareascanbeinterpretedasmeaningthathouseholds“startpurchasing”atlowerincomelevelsinInallregions,therehasbeendiffusionofhigh-food-budgetcountries;thatis,thetransitionpurchasedprocessedfoods,aswellasfoodawayofdietsintheformofpurchasinghasspreadfromhome(e.g.preparedfoodfromvendorsormoreintolower-incomehouseholdsinthatgroupinrestaurants),inurbanandruralareas.Overofcountries.Thiscoincideswiththefindingsofcenturies,small-andlarge-scaleprocessingofotherstudies.12staplefoods(e.g.polishedrice,wheatandmaizeflour,edibleoils)haveintroducedessentialInbothcountryfood-budgetgroups,time-andenergy-savinginnovations,presentingfurthermore,morenon-farmemployment(andopportunitiesfornutritionalenhancementsuchashencenon-farmincome)leadstoahigherfoodfoodfortification.Foodprocessinghascontinuedpurchaseshare.Thiswasfoundreliablyinalltogrow,expandingtopreparedfoods,bothatcountrycasesandwhencontrollingforgendersmallscale(oftenunpackagedandunbranded)(exceptGuinea-Bissau).Maleruralnon-farmandatverylargescale(packagedandbranded).employmentshowsasomewhatstrongereffectinWhilethediffusionofprocessedfoods,includinglow-food-budgetcountries(forthereasonnotedhighlyprocessedfoods,isalreadyadvancedinabove).TheeffectispresentbutlesssupportedAsia9andLatinAmerica,13itisspreadingquicklyforfemaleemploymentinbothhigh-andinAfricaaswell.14low-food-budgetcountries.IncreasingnumbersofwomenareworkingAnotherimportantresultisthateducationoutsidethehomeinbothurbanandruraloftheheadofthehousehold,particularlyareas,whilemenandwomenareincreasinglysecondaryschooling,evenwhencontrollingforcommutingtoworkinurbanareasandgoingincome,iscorrelatedwithahigherhouseholdtooff-farmjobsinruralareas.Thesefactorsfoodpurchaseshare.Theresultisparticularlymaypromptariseinpurchasesofpreparedstronginhigh-food-budgetcountries.Thisfoodfromfoodserviceenterprises,duetomayreflectavarietyoffactorssuchasgreaterreducedtimeavailabilityforhomeprocessingopportunitycostoftime(forhomeproduction)(e.g.hand-poundinggrains)andfoodpreparation.inthetypesofjobsheldbythemoreeducated.ThedynamicsofsupplyanddemandforInaddition,whenaccountingforgender,thereisprocessedfoods,however,arecomplex.Therehasapositiveeffectforfemale-headedhouseholdsinbeenasurgeonthesupplyside,withsmallandhigh-food-budgetcountries,excludingMalawi.mediumenterprisesandlargeprivatecompaniesThiscouldagainbelinkedtoopportunitycostofalikemakingmassiveaggregateinvestmentsintimeforwomeninthesehouseholdstodobothalltypesofprocessedfoods(fromminimallytotheirownfarmingandhomeprocessingoffood,highlyprocessed)inresponsetodemand.14Attheversusbuyingfoodtofreeuptimeforhomesametime,aggressivemarketingandrelativelychoresandmanagement.lowpricing–andeveninterferenceinpolicies82THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023tocurbconsumptionofhighlyprocessedfoodsGroups2and3werecombinedasonegroup,andsugar-sweetenedbeverages–aredrivingreferredtoas“lowprocessed”,andgroup4wasupconsumption.maintainedashighlyprocessed.SeeAnnex5foranexplanationandfulldescriptionandsourcesThereisacriticalroleforminimallyandlowoftheprocessingcategoriesapplied.Inadditionprocessedfoodsaspartofahealthydiet;intothesetwocategories,foodawayfromhomeaddition,theyareamajorandgrowingsourceofwasmadeaseparate,singlecategory,becauseemploymentacrosstherural–urbancontinuumthereisinsufficientinformationtoidentify(seeChapter3).Ontheotherhand,thereistheextentofprocessingforallitemsinvolvedgrowingevidenceoftheroleofhighlyprocessedanditisthereforenotpossibletoaccuratelyfoodsinthedevelopmentofoverweight,categorizesuchfood.obesityandrelatedNCDs(seeChapter3).ManycountriesnowseektocurbconsumptionthroughThediffusionofprocessedfoodsacrossthetargetedinterventions(e.g.bansinschools)andcontinuumissimilarandquiteextensiveforbothpopulation-basedpolicies(e.g.taxationandhigh-andlow-food-budgetcountries(Figure26A).front-of-packlabelling)(seeChapter5).RecentTheexceptiontothisisinareaslessthan1hourstudiesinAfricashowthattheexpansionoffromintermediatecitiesoflow-food-budgetfoodsupplychainsintheprocessingsectorcountries,wheretheshareismuchlowerif(processing,wholesale,transportandretail)comparedtothesamecatchmentareasofprovidesamajorsourceofemploymentacrossthehigh-food-budgetcountries.Onaverage,thesharerural–urbancontinuum,especiallyforwomenandoftotalprocessedfoodsandfoodawayfromyouth.12Latestestimatesindicatethat20percenthomeis29percentinhigh-food-budgetcountries,ofruralemploymentand25percentofurbanand25percentinlow-food-budgetcountries.employmentareinagrifoodsystemsjobssuchasEvenhouseholdslivinginruralareas1to2hourswholesaleandprocessing.12Unfortunately,fewormorefromacityortownareconsumingofthesestudiesprovidesufficientdisaggregationprocessedfoodsandfoodawayfromhome.ofproductportfoliostoassessthebalanceofpotentialbenefitsandharmstohealthydietgoals.WhiletheconsumptionofprocessedfoodsandfoodawayfromhomeishigherincitiesandExaminingthehouseholdconsumptionofbothtowns,intermsofconsumedvalueshares,itonlylowprocessedandhighlyprocessedfoodsanddeclinesgraduallymovingintoperi-urbanareas;foodawayfromhomeprovidesinsightsintohowever,thereisamoreabruptdropinperi-urbanfooddemandacrosstherural–urbancontinuum.areasofintermediatecitiesinlow-food-budgetThedemandforprocessedfoodsofalltypesincountries(Figure26A).EvidenceofasmoothandAfricaisexpectedtocontinuetoriseoverthegradualdiminishingsharealongthecontinuumnextdecadeswithurbanization,thecontinueddispelsthenotionofasharprural–urbandivideinriseinruralnon-farmemploymentandthetheconsumptionofprocessedfoods.concomitanteffectsoncostsavingsoffoodpreparationandthusdemandforconvenienceLookingatlowprocessedandhighlyprocessedfoods.Increasedcommutingtoworkisalsofoodsseparately,wefindthatinbothsetsofraisingtheopportunitycostoftimeforbothmencountries,highlyprocessedfoodsaccountandwomen,withmealsandsnackspurchasedforasmallproportionoftotalconsumptionatroadsidestalls,restaurantsandmarketkiosks.(Figure26B).However,thesharesareslightlyhigherEvidenceshowsthatthisprocesshasalreadybeeninperi-urbanareasofsmallcitiesandtownsseeninotherdevelopingregions.15,16andruralareasoflow-food-budgetcountriescomparedtothesameareasinhigh-food-budgetIntheanalysisthatfollows,allfooditemscountries.ThesharesofhighlyprocessedfoodswereclassifiedbyleveloffoodprocessingarealsofoundtobegreaterinurbanareasbasedonthefourmaingroupsintheNOVAthaninruralareas,inbothsetsofcountries.foodclassificationsystem.UnprocessedandTheresultshighlightthepenetrationofhighlyminimallyprocessedfoods(group1)werethenprocessedfoodsintoruralareas,eventhoseexcludedfromtheanalysesinthissection.living1to2hoursormorefromacityortown.»83CFHIGAUPRTEE2R64ITNHTEHINET1E1RCPOLAUYNOTFRIFEOSOIDNSAUFPRPICLYA,ARNUDRDAELMHAONUDSAENHDOLTDHSECAORSETCAONNDSUAFMFIONRGDPARBOILCITEYSS<.E..D>FOODS,INCLUDINGHIGHLYPROCESSEDFOODS,EVENTHOSELIVING1TO2HOURSORMOREFROMACITYORTOWNA)AVERAGECONSUMPTIONSHARESOFPROCESSEDFOODSANDFOODAWAYFROMHOMEACROSSTHERURAL–URBANCONTINUUMFORSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAURBANCENTRESPERI-URBANAREASRURALAREAS45PURCHASEDPROCESSEDFOOD40CONSUMPTIONSHARE(PERCENTAGE)35302520151050LargecityIntermediateSmallcityTown<1hour<1hour<1hour<1hour1–2hours>2hours(>1millioncity(50–250(20–50toalargetoantoasmalltoatowntoacitytoacitythousandthousandintermediateortownortownpeople)(0.25–1millionpeople)people)citycitycitypeople)RURAL–URBANCONTINUUM(URCA)High-food-budgetcountries:LowprocessedfoodsHighlyprocessedfoodsFoodawayfromhomeLow-food-budgetcountries:LowprocessedfoodsHighlyprocessedfoodsFoodawayfromhomeB)COMPOSITIONOFAVERAGECONSUMPTIONSHARESOFPROCESSEDFOODSACROSSTHERURAL–URBANCONTINUUMFORSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICA25PURCHASEDPROCESSEDFOOD20CONSUMPTIONSHARE(PERCENTAGE)151050LowprocessedfoodsHighlyprocessedfoodsFoodawayfromhomeLowprocessedfoodsHighlyprocessedfoodsFoodawayfromhomeHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESURBANPERI-URBANRURALLargecity(>1millionpeople)<1hourtoalargecity<1hourtoatownIntermediatecity(0.25–1millionpeople)<1hourtoanintermediatecity1–2hourstoacityortownSmallcity(50–250thousandpeople)<1hourtoasmallcity>2hourstoacityortownTown(20–50thousandpeople)NOTES:Thefiguresshowhouseholdfoodconsumptionofprocessedfoods(lowandhighlyprocessedfoods)andfoodawayfromhomeasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)acrosstherural–urbancontinuum(URCA).Allsurveysarefor2018/19,exceptMalawi(2019/20).TheclassificationoffooditemsbyleveloffoodprocessingwasadaptedfromtheNOVAfoodclassificationsystem.SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.84THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE27INTHE11COUNTRIESINAFRICA,LOWPROCESSEDANDHIGHLYPROCESSEDFOODCONSUMPTIONSHARESAREHIGHERACROSSTHERURAL–URBANCONTINUUMINLOW-FOOD-BUDGETCOUNTRIES,WHILESHARESOFFOODAWAYFROMHOMEAREHIGHERINHIGH-FOOD-BUDGETCOUNTRIES>2hourstoacityortown1–2hourstoacityortownRURAL–URBANCONTINUUM(URCA)<1hourtoatown<1hourtoasmallcity<1hourtoanintermediatecity<1hourtoalargecityTown(20–50thousandpeople)Smallcity(50–250thousandpeople)Intermediatecity(0.25–1millionpeople)Largecity(>1millionpeople)-10-8-6-4-20246810DIFFERENCEINSHARESBETWEENHIGH-ANDLOW-FOOD-BUDGETCOUNTRIES(PERCENTAGE)LowprocessedfoodsHighlyprocessedfoodsFoodawayfromhomeNOTES:Thefigureshowsthedifferenceinhouseholdfoodconsumptionpercentageshares(atmarketvalue)oflowprocessedfoods,highlyprocessedfoodsandfoodawayfromhome,comparinghigh-food-budgetcountrieswithlow-food-budgetcountriesacrosstherural–urbancontinuum(URCA).TheclassificationoffooditemsbyleveloffoodprocessingwasadaptedfromtheNOVAfoodclassificationsystem.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.»Highlyprocessedfoodsareprimarilypackagedofbothlowprocessedandhighlyprocessedfoodsandfoodawayfromhomebetweenwithextendedshelf-life,17whichmayenhancehigh-andlow-food-budgetcountries.Tomoretheirspreadtomoreremoteruralareasgivenclearlyseethesedifferences,Figure27showstheirstorability.thedifferencebetweenthefoodvaluesharesofthetwocategoriesofprocessedfoodsandInbothsetsofcountries,theconsumptionfoodawayfromhomecomparinghigh-andvaluesharesoflowprocessedfoodsarehigherlow-food-budgetcountries.comparedtohighlyprocessedfoods,butinurbanandperi-urbanareasoflow-food-budgetInlow-food-budgetcountries,lowprocessedcountriesthedifferenceismuchgreater.Thisisfoodconsumptioninurbanandperi-urbannotunlikethepatternseeninothercountriesareasishigherthaninhigh-food-budgetwithinitialhigherpenetrationoflowprocessedcountries.Notashigh–butstillhigherinratherthanhighlyprocessedfoods.14low-food-budgetcountries–istheshareofhighlyprocessedfoodsinallareas,exceptlargeHowever,thereisamarkeddifferenceinthecitiesandtheirsurroundings.Thisissurprisingfoodconsumptionshares(atmarketvalue)85CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>because,ashighlightedearlier,itisexpectedformalenon-farmemployment,astheeffectisthathighlyprocessedfoodswouldbegreaterinfoundtobestatisticallysignificantin8outofhigh-food-budgetcountries.Ontheotherhand,the11countriesanalysed.Theeffectforfemalefoodawayfromhomeishigherasashareoftotalnon-farmemploymentissimilartothatformalehouseholdfoodconsumptioninhigh-food-budgetnon-farmemploymentinhigh-food-budgetcountries(Figure27).Thiscouldsuggestthattherecountries,butisnotstatisticallysignificantinismoreoff-farmemploymentinruralareasoflow-food-budgetcountries.high-food-budgetcountries.ThismakessenseasfoodawayfromhomeiscorrelatedwithAllotherthingsequal,theprimaryschoolingofworkingoutsidethehomeandcommutingwithinthehouseholdheadissignificantlycorrelatedcitiesorfromruraltourbanareasorotherruralwithagreaterconsumptionvalueshareofhighlyareas(seeChapter3).Suchemploymentpatternsprocessedfoodsinonlythreecountries,whiletheemergewithdevelopmentandurbanization,bothhouseholdheadbeingfemaleiscorrelatedwithacorrelatedwithhigh-food-budgetcountries.greatershareinmosthigh-food-budgetcountries,exceptforadampeningeffectinEthiopia(TableA7.2Aswasdoneforfoodpurchases,aneconometricinAnnex7).Intheformer,thisissupportedbyanalysiswasundertakentolookintotheotherstudiesshowingthatwomensubstitutedeterminants(i.e.locationeffectofeachURCA,processedfoodsformealpreparationtofreeuphouseholdincome,non-farmemployment,etc.)timeforotherhouseholdchores,aswellasoff-farmoftheshareofpurchasesofhighlyprocessedwork.14Butinpoorercountries,itcouldbethatfoodsasavalueshareoftotalhouseholdfoodwomenmanagingthehouseholdalonehavelessconsumption.TableA7.2inAnnex7presentsthetime(andthereforelessaccess)tobuythesefoods.statisticallysignificantresults,ofwhichthekeyHowever,theseresultsrequirefurtherexploration.pointsarehighlightedbelow.Finally,largerhouseholdshavealowershareofhighlyprocessedfoodpurchasesinsomeoftheHoldingotherfactorsconstant,theeffectsofhigh-food-budgetcountries,whereastheeffectislocationacrosstherural–urbancontinuummixedinlow-food-budgetcountries(TableA7.2incorroboratethedescriptivefindings:thefartherAnnex7).Thehigherthedependencyratioyinbothfromalargecity,thesmallertheshareofcountryfood-budgetgroups,thehigherthesharehighlyprocessedfoodsintotalhouseholdfoodofhighlyprocessedfoodspurchased.consumptionforhigh-food-budgetcountries,exceptformoreremoteareasinlow-food-budgetHouseholdfoodconsumptionbyvariouscountries.Thefindingonthelocationeffectisfoodgroupsvariesovertherural–urbansimilartothatobservedfortheUnitedRepubliccontinuum,drivenbypatternsofofTanzania(notincludedinthisanalysis),urbanization,incomeandnon-farmaccordingtoastudyusingdetailedhouseholdemploymentbudgetsurveydatawithurban,peri-urbanandruralgradations.17ItisalsosimilartofindingsforUrbanizationisimplicitlyassociatedwithshiftsruralandurbanareasinBangladesh,Indonesia,inhouseholdfoodconsumption,inwhichurbanNepalandVietNam.9householdspurchaseamorevarieddiet,onethatislessdominatedbystaplefoodsandcomprisesThepureeffectofincomeisassociatedwithaalargervarietyoffoodsfromotherfoodgroups,highershareofhighlyprocessedfoodsinbothincludingmoreexpensivefoodssuchasmeatcountryfood-budgetgroups,butwithagreateranddairy(seeChapter3).However,somestudiesimpactinlow-food-budgetcountries(TableA7.2insuggestthatitishigherincomeinurbanareas,Annex7).Thiscorroboratesfindingsfromotherratherthanurbanizationperse,thatiscausingrecentstudiesinAfrica,forexampleinUgandatheseshifts.18ThissectionprovidesfurtherandtheUnitedRepublicofTanzania.17Inbothanalysisoftheseissues.high-andlow-food-budgetcountries,morenon-farmemploymentleadstoahighershareofyDependencyratiotakesintoaccounttheconsumptionneedsofhighlyprocessedfoodsintotalhouseholdfoodyoungandelderlypeople,andtheproductivityofmiddle-agedpeople.consumption.Thisfindingisparticularlytrue86THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023AllfooditemsarecategorizedintoeightfoodStaplefoodsasashareofhouseholdfoodgroups:i)staplefoodsincludingcereals,roots,consumptioninvaluetermsareonaveragetubers,plantainsandtheirproducts;ii)pulses,30percent(high-food-budgetcountries)andseeds,nutsandtheirproducts;iii)animalsource28percent(low-food-budgetcountries)inurbanfoodsincludingmilk,eggs,meat,fish,shellfish,areas(Figure28).Notethatthisshareisjustslightlyinsects/grubsandalltheirproducts;iv)vegetablesabovetheshareof25percentinAsiancities.9andtheirproducts;v)fruitsandtheirproducts;vi)fatsandoils;vii)sweets,condimentsandbeverages;Consumptionvaluesharesofstaplefoods,andviii)mealseatenoutsidethehome(foodawayincludingmarket-valuedown-producedstaplefromhome).SeeTableA5.6inAnnex5fordefinitionsfoods,aresimilarinperi-urbanandruralareas,offoodgroupaggregates.Giventhenumberoffoodbutroughly12percentagepointshigherthaningroupstobeanalysed,thetenURCAcategoriesareurbanareas.Theaverageshareofstaplefoodsfurtheraggregatedintothreecategories–urban,intotalhouseoldfoodconsumptionissimilarinperi-urbanandrural–tofacilitatethepresentationhigh-andlow-food-budgetcountries:41percentofsomefigures(seeTable9).and40percent(respectively)inperi-urbanareas,and42percentand43percent(respectively)Lookingathouseholdfoodcompositionintermsinruralareas.ofthevaluesharesoffoodconsumptionbyfoodgroup,adiettransitionisclearlyoccurringacrossAsexpected,followingBennett’slaw,astherural–urbancontinuum(Table11).Thisinvolveshouseholdincomerisestheshareofstapleadiversificationofdietsatthehouseholdlevel,foodsintotalhouseholdfoodconsumptionfallsincludingtheconsumptionofmoreexpensive(Figure28).Thisholdstrueacrosstherural–urbanfooditems,likeanimalsourcefoodsandfruits.continuum,whetherlookingaturban,peri-urbanThissuggeststhetransitionisalsooccurringinorruralaggregatecategories(asshowninruralareas,thoughlaggedandtoalesserextentFigure28)oratmoredisaggregatedURCAthaninurbanandperi-urbanareas.categories(notshown).Interestingly,inthissmallgroupofcountriesinOverall,thevaluesharesofstaplefoodscompriseAfrica,therearenomajordifferencesbetweenaminorityoftotalhouseholdfoodconsumption,high-andlow-food-budgetcountries.Thismightnotonlyinurbanareasbutacrosstherural–urbansuggestaconvergenceinthediettransitioncontinuum.Itisstrikingthatthediversificationoccurringacrossthesetofcountries.Thefindingofhouseholdfoodconsumption,whichisthethatconsumptionvaluesharesofnon-staplefoodsinverseofdependenceonstaplefoods,issimilararesimilarinthetwofood-budgetgroupsisinurbanareasofbothcountryfood-budgetsomewhatparadoxical.Thiscouldbebecauseingroups.Furthermore,theratioofthesharesbothsetsofcountries,low-costnon-staplefoodsofstaplefoodsinruralareastourbanareasis–suchasvegetablesorpulses–areaccessiblenearlythesameinhigh-andlow-food-budgetandalsodesiredbyhouseholds.Anotherstudycountries(1.4and1.5,respectively),suggestinganinSenegal19foundthathouseholdexpenditureintercountryconvergence.sharesweresimilarinurbanandruralareas,buttheabsolutelevelsofexpenditurewerelowerThesmallerstaplefoodsharesinurbanareasareinruralareasandamongthepoor.Thismaygenerallyoffsetbylargersharesofanimalsourcebesimilartosayingthatlow-costpulsesfigurefoodsandfoodawayfromhome(Figure29A).largelyinthedietsofthepoor.ThefindingsThisisexpected,asurbanizationisgenerallydonotnegateBennett’slaw,zbutmakeitsassociatedwithurbanhouseholdsprocuringslopemoregradual.morevariedfoods,includingmoreexpensivefoodssuchasmeat,butalsoeatingoutsidethezInagriculturaleconomicsanddevelopmenteconomics,Bennett’shomemoreoften.Withthisanalysis,however,aslawobservesthatasincomesrise,peopleeatrelativelyfewercalorie-previouslymentioned,itisnotpossibletoassessdensestarchystaplefoodsandrelativelymorenutrient-densemeats,thetypesoffoodsconsumedawayfromhome,oils,sweeteners,fruitsandvegetables.8whethertheycontributetodiversity,andtheirlevelofprocessing.87CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>TABLE11INTHE11COUNTRIESINAFRICA,ADIETTRANSITIONATTHEHOUSEHOLDLEVELISOCCURRINGACROSSTHERURAL–URBANCONTINUUMANDINHIGH-ANDLOW-FOOD-BUDGETCOUNTRIES–EVENINRURALAREAS,THOUGHLAGGEDANDTOALESSEREXTENTTHANINURBANANDPERI-URBANAREASLargecity(>1millionpeople)Intermediatecity(0.25–1millionpeople)Smallcity(50–250thousandpeople)Town(20–50thousandpeople)<1hourtoalargecity<1hourtoanintermediatecity<1hourtoasmallcity<1hourtoatown1–2hourstoacityortown>2hourstoacityortown(%)Staplefoods26323134344144454147Pulses,seedsandnutsHigh-food-budgetcountriesAnimalsourcefoods56677886810VegetablesFruits22171717181312161410Fatsandoils121212111111109111032333221215667666555Sweets,condimentsand98910789121112beveragesFoodawayfromhome1716151114118585StaplefoodsPulses,seedsandnuts25313034334340444344AnimalsourcefoodsLow-food-budgetcountriesVegetables3445688886FruitsFatsandoils252322201915161515141414141314141311131243434233325555545445Sweets,condimentsand13121313121112111215beveragesFoodawayfromhome12777734333NOTES:Thetableshowshouseholdfoodconsumptionbyfoodgroupasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)acrosstherural–urbancontinuum(URCA)forhigh-andlow-food-budgetcountries.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeAnnex5forthefulldefinitionofvariables.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.Inurbanareas,onaverageacrossthecountriesseeFigureA7.1AinAnnex7).Animalsourcefoodsanalysed,animalsourcefoodconsumptionvalueshares(whichincludemilk,eggs,meat,fish,Thereisalsoanotableandfoodawayfromhomeshellfishandinsects)are40percenthigherthandecreaseinvaluesharesincreasinglysubstituteinperi-urbanareasand44percenthigherthaninofpulses,seedsandnutsstaplefoods,movingruralareas.Lookingatlow-food-budgetcountries,inurbanareascomparedtheshareinurbanareasis1.5timeshigherthantoperi-urbanareasandfromruraltourbanareasinperi-urbanareasand1.6timeshigherthaninruralareas.Forhigh-food-budgetcountries,theruralareas(40percentacrossthecontinuumdifferencesaresmaller:urbansharesare1.4timeshigherthanperi-urbanandrural(notshownhere,and47percentlowerthaninperi-urbanandruralareas,respectively)(Figure29A).Thisfindingistypical,astheseitemsarecheapersourcesofnutrient-richfoods,but88THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE28INTHE11COUNTRIESINAFRICA,THESHAREOFSTAPLEFOODSREPRESENTSAMINORITYOFSTAPLEFOODCONSUMPTIONSHARETOTALHOUSEHOLDFOODCONSUMPTIONINVALUETERMS,ANDRISESASINCOMEFALLSACROSSTHE(PERCENTAGE)RURAL–URBANCONTINUUMINBOTHHIGH-ANDLOW-FOOD-BUDGETCOUNTRIES6050403020100NationalHighincomeMiddleincomeLowincomeUrbanHighincomeMiddleincomeLowincomePeri-urbanHighincomeMiddleincomeLowincomeRuralHighincomeMiddleincomeLowincomeNATIONALURBANPERI-URBANRURALHigh-food-budgetcountriesLow-food-budgetcountriesNOTES:Thefigureshowshouseholdstaplefoodconsumptionasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)bynational,urban,peri-urbanandruralarea(URCA),andbyincometercile(low-income,middle-incomeandhigh-incomehouseholds)withineachcategory.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeAnnex5forthedefinitionofurban,peri-urbanandrural.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.tendtobesupplantedbyanimalsourcefoodsAmoredisaggregatedlookattheconsumption(ifonlybymilkinpartiallyvegetariancountriesvaluesharesbyfoodgroupshowsthatonsuchasIndia)aspeople’sincomesincrease.averageacrossallcountries,thereisnoabruptrural–urbandivideacrossthecontinuumAcrossallcountries,sharesoffoodawayfrom(Figure29B).Again,thisisasurprise,asitishomearehigherinurbanareas,anddeclinegenerallyassumedthereisamarkeddifferencesteeplymovingtoperi-urbanandruralareasbetweenurbanandruralareas.Movingacrossthe(Figure29).Onaverage,sharesare1.6timeshighercontinuumfromurbantoruralareas(Figure29B),inurbanareasthaninperi-urbanareas,andthereisanincreasingshareofstaplefoodsand2.6timeshigherthaninruralareas.Thispatternpulses,seedsandnuts,andadecreasingshareofisstrongerinlow-food-budgetcountries,withanimalsourcefoodsandfoodawayfromhome.urbanshares2.4timeshigherthaninperi-urbanIncontrast,sharesforvegetables,fruits,andfatsareas,and3.2timeshigherthaninruralareasandoilsarefairlyuniformacrosstherural–urban(seeFigureA7.1BinAnnex7).continuum.Althoughtherearesomevariations,»89CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>FIGURE29INTHE11COUNTRIESINAFRICA,ANIMALSOURCEFOODSANDFOODAWAYFROMHOMESUBSTITUTESTAPLEFOODS,MOVINGFROMRURALTOURBANAREASA)AVERAGESHARESOFHOUSEHOLDFOODCONSUMPTIONVALUESBYFOODGROUPANDURBAN,PERI-URBANANDRURALAREAS(URCA)15%9%6%9%12%10%6%5%30%2%5%42%3%11%5%41%2%12%20%14%8%11%14%8%URBANPERI-URBANRURALStaplefoodsPulses,seedsandnutsAnimalsourcefoodsVegetablesFruitsFatsandoilsSweets,condimentsandbeveragesFoodawayfromhomeB)AVERAGESHARESOFHOUSEHOLDFOODCONSUMPTIONBYFOODGROUPACROSSTHERURAL–URBANCONTINUUM(URCA)504540FOODCONSUMPTIONSHARE35(PERCENTAGE)302520151050StaplefoodsPulses,seedsandnutsAnimalVegetablesFruitsFatsandoilsSweets,condimentsFoodawaysourcefoodsandbeveragesfromhomeFOODGROUPSURBANPERI-URBANRURALLargecity(>1millionpeople)<1hourtoatown<1hourtoalargecityIntermediatecity(0.25–1millionpeople)<1hourtoanintermediatecity1–2hourstoacityortownSmallcity(50–250thousandpeople)<1hourtoasmallcity>2hourstoacityortownTown(20–50thousandpeople)NOTES:Thefiguresshowhouseholdfoodconsumptionbyfoodgroupasapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue),byurban,peri-urbanandruralarea(URCA)(FigureA),andbyrural–urbancontinuum(URCA)(FigureB).Allsurveysare2018/19,exceptMalawi(2019/20).SeeAnnex5forthedefinitionofurban,peri-urbanandrural.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.90THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023»sweets,condimentsandbeveragesalsoarefromalargecity,thesmallertheshare(TableA7.4inAnnex7).Theconsumptionoffoodawayfromuniform(seeTable11fordisaggregatedvaluesbyhomeisoftenlinkedtocommutingforwork;high-andlow-food-budgetcountries).thereforethesepatternsreflecthowmuchfartherworkershavetocommutefromhomeincitiesAneconometricanalysisofthedeterminantsofcomparedtoruralareas.consumptionofthedifferentfoodgroupsprovidesfurtherinsights.Forexample,thedeterminantsIncontrasttoanimalForhouseholdconsumption,ofconsumptionofanimalsourcefoodsandfoodsourcefoodsandfoodsharesofanimalsourceawayfromhomecorroboratethedescriptivetrends.awayfromhome,Increasesintheshareofconsumptionofanimaltheanalysisofthefoodsaredrivenbyincome,sourcefoodsinhouseholdfoodconsumptionaredeterminantsofthewhilesharesoffruitsandmainlydrivenbystatisticallysignificantincreasesinincome(seeTableA7.3inAnnex7).shareofvegetablesinvegetablesaredeterminedbyForthesharesoffoodawayfromhome,thetotalhouseholdfoodaccessandavailability.effectofincomeismixedacrosshigh-andconsumptionsuggestslow-food-budgetcountries,butitshowsanaveragehigherconsumptionshareasincomethatthisconsumptionincreaseswhenallcountriesarepulledtogether(TableA7.4inAnnex7).However,inisdrivenmorebybothcountryfood-budgetgroups,moremalenon-farmemploymentleadstoahighershareaccessandavailabilitythanbyincome.Theeffectoffoodawayfromhomeandtheeffectishigherinhigh-food-budgetcountriesthaninofincomeonvegetableconsumptionismixed,low-food-budgetcountries.Thismayreflectemploymentthatismorespatiallydispersed,withbutoverallnegativeandstatisticallysignificant,longercommutes,andthusagreaterneedforfoodawayfromhome.Itmayalsobethecasethatinindicatingareductioninvegetableconsumptionsomehigh-food-budgetcountries,restaurantsandvendors(i.e.foodservices)thatpreparemeals(forsharesasincomeincreases(TableA7.5inAnnex7).foodawayfromhome)aremoreplentiful.Ontheotherhand,consideringallcountriesThelocationeffectacrosstherural–urbantogether,therearestatisticallysignificantcontinuumispresentandstatisticallysignificantlocationeffectsontheshareofvegetablesininlow-food-budgetcountries.Inthiscase,thetotalhouseholdfoodconsumptionacrosstheconsumptionvalueshareoffoodawayfromrural–urbancontinuum–aftercontrollinghomeismuchgreaterinlargecitiesthaninforincome.Large,intermediateandsmalltowns,butdecreasesincrementallyinperi-urbancitiesandareaslessthan1hourfromlargeareasthelargerthesizeoftheclosestcity,andandintermediatecitieshavehighersharesofdecreasesmovingfromtownstoruralareas,vegetableconsumptionthandotowns(TableA7.5inwiththelargestdecreaseoccurringinareas1Annex7).Forlow-food-budgetcountries,thereisto2hoursfromanyurbancentre.ThelocationalsoanotabledecreaseintheshareofvegetableeffectisstatisticallysignificantforfewerURCAconsumptioninruralareas.Thesefindingscategoriesinhigh-food-budgetcountries.Itshowsmayreflectthepresenceofmajorhorticulturalagreaterconsumptionoffoodawayfromhomeincommercialzonesnearcities,orinwell-wateredlargeandintermediatecitiescomparedtotowns,areasnearhighwaysandrivers,inbothlow-andandadecreaseinruralareas,withthelargesthigh-food-budgetcountries.dropoccurringinareasmorethan2hoursfromanyurbancentre.TheseresultscorroboratetheInbothhigh-andlow-food-budgetcountries,descriptivefindings:thelargertheurbancity,theeffectofnon-farmemploymentismostlythehighertheshareoffoodawayfromhomenon-significant(TableA7.5inAnnex7).However,intotalconsumption;thegreaterthedistanceifthehouseholdisheadedbyawoman,thereisapositiveeffectontheshareofvegetableconsumptioninbothcountryfood-budgetgroups.Sincetheeffectofincomeistakenintoconsiderationatthesametime,thiscanbeinterpretedasanindicationthatfemaledietchoicesforhouseholdsmakeadifference,aswomen,forexample,choosefoodwithgreaternutrientandvitamincontent.n91CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>4.2èInthethreecountriesanalysedinAfrica,theCOSTANDAFFORDABILITYprevalenceofchildstuntinggenerallyincreasesOFAHEALTHYDIET,ascitiesbecomesmallerandasonemovesawayANDFOODSECURITYfromurbancentres.ChildwastingandoverweightANDNUTRITIONACROSSarelowerandexhibitlessevidenttrendsacrossTHERURAL–URBANtherural–urbancontinuum.CONTINUUMBasedonthelatestestimates(Chapter2),weareKEYMESSAGESnotontracktoendallformsofmalnutritionby2030.Forinstance,still148.1millionchildrenèInthe11Africancountriesanalysed,thecostofaunderfiveyearsofagewerestuntedin2022,healthydietinurbanareasismuchhigher(onaveragewhile45millionwerewastedand37million1.2timeshigher)thaninperi-urbanareas,anditwereoverweight.AccordingtotheGlobalthendecreasesthesmallerthecitysizeandmovingBurdenofDiseaseStudy,in2019dietaryriskclosertoruralareas.ThistrendislesspronouncedinwasthesecondlargestLevel2riskfactoraaforhigh-food-budgetcountries,whichshowsimilarcostsattributabledeathsamongfemalesandtheacrossallurbanareas.thirdamongmales.20èThehighercostofanimalsourcefoods,comparedAllformsofmalnutritionhavemultipletotheotherfoodgroups,drivesupthecostofahealthycauses,buthealthydietscanhelpreducethedietacrosstherural–urbancontinuum,especiallyinriskofmalnutritioninallitsforms,includingurbanareasandremoteruralareas.micronutrientdeficiency,stunting,wasting,overweightandobesity,aswellasdiet-relatedèThelowercostofahealthydietinperi-urbanareasNCDs.21Thedeterminantsofconsumptionofthe11countriesanalysedcomparedtourbanareasofhealthydietsaresimilarlyhighlycomplexdoesnottranslateintomoreaffordablehealthydiets,asandincludebehaviouralandculturalfactors,incomelevelsareaconsiderablefactor.Thepercentagefoodplacementandpromotionwithinthefoodofthepopulationunabletoaffordahealthydietinenvironment.Itisclear,however,thattoensureperi-urbanareasishigherthaninurbanareasandaccesstohealthydiets,nutritiousfoodsmustsimilartoruralareas.bebothavailableandaffordable.AvailabilityreferstotheexistenceoffoodcomingfromèInthe11countriesinAfrica,thecostofahealthyeitherownproductionorthemarket,whiledietexceedsaveragefoodexpenditureforlow-affordabilityreferstopeople’sfinancialcapacityandmiddle-incomehouseholdsinbothhigh-andtoacquiresufficientfood,whichinturndependslow-food-budgetcountries.Low-incomehouseholdsonhouseholdincomeandfoodprices.Lowlivinginperi-urbanandruralareasareespeciallyincomesconstrainhowmuchfoodhouseholdsdisadvantaged,astheywouldneedtomorethancaneconomicallyaccess,butrelativepricesdoublewhattheycurrentlyspendonfoodtosecureaandsystematicfoodpricedispersionabwillhealthydiet.greatlyinfluencethetypesoffoodsselectedand,asaresult,mayinfluencediet-relatedèInmanyoftheseAfricancountriesstudied,thenutritionoutcomes.22prevalenceofmoderateorseverefoodinsecurityinurbanandperi-urbanareasissimilartothatinruralaaTheGlobalBurdenofDiseaseStudy20estimatestheprevalenceofareas,andinsomecases,slightlyhigher,indicatingthatexposureandattributabledeathsfor,amongothers,23agegroups;foodinsecurityisnotexclusivelyaruralprobleminmostmales,females,andbothsexescombined;and204countriesandofthecountriesanalysed.territories.Thestudyusesariskfactorhierarchyof87risksorclustersofrisks.Level1riskfactorsarebehavioural,environmentalandoccupational,andmetabolic;Level2comprises20riskfactorsorclustersofrisks;Level3comprises52riskfactorsorclustersofrisks;andLevel4comprises69specificriskfactors.abFoodpricedispersionemergeswhenthesamekindoffoodsaresoldatdifferentpricesbystoresinthesamemarket.92THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023ItisworthrecallingthattheaffordabilitySimilartoSection4.1,patterns,differencesandindicatorisameasureofeconomicaccess.ItsimilaritiesarealsoanalysedacrosstenURCAmeasuresnotthenumberofpeoplenoteatingacategoriesoftherural–urbancontinuum,aswellhealthydiet,butratherthenumberwhodonotasafurtheraggregationintourban,peri-urbanhaveenoughresourcestoacquireahealthydiet.andruralcategories(seeTable9andAnnex5,Assuch,thecontributionofsocialprotectionSectionBforfurtherdetails).programmessuchasschoolfeedingprogrammesarenottakenintoconsideration.OntheotherCostandaffordabilityofahealthydiethand,socialprogrammessuchascash-basedacrosstherural–urbancontinuumtransfers,whetherin-kindormonetary,orfooddonationprogrammes,areconsideredpartoftheThecalculationofsubnationalcostandhouseholdincome.affordabilityofahealthydietfollowsthesamemethodologyastheglobalmonitoringCoAHDThe2020editionofthisreportshowedtheindicatorspresentedinChapter2.However,existenceofwithin-countryvariationsinthenationalestimatesderivedfromtheaggregationcostandaffordabilityofahealthydiet,butitofsubnationalindicatorsarenotcomparabledidnotcovervariationsacrosstherural–urbanwithglobalCoAHDindicatorsduetodifferencescontinuum.Studiessuggestthaturbanizationindatasources.Forfurtherinformationandmaydirectlyexertupwardpressureonfoodthefulldescriptionofthedatasourcesandpricesinpoorcountries.18Thisisbecausemostmethodology,seeAnnex8.householdsnowdependonfoodsuppliedbymarketsratherthantheirownproduction.CostofahealthydietThisisparticularlytrueinurbanareaswhereAcrossthe11Africancountriesanalysed,thecost–asshowninFigure24inSection4.1–foodofahealthydietinurbancentresismuchhigherpurchasesconstitutemorethan78percentof(onaverage1.2timeshigher)thaninperi-urbanhouseholdconsumptioninthe11sub-SaharanareasanditthendecreasesthesmallerthecityAfricancountriesanalysed.However,italsosizeandmovingclosertoruralareas.Thehigherholdstrueinperi-urbanandruralareas,costofahealthydietinurbancentresinalmostwherehouseholdsofalmostallcountriesallcountriesanalysedmaybeassociatedwiththeanalysedacquiremorethan50percentofthewidespreaddiffusionofsupermarketsincities.foodconsumedinmarkets.SuchhighsharesWhilediffusionofsupermarketsmayincreaseincreasetheriskoffoodhoardingwhenpricesaccesstoamorediversediet(seeChapter3),areexpectedtorise,whichitselfcancontributeitmayalsopushthecostofahealthydietup,tohigherprices.makingitlessaffordableforpoorerhouseholdsinurbancentres.Thissectionpresentsanewdescriptiveanalysisofindicatorsofhealthydietaccess,foodsecurityHowever,thereareexceptionstothiscostandnutritionforselectedcountries.Theanalysispattern.Forexample,inGuinea-Bissau,thereliesonthegeospatialURCAdataset(seeBox2costinperi-urbanareasisslightlyhigherthanandBox3inChapter3,andAnnex4,SectionA);inurbanareas.Thisislikelyattributedtothewhilethereisnocomparableglobaldatasettouniquegeographicconcentrationofcitiesinsupporttheanalysis,therearemicrolevelnationalthesoutharoundtheportofBissauandtopoorsurveydatathat,oncemergedwiththeURCAinfrastructure,particularlyinferryandroaddataset,couldprovideinsightsondifferencestransportsystemslinkingurbanandperi-urbanacrosstherural–urbancontinuum.Theanalysisareasthatare1hourawayorless(FigureA6.1Dfocusesonthe11sub-SaharancountriescoveredinAnnex6).23InEthiopiaandTogo,theotherinSection4.1,usingthesamehouseholdsurveyexceptions,thecostishigherinruralareasdata(seeTableA5.1inAnnex5),andstillgroupingthaninperi-urbanareas;thisisdirectlyrelatedthemintohigh-food-budgetcountries(2.3PPPtothedispersedurbanizationpatterninthesedollarspercapitaperday)andlow-food-budgetcountries(seeFigureA6.1CinAnnex6),withpoorcountries(1.6PPPdollarspercapitaperday)ruralareasinadequatelyconnectedtourbanareas(seeTable10forthelistofcountriesbycategory).duetopoorandlimitedroadinfrastructure.2493CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>Generally,inthesethreeexceptionalcases,dietbasketisparticularlyhighinveryremotepoortransportinfrastructureisamajorfactorruralareas,morethan2hoursfromanyurbanhamperingavailabilityofnutritiousfoods(oftencentreinhigh-food-budgetcountries(TableA9.2inhighlyperishable)andpushinguptheircostAnnex9).Amongthehigh-foodbudgetcountries,inruralareas.thecostdifferencebetweentheseremoteareasandruralareas1to2hoursfromanyurbancentreAveragevaluesacrosscountriesalsohideisparticularlyhighinNigeria.Thismaybeadifferencesbetweenhigh-andlow-food-budgetreflectionofthedifferenturbanizationpatternscountriesasshowninFigure30A.Thecostofainthosecountries,whichhaveundergoneahealthydietinhigh-food-budgetcountriesismetropolitanexpansionprocesswithmostofthe23percent–22percentand28percenthigherpopulationlivinginlargeand/orintermediatecitiesthaninlow-food-budgetcountries,comparingandinperi-urbanareas1hourawayorless.Inurban,peri-urbanandruralareas.Thehigherthissituation,amoreabruptseparationfrommorecostinhigh-food-budgetcountriesismainlyremoteruralareascanbeexpected,withdisruptionduetothehighercostofvegetablesandanimalinthefoodsupplychainandhigherprices.sourcefoods(29percentand32percenthigherthaninlow-food-budgetcountries,respectively).ThecoststructurebyfoodgroupofahealthyForbothcountryfood-budgetgroups,thelargestdietdoesnotpresentanystrikingdifferencesdecreaseinthecostoccursmovingfromurbantoacrossURCAs,witheachofthesixfoodgroupsperi-urbanareas,whileinruralareasthecostiscontributingtothetotalcostofahealthydietsimilarto(inhigh-food-budgetcountries)oronlyinaboutthesamepercentage,independentlyslightlylowerthan(inlow-food-budgetcountries)ofthecatchmentareaforbothhigh-andthatinperi-urbanareas.low-food-budgetcountries(FigureA9.1inAnnex9).ThelargestcostcontributionbyfoodgroupAmoredisaggregatedviewoftherural–urbantoahealthydietcomesfromanimalsourcecontinuum(i.e.consideringthetenURCAfoods(31–41percent),followedbyvegetablescategories)revealsamuchcloserconvergence(17–22percent),staplefoods(16–21percent),fruitsinthecostofahealthydietinhigh-food-budget(10–18percent),fatsandoils(6–8percent),andcountries,particularlyinurbanareas(Figure30B).pulses,seedsandnuts(6–8percent).Ontheotherhand,therangeinthecostiswiderforlow-food-budgetcountries.ThegreaterHowever,itisworthnotingthehighercostshareconvergenceinthecostofahealthydietinofanimalsourcefoodsinallurbancentresandhigh-food-budgetcountriespointstotheirperi-urbanareasofhigh-food-budgetcountries,betterconnectivityinfoodsupplychainscomparedtolow-food-budgetcountries(betweenacrosstherural–urbancontinuumcomparedto2and6percentagepointsdifference)(FigureA9.1low-food-budgetcountries.inAnnex9).Thelargestcostdifferenceisfoundintowns,wherehouseholdsinhigh-food-budgetLookingatthecostpatternacrosstherural–urbancountriesspendUSD0.29moreperpersonpercontinuumforindividualcountriesalsoprovidesdayonanimalsourcefoodsthandohouseholdsfurtherinsights(TableA9.2inAnnex9).Forexample,inlow-food-budgetcountries(Figure31).inBeninandTogo,householdslivinginurbancentresfaceacost,respectively,1.4and1.7timesTheothertrendtohighlightisthehighercosthigherthanhouseholdslivinginperi-urbanareascontributionofanimalsourcefoodscomparedto–andmostofthepopulationofthesecountriesisallotherfoodgroups,evenvegetablesandfruitsconcentratedinperi-urbanareasofsmallcities.combined,inalmostallURCAsinbothcountryThissuggeststhatamoredispersedurbanizationfood-budgetgroups.Themainoutliersarelargepattern,likelyinvolvingdecentralizedmarketscitiesoflow-food-budgetcountries,duetotheservedbylocalproducers,maysignificantlydrivehighershareoffruitsinthecostofahealthydietthecostofhealthydietsdown.(FigureA9.1inAnnex9).Finally,anddifferentlyfromthatseenforFinally,thecostcontributionofanimalsourcelow-food-budgetcountries,thecostofahealthyfoodsinthetotalcostofahealthydiet(bothas»94FIGURE30INTHE11COUNTRIESINAFRICTHAE,TSHTEATCEOOSFTFOOFOADHSEEACULTRHITYYDAINETDINNUUTRRBITAIONNAIRNETAHSEISWMORULCDH2023HIGHERTHANINPERI-URBANAREAS,ANDITDECREASESTHESMALLERTHECITYSIZEANDMOVINGCLOSERTORURALAREAS;THISTRENDISLESSPRONOUNCEDINHIGH-FOOD-BUDGETCOUNTRIES,WHICHSHOWSIMILARCOSTSACROSSALLURBANAREASA)COSTOFAHEALTHYDIETINURBAN,PERI-URBANANDRURALAREAS(URCA)2.5COSTOFAHEALTHYDIET2.0(PPPDOLLARSPERPERSONPERDAY)1.51.00.50UrbanPeri-urbanRuralUrbanPeri-urbanRuralHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESB)COSTOFAHEALTHYDIETACROSSTHERURAL–URBANCONTINUUM(URCA)4.03.53.02.52.01.51.00.50COSTOFAHEALTHYDIET(PPPDOLLARSPERPERSONPERDAY)Largecity(>1millionpeople)Intermediatecity(0.25–1millionpeople)Smallcity(50–250thousandpeople)Town(20–50thousandpeople)<1hourtoalargecity<1hourtoanintermediatecity<1hourtoasmallcity<1hourtoatown1–2hourstoacityortown>2hourstoacityortownLargecity(>1millionpeople)Intermediatecity(0.25–1millionpeople)Smallcity(50–250thousandpeople)Town(20–50thousandpeople)<1hourtoalargecity<1hourtoanintermediatecity<1hourtoasmallcity<1hourtoatown1–2hourstoacityortown>2hourstoacityortownHIGH-FOOD-BUDGETCOUNTRIESRURAL–URBANCONTINUUM(URCA)LOW-FOOD-BUDGETCOUNTRIESNOTES:FigureAshowsthecostofahealthydietinurban,peri-urbanandruralareas(URCA).InFigureB,eachbarvisualizesthemedian,25thand75thpercentilerange,andwhiskersof1.5timesthatrangeofthecostofahealthydietforthe11countriesanalysedacrosstherural–urbancontinuum(URCA)byhigh-andlow-food-budgetcountries,inPPPdollarsperpersonperday(PPP=purchasingpowerparity).Crossesinthehigh-food-budgetfigurearecostofhealthydietinurbancentresinEthiopia,classifiedasoutliercomparedtothevaluesofothercountriesinthesameURCAs.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.95CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>»shareandintermsofmoneyvalue)isalsohighinOnaverageatthenationallevel,thecostofahealthydietislowerthantheamounthouseholdsmoreremoteareas(morethan2hourstraveltoaspendonfoodinthehigh-food-budgetcityortown)inbothhigh-andlow-food-budgetcountriesanalysed(seeTableA9.1inAnnex9).Forcountries.Ontheotherhand,itislowerinhigh-food-budgetcountries,thecostofahealthyperi-urbanareasofintermediateandsmallcities,dietis86percentofaveragefoodconsumption,aswellasinareas1to2hoursfromacityofanyvaryingfrom74percentto97percentamongsize(Figure31andFigureA9.1inAnnex9).thecountriesinthisgroup.Forlow-food-budgetcountries,thereismorevariability.IntwoThelowercostofanimalsourcefoodsincountries(BurkinaFasoandtheNiger),thecostperi-urbanareas,coupledwiththehighcostofofahealthydietisalmost40percentgreaterfruitsandvegetablesinlargecities,particularlyinthanaveragefoodconsumption.However,inthelow-food-budgetcountries,explainsthedecreaseothers,thecostofahealthydietislowerthantheintheoverallcostofahealthydietbasketfromactualamountspentonfood.urbantoruralareasacrossthecontinuum(Figure31).Thelowercostoffruits,vegetablesandThenationalaverages,however,obscurethefactanimalsourcefoodsintheoutskirtsofcitiesisthatforlow-andmiddle-incomehouseholdsinclearlyaconsequenceoftheproximitytothebothcountryfood-budgetgroups,thecostofaproductionsiteoftheseperishableproducts.Inhealthydietactuallyexceedsaverageexpenditurefact,theincreasingdemandforanimalsourceonfood(Figure32A).Forlow-incomehouseholds,foodsfrombetter-offurbandwellersisattractingthecostofahealthydietbasketisabouttwicemoremedium-andlarge-scalelivestockoperatorstheamountthathouseholdsspendonfood:tourbanandperi-urbanareas(suchoperatorsspecifically,2.3timeshigherinlow-food-budgethadmovedfartherawaywhenurbanizationfirstcountriesand2timeshigherinhigh-food-budgetbegantointensify).25Furthermore,thewidercountries.Middle-incomehouseholdswouldcostdifferenceforanimalsourcefoodsacrossalsoneedtoincreasecurrentspendingtohavetherural–urbancontinuumoflow-food-budgetaccesstoahealthydiet(i.e.by34percentincountriesislikelyduetothehigherconstraintsinlow-food-budgetcountriesand17percentinthecoldsupplychain.high-food-budgetcountries).CostofahealthydietcomparedtoactualhouseholdThisproblemisseenforalllow-andfoodexpendituremiddle-incomehouseholdsinbothhigh-andThefooddemandanalysisinSection4.1low-food-budgetcountriesacrosstherural–urbanshowsthepatternsoffoodconsumptionacrosscontinuum,althoughitbecomesparticularlyacutetherural–urbancontinuum,includingthemovingfromurbantoperi-urbanareas(Figure32B).marketvalueofthefoodsconsumedbyfoodLow-incomehouseholdslivinginperi-urbangroup.Fromthisanalysis,however,itisnotandruralareasareespeciallydisadvantaged,aspossibletodeterminewhethertheconsumedtheywouldneedtomorethandoublewhattheydietprovidesthequantityofcaloriesandcurrentlyspendonfoodtosecureahealthydiet.nutrients,andthediverseintakeoffoodsfromdifferentfoodgroupsthatwouldconstituteaAffordabilityofahealthydietacrossthehealthydiet.Thiswouldrequireadifferentsetrural–urbancontinuumofdataandinformation,whichisnotavailable.Affordability,orthecostofahealthydietOntheotherhand,itispossibletocomparerelativetoincomethathouseholdscancrediblythecostofahealthydiettowhathouseholdsreserveforfood,reflectstheabilitytoaccessaareactuallyspendingonfood(includinghealthydiet.Tracingthisaffordabilityacrossmarketvalueofownfoodproduction),ineachURCAinthe11countriesanalysedshowsordertodeterminewhethertheywouldhavehoweconomicaccesstoahealthydietfollowstospendmoreorlessoftheincometheyhavedifferentpathsincountrieswithdifferentavailabletosecureahealthydiet.Thisisalevelsofdevelopmentandurbanization.usefulcomparison,especiallyasestimatesImportantly,highcostsdonotnecessarilycanbedisaggregatedbyURCAcategoryandtranslateintogreaterunaffordability,andvice»householdincomelevel.96FIGURE31INTHE11COUNTRIESINAFRICTHAE,TSHTEATHEIGOHFEFROOCDOSSTECOUFRAITNYIMANADLSNOUUTRRCITEIOFNOOINDTSHDERWIVOERSLD2023THEHIGHCOSTOFAHEALTHYDIETACROSSTHERURAL–URBANCONTINUUM,ESPECIALLYINURBANANDREMOTERURALAREASA)AVERAGECOSTOFEACHFOODGROUPINAHEALTHYDIETACROSSTHERURAL–URBANCONTINUUMINHIGH-FOOD-BUDGETCOUNTRIES2.5AVERAGECOSTOFEACHFOODGROUPINAHEALTHYDIET0.20.1(PPPDOLLARSPERPERSONPERDAY)0.10.10.20.20.10.10.92.00.10.10.10.30.10.10.50.10.10.4>2hours0.10.10.1toacity0.1ortown0.90.90.11.50.90.90.80.60.70.60.80.21.00.30.30.30.30.30.30.40.20.20.31–2hours0.50.40.40.40.40.40.40.40.4toacity0.40.40.40.30.40.30.30.4ortown0<1hourtoIntermediate<1hourtoanSmallcity<1hourTown<1hourLargecityalargecitycityintermediate(50–250toasmall(20–50toatown(>1millionthousandthousandpeople)(0.25–1millioncitypeople)citypeople)people)RURAL–URBANCONTINUUM(URCA)B)AVERAGECOSTOFEACHFOODGROUPINAHEALTHYDIETACROSSTHERURAL–URBANCONTINUUMINLOW-FOOD-BUDGETCOUNTRIES2.5AVERAGECOSTOFEACHFOODGROUPINAHEALTHYDIET2.00.10.10.10.1(PPPDOLLARSPERPERSONPERDAY)0.10.10.10.10.10.10.10.10.70.70.10.10.11.50.10.20.20.70.60.10.40.10.30.70.50.10.10.60.60.40.41.00.20.5<1hour0.5>2hours0.30.20.2toatowntoacity0.40.30.20.2ortown0.20.30.30.50.40.30.30.30.30.30.30.30.3<1hour0.300.40.40.3Smallcitytoasmall1–2hours(50–250TowntoacityLargecity<1hourtoIntermediate<1hourtoanthousandcity(20–50ortown(>1millionalargecitycityintermediatepeople)thousandpeople)people)(0.25–1millioncitypeople)RURAL–URBANCONTINUUM(URCA)StaplefoodsVegetablesFruitsAnimalsourcefoodsPulses,seedsandnutsFatsandoilsNOTES:Thefiguresshowtheaveragecostofeachfoodgroupinahealthydietacrosstherural–urbancontinuum(URCA),forhigh-food-budget(FigureA)andlow-food-budget(FigureB)countries.ThecostofahealthydietisexpressedinPPPdollarsperpersonperday(PPP=purchasingpowerparity).Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.97CFHIGAUPRTEE3R24TTHHEECINOTSETROPFLAAYHOEFAFLOTOHDYSDUIEPTPLEYXCANEEDDDSEAMVAENRDAGANEDFOTOHDECCOOSNTSAUNMDPATFIOFNORFDOARBLILOITWY-<A.N..>DMIDDLE-INCOMEHOUSEHOLDSINBOTHHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINTHE11COUNTRIESANALYSEDINAFRICAA)RATIOOFTHECOSTOFAHEALTHYDIETANDAVERAGEFOODCONSUMPTIONBYHOUSEHOLDINCOMELEVELINHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESHigh-incomehouseholdsMiddle-incomehouseholdsLow-incomehouseholds00.51.01.52.02.5COSTOFAHEALTHYDIETTOFOODEXPENDITURERATIOHigh-food-budgetcountriesLow-food-budgetcountriesB)RATIOOFTHECOSTOFAHEALTHYDIETANDAVERAGEFOODCONSUMPTIONBYHOUSEHOLDINCOMELEVELANDBYURBAN,PERI-URBANANDRURALAREA(URCA)INHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESCOSTOFAHEALTHYDIETTOFOODEXPENDITURERATIO2.52.062.061.892.232.251.231.261.101.391.372.00.610.650.530.690.691.601.50.991.00.510.50UrbanPeri-urbanRuralUrbanPeri-urbanRuralHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESHigh-incomehouseholdsMiddle-incomehouseholdsLow-incomehouseholdsNOTES:Inthefigures,totalhouseholdconsumption(atmarketvalue)servesasaproxyforhouseholdincome,andtercilesarecalculatedtoclassifylow-,middle-andhigh-incomehouseholds.Aratiogreaterthan1showshowmanytimesahealthydietismoreexpensivethanaveragehouseholdfoodconsumption.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.98THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE33INTHE11COUNTRIESINAFRICA,THEPERCENTAGEOFTHEPOPULATIONUNABLETOAFFORDAHEALTHYDIETINPERI-URBANAREASISHIGHERTHANINURBANCENTRESANDSIMILARTORURALAREASPEOPLEUNABLETOAFFORDAHEALTHYDIET100(PERCENTAGE)908070EthiopiaCôted'IvoireMaliNigeriaGuinea-BissauBeninTogoBurkinaFasoMalawiNiger6050403020100SenegalHIGH-FOOD-BUDGETCOUNTRIESLOW-FOOD-BUDGETCOUNTRIESURBANPERI-URBANRURALLargecity(>1millionpeople)<1hourtoalargecity<1hourtoatownIntermediatecity(0.25–1millionpeople)<1hourtoanintermediatecity1–2hourstoacityortownSmallcity(50–250thousandpeople)<1hourtoasmallcity>2hourstoacityortownTown(20–50thousandpeople)NOTES:Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.»versa,asthisdependsonthelevelofincomeIntheNiger,alow-food-budgetcountrywiththehighestpercentageofpopulationlivinginrelativetothecost.areasmorethan1hourfromanyurbancentreamongthe11countriesanalysed,thepercentageIndeed,thisisakeyfindingfromtheanalysis.ofpopulationunabletoaffordahealthydietAlthoughthecostofahealthydietinperi-urbangrowsascitiesgetsmallerandasonemovesareasislowerthaninurbanareas(Figure30A),thisintoruralareas.Inthiscase,thereisanincreasedoesnottranslateintoamoreaffordablehealthyof52percentagepointsbetweenlargecitiesdietintheformer(Figure33).Onaverage,theandtowns(Figure33andTableA9.3inAnnex9).percentageofthepopulationunabletoaffordaSurprisingly,BurkinaFasoandGuinea-Bissau,healthydietinperi-urbanareasis1.5timeshigherbothlow-food-budgetcountries,followathaninurbancentresandsimilartoruralareas.99CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>patternsimilartothatofhigh-food-budgetevenslightlyhigher(e.g.Niger,Nigeria)countries,withaffordabilitylevelswithin(Figure34).Thissuggeststhatfoodinsecurityiseachcountryremainingmoreorlessconstantnotexclusivelyaruralprobleminmostoftheacrossurbancentres.countriesanalysed.Inlow-food-budgetcountries(exceptBeninTheFIESanalysisshowsadifferentpatternandTogo),movingawayfromurbancentresacrosstherural–urbancontinuuminhigh-introducesastructuralchange,withtheandlow-food-budgetcountries.Ingeneral,percentageofpopulationunabletoaccesslow-food-budgetcountriesshowlargerdifferencesahealthydietincreasingsignificantly.Inandvaryingpatternsinfoodinsecurity(Figure34A).high-food-budgetcountries(exceptEthiopia),InMalawi,moderateorseverefoodinsecuritythisjumpoccursonestepfartheralongtheismuchlowerinurbanareasandincreasescontinuum,crossingperi-urbanareasoflargeandsignificantlymovingtoperi-urbanandruralintermediatecities.Finally,inhigh-food-budgetareas,withextremelyhighlevelsofseverefoodcountries,thepercentageofthepopulationinsecurityinbothareas.Moderateorseverefoodunabletoaffordahealthydietincreasesacrossinsecurityinurbanandperi-urbanareasisaboutperi-urbanareasasthesizeoftheclosesturbanthesameinBenin,butinBurkinaFasoitishighercentredecreases(Figure33).inurbanareasthaninperi-urbanareas.OnlyinGuinea-BissauandTogoisthereagradualFoodinsecurityacrosstherural–urbanincreasemovingfromurbantoruralareas.continuumIncontrast,inhigh-food-budgetcountries,theThecomparisonoffoodinsecurityamongprevalenceofmoderateorseverefoodinsecurityrural,peri-urbanandurbanpopulationsattheisaboutthesameacrosstherural–urbanglobalandregionallevelsbasedontheDegreecontinuum(Figure34A).InthecaseofNigeria,thereofUrbanization(DEGURBA)classification,acissomeindicationthatmoderateorseverefoodpresentedinChapter2,indicatesthatfoodinsecuritymaybehighestinperi-urbanareasandinsecurityislowerinurbanareasatthegloballowestinruralareas(Figure34A).level.Attheregionallevel,AfricaandLatinAmericaandtheCaribbeanfollowthispattern,FurtherdisaggregationrevealssomeadditionalbutnotAsianorNorthernAmericaandEurope,differences.However,thesamplesizesineachrevealingcontext-specificdifferencesthatdefycategoryaresmallandthemarginsoferrorgeneralization.Ananalysisofpatternsoftheareverylarge,sotheobservedpatternsmustprevalenceofmoderateorseverefoodinsecuritybeinterpretedwithcaution(seethefullsetofbasedontheFoodInsecurityExperienceScaleresultsinTableA10.1andTableA10.2inAnnex10).(FIES),usinghouseholdsurveydatafor9oftheForexample,inNigeria,ahigh-food-budget11countriesstudiedupuntilnow,groupedbycountry,theprevalenceoffoodinsecurityisfoodbudget(seeTable10)andaccordingtothepositivelyassociatedwithcitysize:thebiggerURCA-definedrural–urbancontinuum(seeTable9),thecity,thehighertheprevalenceoffoodshedslightonsomecontext-specificdifferencesinsecurity(Figure34B).Moreover,levelsofsevereandhasthepotentialtocomplementthefoodinsecurityinlargeandintermediateanalysisinChapter2.cities(15percentand14percent,respectively)areevenhigherthaninmoreremoteareasInmanyoftheanalysedcountries,theprevalence(10percentinareasmorethan2hourstravelofmoderateorseverefoodinsecurityinurbantoanyurbancentre).Thisislikelyrelatedtoandperi-urbanareasissimilartothatinruralthepresenceofslumsoutsidethelargercities.areas(e.g.Côted’Ivoire,Senegal)orsometimesAsimilarpatternisalsoobservedinBurkinaFaso,alow-food-budgetcountrywithamoreacTheDEGURBAclassificationwasdevelopedbyEUROSTAT,ILO,dispersedurbanizationpattern.FAO,OECD,UN-HabitatandtheWorldBankandwasapprovedatthe51stsessionoftheUNStatisticalCommissioninMarch2020.26ThisIntheNiger,thepatternisreversed:thediffersfromtheUrbanRuralCatchmentAreas(URCA)criteriausedfortheanalysisofsubsetsofcountriesinthissection(seeBox3).prevalenceofmoderateorseverefood»100NOTES:Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.PREVALENCEOFMODERATEORSEVEREFOODINSECURITY01020304060708090PREVALENCEOFMODERATEORSEVEREFOODINSECURITY01080FIGURE34INMANYOFTHENINECOUNTRITEHSEASNTAALTYESEODFIFNOAOFDRSICECAU,TRHITEYPARNEDVANLUETNRCIETIOOFNMINODTHEREAWTOEROLRD2023SOURCE:Authors’(FAO)ownelaboration.(PERCENTAGE)52.6(PERCENTAGE)70SEVEREFOODINSECURITYINURBANANDPERI-URBANAREASISSIMILARTOTHATINRURALAREAS,ANDINSeverefoodinsecurityHIGH-FOOD-BUDGETCOUNTRIESB)PREVALENCEOFMODERATEORSEVEREFOODINSECURITYACROSSTHERURAL–URBANCONTINUUM(URCA)Senegal60A)PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINURBAN,PERI-URBANANDRURALAREAS(URCA)SOMECASES,SLIGHTLYHIGHER,INDICATINGTHATFOODINSECURITYISNOTEXCLUSIVELYARURALLargecity(>1millionpeople)5044.7FORSELECTEDCOUNTRIESUrban50BYHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESPROBLEMINMOSTOFTHECOUNTRIESANALYSEDIntermediatecity(0.25–1millionpeople)Peri-urban4038.940.038.734.2HIGH-FOOD-BUDGETCOUNTRIES30Smallcity(50–250thousandpeople)Rural20Town(20–50thousandpeople)25.1<1hourtoalargecityUrbanNigeria<1hourtoanintermediatecity51.4Côted'IvoirePeri-urban40.540.340.6<1hourtoasmallcity43.641.8<1hourtoatownRural1–2hourstoacityortown61.4>2hourstoacityortownUrbanModeratefoodinsecurityLargecity(>1millionpeople)37.837.737.433.934.936.234.644.4NigeriaPeri-urban45.942.9Intermediatecity(0.25–1millionpeople)RuralSmallcity(50–250thousandpeople)39.3Town(20–50thousandpeople)UrbanBurkinaFaso<1hourtoalargecity41.3Guinea-BissauPeri-urban67.3<1hourtoanintermediatecity63.5<1hourtoasmallcity45.5Rural<1hourtoatown52.41–2hourstoacityortownUrban101>2hourstoacityortown41.9Peri-urban69.7Largecity(>1millionpeople)66.966.335.5BeninRuralIntermediatecity(0.25–1millionpeople)LOW-FOOD-BUDGETCOUNTRIESMalawiSmallcity(50–250thousandpeople)60.7LOW-FOOD-BUDGETCOUNTRIESTogoUrban65.8Town(20–50thousandpeople)55.957.4Peri-urban61.7<1hourtoalargecity<1hourtoanintermediatecity52.7Rural54.0<1hourtoasmallcity<1hourtoatown87.6BurkinaFasoUrban40.341.11–2hourstoacityortown83.9Peri-urban35.3>2hourstoacityortownLargecity(>1millionpeople)78.279.281.2RuralIntermediatecity(0.25–1millionpeople)37.8UrbanSmallcity(50–250thousandpeople)Peri-urbanTown(20–50thousandpeople)42.2<1hourtoalargecityRural<1hourtoanintermediatecity<1hourtoasmallcityUrban<1hourtoatownPeri-urban1–2hourstoacityortown>2hourstoacityortownRural48.2Malawi79.368.8Niger51.550.450.822.545.848.245.443.362.5Niger42.543.3CHAPTER4THEINTERPLAYOFFOODSUPPLYANDDEMANDANDTHECOSTANDAFFORDABILITY<...>»insecurityincreasesasthesizeofthecityNutritionalstatusacrosstherural–urbancontinuumdecreases(Figure34B)–similartothepatternfoundforthepercentageofthepopulationTheprevalenceofmalnutritionacrosstheunabletoaffordahealthydietbasketinthosetenURCAcategorieswasalsoestimatedonlycountries–butthenbeginstofallmovingintofor3ofthe11countriesofthesectionsaboveperi-urbanareas,withtheexceptionofasharp(i.e.Benin,NigeriaandSenegal),adduetodatauptickinareaslessthan1hourfromatown.limitations.Theanalysisisbasedon2018Malawi,ontheotherhand,presentsevidencedatafromdemographicandhealthsurveysofastructuralchange:asuddenworsening(TableA5.1).SeeTableA10.3inAnnex10forthefulloffoodinsecurity,mostnotablyseverefoodtableofresults.insecurity,forhouseholdslivinginareaslessthan1hourtraveltoanintermediatecity,withInthethreecountries,generallytheprevalencehighlevelsoffoodinsecuritymovingtoremoteofstuntinginchildrenunderfiveyearsofageruralareasmorethan2hourstraveltoanycitygraduallyincreasesascitiesbecomesmallerortown(Figure34B).andasonemovesawayfromurbancentres.ThebiggestincreaseinNigeriaoccursmovingAnotheranalysisoffoodinsecuritybasedtoareaslessthan1hourtraveltoasmallcity,onFIESfrom21ruraldevelopmentprojectswhileinBeninitisseenmovingintomoreworldwide,lookingatthetenURCAcategoriesremoteruralareas(i.e.morethan2hoursoftherural–urbancontinuum,ispresentedtraveltoanurbancentre).TheprevalenceinBox6.WhilethisanalysisisnotnationallyofstuntingisnotablylowerinSenegal,andrepresentative,itprovidessomeperspectivewhilethereisageneralpatternofincreases,beyondthenineAfricancountriesanalysedwithsomevariationsasonemovesawayfromabove,evenifatprojectlevel.urbanareas,theincreasesaresmallerwithsomevariations(e.g.thereisanotabledecreaseInsummary,theresultsoftheanalysisofinareaslessthan1hourtraveltolargeandnationallyrepresentativeFIESdatasetsfromintermediatecities,aswellastoatown).thenineAfricancountries,aswellasoftheFIESdatacollectedinthecontextoftheseruralFurthermore,asalreadyemergedinthedevelopmentprojects,tendtoindicatethatfoodinsecurityisnotexclusivelyaruralprobleminanalysisofthecostandaffordabilityofamanyplaces.WhileitisnotpossibletodrawgeneralconclusionsgiventhelimitednumberhealthydietacrossURCAs,thedatasuggestofcountriesinthischapter’sFIESanalysis(allfromoneregion),theresults–includingthosethatthesizeoftheclosesturbancentreplaysafromthe21ruraldevelopmentprojects–signalthatfurtherresearchisneededtoguidemoreroleintheprevalenceofstuntinginperi-urbantargetedpoliciesandinvestmentsacrosstherural–urbancontinuum.areas,withtheprevalencebeinghigherinareasclosesttosmallcitiesandtownsinBeninandNigeria.Thisresultisalignedwithotherstudiesthatfindhighlevelsoffoodinsecurityandmalnutritioninthesprawlingpoverty-strickenareassurroundingmanycitiesinAfrica.Foodaccessislimited,andmanyoftheseperi-urbanslumsarefooddeserts,whereresidents’accesstodiverse,freshornutritiousfoodsislimitedorevennon-existentduetotheabsenceorlowdensityoffoodentrypoints(seeBox4inChapter3)andinadequateaccesstoservices,includinghealthandeducation.»adThechoiceofthethreecountrieswasdatadriveninBeninandNigeria,astheyaretheonlycountriesamongthe11forwhichgeoreferenceddataonmalnutritionfor2018/19exist.102BOX6FOODSECURITYACROSSTHERURATHL–EUSRTABTAENOCFOFNOTOIDNUSEUCMU:REIVTYIDAENNDCENUFRTROIMTIO2N1RINUTRHAELWORLD2023DEVELOPMENTPROJECTSWORLDWIDEBetween2019and2021,household-levelResultsshowthattheprevalenceoffooddatawithGPScoordinateswerecollectedfrominsecurityvariesacrosstherural–urbancontinuum.21ruraldevelopmentprojectssupportedbyIFADThereisahigherprevalenceofmoderateorsevereandimplementedinmostregionsoftheworld.foodinsecurityinareasclosetotowns(lessthanThisincludesfivecountriesinAsiaandthePacific;1hourtravel)comparedtoareasmorethan1hoursixinEasternandSouthernAfrica;fourinLatinfromacityortown.Inaddition,thereisamuchAmericaandtheCaribbean;fourinNearEast,higherprevalenceofmoderateorseverefoodNorthernAfrica,EuropeandCentralAsia;andinsecurityinlargercitiescomparedtosmallercitiesthreeinWesternandCentralAfrica(seeAnnex5,ortowns,anditisevenhigherthanthoseliving1toSectionDforthefulllistofcountriesandprojects).2hoursormorethan2hoursfromacityortown.ThesedatasetscontaininformationfrommoreThisbearssomesimilaritytofindingsshowninthan41000householdsandarerepresentativeFigure34B.Ontheotherhand,severefoodinsecurityofsmall-scaleproducerswhoareengagedinishighestinruralareasthatarelessthan1hourprojectsfinancedbyinternationalfinancialtoatownandmorethan2hourstoacityortown.organizations.ThedataweremergedwiththeUrbanHowever,ofsurpriseisthatseverefoodinsecurityRuralCatchmentAreas(URCA)dataset(usingisalsoveryhighinlargecities,aswellashighinGPScoordinates),andhouseholdsweretherebyperi-urbanareasoflargeandintermediatecities.classifiedacrossthetenURCAcategoriesoftheThisanalysisaddsinformationonfoodinsecurityrural–urbancontinuum.patternsthatcouldbemorespecificallyaddressedandtargeted,butwhicharegenerallynotvisibleFigureAshowstheprevalenceofmoderateorwhenlookingatonlythethreeurban,peri-urbanandseverefoodinsecurityacrosstherural–urbanruralcategories.continuumusingthepooledsampleofthe21ruraldevelopmentprojects.ItisimportanttoclarifythatInsummary,theprevalenceofmoderateorforsomeURCAcategories,thesamplesizeistooseverefoodinsecurityamongaselectednumberofsmalltodrawanystatisticallysignificantinference,small-scaleproducersinurbanandperi-urbanareasthustheresultsarepresentedandinterpretedinishigh–insomecasesashighorevenhigherthanintermsofadescriptionoffoodinsecurityacrosstheruralareas.Thisissimilartothefindingsformanyofrural–urbancontinuum.thenineAfricancountriesanalysed(Figure34).FIGUREAPREVALENCEOFMODERATEORSEVEREFOODINSECURITYAMONGHOUSEHOLDSOF21RURALDEVELOPMENTPROJECTSACROSSTHERURAL–URBANCONTINUUM(URCA)URBANCENTRESPERI-URBANAREASRURALAREAS60PREVALENCEOFMODERATEORSEVEREFOODINSECURITY(PERCENTAGE)50504441401626342826303232>2hours252216162419toacityortown201321131215151019Intermediatecity10161822(0.25–1million13Smallcity9people)(50–2508thousand0people)Town<1hourto<1hourtoan<1hour<1hourto1–2hours(20–50alargecityintermediatetoasmallatowntoacityLargecitythousandortown(>1millionpeople)citycitypeople)RURAL–URBANCONTINUUM(URCA)SeverefoodinsecurityModeratefoodinsecurityNOTES:ThefigureshowstheprevalenceofmoderateorseverefoodinsecuritybasedontheFoodInsecurityExperienceScale(FIES)acrosstherural–urbancontinuumfor21ruraldevelopmentprojectsimplementedincountriesfromallregionsoftheworld.SeeAnnex5,SectionDforthelistofcountriesandprojects,datasourcesandmethodology.SOURCE:Authors’(IFAD)ownelaboration.103CFHIGAUPRTEE3R54TTHHEEPINRTEEVRAPLLEANYCOEFOFFOCOHDISLUDPSPTLUYNATNINDGDEGMENANERDAALNLDYITNHCERCEOASSTEASNADSACFITFOIERSDBAEBCILOITMYE<S..M.>ALLERANDMOVINGAWAYFROMURBANCENTRES;CHILDWASTINGANDOVERWEIGHTARELOWERANDEXHIBITLESSEVIDENTTRENDSACROSSTHERURAL–URBANCONTINUUMPREVALENCEOFSTUNTINGINCHILDREN<5YEARSA)PREVALENCEOFSTUNTINGINCHILDRENUNDERFIVEYEARSOFAGEACROSSTHERURAL–URBANCONTINUUM(URCA)(PERCENTAGE)706050403020100LargecityIntermediatecitySmallcityTown<1hourto<1hourtoan<1hour<1hour1–2hours>2hours(20–50alargecityintermediatetoasmalltoatowntoacitytoacity(>1million(0.25–1million(50–250thousandortownortownpeople)citycitypeople)people)thousandpeople)PREVALENCEOFWASTINGINCHILDREN<5YEARSB)PREVALENCEOFWASTINGINCHILDRENUNDERFIVEYEARSOFAGEACROSSTHERURAL–URBANCONTINUUM(URCA)(PERCENTAGE)14121086420LargecityIntermediatecitySmallcityTown<1hourto<1hourtoan<1hour<1hour1–2hours>2hours(20–50alargecityintermediatetoasmalltoatowntoacitytoacity(>1million(0.25–1million(50–250thousandortownortownpeople)citycitypeople)people)thousandpeople)PREVALENCEOFOVERWEIGHTINCHILDREN<5YEARSC)PREVALENCEOFOVERWEIGHTINCHILDRENUNDERFIVEYEARSOFAGEACROSSTHERURAL–URBANCONTINUUM(URCA)(PERCENTAGE)5.04.54.03.53.02.52.01.51.00.50LargecityIntermediatecitySmallcityTown<1hourto<1hourtoan<1hour<1hour1–2hours>2hours(20–50alargecityintermediatetoasmalltoatowntoacitytoacity(>1million(0.25–1million(50–250thousandortownortownpeople)citycitypeople)people)thousandpeople)SenegalNigeriaBeninNOTES:FiguresshowtheprevalenceofmalnutritioninchildrenunderfiveyearsofageinthreeWesternAfricancountries,byURCAcategory(2018).GapsinURCAindicatemissingdata.SOURCE:Authors’(UNICEF)ownelaboration.104THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023»Theprevalenceofwastinginchildrenunderfiveofoverweightinchildrenislowinallcountriesanddoesnotpresentacleartrendacrosstheyearsofageislowerthanthatofstuntinginallrural–urbancontinuum(Figure35C).However,itthreecountriesandexhibitslessevidenttrendsisworthnotingthereisasuggestiontowardsacrosstherural–urbancontinuum(Figure35B).loweroverweightinperi-urbanareasandhigherNevertheless,therearehintsofincreasedoverweightinsomeruralareascomparedwastinginsomeperi-urbanandruralareasintourbanareas.nNigeriaandSenegal.Similarly,theprevalence105NETHERLANDS(KINGDOMOFTHE)Hangingtomatoesripeningontheirstalksinanindustrialgreenhouse.©Shutterstock/SergeyBezverkhyCHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATIONFORHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMKEYMESSAGESirrigationinfrastructureareneededacrossthewholerural–urbancontinuum,butsupportshouldtargetèActions,policies,newtechnologies,andespeciallysmallholderfarmersinruralareasandconsequentlyneededinvestmentstoovercomeurbanandperi-urbanagriculture(UPA)elsewhere.thechallengesandseizetheopportunitiesthaturbanizationcreatesrequireaclearunderstandingèPublicinvestmentinresearchanddevelopmentoftheinteractionbetweenagrifoodsystemsandtheneedstobeincreasedtodeveloptechnologiesandrural–urbancontinuum.innovationstocreatehealthierfoodenvironmentsandincreasetheavailabilityandaffordabilityofnutritiousèThepolicyapproachneedstoleveragethefoods.Technologycanbeparticularlyimportanttoprogressiveconnectivitybetweenurban,peri-urbanboostthecapacityofUPAtosupplynutritiousfoodsinandruralareasthroughinvestmentsininfrastructure,citiesandtowns.publicgoodsandenhancedcapacities,inordertoincreaseaccesstoaffordablehealthydietsandèTostrengthenrural–urbancontinuumconnectivityachievefoodsecurityandnutritionforeveryoneandlinkages,agrifoodsystemsgovernanceacrossthecontinuum.mechanismsandinstitutionsneedtocrosssectoralandadministrativeboundaries.SubnationalandlocalèInthefaceofagradualconvergenceindietarygovernmentsmustplayakeyroleindesigningandpatternsacrosstherural–urbancontinuum,includingimplementingpoliciesbeyondtheiradministrativetheconsumptionofhighlyprocessedfoods,policiesauthority,engagingwithagrifoodsystemsandlegislationareneededtopromotehealthyfoodstakeholdersatalllevels.environments,bothformalandinformal,andtoempowerconsumerstomakenutritiousfoodchoices.èEvidencefrommultilevelandmultisectorgovernancemechanismsimplementingschoolèInintermediateandsmallcitiesandtownsfeeding,UPAand/orpublicprocurementsuggestsandtheirperi-urbanandruralsurroundings,thesearepotentialentrypointsformakinghealthythemidstreamactivitiesofagrifoodsystemsdietsavailableandaccessible.(i.e.logistics,processingandwholesale)canplayanessentialroleineconomicdevelopment,reducingPatternsofurbanization,aswellasthesizethecostofnutritiousfoodsandimprovingincomeandclusteringofurbanagglomerationsandopportunities.Thisisparticularlythecaseforthesurroundingruralareas,aretransformingnewinvestmentsthatenablesmallandmediumagrifoodsystemswithimplicationsforaccesstoenterprisestoexpand.affordablehealthydiets,aswellasfoodsecurityandnutrition(Chapter3).TheincreasedlinksèTherural–urbancontinuumlensiscriticaltoacrosstherural–urbancontinuum,coupledwithdeterminewhatandwheresupportismostneededcloserinteractionsbetweenthecomponentstoaddresstheinsufficientworldwideavailabilityofofagrifoodsystems,createanumberofandaccesstonutritiousfoods,particularlyfruitsandvegetables.Improvedaccesstoproductioninputsand107CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>opportunitiesandchallengesfortheavailabilityhinterlandthroughadensesetofagrifoodandaffordabilityofhealthydiets.Thischaptersystemslinks.Thoselinkscanbeleveragedarguesthatsuchinteractionsalsocreateatopromoteaplace-basedagrifoodsystemsnumberofpolicyandprogrammeentrypointstotransformationforimprovedaccesstoaffordablesupportagrifoodsystemstransformationtowardshealthydietsacrosstherural–urbancontinuumaffordablehealthydiets.However,achangeofleadingtowin–winsituations.afForinstance,directioninpolicyisneededwhichconsidersincreasedoff-farmincomeopportunitiesinbothagrifoodsystemsandspatialdynamics,peri-urbanandruralareasinmidstreamandandtheirinteractionsandinterconnectedness.downstreamactivitiescouldincreaseeconomicAsystemsapproachisthereforebettersuitedforaccesstohealthydiets,whileimprovedeffectivesolutions.1efficiencyintheconnectivitybetweenproducersinruralareas,midstreamactivitiesinperi-urbanSuchanapproachshouldalsoconsidertheandurbanareas,andconsumerscouldreduceincreasingconvergenceinfooddemandandthecostofnutritiousfoods.agsupplypatternsacrosstherural–urbancontinuum(Chapter4).ThegrowingimportanceoffoodThepolicyapproachshouldtakeintopurchases,andofprocessedfoodsindietaryconsiderationthedevelopmentandadoptionpatterns,opensuptheopportunityforleveragingoftechnologiesandinnovationsasessentialmidstreamanddownstreamagrifoodsystemselementsfortransformingagrifoodsystemsactivitieswhichlinkprimaryproductiontotheinclusivelyandsustainablytowardsimprovedfinalconsumer.Atthesametime,thestrongaccesstoaffordablehealthydiets.7,8Reinforcinggrowthofsmallandintermediatecitiesandthescience–policyinterfaceisfundamentaltowns(SICTs),which,asshowninFigure19Boftoleveragetransformativeopportunities,8Chapter3,comprisealmostone-thirdoftheglobalandcanbeanessentialcomplementformanypopulation,needstobeconsideredinpolicyandpolicies,investmentsandlegislationsorientedplanning.Scholarshavecalledthemthe“hidden”toshiftdietarypreferencestowardshealthyandthe“missing”middle,respectively.aediets,improvetheefficiencyofmidstreamTherefore,policies,investmentsandlegislationactivitiesandincreasethesupplyofnutritioussupportingthe“hidden/missingmiddle”canfoods.Giventhemultipleentrypointscreatedleveragetheincreasedinterconnectednessbyurbanization,however,therewillbenodrivenbyurbanizationtofacilitatethecreation“one-size-fits-all”technologicalorinnovativeofscaleeconomiesforsmallholderfarmersandsolutionstoaddressallthechallengesandagrifoodsmallandmediumenterprises(SMEs),takeadvantageoftheopportunitiesforcurrentincreaseoff-farmemploymentopportunitiesandagrifoodsystems.ruralhouseholdincomes,andreducethecostofhealthydiets.Finally,apolicyapproachwhichconsiderstheterritoryisinherentlyintersectoralandTheinteractionbetweenagrifoodsystemsinvolvesdifferentagrifoodsystemsstakeholders:andtherural–urbancontinuumintroducespublic,privateandcivilsociety.Thesuccessthenotionofa“territory”asaunitofanalysisofthisterritory-orientedpolicyapproachandpolicymakingforagrifoodsystemsreststhereforeonthecoordinationofseveraltransformationtowardsimprovingfoodactorsandstakeholders.Stronginstitutionssecurityandnutrition.4Aterritoryinthisandgovernancemechanismsarerequiredtocontextincludesoneormoreurbanareaswhichcoherentlyimplementpolicies,investmentsandareconnectedtoeachotherandtotherurallegislationononeside,andleveragetechnologyandinnovationontheother,buttheyhavetobeaeThe“hiddenmiddle”isattributedtoReardon(2015)2andreferstotheagrifoodcomponentbetweenprimaryproducersandfinalafThisapproachisalsocalled“agroterritorialdevelopment”andisconsumers.Itincludesthe“midstream”and“downstream”segmentsasanalysedindetailinthe2017editionofTheStateofFoodanddefinedinChapter3ofthisreport.The“missingmiddle”isattributedtoAgricultureintheWorld.5ChristiaensenandTodo(2014)3andreferstosmall-andmedium-sizedagAsindicatedinthe2020editionofthisreport,6inadequatefoodcities.Inbothcases,thetermshavebeenusedtoindicatethatpolicieslogisticsandpoorpublicinfrastructure,especiallyforperishablefoods,oftenmisstheparticularitiesanddynamismofthetwo“middles”.arekeydriversofthecostofnutritiousfoods.108THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023FIGURE36REINFORCINGAGRIFOODSYSTEMSLINKAGESANDRURAL–URBANCONNECTIVITYTOMAKEHEALTHYDIETSAFFORDABLEACROSSTHERURAL–URBANCONTINUUMGreateravailabilityanddemandforenergy-densefoodsCommonandhighinfats,sugarsand/orsaltdierentiatedagrifoodpoliciesInsucientproductionoffruitsandvegetablesandandinvestmentshighpricesofnutritiousfoodsContext-speciﬁcExclusionoffarmersfrommoreformalfoodvaluechainstechnologiesCHALLENGESandinnovationsURBANIZATIONProgressiveReinforcingGovernanceAgrifoodinterconnectednessandagrifoodmechanismssystemsgradualdietaryconvergencesystemsandinstitutionstransformationsacrosstherural–urbanacrosssectoraltomakelinkagesandandadministrativehealthydietscontinuumrural–urbanboundariesaordableconnectivityforalltoaddresschallengesandleverageopportunitiesOPPORTUNITIESMorediversiﬁeddietsandmainstreamingofpurchasingofprocessedfoodsIncreasedo-farmincomeopportunitiesImprovedproductivityforfarmerswellconnectedtocitiesSOURCE:Authors’(FAO)ownelaboration.orientedtoenhanceagrifoodsystemslinkagesenvironments;policiesandinvestmentsthroughthegrowingrural–urbanconnectivity.toleveragetheeconomicpotentialoftheInparticular,subnationalgovernmentsandmidstreamofagrifoodsystemsinSICTs,localgovernancemechanismsarekeyfactorswhichcanleadtoreducedcostandimprovedforimprovinglinkagesacrosstherural–urbanaffordabilityofhealthydiets;andfoodcontinuum.9Figure36providesavisualsummaryproductionpoliciestoincreasethesupplyofofthisapproachtoaddressthechallengesandnutritiousfoods.Itthenidentifiestechnologicalleveragetheopportunitiesthaturbanizationandinnovativesolutionsacrossthedifferentcreatesinagrifoodsystemsforensuringagrifoodsystemscomponentsthatshowaccesstoaffordablehealthydietsacrossthepotentialtosupportagrifoodsystemsrural–urbancontinuum.transformationtowardsaffordablehealthydiets,notingthosethatcanparticularlywork.ThischapterfirstanalysesdifferentpolicyFinally,thechapterexaminesgovernancealternativesavailableamongthecomponentsmechanismsdeemedmostappropriatetoofagrifoodsystems,througharural–urbanmanagetheproposedpolicyapproachacrosscontinuumlens,toaddressthechallengesadministrativeandsectoralboundaries,andandleveragetheopportunitiesforaccesshighlightstheroleofsubnationalgovernmentstoaffordablehealthydietsidentifiedintheandlocaladministrationsindesigningandpreviouschapters.Assuch,thischapterimplementingsuchmechanisms.nfocusesonpoliciestopromotehealthyfood109CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>5.1policyentrypointsforkey“nodes”acrossthePOLICIESANDcontinuum(e.g.foodenvironmentsinsmallINVESTMENTSFORcitiesortownsversusfoodenvironmentsHEALTHYDIETSACROSSinlargecities).THERURAL–URBANCONTINUUMRegulationoffoodandbeveragemarketingcanbeimportantinavarietyofsettingsacrosstheFoodenvironmentsandconsumercontinuum.aiAdvertisingofhighlyprocessedbehaviourpoliciesfoodsinruralsettingsiscommonand,dependingonthecountry,sometimesevenmorewidelyusedHouseholdsobtainfoodsthroughvariousthaninurbanareas.11Examplesoflocalinitiativessources,forexamplethroughownproduction,tocreatehealthierretailfoodenvironmentspurchasesorgifts.Ashasbeennotedpreviously,includerestrictingadvertisingofenergy-densethemajorityofhouseholdsacrosstherural–urbanfoodshighinfats,sugarsand/orsaltinthecontinuumacquirefoodsthroughpurchases.Invicinityofschools15inMandurah(Australia),andaddition,processedfoodsareanimportantpartonpublictransportinLondon.16,17ofhouseholds’foodconsumption,notonlyinbigcitiesbutalsoinsmalltownsandruralareas.Taxationofenergy-densefoodsandbeverageshighinfats,sugarsand/orsalthasbeenimplementedCertainaspectsofretailfoodenvironmentsaharein85(forsugar-sweetenedbeverages)andbecomingmoresimilaracrosstherural–urban29(forfoodshighinfats,sugarsand/orsalt)continuum,forexample,thepresenceofcountries18andhasshownclearevidenceoffoodoutletsandtheirroleinmakinghighlyprovidingdisincentivesforbuyingthesefoods,19processedfoodsmoreavailable.However,contributingtoshiftingthedemandtowardsmoretherearealsodifferencesinthelevelofnutritiousfoods.14Arecentsystematicreviewinformalityoffoodoutlets(e.g.supermarketssixcountries(Australia,Canada,Mexico,Southorsmallerfoodshops).LargeandformalAfrica,UnitedKingdomofGreatBritainandoutletsaremorecommoninurbansettingsNorthernIreland,andUnitedStatesofAmerica)andtheirsurroundings,andlesssoinruralfoundnotonlyevidenceoftheimpactsofsuchareasfarfromcitieswhereinformalvendorstaxationonreducingthesalesofenergy-denseor“traditional”outlets(i.e.open-airorwetfoods,butalsothatthehealth-relatedbenefitsmarkets)aremoreprevalent.11,12Yettheselargelyexceedthepossiblehealthcostsofnotinformalvendorsstillplayanimportantroleintervening.20Taxationcanalsoencourageinretailfoodenvironmentseveninlargeorproductreformulationtoreducethecontentofintermediatecities,particularlyinlow-incomethetargetcomponent(e.g.sugars,salt,unhealthyneighbourhoodsandslums.13Influencingfats),thusimprovingitsnutrientprofile.foodenvironmentsthroughsupportivenutritionpoliciesisanimportantentrypointNutritionlabelling,byprovidinginformationontofacilitatebetteraccesstosafe,affordableandthenutritionpropertiesandthequalityoffoodsnutritiousfoodsandreduceconsumptionoftoaidpurchaseandconsumptiondecisions,highlyprocessedfoodsofhighenergydensityhasthepotentialtohelprebalanceafoodretailandminimalnutritionalvalue.Forthis,anenvironmentcurrentlyskewedtowardsfoodsunderstandingofthespecificitiesofretailfoodthatunderminehealthydiets.21Marketingenvironmentsacrosstherural–urbancontinuuminfluenceschildren’sfoodpreferences,purchasewillbekeytoidentifycommonpoliciesforrequestsanddietaryintakes.Governmentstheentirecontinuumbutalsodifferentiatedhavealegalobligationtoprotectchildrights,includingthosethatarethreatenedbyahAlsocalled“built”foodenvironments,theyincludeinformalandharmfulmarketing.22formalmarketswhereavailablefoodischosenandpurchased.10aiFormoredetailsregardinghowthesepoliciescontributetohealthydiets,pleaserefertothe2022editionofthisreport.14110THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Supportinghealthierfoodoutletswillbekeyforareas,thesecancontributetoimprovedietaryenablingaccesstohealthydiets,asthishasshownpatternsandpromotediversificationofpositiveimpactsondietaryquality.23Whilefoodproductionthroughthealleviationofsmallneighbourhoodfoodshopsareimportantliquidityconstraints.33,34Inaddition,cashforthefoodsecurityofhouseholds,particularlytransferprogrammesassociatedwithnutritionforlow-tomiddle-incomeones,consumersareeducationoffergreaterchancestoimprovechilddisproportionatelyexposedtoenergy-densenutritionandhealth.35highlyprocessedfoodsintheseshops.10Thiscouldbeparticularlyimportantinruralareas,Turningtourbanandperi-urbansettings,streetwherefoodisincreasinglypurchasedinthesefoodandfoodawayfromhomebusinessesajkindsoffoodoutlets.11,12Policyincentivesareplayaparticularlyimportantroleinbothnecessarytoencourageshopstostockandsellemploymentprovisionandfoodsecurityforthegreateramountsoffreshandminimallyprocessedmostvulnerablepopulations.Streetfoodsarefoods,forinstance,byimprovingtheircoldespeciallyconvenientforlow-incomeworkersstoragefacilities.24Theavailabilityofhealthierandhouseholdswhomaynothavetheresources,foodoutletsinparticularareasacrossthefacilitiesand/ortimetopreparedishesathome.1rural–urbancontinuumcanbeimprovedthroughInsomecontexts,informalstreetvendorscanland-useplanningandzoningregulations;taxalsobeakeysourceofbothnutritiousfoodsandcreditsorexemptions;orlicensingagreements.14livelihood;forexample,inaperi-urbanareaofAlthoughland-useplanningtoolsaregenerallyDaresSalaamwhere70percentofvegetablesunderutilizedtosupporthealthydiets,aweresoldbyinformalvendors,oftenmostofcombinationoffinancialandzoningincentivesthesevendorswerewomen(i.e.for95percenthasbeenusedatthecityleveltoincreasetheofgreenleafyvegetables).36However,streetavailabilityofhealthyandaffordablefoodoptionsfooddoesnotalwayscontributetohealthyinshopsinunder-servedareas.25Measuresindietsamongpoorurbanandperi-urbanfoodplacetorestrictoutletsthatpredominantlysellconsumers.37Acriticalaspectistoensuretheenergy-densefoodshighinfats,sugarsand/orsafetyandnutritionalqualityofstreetfoods,saltinclude,forexample,localauthorityzoningconsideringboththehighdegreeofinformalitymeasuresthatlimittheestablishmentofhotfoodofthestreetfoodsectorandthefactthatstreettakeawaysorfastfoodrestaurantsinoraroundfoodsareconsumedbyanestimated2.5billionschools26,27,28,29orinparticularneighbourhoods.30peopleworldwideeveryday.38InformalstreetvendorsplayamajorroleinprovidingInruralareas,wherefoodsourcesincludefoodtothemostvulnerablepopulationsinpurchasedfoodandownproduction,somelow-incomecountries(LICs)ofAfricaandpoliciescouldhavepositiveeffectsnotonlyAsia,particularlyinurbansettings.1Thereareinshiftingdietarypatternsbutalsoonthemultipleinfrastructureandregulatorygapsavailabilityandaccessibilityofhealthydiets.alongthestreetfoodsupplychainandmanyNutritioneducation,whilemorecommoninstreetvendorshavetemporarystructureswithurbansettings,hasprovenvitaltoencouragenorunningwaterorcoldstorageandsanitationmorediverseandhealthierdietarypatternsatfacilities.Importantfoodsafetyactionsincludethehouseholdlevel.Severalstudieshavefoundensuringasupplyofwaterofacceptablequalitythatinruralsettings,nutritioneducationathomeforfoodpreparation,cleanplacesforpreparationorinschoolscouldincreasedietarydiversityandconsumptionoffood,sanitaryfacilitiesinfoodconsumptionand,atthesametime,forworkersinfoodoutlets,trainingforstreetincentivizediversificationoffoodproduction,vendorsandconsumereducation.38Interventionspossiblyimprovingtheavailabilityofnutritiousatnationalandlocalgovernmentlevelsarealsofoodsatthecommunitylevel.31,32requiredtoensurenutritionalqualityforstreetfoodsineachlocalsituation(seeBox7).Consideringthatincomeisamaindeterminantoftheaffordabilityofhealthydiets,cashajAllfoodandbeverageoutletswherefoodanddrinkcanbetransfersarealsoimportantforpoorhouseholdspurchasedandconsumedoutsidethehome,eitheronorofftheacrosstherural–urbancontinuum.Inruralpremises.SeetheAnnex11forafulldefinitionoffoodawayfromhome.111CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX7INITIATIVESFORMORENUTRITIOUSFOODAWAYFROMHOMEINSOUTH-EASTERNASIAReady-to-eatfoodssoldinrestaurants,small-scalefoodoutletstoincorporatehealthyoptionsthrougheateriesoronline,andalsosoldbyfoodhawkersandreformulationgrants.33Thesegrantscan,forexample,streetvendors,makeupanimportantpartofthedietshelpincoveringthecostofbuyinghealthieringredients,ofmanyurbanpopulationsinSouth-easternAsia.payingforhealthycookingclassesorfundingresearchManypeopleconsumefoodawayfromhomeatleastanddevelopment.Separategrantsareavailableforonceaday,andsometimesforallthreedailymeals.41,42promotionofhealthierfoodanddrinkoptions.45Foodawayfromhomeisalsoofculturalandeconomicimportanceintheregion,withmanypeoplerelyingonTohelpincreasedemand,awareness-raisingtheinformalfoodsectorfortheirlivelihood.campaignshaveusedsimplemessagestohighlighthealthyoptions.FooditemsendorsedbytheSingaporehasimplementedacomprehensive,HealthierDiningProgrammeareclearlylabelledmultistakeholderapproach,ledbytheHealthPromotionwith“HealthierChoice”mealidentifiersonmenus/Board,toimprovethesupplyofhealthieroptionsinmenuboards,countertops,shelvesandpackaging.thefoodawayfromhomesector,whilealsoincreasingInaddition,theEat,Drink,ShopHealthyChallengedemandfortheseoptionsamongconsumers.campaign46promoteshealthieroptionsandoffersrewardsforselectionofhealthierchoicesthroughaToimprovetheavailabilityandaccessibilitysmartphoneapp.ofnutritiousfoods,thegovernmentprovidesresearch-basedsupporttoindustrytoproducehealthierTheseelementsaresupportedbyabaseingredientssuchaswholegrainnoodleswithawhole-of-governmentapproach,includingahighfibrecontent.TheHealthierDiningProgramme43commitmenttousehealthieringredientsinallcatering–buildingontheearlierHealthierHawkerProgrammeservicesingovernmentinstitutesincludingschools.andthecreationofhawkercentresintheearly1970sThispledgewasimportantforencouraginginvestmenttoimprovethesafetyofstreetfoods44–supportsinproductinnovationandreformulation.Finally,itisimportanttoconsiderthatgenderstrategicallylocatingcityfoodoutletsthatsupplyplaysanimportantroleinaccessingaffordablenutritious,diversefoodontheroutesthatwomenhealthydietsand,inturn,foodsecurityandtakeintheirdailylives.39nutrition.Improvingwomen’sstatusandgenderequalitypositivelyinfluencethenutritionalMidstreamfoodsupplychainpolicies:statusofwomenandtheirfamilies.Therefore,strengtheningtheroleofthe“hidden/eliminatingstructuralgenderinequalitiesmissingmiddle”inmakinghealthydietsandunleashingwomen’spotentialcanplayaffordableforallafundamentalroleinimprovingaccesstoaffordablehealthydiets.Forinstance,evidenceAscountriesgrowandtransform,urbandemonstratesthatmosttransportsystemsarepopulationsalsogrowbutfollowdifferentialbiasedtowardsthetravelneedsofmen.39InclusteringpatternsindifferentcountriesorBlantyre,Malawi,reducedtransportoptionstocontexts(Chapter3).Structuraltransformationisperi-urbanandruralinformalmarkets,whichaccompaniedbyarapidincreaseinlargecitiesareoftenmoreaffordablethanurbanmarketsforinsomecountries,whileinothersbythegrowthpoorpeople,havereducedaccesstoaffordableofSICTsreducingthespacebetweenlargecitiessourcesoffoodforfemale-headedhouseholds.40andtheruralhinterland.47,48DifferentialpatternsThispointstotheneedformultifacetedofpopulationagglomerationshavebeenfoundandtargetedterritorialplanningtoaddresstobeassociatedwithdifferentratesofeconomicgender-relatedchallengestoaccessaffordablegrowthandpovertyreduction,3,49andhavehealthydiets.Efficienttransportsystemscanimplicationsforagrifoodsystemsandhealthyreducethetimebetweenhomeandwork,ascandietsandnutrition.112THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Foodproduction,especiallythatofperishablescomparedtothebenefitsthattrickledownfrom(suchasfruitsandvegetables,whicharegrowthinlargecities.akimportantelementsofhealthydiets),tendstobelocatedintheproximityofurbanmarketsHowever,inmostcases,especiallyintominimizetransactionsandtransportcosts.50lower-middle-incomecountries(LMICs),However,asagrifoodsystemsaretransformedSICTsareconstrainedfromdeliveringontheirbyurbanization,itisnotphysicaldistancebutpotentialforcatalysinginclusiveagrifoodtraveltimethatmatters.Thus,foodproductionsystemstransformationandimprovingaccesslocatedinareasfarfromurbancentrestoaffordablehealthydiets.Urbanexpansionbutwithbetteraccesstonaturalresourcesisunplannedandunregulated,whilelocal(e.g.high-qualitysoil,water)canbebettergovernanceischaracterizedbyweakcapacitytosuitedforsupplyingthesecentres,providedtheplanandexecuteprogrammesandinsufficientcostoftransportislowandmidstreamactivitiesresources(fromnationaltransfersorlocalsuchasprocessing,logisticsandtransportarerevenueraising)tofinancethem.Thistranslatesavailableandefficient.intolackofbasicinfrastructuresandservices(roadnetworks,ports,housing,accesstomarkets,Thekeyroleofsmallandintermediatecitiesandhealth,educationandsocialprotection),whichintownsinagrifoodsystemstransformationturnlimitsprivateinvestmentingrowthsectorsChapter3indicatedthatone-fourthoftheglobalandthepotentialforemploymentandincomepopulationliveinperi-urbanareasofsmallgeneration.54Forinstance,absenceoftransportandintermediatecitiesandtowns.Forpoorinfrastructureconnectingruralareastonearbypopulationsseekingtoincreasetheirphysical,townsandintermediatecitieshasbeenshowntoeconomicandsocialmobility,SICTsserveasanegativelyaffectagriculturalproductivityand“firststep”towardsmigrationtobiggercitiesnutrition.55,56(orabroad)butalsoasanenddestinationforpermanentmigration.3ProximityofSICTsAddressingsomeofthechallengesfacedbytoruralareasallowsagriculturalandruralSICTscanallowagrifoodsystemstobethehouseholdstoincreaseanddiversifytheirdriverofinclusiveruraldevelopmentthroughincomesthroughdailycommutingtonearbythecreationofon-andoff-farmemploymentfortowns,seasonalorpermanentmigration,ruralhouseholds,aswellasofincreasesinfoodandremittances.productionandproductivityduetoincreasedfooddemand,scaleeconomiesandexpandedIngeneral,theclusteringofpopulationsinmarketoutlets.Thisalsocreatesopportunitiesforonlyafewlocalities(i.e.urbanconcentrationinSMEs,whichhaveanessentialroletoplayinthismetropolises)isassociatedwithhigheroveralldevelopment,asdiscussedbelow.economicgrowthasaresultofeconomiesofscaleandagglomerationwhendrivenbystructuralSupportingmidstreamsmallandmediumtransformation(Chapter3).Nevertheless,lowenterprisestoincreaseavailabilityandaffordabilityskillemploymentopportunitiesinnon-farmofnutritiousfoodseconomicactivitiesgeneratedinSICTsmaybeSmallandmediumenterprises(SMEs),morereadilyaccessibletothepoor,whotendespeciallyinLMICs,playakeyroleinensuringtobeunskilledandsemi-skilled.38,39Properlyconnectivitybetweenprimaryproducersandtargetedpublicpoliciesandinvestmentsfinalconsumers.Fromaspatialpointofview,inSICTscouldattractprivateinvestmentsSMEsconnecttheruralhinterlandtoexpandingincludinginagrifoodactivities,thuscreatingurbanandperi-urbanagglomerationsofallemployment,increasingdemandforfoodfromsizes.Theyincludeaconstellationofmidstreamlocalagriculture,andenablingpoorpeopleinactivitiesinvolvingruralandurbantradersthoselocationstoescapepovertyandincreasetheiraccesstohealthydiets(Box8).InvestinginakThisisparticularlyimportantconsideringtheanalysispresentedinSICTsislikelytohaveamoresignificantimpactChapter2,whichshowsthattheprevalenceofmoderateorseverefoodonhealthydietsbothfortheirpopulationsandinsecuritytendstobehigherinperi-urbanandruralareasaroundtheforthepopulationsoftheircatchmentareasworld.PleasereferalsotoChapter3,inwhichtheimportanceofSICTsforpovertyreductionisanalysed.113CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX8THEROLEOFURBANPROXIMITYINAGRICULTURALINTENSIFICATION:CASESTUDIESINETHIOPIAANDINDIAEvidencelargelyshowsthatagriculturepractisedinAstudyfocusedonthelargeIndiancityofproximitytourbancentresismoreproductiveduetoBangaloreanditssurroundingsprovidesevidencethatbetterinputpricesreceived,accesstoinputmarketsmayconfirmtheessentialroleofSICTsinincreasingandincreasedadoptionofmodernagriculturaltheuseofmodernagriculturalinputsinruralareas,inputs.However,lessisknownabouthowpatternsbyofferingimprovedlinkageswithmarkets.Insomeofurbanizationandthesizeofurbancentresaffectcases,farmerslocatedfartherfromBangaloreshowagriculturalproduction.ahigheruseofmoderninputsduetotheinfluenceofthetownofDoddaballapura.52Inaddition,evidenceofAstudyinEthiopiashowsthattheproximitytothepotentialofSICTsforimprovingrurallivelihoodscitiesofdifferentsizeshasdifferentiatedimplicationsthroughnon-agriculturaljobsemergesinalaterforfarmers’agriculturalintensificationdecisions:ruralstudyinEthiopia,whichshowsthattheexpansionoffarmerslivingnearalargecitysuchasAddisAbabaSICTshasapositiveshort-termeffectonhouseholdusemoremoderninputsandachievehigheryieldsthanwelfare,drivenbyincreasedparticipationinthefarmersnearsmallandintermediatecitiesandtownsnon-agriculturesector.53(SICTs).However,intheabsenceofSICTs,farmersexcludedfromthecentralmarketinalargecitywouldPolicycanstrengthenintensificationandincreasedmostlikelyremainsubsistenceoriented.ButwhentheproductivityinfarmingclosetoSICTs,byimprovingpopulationispartiallydistributedinSICTs,farmersconnectivitybetweenfarmsandinputandoutputwhowereinitiallylocatedtoofarfromalargecitytomarkets,thusreducingthecostofaccesstobothproduceforitsmarketcanmeeturbandemandforfooddomesticandinternationalmarketsandfosteringfromSICTs.51farmers’accesstoanduseofmoderninputs.andretailers,truckers,third-partylogisticsexpansioncanalsocontributetogainsinthefirms,storageserviceproviders,processorsandproductionandproductivityofnutritiousfoods,distributionnetworks.andapossibleparallelreductioninthecostoffoodforconsumers.Forexample,inKenyamoreForSMEslocatedinSICTs,manyaretakingthan95percentofthefreshfruitsandvegetablesadvantageof,interalia,theclosenesstoconsumedaregrowndomestically,mainlybyproductionareas.However,thisisnotalwayssmallholders,andaresuppliedmainlybySMEsthecase:thelocationofSMEsdependsonathroughinformalsupplychains.62numberofotherfactorsincludingregularsupplyofagriculturalproducts,perishabilityofrawThepresenceofprocessedfoodsinhouseholdmaterials,bulkinessandvalueofagriculturaldietsacrossthewholerural–urbancontinuumcommoditiesvis-à-visprocessedproducts,theconstitutesadrivingforceforexpansionofthestateofinfrastructureandtransportnetworks,servicesprovidedbySMEsinprocessingandelectrification,andaccesstowater.57,58,59distribution,astheseenterprisesareinvolvedinawiderangeofprocessedfoods(Box9).63MidstreamSMEscanbefundamentalforruralBytransformingperishablerawmaterialsintoinvestment,off-farmemployment,modernizationpalatableproductswithalongshelf-life,SMEsoftheagrifoodsector,upgradingutilitiessuchcontributetobroadeningoptionsforconsumers,aswaterandenergy,andlinkingsmallfarmshelpingoffsetseasonalityandreducingfoodtoexpandingurbanfoodmarkets.60Assuch,loss.Increaseddemandforagriculturalinputs,theycansupportlivelihoodsforagriculturalanddownstreamprocessingandrelatedhouseholdsandcommunitiesandfornearbyservicesandlogistics,constituteadditionalpopulations.61Strengtheningtheirefficiencyanddriversforexpansion.114THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX9SUPPORTINGINCLUSIVEFOODVALUECHAINSINAFRICAInvestinginagrifoodprocessingcreatesopportunitiesparticipatingfinancialinstitutionsincludingruralfordevelopinglocalentrepreneurshipandgeneratingandperi-urbanbanks.Totalincome,durableassets,employmentandvalueadditioninruralandperi-urbanandbusinessincomewere,respectively,50percent,areasofAfrica.65Whilemostprocessedagrifood55percentand25percenthigherforbeneficiaryproductshavetraditionallybeenimportedfromoutsidehouseholdsvis-à-visnon-beneficiaryones,68andAfrica,localsourcingoftheseproductsisontherise,householddietarydiversityincreasedby10percent.includingfromcottageindustries.ThisincreaseisFurthermore,womenweremorelikelytomanagelargelyinresponsetothegrowingperi-urbanandruralself-employmentactivitiesjointlywithmenandhavemarketdemandforprocessedfoods.66,67Ifinvestmentshigherdecision-makingpowerrelatedtoaccessindomesticagrifoodprocessingarenotmadeinAfricantocredit.countries,therewillbeacontinueddependenceonimportsfortheseproducts.IntheUnitedRepublicofTanzania,theMarketingInfrastructure,ValueAdditionandRuralCapitalizingonthispotentialrequireschannellingofFinanceSupportProgrammewascreatedto,intersubstantialresourcestowardslocalagrifoodprocessingalia,providesupporttosmall-scaleproducerstoinadditiontoloweringofbarriersfacedbylocalovercomethemainbarriersencounteredalongtheprocessorstoentryinnewanddistant(includingexport)agrifoodvaluechain.Suchbarriersincludelimitedmarkets.Thisrequires,interalia,supportivefinancialaccesstocreditandinputs,absenceoffunctioningandmarketlinkageservicestoconnectsmall-scalepost-harveststoragefacilities,difficultaccesstoproducersinruralareaswithtradersandaggregatorsmarkets,andthedearthofskillstouseavailableinperi-urbanandurbanareas.However,therecouldbetechnology.Theprojectrehabilitatedruralroads,otherapproaches.Futureresearchcouldfocusonhowstrengthenedagrifoodprocessingandagriculturalavarietyofmeasures–suchasinternationaltransfersmarketinformationsystems,supportedproductionandaswellastradeandfiscalmeasuresinhigh-incomedecision-makingcapacityofproducersandtraderscountries–mightalsohelpaddressthechallengestoregardingpurchaseandsaleofinputsandoutputs,financingagrifoodprocessingthatAfricanandotherandincreasedthecapacityofruralandperi-urbanlow-andmiddle-incomecountriesface.14financialinstitutions,forexamplebylinkingthemtotheformalbankingsector.ThisresultedinsignificantTherearealreadyexamplesofinvestmentsinincreasesinagriculturalincome,livestockassetsagrifoodprocessinginperi-urbanareasofAfrica.andproductiveassetsforbeneficiaryhouseholdsForinstance,inGhana,theRuralEnterprisesrepresenting16percent,11percentand7percent,Programmeworkstoimprovethelivelihoodofruralrespectively.69Cropyieldsandcroprevenuesincreasedsmallandmediumenterprisesbyincreasingprofitabilityby29percentand18percent,respectively;householdandgeneratinggrowthandemploymentopportunities.dietarydiversitywasalsofoundtohaveincreasedbyTheprojecthasestablishedsustainabledistrict-level4percent.Moreover,womenweremorelikelytoholddeliverysystemsforbusinessdevelopmentservicesdecision-makingpowerregardingcroprevenuesjointlyinperi-urbancentres;offeredcapacitybuildingandwithmen,andwerealsomorelikelytobemembersoftrainingrelatedtomanufacturingprocessingequipmentinfluentialgroupsintheircommunities.andtestingprototypes;andfacilitatedlinkageswithSmallandmediumenterprisescancontributepovertyreductionandaccesstohealthydiets,tonutritionimprovementsinruralareasbybyexpandingemploymentopportunitiesintheenhancingsmallholders’accesstomarketsSMEsthemselves,boostingfarmingincomesandinputs.Inaddition,theycanstimulateandincreasingthesupplyofnutritiousfoods.upgradingatthefarmlevelbyprovidinginputsandfinance64andofferingdifferentiatedHowever,anumberofchallengespreventpricingbasedonquality.Forthesereasons,SMEsfromfulfillingtheirpotentialandSMEshavegreatpotentialtocontributetoruraltakingadvantageofgrowthopportunities.115CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>Thesechallengesareoftenneglectedinfoods,therebycreatingacostadvantagevis-à-visresearchandnationalpolicyformulationminimallyprocessedorunprocesseditemssuchaimingatagrifoodsystemstransformation,asfruitsandvegetables.6,75inclusiveruraldevelopmentorurbanplanning.70,71,72InLMICs,SMEsareoftenThegrowingmiddleclassfoodmarketsinscattered,numerous,andsmalltoverysmallLICscanbeleveragedtoincreasesuppliesofinsize;theyarepredominantlyinformal,andprocessednutritiousfoods.76,77Inthiscontext,familyowned.Theyfacehightransactioncoststhereareopportunitiestoinvestinprocessingduetotheirsizebutalsoweakinfrastructure,SMEs,throughtheidentificationofspecificwhiletheirgrowthislimitedbyinsufficientvaluechainsandproductsthatcanbothbeaccesstofinance,lackofsupportforaccessingnutritiousandprovidevalue-addedlivelihoodimprovedtechnologies,andlackofpolicyopportunitiesforvaluechainparticipants.initiativestargetingtheirgrowth.BecauseExamplesofthisaremoringa(moringapowder)manyofthemdependonlocalsourcingratherandarangeofnon-timberforestproducts.78thanonadiversifiedbaseofcommoditysupplies,theyfacecovariateriskswithlocalPoliciesandinvestmentstoleveragethepotentialoffarming.Theexistenceofmultipleconstraintsthe“hidden/missingmiddle”toprovideaffordablelimitstheirpotentialtoaccumulateassetsandhealthydietsforallexpandoperations,includingassourcesofPoliciestoenablethepotentialofSICTsforemploymentandincomediversificationandgrowth,povertyreductionandimprovedaccessascontributorstohealthydiets.60Thereistoaffordablehealthydietsshouldfacilitatethealsopublicunderinvestmentinspecificvalueflowofpeople,productsandresourcesbetweenchainsthatwouldcontributetowardsincreasedsuchcitiesandtheirruralcatchmentareas,butavailabilityofnutritiousfoods:namely,aalsoexpandthereachoflocalagriculturetodisproportionateamountofpublicinvestmentmoredistantmarkets.Theseimprovementsinisdirectedtowardsstaplecropproductivity.14connectivityarealsocriticalforSMEs.Betterlinkagesbetweenproducers,agro-industrialFurthermore,SMEslocatedinSICTsareataprocessors,alagriculturalandnon-agriculturalcompetitivedisadvantagevis-à-vislargerfirms.services,andotherdownstreamsegmentsofScatteredevidenceshowsthateconomiesoftheagrifoodvaluechaincouldprovidemorescaleandscopefeaturemoreprominentlyopportunitiesforSMEdevelopmentand,fromawhenintermediariesserveanurbanpopulationspatialperspective,couldturnSICTsintocrucialconcentratedinlargecities,ratherthanone“foodexchange”nodes.am,5thatisspreadacrossmanymid-sizedcities,althoughmoresystematicresearchisneededonBuildingruralinfrastructure,includingqualitythisaspect.70WomenarealsoheavilyengagedruralandfeederroadstoconnectremotefarmsinSMEs,bothasworkersandasentrepreneurs;andenterprisestomainroadnetworks,ishowever,theysystematicallyfaceconstraintsessentialforunlockingtheproductivepotentialtoscalinguptheirbusinessduetofinancial,ofSICTsandtheircatchmentareas.55,56Theremobilityandempowermentgaps.73Inaddition,isampleevidencethatruralroadsleadtoothermanySMEsinvolvedinmidstreamactivitiesareinformal,whichmayexcludethemfrompublicalWithinthemanufacturingsector,agro-industrydevelops,servicesandpoliciesthataremostlyorientedtotransformsanddistributesinputstoandoutputsfromagriculture,formalagribusinesses.74fisheriesandforestry.Itincludesagroprocessing,asubsetofmanufacturingthatprocessesrawmaterialsandintermediateproductsItisalsoimportanttonotethatunleashingderivedfromagriculture,includingfood,beverages,tobaccoproducts,thepotentialofSMEsdoesnotcomewithouttextilesandclothing,woodproductsandfurniture,paperproductsandtrade-offsbetweengrowthandemploymentandrubberproducts.healthydietoutcomes.IncreasingtheproductivityandreducingthecostofunhealthyprocessedamAsstatedbySonnino(2016,p.190),"byhighlightingthecentralityfoods(e.g.sugarydrinks,bleachedflour,refinedoftherelationshipsbetweenurbanandruralareasandactorsasstarches,oilsandsugars)lowersthepriceofthosetargetedinterventionareas,theanalysisraisestheneedforatighterscholarlyandpolicyfocuson'connectivities'–i.e.theroleoffoodexchangenodesandofgovernancecoordinationinthedesignandimplementationofmoreeffectivefoodsecuritystrategies."79116THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX10STRENGTHENINGCAPACITIESOFSMALLANDMEDIUMENTERPRISESTOOFFERSAFEANDNUTRITIOUSFOODSSmallandmediumenterprises(SMEs)canplayanfacilitateaccesstomorelucrativemarkets,itwillalsoimportantroleinimprovingtheavailabilityofandaccessaddvaluetopublicsupportprogrammesthatinvesttohealthydiets.However,theyoftenfacemanagerialintechnologiessuitedtoSMEs(e.g.low-costcoldandtechnicalcapacitygaps.Theseshortcomingsarestorageorsolardryers,affordablepackagingsolutions,compoundedbythelackofsystematicsupporttovalueandlabour-,water-andenergy-savingprocessingchainsforproducingnutritiousfoods,especiallythosetechnologies).Forexample,thedemandforaquaticinwhichthemyriadofSMEsareinvolved.foodshasledtothedevelopmentofinnovativepracticestoturnprocessedby-products(about50percentofTostrengthentheirroleinthesupplyofsafeprocessedfishwiththegreatestconcentrationofandnutritiousfoods,SMEs’capacitiesneedtobenutrients)andotherunderutilizedaquaticfoodssuchasimprovedacrossarangeofskillssuchasbusinessseaweedintoprocessedfoodstoincludeinlocalschoolmanagement,financialplanning,marketing,technicalfeedingprogrammes.87,88aspectsofsustainableagriculture,foodqualityandsafety,processing,andnutrition.EnsuringfoodCapacitydevelopmentforSMEsneedstobesafetyisoneofthebiggestchallenges,asSMEsoftenintegratedintobroaderprogrammestostrengthenoperateininadequatestructuresand/orunhealthyvaluechainsofnutritiousfoods,inordertoovercomesurroundingswithnoaccesstobasicutilities,usingtherisingproductioncostsassociatedwithunreliablerudimentaryorobsoletetechnologies,andwithlimitedaccesstorawmaterialswithinfragmentedvalueapplicationofupdatedproductive,manufacturingandchainsandupgradetheinadequatestorage,powerandhygienepractices.85,86Fillingthesegapswillnotonlytransportinfrastructures.investmentsthatcanimprovenutrition,suchasthatenabledeliveryfromadistributioncentreschoolsandhealthservices,80andhavepositiveorfacilitytotheenduser,opensuppossibilitiesimpactsonruraldietarydiversity,productivity,forproducerstoreachbiggermarketsand,incomesandfoodsecurityoutcomes.81Thereisintheprocess,createsconditionsthatfosteralsoevidencethatasinfrastructureandservicesagribusinessdevelopment.5,84develop,midstreamactivities(especiallyagrifoodprocessing)tendtogetrelocatedinSICTs.82InvestmentforimprovingaccesstomarketsisalsoimportantforhinterlandcommunitiesthatPublicinvestments(inadditiontoroads)toarefarawayfromSICTscatchmentareas,asissupportlinkagesbetween(mainlysmall)farmsthecaseofsomeIndigenousPeoples.TheyoftenandSMEscouldincludewarehousing,coldstorage,facegreatdifficultyaccessingmarkets,anddependableelectrification,accesstodigitaltoolstherebyhavetorelyontradersandaggregators,andwatersupply.Providingthisinfrastructure,whichmayleavethempreytorentextraction.whichformsthebasisforadiversifiedserviceExistingevidenceindicatesthatimprovingindustry,isacriticalsteptowardsmoreefficientmarketaccessofIndigenousproducersinremotefunctioningofSMEs(Box10).Suchinvestmentsareascouldleadtosignificantimprovementsinbuildresilienceandcontributetosmoothingeconomicandlivelihoodoutcomes.InBrazil,incomeshocksfromseasonality,marketforexample,acooperativeefforttoimprovevolatilityandweathervariability.83InordertomarketaccessamongIndigenousPeoples’attractprivatesectorinvestment,thesepubliccommunitiessotheycouldpurchaselargerinvestmentsneedtobemoretargetedandpartboats,therebyallowingsmall-scalefisherstoofmorecomprehensivenationalstrategiesdeliverfishdirectlytomarkets,contributedforinfrastructuredevelopment.Forexample,toa27percentincreaseinincome,89mainlyasbuilding“last-mile”infrastructureandlogisticsaresultoffishersreceivinghigherpricesfor117CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>theirfish.InthePhilippines,aprojectaimedathighlyprofitablefoodssuchasfruits,improvingthelivelihoodsofpoorhouseholdsininsteadoflow-profitabilitystaplefoodsforIndigenousPeoples’communitiesbydevelopingself-consumption.94,95Lowertradingcostscouldmarketaccessinfrastructuresandcommunityprovidetherightincentivesforsmallholderwatersheds,andprovidingfinancialcapitalandfarmerstoshifttheirproductiontomorecapacity-buildingtraining,improvedsmall-scalenutritiousfoodswhich,consideringtheirproducers’marketparticipationby13percentageavailabilitygap,couldbekeyformakinghealthypoints.Asaresult,totalincomewas32percentdietsmoreavailableandaffordableforall.higherintreatmenthouseholdsthanincontrolThisisalignedwithoneofthemaininsightsofhouseholds,andincomesourcesbecamemorethe2022editionofthisreport,whichindicateddiversifiedby6percent.90thatrepurposingandsteppingupfoodandagriculturepolicysupporttowardsgeneralInvestmentstargetingthemidstreammayservicessupport(whichincludesinvestmentsinalsoaddressmultipleconstraintselsewhereinroadsandotherpublicgoods)couldplayakeytheagrifoodvaluechainleadingtowin–winroleintheaffordabilityofhealthydiets.situationsofgreatereconomicdevelopmentandincreasedproductionofnutritiousfoods.Territorialfoodmarkets,includingwholesaleCombinationsofinvestmentsinwholesalemarkets,constituteakeylinkagebetweenmarketsandfeederroadsinChinahavehadproducers,intermediaries,retailersandimportanteffectsonfarminginthemarketconsumersinLatinAmericaandthecatchmentareasofSICTsbyreducingtransactionCaribbean,96South-easternAsia,andAfrica,costsforfarmerstoreachlocalmarkets.Thisandareoftenthemostimportantmarketinghasincreasedadoptionofvegetablefarmingplaceforfruitsandvegetables.97Investinginandintensifiedproduction.91InBangladesh,theimprovedandgender-sensitiveanwholesalegovernmenthasmadeextensiveinvestmentsmarketinfrastructure(e.g.interritorialfoodinfishwholesalemarketsinruralareastomarkets)couldimprovesupplyoffreshproductsserveasnodesfortheformationofwholesaleandfacilitatecompliancewithfoodsafetyandandlogisticsSMEclustersacrossfish-farmingqualitystandardsbysmallholderproducersareas,whichhasencouragedandfacilitated(seeBox11),97incentivizeproducerstosupplycommercialization,intensification,andspecieshigher-qualityfoodsthatcouldbringthemdiversificationinfishfarming.92Ingeneral,betterreturns,andincreasethequantityandinvestmentsinconnectivitybetweenlocationsvarietyoffoodsupplythroughverticalandandcomponentsofagrifoodsystemsinSICTshorizontalscaling.13havespurredsubstantialdevelopmentofandinvestmentsbySMEsandthecreationofTheincreasedrelianceon,anddemandfor,spontaneousclustersofwholesaleandlogisticsprocessedfoodspresentedinChapter3andSMEs.Suchclusters,inturn,inducefarmersChapter4presentbothachallengeandantoincreasetheircropvarietyandtousemoreopportunityregardinghealthydiets.Althoughinputs.91,93InIndia,theconfluenceoffactorsfoodprocessingisoftenassociatedwithhighlysuchasincreaseddemandfromurbanareasandprocessedfoodshighinfats,sugarsand/orsalt,improvedroadsandtransportlinkagesfromitcanalsobeusedtoimprovefoodnutritionalruralareastoSICTs,boostedtheexpansionofqualityandreducethecostofahealthydiet.coldstoragefacilitiesforpotatofarmersinplacesForinstance,improvingthenutritionalqualitylikeAgraandBihar.Theresultwasreducedofprocessedfoodsandbeveragesthroughseasonalityofpotatosupply,adiminishedrolereformulationisessentialacrosstherural–urbanfortraditionalruralbrokersandshortersupplycontinuum:99itcanenhancedietquality,chainsbetweenfarmersandconsumers.70increasingnutrientcontentandreducingtheintakeofsaturatedandtrans-fattyacids,sugarsMoreover,recentstudieshaveshownthatinvestmentsinpublicgoodssuchasroadsanWomenaccountforonly35percentofwholesaleworkersorstoragefacilitiescanreducetradingworldwidebut,ontheotherhand,represent53percentofallretailcosts,thusencouragingfarmerstoproduceworkersinagrifoodsystems.98118THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX11TERRITORIALFOODMARKETS,FOODSAFETYANDHEALTHYDIETSTerritorialfoodmarketsarekeyretailoutletsnotonlyshownbythemajoroutbreaksofzoonoticfoodborneforfruitsandvegetables,butalsoforanimalsourceanddiseasesperiodicallyoccurringoneverycontinent.109staplefoods,amongothers.FromsmallvillagestolargeThecausesofsuchoutbreaksaremanifold,includingmetropolitancities,theyareanimportantfoodsupplyhuman–animalinteractions,poorinfrastructureandsourceofmanyproducts,andarealsopartofthesocialdeficientpost-harvesthandlingpracticesleadingtofoodfabricofcommunities.Thesemarketsareaprimarycontaminationbyviruses,bacteria,parasites,prionssourceofaffordable,nutritiousandfreshfoodsforandchemicals(includingtoxins,pesticides,industrialmanylow-andmiddle-incomegroups,andanimportantchemicals,metalsandpersistentorganicpollutants).110sourceoflivelihoodformillionsofurban,peri-urbanandruralinhabitantsworldwide.106Ensuringthatnutritiousfoodsareavailable,affordable,safeanddesirableinterritorialfoodmarketsTerritorialfoodmarketsarealsocriticalsalesoutletscanpositivelyinfluencepeople’sdietarypreferencesforlocalproducers.InAfrica’sfoodsector,forexample,andchoices,andthushelptoimprovetheirnutritional80percentofdomesticfoodsuppliesarepurchasedstatusandhealth.Tothisend,appropriateregulationinmarketscomprisingprimarilysmallandmediumandinvestmentinrehabilitationandrenovationofenterprises,whileonly20percentremainwithinfarmterritorialmarketsplayanimportantroleinpromotinghouseholds(forownconsumption).107Furthermore,foodsafetyandquality,improvinghealth,enhancingthesefoodmarketsarealsocrucialforprovidingfoodsecurity,andstrengtheningtheeconomy.employmentopportunitiestowomen,whomakeupaThesefoodmarketsarealsoidealsettingsforengagingsignificantshareofretailers.Forexample,inmarketsstakeholders(e.g.vendorsandlocalauthorities)andmappedinMalawi,ParaguayandtheUnitedRepublicthepublictoinformconsumersaboutoutbreaksandofTanzania,womenretailersrepresentaclearmajority,promotegeneralhealth(includinginformationonbetween57and81percent.108nutrition).38ThelatteriskeytonudgingconsumerstopurchasefoodswithhighernutritionalqualityHowever,ifnotwellmanaged,territorialfood(e.g.fruits,vegetables,legumes,nutsandfish).111marketsmayrepresentaglobalpublichealthrisk,asNOTES:Territorialmarketsrefertomarketsthataredirectlylinkedtolocal,nationaland/orregionalagrifoodsystems,andwhicharemostlyorganizedhorizontallyamongthevariousstakeholders.Theyhavemultiplefunctions(economic,social,cultural,etc.)intheirrespectiveterritorybeyondfoodsupply,andarethemostremunerativeforsmallholderfarmers.112and/orsaltinpurchasedfoods.aoInmanyarecoveredbymandatorytrans-fattyacidhigh-incomecountries(HICs),andincreasinglylimits.101,102,103WhilereformulationofprocessedinLMICs,asignificantproportionofsodiumfoodscanleadtoproductswithahealthierinthedietcomesfromprocessedfoodssuchasprofile,itdoesnoteliminatetheconcernforbread,cerealandgrains,processedmeats,andhighconsumptionlevelsofhighlyprocesseddairyproducts.Introducingmaximumlimitsfoods.Forexample,oftenfreesugarsareforsodiuminsuchprocessedfoodscanpromotereplacedbynon-nutritive(orartificial)reformulationandimprovethenutritionalsweeteners,whichalonedoesnotimprovedietqualityoffoodavailable.101Todate,65countriesquality.Instead,freesugarsshouldbereplacedhaveimplementedpoliciestoreformulatewithsourcesofnaturallyoccurringsweetness,manufacturedfoodtocontainlesssodiumsuchasfruits,aswellasminimallyprocessedandalmosthalfoftheworld’spopulationunsweetenedfoodsandbeverages.104Similarly,fortificationisthepracticeofdeliberatelyaoForinstance,intheKingdomoftheNetherlands,areductionintheincreasingthecontentofoneormoreintakeoftrans-fattyacidswasobservedaftertheimplementationofamicronutrients(i.e.vitaminsandminerals)involuntaryreformulationagreement.However,noeffectswereobservedafoodorcondimenttoimprovethenutritionalinsaturatedfatintakes.100qualityofthefoodsupplyandprovideapublic119CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>healthbenefitwithminimalrisktohealth.ChangingthefocusoftheseprogrammescouldFoodvehiclesforfortificationrangefrombasicbeessentialforincreasingtheavailabilityofcommoditiessuchasvarioustypesofflour,thesefoods.115sugarandsaltwhichcanbeingredientsofprocessedfoods,toprocessedfoodsthatareAsmentionedintheprevioussection,investingfortifiedatthepointofmanufactureoruse.105ininfrastructureiskeyforenhancingagrifoodsystemslinkagesacrosstherural–urbanFoodproductionpoliciescontinuum.Fromaproductiveperspective,investinginirrigationisimportantforAshasbeenindicatedinChapter3,theboostingfruitandvegetableproduction,toavailabilityoffruitsandvegetablespercapitathepointthatinIndia,producersthathaveperdayisinsufficienttomeettherequirementsaccesstoirrigationinfrastructureshowofahealthydietinmostpartsoftheworld.Thisbetterdietarydiversityoutcomes.119Incasesmakesitessentialtoboosttheproductionofinwhichtheconditionsandcapabilitiesfornutritiousfoodsand,ingeneralterms,supportproducingdiversenutritiousfoodshaveyetthediversificationoffoodproduction,whichhastobedeveloped,biofortificationhasshowntoshowntohavepositiveeffectsonfoodsupplybeavalidalternativemethodtoimprovetheandfoodsecurity.113Inaddition,changingfoodnutrientintakeanddietaryqualityofruralexpenditurepatternsacrosstherural–urbanpopulations.aqTheadoptionofbiofortifiedcontinuum,ashighlightedinChapter4,couldcropsbysmallholderfarmerscanimprovesendimportantsignalsforredesigningfoodthesupplyofessentialmicronutrientsnotproductionpolicies.aponlyviaownconsumption,butalsothroughcommercializationinlocalmarketsandAccesstoinputssuchasseedsiskeyinclusioninsocialprotectionprogrammesforsupportingproductionoffruitsandincludingin-kindfoodtransfersandschoolvegetables,115andthisistrueacrossthemealprogrammes(thelatterinallkindsofrural–urbancontinuum.Supportingsmallholdersettingsacrosstherural–urbancontinuum).120farmersindiversifyingtheirproductionwillhavepositiveeffectsnotonlyontheoverallItisimportanttohighlightthatmanystudiessupplyofnutritiousfoods,butalsoontheinruralsettingshavefoundthatwomen’saccessibilityofhealthydietsinruralareas.empowermentisoneofthemostimportantForexample,differentkindsofinputsubsidiespathwaysthroughwhichfoodproduction(directdistributionofinputs,vouchersorpoliciescanhavepositiveeffectsonaccesstotargetedpreferentialprices)havebeenshownnutritiousfoodsand,inturn,onfoodsecuritytohavepositiveimpactsinimprovingaccessandnutritionoutcomes,particularlyinruraltodiverseandmorenutritiousfoodsattheareas.Severalstudieshavefoundpositivehouseholdlevel.116InEthiopia,astudyfoundassociationsbetweenwomen’sempowermentthatruralvegetableproducersearnedmoreandhouseholddietarydiversity,117,121makingincomeandweremorefoodsecurethantheclosureofthegendergapinruralareasnon-vegetableproducers.118Agriculturalakeyconsiderationforanyfoodproductionextensionisalsoimportantinruralareas,andpolicyorientedtowardsimprovingaccesstocanhavepositiveeffectsondietarydiversityaffordablehealthydiets.andqualityathouseholdlevels.81However,currentlyextensionprogrammesareoftenOntheotherhand,incitiesandtheirorientedtowardsstaplecropsratherthansurroundings,urbanandperi-urbanagriculturenutritiousfoodssuchasfruitsandvegetables.(UPA)hasthepotentialtoincreasetheavailabilityoffruitsandvegetablesforurbanapForinstance,astudyfoundchangingexpenditurepatternsindwellers.122Infact,ithasbeenfoundthatZambiafrommaizetowardsothercerealssuchaswheat,aswellastohouseholdsinvolvedinurbanagriculturevegetablesandanimalsourcefoods,between1996and2015,drivenbyimprovetheirdietarydiversitythroughownincomegrowthandurbanization.However,Zambianagriculturalpolicyisstillfocusedmostlyonmaize,underminingthepossibilitiesforaqPleaseseeSection5.2.productiondiversification.114120THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023production,andinturnreducetheirfoodurbanization,whicharekeyformakinghealthyexpenditure.123,124,125However,thisevidencedietsavailableandaffordableforalland,inislimitedcomparedtothatforruralareas,asturn,achievingfoodsecurityandnutrition.thereisagapintheanalysisofdirectpolicyinstrumentsorientedtowardsfoodproductionCountrieshavevariedneedsandcapacitiesinurbanareas.arStill,ithasbeenobservedthatwithrespecttotechnologiesandinnovations,theinclusionofurbanagricultureobjectivesinandthereareimportantdifferenceswithincityplanningandregulations,ofteninHICs,cancountriesandbetweensegmentsofagrifoodcreateadequateconditionsforthedevelopmentsystems.Urbanizationoffersadditionalofurbanagriculture.as,126opportunitiesforagrifoodsystemstorapidlyevolveandinnovateacrosstherural–urbanThedevelopmentofUPAiscloselylinkedtocontinuum(seeFigure21inChapter3).theadoptionofproductivetechnologiesandOfcourse,nosingle“silverbullet”technologyinnovations,whichcanleadtoincreasedyieldsorinnovationwillmeetallneedsinallandreducedenvironmentalimpacts.Consideringcontextsacrosstherural–urbancontinuum.thescarcityinurbanareasofnaturalresourcesFurthermore,innovationscannotbeconsideredsuchaslandandwaterneededfortheproductioninisolation:potentialtrade-offsandco-benefitsofnutritiousfoods,technologycouldplayanmustbeconsidered,bothamongtheessentialroleinmakingurbanagricultureainnovationsthemselvesandinrelationtoothersustainablealternativeforfoodsupply.126Theagrifoodsystemsinterventions.Forexample,nextsectionprovidesadetailedanalysisofautomationcanleadtounemployment,thesetechnologicalinnovations,aswellasotherespeciallyformanuallabourers/low-skilledagrifoodsystemsinnovationsthatcouldboostworkers,whenitisincentivizedthroughtheeffectsthatthedifferentkindsofpoliciesgovernmentsubsidiesinareaswherelabourisanalysedherecouldhaveinmakinghealthydietsabundant.However,italsohasthepotentialaffordableacrosstherural–urbancontinuum.ntostimulateemploymentinlogisticsandprocessingduetoincreasedproductionas5.2wellasgeneratenewjobsthatdemandhighTECHNOLOGYANDlevelsofcognitiveability(thisentailsbuildingINNOVATION:AtheknowledgeandskillsofagriculturalKEYENABLERFORworkerstofacilitatethetransition).128AGRIFOODSYSTEMSTherefore,thedevelopmentanduseofTRANSFORMATIONtechnologiesandinnovationsshouldbeguidedUNDERURBANIZATIONbytheassessmentoftheirsocioeconomic,environmentalandethicalimpacts.Inanurbanizingworld,thestrategicdeploymentoftechnologyandinnovationcanbeacriticalAplethoraoftechnologiesandinnovationsiscatalystofagrifoodsystemstransformation.127available(thoughnotnecessarilyaccessibletoThissectiondiscussesthepotentialofallcountriesandsocialgroups)spanningentiretechnologyandinnovationtocontributetoagrifoodsystems.Whetherthesetechnologiesincreasingefficiency,inclusiveness,resilienceandinnovationsareinclusiveforalldependsnotandsustainabilityofagrifoodsystemsunderonlyontheiradoptionandimpact,butalsoonhowresearchanddevelopment(R&D)isshaped.arSomecasesshowdirectsupportofcitygovernmentstourbanBetween1981and2016,therewasadoublingofagriculturalproducers,butnoassessmentoftheirimpacthasbeenglobalpublicinvestmentinagriculturalR&D,found.126andlargermiddle-incomecountries(MICs),inparticularBrazil,ChinaandIndia,significantlyasSeeSection5.3formoredetails.increasedtheirinvestmentinagriculturalR&D.129However,smallerLMICscontinuetohaveinsufficientinvestmentcomparedtoothercomponentsofgeneralservicessupportsuchas121CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>infrastructureinvestments.at,14Thelongtimescopeofthissection.Illustrativeexamplesarelagbetweeninvestmentsandtheirimpactonprovidedtoshowcasediverseoptionsthatcouldtheground,aswellasthe“invisible”natureofbebundledtogetherincontextuallyappropriateresearchandinnovationcomparedtotangiblepackages,andconsideredasintegralelementsofinvestmentsinphysicalinfrastructure,areaportfolioofpolicies,investmentsandlegislationcontributingfactorsforthisneglect.fortransformingagrifoodsystemstomakehealthydietsaffordableforall.137Inparticular,PublicspendingonagriculturalR&Disstillthereareamultitudeofrapidlyadvancinglowerthanprivatespending.From1990to2014,digitalinnovationsthatcross-cutallsegmentsprivatespendingonagriculturalR&Dworldwideofagrifoodsystems,openingupthepossibilitymorethantripled(withcompaniesbasedinoftransformingthesesystemsinunprecedentedHICsaccountingfor88percentofglobalprivatewaysacrosstherural–urbancontinuum,includingagriculturalR&Dspending),butwasstillfocusedofferingLMICsopportunitiestoleapfrogexistingonarelativelysmallnumberofcommodities.131technologiesthatarelessefficient.ItisestimatedVenturecapitalistinvestmentsintheagrifoodthatby2050eachfarmalonecouldproducetechnologysectorreachedUSD29.6billioninaround4.1milliondatapointsdaily(compared2022,thoughthisrepresenteda44percentdeclinewith190000datapointsproducedperfarmfrom2021.132However,theincreasinglyimportantperdayin2014).138ExtrapolatingacrossvariousroleoftheprivatesectorinR&Dposeschallenges.aspectsofagrifoodsystems,suchdatacanTheconcentrationofsomekeyagrifoodmarketsimprovetheuseofpublicfundsbyidentifyinginthehandsofafewmultinationalcorporationsthemosteffectiveandefficientpolicyoptionsandtheincreasedverticalintegrationcouldleadaswellasreducingtransactioncostsalongthetoanR&Dagendathatfavourscertainfinancialpolicycycle(fromimplementationtomonitoringinterestsoversustainabilityconsiderations,andcompliancetoevaluation).Forinstance,theandpromotestheadoptionofhigh-techuseofgeospatialdatacouldprovideevidenceforandhigh-costtechnologicalandinnovativepolicymakingusingarural–urbancontinuumsolutionsaboveothers.133,134Indeed,lookinglens,139anditcouldbeparticularlyimportantatresearchandinnovationtrends,itappearsforimprovingcommonanddifferentiatedthatinhighlyconcentratedmarkets,thefocuspolicyentrypoints.ofinnovationisprimarilyon“defensive”R&D,aimedatsafeguardingexistingproductsorHowever,innovationsindigitaltechnologiestechnologiesratherthanpromotingnovelideas.135riskincreasingthedigitaldivideacrossNevertheless,innovativebusinessapproachessocioeconomicgroups(e.g.income,genderusedintheprivatesectorcouldstillbebeneficialandage),geographies(e.g.ruralandurbanforagrifoodsystems:forinstance,theideapopulations)andgeopoliticalgroups,inadditionofthe“circulareconomy”auispromotingthetoraisingconcernsaroundcontrolofinformationdevelopmentofinnovativeapproachestoreduceandpower,democracyandhumanrights.Somefoodlossandwasteatdifferentstagesofthefoodofthefactorstoaddressincludethehighcostsupplychain,includingatthedomesticlevel.134ofsomedigitaltechnologies,absenceofdigitalinfrastructure,lackofdigitalskillsandliteracy,Anexhaustiveandcompletelistingofandsocioculturalbarrierslinkedtogendertechnologiesandinnovations(includingthoseaswellasissuesofinformationasymmetry,intheever-expandingpipeline)isbeyondthedataownershipandmanagement,privacy,andcybersecurity.Worldwide,2.7billionpeopleatForinstance,ananalysisoffoodandagriculturepublicexpendituredonothaveaccesstotheinternet,andfixedorin13Africancountries(Benin,BurkinaFaso,Burundi,Ethiopia,Ghana,mobilebroadbandservicesaretooexpensiveKenya,Malawi,Mali,Mozambique,Rwanda,Senegal,Ugandaandfortheaverageconsumerinmostlow-incomeUnitedRepublicofTanzania)foundthatnoneofthesereachedthecountries.140Moreover,inLMICs,womenareAfricanUniontargetofspendinganequivalentof1percentoftheir16percentlesslikelytoutilizemobileinternetagriculturalGDPonR&D.130comparedtomen,whileadultsresidinginruralareasare33percentlesslikelytousemobileauAcirculareconomyaimstomaintainthevalueofproducts,internetthantheirurbancounterparts.141materialsandresourcesforaslongaspossiblebyreturningthemintotheproductcycleattheendoftheiruse,whileminimizingthegenerationofwaste.136122THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Foodenvironmentsandconsumertoproducefoodswhichhavehealthiernutritionbehaviour-orientedtechnologyandprofiles.146Nutrientprofilingisamethodthatinnovationassessesthenutritionalqualityofprocessedfoodsandbeverages.ItisalsoatooltoguideInurbanizingcontexts,whereconsumersarepolicyinterventionssuchasfront-of-packageincreasinglyexposedtohighlyprocessedfoods,(FOP)ormenulabellingandrestrictionsonincreasingthedemandfornutritiousfoodsmarketingtochildrentohelpinformandisparticularlyimportant.Theapplicationofempowerconsumerstoshiftdemandtowardsbehaviouralscienceisanessentialinnovationhealthydiets.Forexample,theOBAASIMAthatenablesgovernments,scientistsandprojectinGhanahasusedaFOPsealandsocialthepublictoworktogethertodevelopmarketingcampaigntoencouragelocalSMEsevidence-basedapproachestoincreaseaccesstoproducenutritiousproducts.Theprojecttoaffordablehealthydiets,aswellasempowerhasshownpromisingpreliminaryresultsconsumerstochoosehealthydiets.WheninincreasingconsumerawarenessandSMEemployedasaniterative,innovationprocess,capacityandisexpandingtomorecities.54behaviouralsciencecanhelpidentifybarrierstoRegionalnutrientprofileshavealsobeenconsumingahealthydietaswellashelpdesign,developedasaresourcefornationalorlocaltestandscalesolutionstoovercomethem.policymakers.147,148,149,150,151Consideringthatfoodoutletsareamajorsourceoffoodsallacrosstherural–urbancontinuum,Promoting–whilepreserving–traditionalfoodsnudgesavatthepointofpurchasecanbeusedtooriginatingfromIndigenousPeoples’agrifoodinterruptautomatedbehaviouralresponsesandsystemsthroughlabellingandcertificationredirectthemtowardshealthierfoodchoices.(includingterritoriallabels,geographicindicationsandparticipatoryguaranteeschemes)Nudginginterventionsinschoolcafeteriasorcancreatenichemarketsandenhanceawarenesslocalgroceryshopshaveproducedpositiveofthespecificityofsuchproducts.Forexample,resultsinsteeringindividualdietarychoicesinEcuador,theChakralabelprimarilytargetstowardsmorenutritiousfoodsinhigh-incomelocalmarketsandsensitizesconsumersaboutcountries,143,144andtheywouldnotbetoothedistinctivesocioculturalaspectoftheChakracostlyforlower-incomecountriestoemulatesystemaswellasthenutritionalvalueoflocalasausefuladjuncttoimportantregulatoryproducts.152However,giventhelargenumberandeconomicpolicytools.Forexample,atrialofdifferentlabelsonthemarketandexistinginvolvingtenprimaryschoolsinAustraliabarrierstocompetewithglobalcommodityaimedtoencouragetheselectionofhealthierprices,innovativelabelsalonemaynotenableanfoodsandbeveragesfromtheonlineschoolupscalingofIndigenousPeoples’productsales.menu.ByintroducingmultiplenudgesincludingTherefore,buildingrelationshipsandcollectiveplacement(listinghealthyitemsfirst),promptsprocessestogetherwithtrustedrepresentativesandappealingdescriptionsoftargetfoods,theoftheprivatesector,especiallyrelevantmarketinterventionwasabletosignificantlylowerplayers,aswellasgovernmentsandresearcherstheenergy,saturatedfatandsodiumcontentinbothsocialandnaturalsciences,canbecriticalofchildren’sschoollunchescomparedtoaindevelopingsustainablemarketingstrategiesfornon-interventioncontrol.145IndigenousPeoples’foodproducts.FoodlabellingcancontributetoahealthyfoodTheuseofwholegenomesequencingcanbeenvironmentbyprovidinginformationtotheaneffectivetoolforidentifyingandtracingconsumeraboutthecontentoffoods,drawingfoodbornepathogens,andfordetectingconsumerattentiontothebenefitsandriskscontaminantsaswellasoutbreakinvestigations.153ofparticularnutrientsoringredientsofpublicTraceabilitydata,includingthroughmobilehealthconcern,andmotivatingmanufacturersapplications,helpsinformconsumersabouttheoriginoffoodsoldinsupermarkets,promotingavAnudgeisanyformofchoicearchitecturethatalterspeople’stransparencyinpricingandmakingsupplybehaviourinapredictablewaywithoutrestrictingoptionsorchainsmoreefficientandaccountable.154significantlychangingtheireconomicincentives.142123CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>Onlinefoodsharingservicescangatheragrifoodsystems,includingthosenotnormallyandredistributefoodsurplusesacrosslocalgivenavoice,inordertogeneratestakeholdercommunitiesandsupermarketsinurbanawareness.Thecountry’sfirstPeople’sSummitandruralareas,thushelpingtoreducefoodonFoodwasthenconvened,resultinginarangewaste.Theycanalsohaveapositiveimpactonofcommitmentsfromallstakeholdergroups.160foodenvironments,especiallywhensurplusInBrazil,thecollaborativeplatform,UrbannutritiousfoodssuchasfruitsandvegetablesLaboratoryofPublicFoodPolicies(LUPPA),are“rescued”andredistributed.Smartphonesupportsthedevelopmentandstrengtheningofapplicationsthatenableuserstomakesmallanintegratedurbanfoodagenda,whileprovidingdonationstospecificinitiativescanprovidedataandcontentonmunicipalexperiences.supportforarangeofoperations,frombuildingItincludesayear-longprogrammethatdeliversresiliencetoimplementingschoolfeedinganextendedrepertoireoftoolsforcitiestoprogrammestodeliveringfoodassistanceinbecomebetterabletodeveloptheirlocalfoodemergencysituations.155policystrategies.LUPPA’sparticipantcitiesencompassBrazil’s5regions,covering18oftheTheincreaseduseofmobilephonesinLMICs26Brazilianstates,andcomprisingmorethanhascontributedtotheadoptionofotherservices11millionpeople.161suchasmobilemoney,enablingreducedtransactioncostsandenhancedfinancialMidstreamfoodsupplychain-relatedinclusion.Mobilemoneycanimprovefarmers’technologyandinnovationaccesstohigher-valuemarkets(thusincreasingtheirincome)andtooff-farmincomesourcesUrbanizationisleadingtoagrowingdemandaswell.156InKenya,UgandaandtheUnitedforpackagedandpre-preparedfoods,eveninRepublicofTanzania,ithasbeenshowntohavelow-incomecountries.AsanalysedinChapter4,positiveimpactsonhouseholdwelfare,includingconsumptionofprocessedfoodsandfoodawayinsomecasesbydiversifyingfoodpurchasesfromhomeishigherinurbanareas,butthereisandimprovingdietarydiversity.157Whiletheadiffusionacrosstherural–urbancontinuum.benefitsofusingmobilemoneyinruralareasThereisalsoanoticeableriseinthenumberarealreadyestablished,theadvantagesforofmidstreamSMEsinvolvedinwholesale,urbanareasarenowbeingrecognizedaswell–transportandprocessing,aswellasupstreamasseeninZimbabwe,forinstance,wherecashSMEsinvolvedinsupplyinginputs,especiallytransfersaredeliveredinurbansettingsthroughinAfricaandSouthernAsia.162Smallandmobilemoney.158mediumenterprisesaretypicallyembeddedinruralagriculturalareasandplayanimportantFoodlabsinvolvethecomingtogetherofaroleinexpandingmarketopportunitiesandgroupofpeopleincomplementaryrolesinorderstrengtheningthelinkagesbetweenurbanandtoexperimentwithfindingnovelsolutions159ruralareas.Assuch,innovativeapproachestocomplexchallengesinagrifoodsystems,thatenhancethecapacityofSMEstoincreaseincludingfoodinsecurityandunaffordabilitytheavailabilityofnutritiousandsafefood,ofhealthydiets.Experimentingwith,interalia,improvethefoodenvironment,andfacilitatethetechnologies,policies,participatoryapproaches,consumptionofhealthydietsarekey.actionsandideascanbeanimportantsourceofinnovationandcapacitybuilding.Forexample,InnovativebusinessmodelssuchastheEggtheUgandaFoodChangeLabwassetuptoHuboperatormodel(Box12)cansupporttheaddressdistrict-levelissuesoflimitedlocalconsumptionofhealthydiets,whileprovidingprocessingfacilities,depletedlocalsoilsandchildsmall-scaleproducerswithqualityinputsandmalnutrition,largelyaresultofundiversifiedservicesaswellasmarketaccess.diets.Thelabcarriedoutfooddialogues,researchandworkshopswithagroupofdiverseactorsawinTheincreasingdemandforperishableproductssuchasfruitsandvegetables,dairyproducts,awIncludingcivilsocietyorganizations,localpoliticians,foodmeatandaquaticfoodshasledtoaproliferationvendors,farmersandtraders.offreezingandpackagingtechnologies.124THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX12EGGHUBOPERATORMODEL:ASCALABLEWIN–WINSOLUTIONFORSMALL-SCALEPRODUCERSANDLOW-INCOMECONSUMERSTheEggHuboperatormodelhasbeenpilotedbyThemodel’s175farmersincreasedtheireggSightandLife,anon-profitfoundation,inseveralproductionthreefold,allowingthemtoselleggscountriesincludingEthiopia,IndiaandMalawi.toconsumersata40percentdiscount,reachingThismodeloffersruralsmall-scaleproducersaccessanestimatednumberof210000ruralpoor.tourbanandperi-urbanmarketsfortheirsurplus.Womenparticularlybenefited,astheywereTheproducersareorganizedintogroupsoffiveandextensivelyinvolvedinsmallanimalraising.TheEgggiveninputpackages,loans,trainingandmarketHubmodelalsoprovidedanaddedadvantagesupporttoselltheireggs,aswellaswholesaleratesbyhelpingsmall-scaleproducerstransitionfromforimprovedfeed.Theeggsproducedbythesegroupsbackyardrearingtosmall-scalefarmrearing,reducingareprimarilysoldwithintheircommunities,andnottotheriskofchildren’sexposuretochickenfaecesandcommercialestablishmentswhereeggswouldbeusedinfections.Additionally,theMalawimodelprovedtoasingredients.Anyexcesseggsarecollectedandsoldbemoresustainable,requiring69percentlesslandinurbanandperi-urbanmarkets.Thefarmersrepayusage,33percentlesswaterusage,andgeneratingtheirloanswithinthreetofiveyears,andthemoney84percentfewergreenhousegasemissionsfromtheloanrepaymentsisusedtocreatearevolvingcomparedtobackyardpoultry,primarilyduetofundtohelpincreasethenumberoffarmersinthelowerlevelsofeggwastageandbetterbiosecurity.hub.AnEggHuboperatoranditsaffiliatedfarmersAnothercrucialaspectoftheEggHubmodeliscancatertoacatchmentareawithamaximumradiusitsabilitytoaddressthechallengeofsmall-scaleof100km.producersaccessingbankloans.ByprovidingaccesstoqualityinputsandaguaranteedmarketfortheirInMalawi,thefirstEggHuboperatormodelproducts,themodeloffersfarmersabetterchanceofaimedtoproduceover10millioneggsannuallysecurefundingfortheirbusiness.163forsmall-scaleproducersandruralcommunities.Mobilepre-coolingandpackhouseunitsenvironmentaldamagethattherefrigerationofferfarmerstheoptionofpre-coolingtheirequipmentcancause.Furthermore,manyproducewhenthereisnoimmediateaccesstobarriersimpedetheuseofcoldchainsinLMICs:coldstoragetechnology.164Coldchainscanbelackofaccesstoreliablepowerandequipment,augmentedwithinternetofthingsaxsensorsandlimitedresourcesforpublicandprivatesectorbigdata,allowingforreal-timedecision-makinginvestments,inabilityofsmall-scalefarmersfortemperature-sensitiveproductsandtoaffordcoolingtechnologies,andlackofperishablesastheymoveacrossthechainoraretechnicalskills,amongothers.166WithinLMICs,maintainedinstorage.coldchaincapacityandutilizationismuchgreaterforexportedfoodproductsthanforfoodColdchainsprovidebenefitsintermsofdestinedfordomesticmarkets.Climate-friendlymaintainingfoodquality(includingnutritionalrefrigerationsystemsbasedonrenewableenergyquality)andsafety,reducingfoodlossandwaste,canhelpcoldchainsbecomemoresustainable,andfacilitatingmarketaccess,andtheyarealsothoughchallengessuchasaccesstoreliableandkeytomaintainingtheintegrityofveterinaryaffordableenergyneedtobeaddressed.167medicinesandvaccinestohelppreventandmanageoutbreaksofzoonoticdiseases.However,Innovationsinfoodpackagingcanmaintaincoldchainsposesignificantrisksintermsofthequality,safetyandnutritionalvalueoffoodproducts,meetconsumerneedsandpreferences,axAsysteminwhichdevices–includingmobilephones,sensors,reducefoodlossandwaste,andreducethecostdrones,machinesandsatellites–areconnectedtotheinternet.165ofnutritiousfoods,especiallyacrosslonger125CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>distributionchains.Forexample,organicspraysearnanindependentsourceofincome,workofthinlipidsonfruitsandvegetablescanextendfromhome,andsettheirownworkinghours.shelf-life,offeringgreatbenefitsincountrieswithMoreover,e-commercehasthepotentialtolimitedrefrigeration.168“Intelligent”packagingreducethenumberofintermediariesandbalanceutilizesmaterialsthatcanmonitortheconditionthepowerrelationshipswithinvaluechains,andenvironmentofpackagedfood,alertingresultinginhigherpricespaidforproducersandretailersorconsumerstoanycompromiseorcheaperproduceforconsumers.173,174Thegrowthcontaminationsuchaschangesincolour.Itcanofe-commercewasfurtheracceleratedbythealsoinclude“smart”labelssuchasQRcodesCOVID-19pandemic,from10to20percentthattrackproductsthroughoutthesupplyperyearinChina,30to70percentinIndia,chain,verifyingproductsafetyandprovidingand20to50percentinNigeria,175andtosomeadditionalinformation(e.g.detailsonallergensextent,consumersarenowmorereliantonandsourcing).Alternativestoplasticpackagingfoode-commerce(anddelivery)thantheywereincludebiopackagingsolutionssuchasbioplasticspre-pandemic.83Akeybarriertotheadoptionfromorganicwastestreams,thoughmaterialsandscalingofe-commerce,however,isthevarysignificantlyintermsofthequantityofunequalaccesstointernetconnectivityinsomerenewableresourcesusedintheirformulation,regions.Thiscanlimitnotonlytheconsumerandmaynotbeasreadilycompostableasbaseofe-commerceplatforms,butalsotheclaimed.Moreover,thesesolutionsremainpossibilityforsmall-scaleproducerstodirectlydifficulttoupscaleastheymustbetailoredtoadvertisetheirproductsonsuchplatforms,usagerequirements.169thereforemaintaining(orevenincreasing)theirrelianceonintermediariesfornon-traditionalCircularpackagingsolutionscanincludesupplychannels.redesigningpackagingformatsanddeliverymodels,introducingreusablepackaging,andWiththerisingpopularityofe-commerce,improvingtheeconomicsandqualityofrecycledfoodsafetyhasbecomeacrucialissueforplasticmaterials.170Forexample,returnableandonlineretailers.Toensurefoodsafety,retailerstransitpackagingintheformofreturnableplasticmusttakemeasurestopreventcontaminationcratesiswidelyusedinagrifoodvaluechainsduringstorage,transportationanddelivery.Thisbecauseofitscost-effectiveness,durabilityandincludesmaintainingappropriatetemperaturesreusabilityoverextendedperiods.InBangladesh,forperishablegoods,usingsafepackagingtheswitchfromsingle-useplasticstoreturnablematerials,andimplementingpropersanitationplasticcratesforlong-distancetransportationmeasures.Retailersmustalsoadheretolocaloffreshfruitsandvegetables,togetherwiththeandfederalregulationsgoverningfoodsafety.applicationofgoodmanagementpractices,hasClearandaccurateinformationabouttheorigin,improvedfreshproducequalityandshelf-lifecontentsandexpirationdatesoffoodproductsisandincreasedstakeholderincomeswhileessentialforinformedconsumerchoicesandtosafeguardingconsumersagainstfoodsafetymitigatepotentialhealthrisks.176,177,178,179risksandconsiderablyreducingpost-harvestlosses.171Thedevelopmentofcross-collaborativeTheriseofe-commerceduetoadvancesinengagementamongproducers,processors,mobiletechnologyandwidespreadwirelessretailersanddistributorswillbecriticalininternetavailabilityisshiftingthewaypeopledrivingtheshiftfromthecurrent,linearinteractwiththeirfoodenvironments.This“take–make–consume–dispose”modelofthe“digitalization”offoodenvironmentsisenablingagrifoodvaluechain,towardsmorecircularfoodretailerstosellfoodsonline,resultingsystemicapproachestoensuresustainability.172inunprecedentedconsumeraccesstoalargevarietyoffoods(bothnutritiousfoodsandfoodsE-commerceplatformsofferopportunitiesofhighenergydensityandminimalnutritionaltoincreaseaffordabilityofhealthydiets,byvalue).Onthedownside,onlinefoodretailshorteningvaluechainsandincreasingmarketandmealdeliveryappsoftenhavespecificaccess.Theseplatformscanalsocontributetopromotionsonfoodshighinfats,sugarsand/orwomen’sempowermentbyenablingwomentosalt.180,181,182,183,184,185,186,187Thoughmainlyused126THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023inurbansettingsinhigh-andmiddle-incomegrowingfoodoragriculturalactivities,andurbancountries,mealdeliveryappsaregrowinginagglomerationsencompassaglobalfarmareathatpopularityandspreadingtosmallercitiesandexceeds60millionhectares.126Nonetheless,whiletowns,potentiallycontributingtoanexpansionUPAcanimprovefoodsecurityandnutritionoffoodswampsbyincreasinggeographicinandaroundcities,itisunlikelythatitcanaccesstofoodspreparedawayfromhome188,189satisfytheneedsofurbanpopulations,soitsand/oravailabilityoffoodshighinfats,sugarsdevelopmentshouldbecomplementarytothatand/orsaltinareaswherephysicalshopssellingofruralagricultureandconcentrateonactivitiesnutritiousfoodsaresparse.Astudyanalysingwherethereisadistinctcomparativeadvantage,mealdeliveryappsfound,forexample,suchasproductionoffresh,perishablefoods.thatagreaternumberoffastfoodoptionswereavailableinthemostdisadvantagedNumeroustechnologiesandinnovationscanneighbourhoods.190beleveragedforenhancingproductivityinrural,peri-urbanandurbanareasaswellasFoodproduction-relatedtechnologyforclosingtheproductivitygapinLMICs,andinnovationespeciallyinthefaceoftheclimatecrisisanddwindlingnaturalresources.WithwaterscarcityFamilyfarmsproduceapproximately80percentbecomingarealityinmanyplacesacrosstheoftheworld’sfoodinvalueterms,withfarmsrural–urbancontinuum,technologiessuchunder2hectaresproducingroughly35percent.191asrainwaterstoragecanoptimizewater-useAdditionally,themajorityoftheworld’spoorefficiencyinrainfedagriculture.193Forexample,andfoodinsecureliveinruralareasanddependroof-harvestedrainwatercanpositivelyimpactonagriculturefortheirlivelihood.192HenceitproductivityandimprovethesustainableusageiscriticaltoincreasefarmproductivityandofwaterinUPA.194Moreover,thesafeuseofincomesinruralareas,enhancemarketaccessforwastewatercanleadtoimportantenergysavingssmall-scaleproducers,andimproveconnectivityforfoodproduction,andforcitiesingeneral.tofacilitatesmootherflowsofgoods,servicesandNutrientsrecoveredfromwastewatercanbeinformationacrosstherural–urbancontinuum.usedinsteadofinorganicfertilizersaswell.195Inaddition,fogcatchersystemshavebeenSimultaneously,rapidurbanizationcombinedimplementedinaridzonesandhaveincreasedwithrisingincomesisshiftingpatternsoffoodtheavailabilityofwaterforfoodproductionsupplyanddemand,acceleratingadiettransition.inseveralLatinAmericaandtheCaribbeanConsumptionisalsochanginginruralareas,countries.196,197leadingagriculturalproductiontodiversifytowardsnutritiousfoods.GrowingfruitsandAgroecologicalinnovationsaycanbemarketvegetablescancreateeconomicopportunitiesforbased,institutional,ecologicalandtechnological,farmers,notonlyinruralbutalsoinperi-urbanoftenwithafocusonknowledgeco-creation.199andurbanareas.DiversificationalsoincreasesAgroecologyrecognizesthatfoodproduction,resiliencetoclimate,environmentalandmarketdistributionandconsumptioninherentlylinkshocksacrossdifferentproductionsettings.economic,ecologicalandsocialprocesses,anditispractisedindiverseandlocallyadaptedAsalreadynoted,urbanandperi-urbanformsacrosstherural–urbancontinuum.Attheagriculture(UPA)canprovideeasyaccesstoplot,farmandlandscapelevels,itcanhelpfreshandnutritiousfoods,andmakehealthyincreasefarmers’incomes,200improvefooddietsmoreaffordableinperi-urbanandurbansecurityandnutrition,201usewaterandsoilareas.Inaddition,itcanhelpoptimizetheuseofmoreefficiently,conservebiodiversity,providescarceurbanresourcessuchaslandandwater,ecosystemservices,andenhancenutrientthoughitisimportanttoexercisecautioninareaswhichmayhavecontaminationissuesasayAsstatedinFAO(2018,p.1)agroecologyis“anintegratedtherecouldpotentiallybesubstantialfoodsafetyapproachthatsimultaneouslyappliesecologicalandsocialrisks.Morethan1billionindividualsresidingconceptsandprinciplestothedesignandmanagementoffoodandinurbanandperi-urbanregionsareinvolvedinagriculturalsystems."198127CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>recycling,amongotherbenefits.202InIndia,theofsmall-scaleproducersduetothecostofAndhraPradeshCommunity-managedNaturalcertificationandtothepriceoforganicproducts,Farmingprogrammethataimstotransitionallwhichareoftentoohighforconsumers.2126millionfarmersinthestatetoagroecologicalapproacheshasalreadyreachedmorethanControlledenvironmentagriculture(CEA),also630000farmers,resultinginhigherincomesreferredtoasverticalorindoorsoil-lessfarming,andbetteryieldsaswellashealthbenefits.203encompassesnumeroustechnologiesincludingInEcuador,theParticipatoryUrbanAgriculturehydroponics,aeroponicsandaquaponics.ProgrammeemphasizesthesocialinclusionofVerticalfarmingrequiresonlyasmallplotofvulnerablegroupsandsupportstheproduction,landandcanbecarriedoutindoors,allowingforprocessinganddistributionoffoodfromurbanthecultivationoffoodinurbanandindustrialandperi-urbanareas,generatingrevenue,spaces,andleadingtoshortersupplychains.creatingjobsandpromotingagrobiodiversity.204Forshort-cyclefast-growinghorticulturalcropsItalsofacilitatestheprovisionoftechnicalsuchaslettuceandleafyherbs,productioninaassistance,microcreditandcapacitybuildingtocontrolledenvironmentcancutwaterusebyupproducers.Blendingagroecologywithterritorialto95percentwhilesupplyingconsistent-quality,approachescanhelpempowerruralcommunitieshigh-valueproductsallyearround.Verticalandbringagroecologytoscale,forexamplebyfarmscanminimizerisksoffoodborneillnessesimplementingterritorialcertificationschemesandandconsiderablyreducetheneedforbothshortervaluechainstoimproveaccesstomarketsinputs(e.g.fertilizersandpesticides)andwaterandincreaseincomesofsmall-scaleproducers.205(throughrecycling).Forcerealssuchaswheat,studieshaveshownthatyieldsinindoorverticalAsat2021,organicagriculturewaspractisedinfarmscouldbe220to600timeshigherthan191countriesbynearly3.7millionproducers,yieldsinthefield,whileatthesametimeusingbutitoccupiedonly1.6percentofthetotallessland.213However,thehighenergycostofagriculturalland.206OrganicfarmingsystemsproducingartificiallightingandmaintainingcanprovidemoreprofitswithlessenvironmentaltemperatureandairqualitymakestheadoptionfootprintandproducenutritiousfoodswithlessofCEAviablemostlyinHICs.Thelargestpesticideresidue.207Ingeneral,organicagriculturemarketsharefromCEA,andmostofitspositivehasapositiveeffectonabove-andbelow-groundresults,havebeenfoundinthiscountryincomebiodiversity,soilcarbonstocksandsoilqualitygroup,214,215butithasalsobeenusedtosupportandconservation,butitoftenproduceslowervulnerablecommunitiesinLMICsusingyieldsthanconventionalagricultureandhaslow-techhydroponicunits.216higherlabourrequirements.208MASIPAG,agrassrootsfarmer-ledadvocacynetworkintheBiotechnologicalinnovationsingeneticsPhilippines,promotesorganicfarmingasapathandbreedinghaveledtotremendousgainsforruraldevelopment.Farmersareinvolvedininproductivity,adaptationtobioticandparticipatoryplantbreedingofricevarieties,abioticstresses,andenhancednutritionalfarmer-to-farmerexchanges,andparticipatoryvalue.Consumptionofbiofortifiedcropscanguaranteesystemsforincreasedmarketaccessenhancenutritionalstatusandpromotebetteroforganicproducts.209Organicfarmingisalsohealthoutcomes,especiallyinruralareasinacommonpracticeinUPA,withmanureandLMICs,wheredietsaresignificantlyrelianturbanwastecompostfrequentlyutilizedtoonself-producedorlocallyprocuredstapleimprovesoilfertility.Forexample,theKiberacrops.HundredsofbiofortifiedvarietiesYouthReformOrganicFarm,whichbeganonaof12staplecropshavebeenreleasedforgarbagedumpinAfrica’slargestsluminNairobi,plantinginover60countries,withmoregrowsarangeofcropsforownconsumptionthan86millionpeopleinfarminghouseholdsaswellasforsale.210Sinceorganicagricultureeatingbiofortifiedfoods.InNigeria,farmersdoesnotrelyonsyntheticnitrogenfertilizers,growingbiofortifiedvitaminAcassavahavenitrogenavailabilityistheprimaryimpedimentbeenlinkedtoaggregatorsandprocessors,totheglobalexpansionoforganicagriculture.211withlabelledprocessedproductssoldinrural,Additionalissuesrelatetothepotentialexclusionperi-urbanandurbanareas.Additionally,128THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023organizingtheannualNutritiousFoodFairsourcefoods(e.g.meat,dairy,eggsandaquatichasbeeninstrumentalinfosteringlinkagesfoods)isontherise,althoughcautionisneededamongfarmers,processors,marketerstopreventtheinadvertentincreaseinuseofandconsumers.217commonallergensindiets.220Inadditiontofoodsafetyaspects,thepriceandculturalacceptanceGeneeditingisarelativelynewtechnologythatofplant-basedalternativesmustbeconsidered.offersimprovementsinaccuracyandprecisionTheaffordabilityofplant-basedalternativesisforplantandanimalbreeding,withtheaddedanticipatedtoimproveasconsumerdemandandadvantageofspeedingupthecomponentsupplygrow.Currently,plant-basedalternativesprocessesatareducedcost.Inparticular,genepredominantlycatertoaWestern-stylediet,witheditingcanbeexploitedtoincreasetheutilitylimitedexplorationintomoretraditionalfoodsinof“forgotten”cropsaswellasneglectedanddifferentregions.underutilizedspeciesthatarenutritiousandoftenadaptedtoharshenvironmentsandWhileinsectshavebeenatraditionalpartofconditions.Marketedgene-editedproductsmanycultures’dietsforcenturiesindifferentincludeagamma-aminobutyricacid-enrichedregions,thecultivationofedibleinsects,fortomatoandtwogene-editedfishinJapan,bothhumanconsumptionandanimalfeed,isaswellassoybeanwithimprovedfattyacidgarneringsignificantattentionworldwideduecompositionintheUnitedStatesofAmerica.218tothemanypossibleadvantagesintermsofTherearediverseviews,however,onhownutrition,theenvironmentandtheeconomy.gene-editedproductsshouldberegulated,andNonetheless,similartootherfooditems,ediblelegislationcandifferwidelyamongcountries.insectscanbeassociatedwithanumberoffoodInaddition,priordebatesassociatedwithsafetyhazardsthatrequireattentionandcareingeneticmodificationmayinfluenceconsumerthepreparationprocess.221Furthermore,agreateracceptanceofgene-editedproducts.Publicpushfortheconsumptionofinsectscouldresultperceptionstudiesvaryonwhetherconsumersintheoverexploitationofinsectsintheirnaturalcandistinguishbetweengeneticmodificationandhabitats,posingathreattobiodiversityandgeneeditingwhenformingtheiropinions.Inaecosystemstability.222recentstudy,respondentsviewedgene-editedandgeneticallymodifiedfoodsimilarly,andThecommerciallandscapeforcell-basedfoodlessfavourablythanconventionalfood.Othertechnologiesthatuseanimalormicrobialcellsstudiessuggestthatpeoplemaybemoregrowninvitrotoproduceanimalproteinsacceptingofcisgenicazmodificationsthanof(sometimesreferredtoas“cultured”ortransgenicbaones,butlessacceptingcomparedto“cultivated”meat)isemergingandrapidlyconventionallybredcrops.218expanding,withSingaporeapprovingthefirstcell-based“chicken”nuggetsin2020.223Fundamentallifestyleshifts,incomedisparities,Cell-basedfoodproductionisanticipatedtogrowingurbanpopulationdiversityandchangingrequirelesslandthantraditionallivestockconsumerbehaviourinresponsetonumerousfarming,thoughthelatterstillplaysavitalrolefactors(suchasconcernsabouttheimpactofinenvironmentalfunctionssuchasmaintainingfoodproductiononenvironmentalsustainabilitysoilcarboncontentandfertility.Further,itisaswellasanimalwelfare)aredisruptingtheunclearifcell-basedfoodshaveagreenhousestatusquoofagrifoodsystems.Newfoodsandgasemissionsadvantageoverlivestockwhennovelwaysofproducingfoodarebeingexplored.scaledup.Differenttypesofcell-basedfoodsThepopularityofplant-basedalternativeshavedifferentenvironmentalimpacts;for(e.g.soy-andnut-basedproducts)toanimalexample,acell-basedfoodmayhavehighenergyrequirementsbutreducedland-userequirementsazGeneticchangesintroducedfromthesamespecies,suchasthoseandloweutrophicationpotential.220Itisnotproducedbysomegene-editingtechnologies.218knownhowpeoplewillperceivecell-basedfoodsandwhethertheywillbeacceptabletoconsumers.baAnindividualinwhichatransgenehasbeenintegratedintoitsTechnologicaladvancementsforcell-basedgenome.Atransgeneisanisolatedgenesequenceusedtotransformanfoodshaveprogressedsignificantly,buttheyorganism.Often,butnotalways,thetransgenehasbeenderivedfromadifferentspeciesfromthatoftherecipient.219129CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>havenotyetreachedthestageofwidespreadLookingahead:makingtechnologyandproductionorcommercializationinthemajorityinnovationworkwellforallacrosstheofcountries.Finally,althoughtheproductionrural–urbancontinuumcostsforcell-basedfoodshavefallen,theyarestillprohibitiveformanyLMICs.Globally,urbanizationisaccelerating,affectingagrifoodsystemsacrosstherural–urbanDigitaltechnologiescanguideandfacilitatecontinuumandconsequentlytheavailabilityanddata-drivendecision-makingatthefarmaffordabilityofhealthydiets.Asevidentfromlevelacrosstherural–urbancontinuumbytheexamplesprovidedabove,technologyandleveraginggranulardataaboutfieldsandinnovationaredrivingchangesinproductionanimalsinconjunctionwithaccurate,timelyandprocesses,distributionsystems,marketinglocation-specificweatherandagronomicdata.strategies,andthefoodproductsconsumedbyPrecisionagricultureusesinformationtooptimizepeople,withbenefitsforproducers,consumers,inputs(especiallytargeted,timelyapplicationssmallandmediumenterprisesandretailers,ofagrochemicals)andcanimproveresource-useamongothers.However,promisingtechnologiesefficiencyinincreasinglyconstrainedconditionsandinnovationsoftendonotgaintraction,foragriculturalproducers.Butefficiencygainsespeciallyinlow-andmiddle-incomecountries,comewithariskofreboundeffects,thatisduetoissuesofcontextualreadinessandtheycanleadtoenhancedmachineryandappropriateness,andthelackofanappropriateassociatedenergyuseaswellasincreasesinenablingenvironmenttosupportdevelopment,usageofnaturalresources.224Automationcandiffusionandadoption.replacedullanddangerousmanualjobs,addresslabourshortagesincertainareasandattractThepotentialoftechnologyandinnovationyounger,moreskilledworkers.Forexample,canandmustbeunlockedforthecommonagriculturalrobotscandecreaselabourandgood,butalltechnologiesandinnovationsinputrequirements,andreduceyieldlosseshaveprosandconsintermsofhowtheyaffectresultingfromthelatedetectionofpestsandagrifoodsystemstransformationandhowtheydiseases.225However,theirhighpurchasepricecanreinforceinequalities,creatingwinnersandoperatingcostsmaketheiruseprohibitiveandlosersacrosstherural–urbancontinuum.forsmall-scaleproducers.Additionally,ifItisalsoimportanttoacknowledgeregionalunskilledworkersdonotlearnnewskillsheterogeneityandthediversityanddynamismquicklyenough,itcanbedifficulttotransitionofagrifoodsystems.Therefore,technologiestonewjobs.Besides,thereisapossibilitythatandinnovationsmustbeadaptedtolocalneeds,small-scaleproducersmightbedrivenoutofopportunitiesandconstraints,toensuretheybusinessandforcedtomigratetocities,becauseareaccessibletoallwhowanttoadoptthem.theylacktheeconomiesofscaletocompeteiftheToscaleuptechnologiesandinnovationsinautomationtechnologiesarenotscaleneutral.agrifoodsystemsaswellasmakethemmoreDigitalservicessuchassharedassetservicescaninclusive,policiesandinvestmentsareneededenhancefarmeraccesstomechanizationhireinanumberofareasincludinginfrastructureservicesandsignificantlyreducetransaction(e.g.internetandtransportconnectivity);costsforsmall-scaleproducers.128Finally,digitalrelevantcapacities,skillsandknowledge;technologiesalsohavethepotentialtofacilitateeffectiveregulatorymeasures;economicandcost-effective,uninterruptedandscalablelegalinstrumentstoreducecostsandrisksextensionandadvisoryservicesinruralareas.(e.g.overconcentrationofmarketpower);Mobilephone-basedextensionsystemscanreduceappropriatemarketincentives;andpromotioninformationdeficiencies,andinsub-Saharanofinclusiveagribusinessmodels.Further,AfricaandIndiahavebeenestimatedtoimprovebundlingcontextuallysuitabletechnologieswithcropyieldsby4percentandtheoddsofadoptioncomplementaryfinancial,socialandinstitutionalofrecommendedinputsby22percent.226innovationscanallowformitigationoftrade-offs,whereoneinnovationcancompensatefornegativeimpactscausedbyanotherone.7130THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Increasedpublicinvestmentinagriculturalcreatedinagrifoodsystemsunderurbanization.R&DbeyondthemajorstaplestoincludeaPolicymakingprocesseswillnotworkwithbroaderrangeofplantandanimalspeciesatraditional,mostlynationalandtop-down(includingfruitsandvegetables)isnecessarytoapproach,becauseoftheneedtofocusonsupportthediversificationofagrifoodsystems.placesandtheirfunctionalandspatiallinkages.Further,theresearchfocusmustbroadenfromBecausetheselinkagesoftenplayoutacrosssolelyimprovingproductivitytoimprovingsectoralandadministrativeboundaries,thefunctioningofentireagrifoodsystemspolicymakingprocessesshouldfacilitate(i.e.theoff-farmcomponentsthataccountforinterjurisdictionalagreementsandregulations,upto70percentofvalueadded).Urbansoilsaswellastheparticipationofavarietycancontainmultiplecontaminantssuchas(includingnon-governmental)ofactors.5Hence,heavymetals,asbestosandpetroleumproductsagrifoodsystemsgovernancecanbeunderstoodatdifferentlevels,whilechemicalhazardsorasthemechanismsandprocessesestablishedpathogenscanbefoundinurbanwastewaterforstakeholderstoarticulatetheirinterest,thathasbeenimproperlytreated;thereforemoremediatetheirdifferencesandcoordinatearoundresearchisneededonthepotentialhealthrisksgovernmentinstitutions.Moreover,institutionaltohumanswhoconsumefoodthatisspecificallyarrangementsneedtoconsiderthekeyroleofgrownwithinurbanandperi-urbanareas.subnationalgovernments(localandregional)asOpportunitiesexistforachievingmorewiththewellasthatofnon-governmentalactors.5resourcescurrentlyinvestedbygovernments.Asanalysedinthe2022editionofthisreport,14Workingwiththespatialandfunctionalmostoftheglobalsupporttofoodandagriculturelinkagesacrosstherural–urbancontinuum,isorientedtowardsproducersthroughpricewithsubnationalgovernmentsasimportantincentivesandotherfiscalsubsidies.Theseplayers,canleverageagrifoodsystemssubsidiescoulddistorttheincentivesforadoptingtransformationunderurbanization.Thenationalcertaintechnologies,favouringsomeproducersandtransnationalproduction-orientedpoliciesoverothers;instead,publicsupportcouldbeandagendasofthelastcenturycreatedgapsinrepurposedtowardsincreasinginvestmentsinaddressingfoodinsecurityandmalnutrition.generalservicessupport(whichincludesR&D)Inreactiontothesepolicies,subnationaltoencouragethedevelopmentandadoptionofgovernmentshaveemergedasimportantplayerstechnologiescollectively.14,128Reassessingpolicyinagrifoodsystemstransformation.prioritiesconsideringthechallengescreatedbyurbanizationcouldopenthepolicywindowtoOtherfactorswhichhaveincreasedtheroleofre-examine–andrepurpose–currentfoodandsubnationalgovernmentsontheglobalstageagriculturesupport.227nhavebeenthesteadyincreaseinpoliticalandculturalpowerofcitiesofdifferentsizes,the5.3rapidurbanizationprocesses,andtherelativelyINTEGRATEDPLANNINGrecentwaveofdecentralizationfromnationaltoANDGOVERNANCElocalgovernmentsinanincreasingnumberofMECHANISMSACROSScountries.Intheaftermathofthesedevelopments,THERURAL–URBANurbanfoodpolicypioneersinmunicipalitiesCONTINUUMaroundtheworldgotengagedintheagrifoodsystemsagendatodevelopfoodstrategiesandThepolicies,technologiesandinnovationsimplementspecificlocalmeasures.228presentedupuntilnowwillrequireadequategovernancemechanismsthat,whileengagingDuetothemultisectoralnatureofthemultipleactors,coherentlyaddressthechallengesandopportunitiesthaturbanizationchallengesandleveragetheopportunitiescreatesacrosstherural–urbancontinuum(Chapter3),subnationalgovernmentsshouldalsobeimportantactorsforformulatingandimplementingcoherentpoliciesthatgobeyondagrifoodsystems(e.g.environmental,energy,131CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX13URBANFOODSYSTEMSCOALITION:AGLOBALPLATFORMTORAISEAWARENESSONTHEKEYROLEOFSUBNATIONALGOVERNMENTSINAGRIFOODSYSTEMSTRANSFORMATIONACROSSTHERURAL–URBANCONTINUUMTheUnitedNationsFoodSystemsSummit,continuuminmultiplecountries.Thecoalition229aimsorganizedin2021,recognizedtheimportanceoftosupportnationalandsubnationalgovernmentssubnationalgovernmentsaskeyleversforinclusivetotransformtheiragrifoodsystemsbyfacilitatingandsustainableagrifoodsystemstransformation.coherent,coordinatedpoliciesandactions.DuringtheSummit,theUrbanFoodSystemsCoalitionItsupportssubnationalgovernmentstoengageinwasestablished;itiscurrentlyfacilitatedbytheFoodglobalpolicydebatesandestablishthemselvesaskeyandAgricultureOrganizationoftheUnitedNationsplayersintheoverallagrifoodsystemstransformation.andtheGlobalAllianceforImprovedNutrition,Moreover,thecoalitionworksacrosstherural–urbanandincludesUNAgencies,citynetworks,civilcontinuumtoidentifycontext-specificmechanismssocietyorganizationsandacademicinstitutionsasforbridgingnationalandlocalagrifoodsystemsactivemembersoperatingacrosstherural–urbangovernancegaps.healthandothersystems).Theyareinclosebetweenmultipleadministrativezonesandcontactwithlocalstakeholdersandcanensuremultistakeholderplatformsandnetworks.thatthesepoliciesareadaptedtolocalconditionsbypromotingadvantagesandaddressingMultistakeholderagrifoodsystemsgovernancebottlenecks.ThelaunchoftheMilanUrbanmechanisms,involvingmultiplenon-stateFoodPolicyPactin2015wasaglobalmarkeractors,farmerorganizations,civilsocietyofsubnationalgovernments’increasingroleinorganizations,theprivatesectorandacademicformulatingandimplementingpoliciesaturbaninstitutions,areincreasinglyemergingandregionallevels,promotingagrifoodsystemsascrucialinstrumentstoaddressgapsinlinkagesacrosstherural–urbancontinuumlocalpoliciesandplanningrelatedtofood.andintegratingdifferentsystemsapproachesAmongsuchmechanisms,foodpolicycouncilsinlocal,regionalandterritorialdevelopment(sometimesalsoreferredtoascommittees,plans.TheNewUrbanAgenda,endorsedbythefoodgroups,platforms,etc.)serveasadvisoryUnitedNationsGeneralAssemblyin2016,hasbodiestolocalorsubnationalgovernments,beenaturningpointintermsofrecognizingsupportpolicydesignandimplementation,theroleofsubnationalgovernmentsinagrifoodpromotestakeholderengagement,andfacilitatesystemstransformation,asitcalledforintegrationmonitoringandevaluationofprogressinpolicyoffoodsecurityandnutritioninurbanandimplementation,effectiveness,efficiencyandterritorialplanning.Thisrecognitionhasalsoimpact(seeBox14).beencarriedoverintoglobalprocessessuchastheUnitedNationsFoodSystemsSummit,withThereiscurrentlyverylimitedevaluationoftheestablishmentoftheUrbanFoodSystemsthecollectiveimpactoffoodpolicycouncilsCoalitionin2021(seeBox13).onchangingpolicyorshiftingconventionalfoodgovernanceparadigms.230SomefoodSubnationalagrifoodsystemspolicycouncilsareformedthroughbottom-up,governancemechanismscitizen-ledprocesses,whichmakesthemcautiousaboutthedegreetowhichtheyassociateAnimportantstartingpointtowardswithoraredependentonlocalgovernment,streamlininggovernancebasedonfunctionalasformalizedlinkswithgovernmentmaydimensionsacrosstherural–urbancontinuumcompromisetheoriginalvisionanddirectionofisthedevelopmentoflocallybasedagreementstheplatformandrestricttheabilitytopropose132THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX14SUBNATIONALAGRIFOODSYSTEMSGOVERNANCEAGREEMENTSAMONGMETROPOLITAN,INTERMEDIARYANDSMALLCITIESINPERUInNovember2019,thePeruvianmunicipalitiesofcontentofmenuitems,andtoonlyprovidesaltshakersLima,Huancayo,Arequipa,PiuraandMaynassignedandcondimentswhencustomersaskforthem.anagreementwiththeobjectiveofstrengtheningagrifoodsystemslinkagesacrosstherural–urbanInaddition,inOctober2020,Limaestablishedcontinuum.Theagreementcovers:i)linkagestheFoodSystemCouncilofMetropolitanLimabetweenproducers,marketsandfairsindifferent(CONSIAL),whichaimstoplan,organize,developcities;ii)knowledgeexchangeonpracticesrelatedandimplementsustainableandresilientfoodpoliciestoagroecologyanditspromotioninruralandperi-urbanthatguaranteethehumanrighttofoodandgenerateareas;iii)modernizationoffoodretailmarketspaces;apositiveimpactinreducingratesofpovertyandandiv)context-specificstrategiestoimproveaccessmalnutrition.Sinceitsestablishment,thecounciltohealthydiets.Italsoincludespeer-to-peerlearninghasenactedseverallocalordinancestopromotepractices,whichallowforsharingexperiencesinareashealthierurbanfoodenvironments,urbanagriculture,suchasdevelopmentofnewurbanfoodenvironmenttheuseofpublicspacesforagroecologyfarmers’ordinances,publicpurchaseoffamilyfarmingproducts,markets,andtherecoveryofunsoldfoodinwholesaleandestablishmentofthefoodpolicycouncilinLima.markets.Thecouncilincludesmultipleactorssuchasrepresentativesfromurbanandperi-urbanagricultureOneexperiencesharedwithmunicipalitiesinvolvesplatforms,ruralproducerorganizations,civilsocietyanordinanceinLimadesignedtocreatehealthypromotersofhealthyeating,researchcentresandfoodenvironmentsinbothschoolsandout-of-homeuniversities,theprivatesector,andnon-governmentalareas.231Theordinanceprohibitsthesaleormarketingorganizationsactivebeyondtheadministrativeofenergy-densefoodshighinfats,sugarsand/orsaltboundariesoftheLimametropolitanarea.Likewise,within200metresofschools.Italsosetsminimumthecounciliscurrentlydevelopinganagrifoodsystemshealthrequirementsforfoodanddrinksprovidedstrategyacrosstherural–urbancontinuum,alignedtostudentsonschoolpremises,andrequireswiththenationalandinternationalagendasrelatedtoschoolstoensureaccesstofreshdrinkingwater.agrifoodsystems,climatechangeandsustainability.Furthermore,aspartoftheLimaComeSano(LimaEatsHealthy)programme,theordinancerequireslocalThecityofHancayohasalsoestablishedtheComitérestaurantstoadoptnewpracticestoreducesaltanddeSistemasAlimentarios(FoodSystemsCouncil)whichsugarintakes.Topromotehealthyeating,restaurantsislinkedtotheCONSIALinLima,creatingthebasisforareencouragedtoprominentlydisplaythecaloricstrengtheningagrifoodsystemsgovernanceacrosstherural–urbancontinuum.changestogovernmentstructuresandpolicy.requirescalingupandstrengthenedcapacityinOthersareformeddirectlywithinorevenordertoreachtheirfullpotential.Forexample,bythemunicipalityitselfandthereforehaveinAfrica,theinformalsectorisexpanding,strongtieswithlocalgovernment.Thestrengthandstreetfoodvendingremainskeyforfoodoffoodpolicycouncilswithclosertiestopurchases.Informalfoodvendorsprovidegovernmentisthattheycanbeinabetterpoorerhouseholdswithbetteropportunitiespositiontomakepolicyrecommendationsandtoachievefoodsecurity,astheyarespatiallyreceivemoresupport.Beinglocatedwithinaaccessibleandcanofferassistancethroughgovernmentdepartmentcanalsoincreasethecredit;232however,theyarebarelyconsideredchancesofreceivingdedicatedresourcesandingovernancemechanisms,noteveninfoodensurecontinuity.policycouncils,whichinmostcasesarestillinanemergingstate(Box15).SupporttoFoodpolicycouncilshaveexistedfor30years,organizetheseinformalfoodactorsingroupstheearliestinNorthernAmerica,buttheystill(e.g.cooperatives)canbecrucialfortheir133CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX15INCLUSIVEAGRIFOODSYSTEMSGOVERNANCEMECHANISMINKISUMUCOUNTY,KENYA,LINKINGURBANANDRURALAREASInKisumuCounty,Kenya,afoodliaisonadvisorythedevelopmentofanagrifoodsystemsstrategygroup(FLAG)wasestablishedin2020undertheencompassingbothruralandurbanareasoftheleadershipofthecountyandwithrepresentativescounty.Thestrategyidentifiespriorityareasoffromacademia,civilsocietyorganizations,theinterventiontofosterrural–urbanlinkages,suchasprivatesector,andfarmerorganizationsoperatingimprovementofmarketinfrastructuretoimprovetheacrosstherural–urbancontinuum.TheFLAGspatialandfunctionalconnectionbetweenKisumuprovidesaspacetoenabledialogueamongandothercountiesandasawaytoreconnectruraldifferentactorsandidentifypriorityactionsproducerswithurbanconsumers.Thestrategyisintendedtopromotelocalfoodproductionandalsointheprocessofconsideringinclusivityamongprocessingaswellasemploymentopportunitiesitspriorities,particularlyinrelationtorecognizingandbusinessincubatorsforwomenandyouth.andformalizingwomenstreetfoodvendorsandThisgroupiscurrentlyintheprocessoffinalizingimprovingtheirbusinesses.integrationinthedecision-makingprocess.233municipalityandkeystakeholderstodesignHowever,ifformalized,itisimportantthatnewnewagrifoodinitiativesandadaptexistingformsofdemocraticgovernancedonotbecomepoliciesandstrategiesinconsiderationofyetanotherbureaucraticmechanism.Onthenewcircumstances;235todosorequiresthecontrary,theymustremainaplacewheremobilizationofhumanandfinancialresources.problemsareaddressedthroughparticipatoryFindinganinstitutional“home”tohostagrifoodmultistakeholderprocessesinaholisticway,systems-relatedmultistakeholderplatforms,andmeasuresareadoptedinawaythatusuallyintheformatofanagrifoodsystemsincludestheinterestsofmultiplestakeholders“unit”withinamunicipality,iskeytotheincludingthemostvulnerable.232sustainabilityoftheseinitiatives.236OnceanagrifoodsystemsgovernancemechanismAdedicatedbudgetisalsocrucialforsustaininghasbeenestablished,amajorcommonchallengecontinuity.Inmostcases,multistakeholderinlocalinstitutionsistoensureitscontinuity.platformshavelimitedpowertoinfluenceMonitoringandevaluation–butalsoadaptationbudgetallocationforagrifoodsystemsasnecessary–arerequiredforcontinuousinitiatives.Municipalitiesthemselveshavelearningoflocalinstitutionsandtoreportthereforeacriticalroletoplayinintegratingprogresstoawideraudience,whichcouldtheinitiativeofaninformalfoodgovernancepotentiallybringnewstakeholdersonboardplatformintothemunicipality’sregulatoryandprovideaccesstoadditionalfundingandframeworkandbudgetviaordinances,annualtechnicalresources.234budgetaryandprogrammeplanning,orothertypesofformaldecisions.DuetothediversityExperienceshowsthatagrifoodoforganizationalstructuresandpriorities,theregovernancemechanismssuchasfoodisnosinglemodelforsuccessfullysecuringpolicycouncilsperformbetteriftheyfunding.Andultimately,thereisnoguaranteeareinstitutionalizedwithinsubnationalthatagrifoodsystemsgovernancewillcontinuegovernments.Institutionalizationreferstoinperpetuity.However,institutionalizingtheformalizationofstructures,rulesandgovernanceprocessescanmakeitharderpracticesthatenableagrifoodinitiativestoforfutureadministrationstoerodeorendure.Itinvolvescreatingthepolicyanddismantlethem.237governanceinfrastructurethatwillallowa134THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023IntegratedlocalagrifoodsystemspoliciesGatheringevidenceisthefirstcrucialsteptoandplanningsupportthedevelopmentoflocalagrifoodsystemspoliciesandplanning.ThisprocesscanincludeaThedesignandimplementationoflocalagrifoodwiderangeofinstrumentsandtools:assessmentsystemspolicies,investmentsandlegislationforstudies,indicators,opendatabases,informationaddressingmultipleagrifoodsystemschallengessharingplatforms,etc.Multipletoolshavealreadyandopportunitiesrequireworkingoutsidethebeendevelopedthatcaninformpolicymakersmunicipaldepartmental“silos”andbridgingaboutagrifoodsystemsbottlenecks–i.e.pointsthegapsbetweendepartmentsandpolicyareasinthesystemsthatproduceconstraintsininordertoachievesystemicchanges.Untilnoweconomic,social,healthorenvironmentaltermshowever,mosturbanfoodpolicieshavetargeted–inordertoprioritizeinterventions,measurespecificsectorssuchasfoodproduction,foodprogressand,justasimportant,drawlessonsdistribution,wastemanagement,publichealthoronhowtoeffectivelyintegrateagrifoodsystemstheenvironment.238Intheprocessofintegratingintourbanandterritorialplanning.Developingfoodintourbanplanningandpolicy,holisticcomprehensiveagrifoodsystemsprofileswithoutfoodstrategies(connectingdifferentandrelevantlosingthesystemicviewremainsachallengeforsectoraldomains,municipaldepartmentsandurbanpolicymakers.disciplines)arejustemerging,settingtheoverallframeworkandagendawithinwhichtargetedTheRapidUrbanFoodSystemsAppraisalpoliciesandactionscanbeimplemented.239ToolisoneexampleofatoolsupportingFurthermore,localinstitutionscanalignagrifoodevidence-basedpolicymakingatlocallevels.bcItsystemsgoalswiththeirbroaderdevelopmentassistspolicymakersandotheragrifoodsystemsgoalsthroughdifferentplanninginstrumentsstakeholdersindevelopingpoliciesandstrategiessuchasordinances,by-laws,declarations,thatimprovefoodsecurityandnutritionofurbanresolutionsandcodes.dwellersandpromotesustainabledevelopmentofagrifoodsystems(seeBox17).Localagrifoodsystemspolicies,planningandstrategiesarequiteoftenintroducedAgrifoodsystemsanalysisisusuallythroughdynamicleadershipof“champions”incomplementedwithevidencegatheredthroughmunicipalitiesofcitiesofallsizes,insomecasesmultistakeholderengagement.Whiletheworkingincollaborationwithothergovernmentavailabilityofdisaggregateddataforthelocallevelsandwithnon-stateactorssuchaslevelmaybelimited,engagementwithlocalnon-governmentalorganizations,civilsocietyagrifoodsystemsstakeholderscangenerateorganizationsandacademicinstitutions.240,241,242deeperinsightsforidentifyingbottlenecksThehistoryoflocalagrifoodsystemsstrategiesbbandprioritizingaction.However,itshouldbeoverthepastdecadeshasdemonstratedhownotedthatpartnershipswithstakeholderswithitispossibletocreateaneffectiveenablingintereststhatruncountertoimprovinghumanenvironmentformainstreamingagrifoodandecosystemhealthcanresultindamageandsystemswithinthelocalagenda243andimprovemistrust.Newmodelsforprivate–publicsectorthelinkagebetweenruralandurbanareas.fundingwillberequiredtoavoidconflictsofSpecifically,thedevelopmentoflocalagrifoodinterestandensureimpartiality,accountabilitysystemspolicies,ordinancesandregulationsandtransparency.244Itisalwaysimportanttohasledtoscalingupofadhocinitiativesandsafeguardagainstconflictsofinterestinpolicyprojects,contributingtotheoverallagrifooddevelopmentanddecision-making–particularlysystemstransformationatthenationallevelwithwhenmultiplestakeholdersareinvolved–andclearmultistakeholderengagement(Box16).toolsareavailabletohelpcountriespreventandmanagesuchconflictsofinterest.245,246bbFoodstrategiescaninitiallybedevelopedasastrategicdeclarationorafoodcharter(includingstrategiclinesandcommunicativeinbcAgrifoodsystemsanalysisacrosstherural–urbancontinuumisnature).Theycanthenbefurtherdevelopedasanactionplan(includingalsoincludedinothertoolssuchastheCityRegionFoodSystemToolkit,operativecontentanddefinedinterventions)andcanbepoliticallyanonlinerepositoryofglobalresources.endorsedwithabudgetallocatedfortheirimplementation.242135CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX16LOCALAGRIFOODSYSTEMSSTRATEGIESLINKINGLARGEMETROPOLITANAREASWITHRURALHINTERLANDINANTANANARIVO,NAIROBIANDQUITOInMadagascar,theMunicipalityofAntananarivoonNairobiCityFoodSystemswasestablished(Analamangaregion),collaboratingwiththeMinistryincludingrepresentativesfromNairobiCityCountyofAgricultureandotherstakeholders,createdGovernmentandrepresentativesfromvariousastakeholderadvisorygroupthroughwhichtheministries(responsibleforfood,agriculture,health,AgrifoodSystemsResilienceStrategy2023–2028forenvironment,land,water,socialprotection,etc.).thecityofAntananarivoanditssurroundingregionAmultistakeholderfoodgovernancemechanism(foodwasdevelopedandvalidated.Thestrategypromotesliaisonadvisorygroup),whichincludesnon-statemultisectoral,multilevelandmultistakeholderactors,wasalsoestablishedandaimstoadvisecollaboration,recommendingcoherentandintegrateddecision-makersatalllevelsontheimplementationimplementationofpoliciesandprogrammessuchofthefoodstrategy.Agrifoodsystemsactionsacrossas:i)theIntegratedWaterResourceManagementthecontinuumwillbeensuredthroughthestrongprogrammeledbytheMinistryofWater,SanitationengagementoftheintercountycoordinationplatformandHygiene;ii)thenationalAgriculture,Livestockatthenationallevel.andFisheriesInvestmentsProgrammeledbytheMinistryofAgricultureandLivestock;andiii)theInEcuador,theMunicipalityoftheMetropolitanAnalamangaRegionalLand-UsePlan2023–2043.DistrictofQuitoendorsedtheQuitoAgri-foodTheimplementationofthesepoliciesandprogrammesStrategyin2019,allowingagrifoodsystemstoinAntananarivoanditssurroundingregionhasbeprogressivelyintegratedincityplanningtoolsthepotentialtoempowerlocalcommunitieswhilesuchastheQuitoResilienceStrategy,Vision2040,strengtheningresiliencetoshocks,improvingfoodtheClimateActionPlanandtheMetropolitandistribution,creatingemploymentopportunitiesandDevelopmentandLandManagementPlan(whichsupportingfoodsmallandmediumenterprises.recognizesfoodsecurityasthestrategicaxisofthecity’ssocioeconomicdevelopment).ThestrategyInKenya,theNairobiFoodSystemsStrategywasdevelopedincollaborationwithmultipleactorswasendorsedbyNairobiCityCountyandintegratedengagedintheagrifoodsystemsgovernanceintheNairobiCityCountyDevelopmentPlan.platform.Theplatformincludeslocal,provincialCurrentlyintheprocessofimplementation,thisandnationalgovernmentrepresentatives;socialfoodstrategyaimstoensureaffordable,accessible,movements;internationalcooperationactors;Unitednutritiousandsafefoodforall,usingamultisectoralNationsAgencies;academia;andtheprivatesectorapproachandworkingacrossalllevelsofgovernment.(mainlyagribusinessesaimingtoworkinbothurbanAnIntergovernmentalRelationsCommitteeandruralareas).Thepriorityareasidentifiedatthelocallocalpoliticalagenda.Urbanandperi-urbanleveltodevelopholisticfoodstrategiesandagriculturehasacloserelationshipwithurbanplanningusuallyincludeurbanandperi-urbanfoodgovernance,asitoftengoesbeyondagriculture;shortsupplychains;inclusiveagroecologicalproductionandsustainablefoodmarkets;healthierfoodoutletsandconsumptiontoincorporateotheraspectssuchstreetfood;publicfoodprocurement;sectoralassocialcohesion,economicdevelopmentplanningandprogrammingsuchasschoolandenvironmentalissues.Anothercommonfeedingprogrammes;inspectionoffoodoutlets;entrypointisschoolfeedingwhosepotentialplanningandzoningrulesonfoodoutletsforimprovingchildren’snutrition,dietaryand/ormarketing;andfoodwasteprevention,habitsandeducationalattainmentisinspiringreductionandmanagement.238,240,241Urbanandmanymunicipalities,evensmallerones,toperi-urbanagricultureinitiativeshavebeenoneaction.Schoolfeedingprogrammesarealsoofthecatalysingentrypointstoputfoodonthevaluedfortheirmultipliereffects.Theycan136THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX17THERAPIDURBANFOODSYSTEMSAPPRAISALTOOL:ONEPOSSIBLETOOLTOANALYSEAGRIFOODSYSTEMSACROSSTHERURAL–URBANCONTINUUMTheRapidUrbanFoodSystemsAppraisalToolcollectedfromlocalauthorities.Fromthesesources,(RUFSAT)aimstoassistpolicymakersandotherRUFSATidentifieschallengesandopportunitiesagrifoodsystemsstakeholderstodevelopandforplanningandtransformationofurbanagrifoodprioritizeevidence-basedpoliciesandstrategiessystems.Itreliesonfeedbackandtechnicaladvicethataddressbottlenecksconstrainingtheeconomic,fromafoodliaisonadvisorygroup–aworkinggroupsocialandenvironmentalperformanceofagrifoodofpolicymakersandsubjectmatterexpertscreatedsystems.Thisisachievedthroughfourinterlinkedthroughaconsultativeprocessatthecitylevelcomponents:i)stakeholdermapping;ii)valuechaindesignedtoprovideinputontheassessmentfindingsanalysis;iii)mappingoftheinstitutionalandpolicyaswellasguidanceonprioritizationofchallengesandenvironment;andiv)aconsumersurveythatincludesopportunitiesatthecitylevel.amappingofthefoodretailenvironment.RUFSATassessmentsprovideusefuldataandThesecomponentsareunderpinnedbygeospatialinformationforthedevelopmentoflocalagrifoodinformationsystemsthatbringalltheinformationsystemsstrategies,ordinancesandregulationsatrelatedtotheagrifoodsystemsandfoodconsumptionthelocallevel,andhavebeenusedinsomeofthepatternswithintheurbansettingontoacommonbasecasestudiesincludedinthischapter:theCONSIALmap.MapsandinformationinRUFSATcomprisetheexperienceinLima(Box14),theKisumuCountyuseofsatelliteimagery,mobileappsforfieldsurveys,initiative(Box15)andtheNairobiFoodSystemsinformationavailableinthepublicdomain,anddataStrategy(Box16).BOX18STRENGTHENINGMULTILEVELINSTITUTIONALAGREEMENTSTHROUGHPUBLICFOODPROCUREMENTINMANABÍPROVINCE,ECUADORIntheframeworkoftheEcuadorianFoodGuidelines,farmerslocatedintheruralmunicipalitiesofChonetheProvincialGovernmentofManabítogetherwithandSantaAna.TheprovincialgovernmentfinancedthemunicipalitiesofPortoviejo,ChoneandSantathepurchaseandcarriedouttheprocurementAna,andincoordinationwiththeEcuadorianMinistrythroughthepublicportal,EPManabíProduce.ofEducation,establishedafoodprocurementschemeThankstotheinitiative,nearly43000childrenfromtodistributefruitstochildrenaspartoftheirschool95schoolsinPortoviejoreceived,onadailybasis,meal.Thisinitiativeaimedatprovidingaccesstoakitcomprisingninefreshfruititems(mandarinshealthydietsforManabístudents,whilepromotingandoranges).Thisinitiativehasbeencrucialforincomeopportunitiesforfarmers.ThefirstdeliveriesfosteringmultilevelagrifoodsystemsgovernancetoschoolsinPortoviejo,theprovincialcapital,startedandinterinstitutionalcoordinationacrossnational,inOctober2021withlocalfreshfruitsfromfamilyprovincialandmunicipallevels.137CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>bedesignedtosupportlocalagriculture,localAfricangovernmentsstillhavelowstrengthenanddiversifylocalagrifoodsystems,administrativeandfiscalcapacity;consequently,andimproveeconomicandsocialdevelopmentinsomecasesstrategicplansarenotimplementedthroughpublicprocurementmechanismsduetolackoffunding.Linkingfoodpoliciesandfocusedonlocalsmallholderfarmersandstrategiestothefiscaldecision-makingprocessissustainableproduction(Box18).Thesamethereforeindispensable.249principlescanbeextendedtofoodprocurementandservicepoliciesforotherlocallyrunDuetothemultisectoralandmultilevelnatureofinstitutionsorservices.247agrifoodsystems,fundingtoimplementthekeyactivitiesofafoodstrategyand/oractionplanFoodwasteandcirculareconomyinitiativescancomefromavarietyofsources:municipal,areanothercommonentrypointforinitiatingprovincial,national,andevennon-stateactorsfoodplanningandpolicyprocesses.Foodsuchasnon-governmentalorganizationsandwastecanbeconvertedtocompostorusedinternationalpartners.Mobilizationofinternaltoproducebiogas,therebyavoidingharmfulandexternalresourcesforeffectivepublicmethaneemissionswhilealsocreatingandprivatefinancingiscrucial,bothintermsemploymentopportunities;fishoffalandwasteofsupportingtheactionsofauthoritiesatallcanalsobeusedtoproducefishsilagewhichlevelsandcreatingincentivestoattractprivateservesasfishmealinanimalfeed.However,capitaltowardsfinanciallyviableinvestmentthisrequiresmunicipalorganicwastetobeopportunities.236,238,240properlymanagednotonlyatthehouseholdlevel,butalsoinfoodretailingoutlets.LocalPolicycoherenceatnationalandsubnationalinstitutionsplayacriticalroleincreatinganlevelsremainsakeychallengeinestablishingenablingenvironmenttoreducefoodwastetheappropriateenablingenvironment.andadoptwastemanagementpractices.ForNationalandregionalgovernmentsusuallyexample,inBangladesh,municipalfoodhavethemandateandresourcestoinvestinwasteinKhulnacityisbeingusedtomeettheinfrastructuredevelopmentforwell-connectedhighdemandfororganiccompostfertilizerruralandurbanareas,andhaveaccesstointheagroforestrysector;buttheprocesspolicyinstrumentsdealingwiththerolehasrequiredsupportfromlocalinstitutionsoftheprivatesectorinagrifoodsystemstoproducecompostatasuitablelevel.Intransformation.250Asmentionedearlierinrelationtofoodwastemanagement,prioritythisChapter5,investmentsingeneralservicesisalsogiventoprevention,recoveryandsupportinSICTscouldscaleupprivateredistributionforhumanconsumption–ainvestmentsandtakeadvantageofthecloserprocessrequiringahighlevelofengagementspatialandfunctionallinksthaturbanizationoflocalgovernments.248Furthermore,iniscreatingacrosstherural–urbancontinuum.Kigali,Rwanda,athematicmultistakeholderTherefore,thesepoliciesandinvestmentswilltaskforceonfoodwastemanagementhasrequirestrongmultilevelgovernanceacrossbeencreatedaspartofthebroaderagrifoodnationalandregionalagrifoodsystemspoliciessystemsstakeholderadvisorygroupaddressinginordertopromotethenecessarystructuralissuesrelatedtoprevention,recovery,transformationofagrifoodsystems.Inorderredistributionandthecirculareconomy.ThetoaddressaspecificissuesystemicallyandKigaliMunicipalityhasassumedleadershipencourageagrifoodsystemstransformation,oftheplatformtostrengthenthespatialandcoordinatedactionsacrosshorizontalandfunctionalagrifoodsystemslinkagesacrosstheverticaldimensionsofgovernanceareneeded.rural–urbancontinuuminRwanda.Horizontalgovernancereferstothecoordinationand/orintegrationamongsectoralinstitutionsThedegreeofdecentralizationindifferent(e.g.relatedtotrade,agriculture,healthandcontextsandtheleveloftechnicalcapacitycanplanning)and/orwithnon-governmentallimittheeffectivenessofsuchlocalpoliciesactorssuchasresearchinstitutions,civilandstrategies.Forexample,despitemajorsocietyorganizations,representativesofthedecentralizationeffortsinrecentdecades,privatesector,andfinancialinstitutions.138THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023BOX19THEMULTISTAKEHOLDERPARTICIPATORYPROCESSFORESTABLISHINGMULTILEVELINSTITUTIONALAGREEMENTSFORFOODSECURITYANDNUTRITIONINWESTERNCAPEPROVINCE,SOUTHAFRICAIn2016,theWesternCapeProvincialGovernmentareassumedtoholdnofoodornutritionmandateofSouthAfricapublishedafoodsecurityand(e.g.departmentsofspatialplanning,education,nutritionstrategy,NourishtoFlourish,whichofferseconomicdevelopmentandenvironment),whileinsightsintointegrated,transversalandmultilevelsupportingexistingprogrammeswithintheagrifoodsystemsgovernance.Thestrategyisfoodsecurityrealm.Avoidingtraditionalpolicyco-ledbytheDepartmentoftheProvincialPremierformulationprocesses,thestrategyretainsanandtheProvincialDepartmentofAgriculture.open-endedgovernanceapproach,wheretheInformedbythemandatesoftheseprovincialleadgovernmentofficialscontinuallyinnovateco-leads,thescopeofthestrategyspanstheandadaptinresponsetoevolvinglessonslearnedrural–urbancontinuumincludingruralareas,andimplementationfeedback.Currently,asthesmalltownsandlargecities,aswellasagrifoodpost-2023SouthAfricaNationalFoodandNutritionsystemsthatflowintotheprovincialsystem.SecurityPlanisbeingdrafted,theMinistryoftheThedevelopmentandimplementationofthePresidentisexploringhowthenationalgovernmentstrategywasfoundedonawide-ranging,innovativecansupportthisstrategyoftheWesternCapeconsultationandcurationprocess,whichbroughtProvincialGovernment,andalsohowsuchtogethermultipleactorsincludingoftenunheardstrategiescanbeappliedinotherregionsandwhatvoicestoimproveagrifoodsystems.Thestrategykindofmechanismscanbecreatedtobridgetheengagesmultiplegovernmentunits,manyofwhomnational–localgovernancegap.Forexample,asagrifoodsystemsusuallythecaseoftheCataloniaRegion,Spain(Box20).fallunderthemandateofmultipleagencies,Moreover,processesofmultilevelagrifoodtoimprovenationalcoordinationamongsystemsgovernanceaddressingspecificentrythem,countriesarecreatinginterministerialpointshavebeeninitiatedinsomecountries.committeesorsimilarmechanismstomanageForexample,Denmarkhasstartedtheprocessdecentralizationprocessesandimplementofmultilevelagrifoodsystemsgovernanceusingagroterritorialinitiatives.Ontheotherhand,publicprocurementasanentrypoint(Box21).verticalormultilevelgovernanceconcernstheTheestablishmentofnationalnetworksthatdistributionofpower,policymakingcapacityengagevariouslevelsofgovernmentappearstoandresponsibilityacrosssupranational,beanimportantstartingpointtoinitiatesuchnational,regionalandlocalgovernmentmultilevelgovernancemechanisms.levels.243,251MultilevelgovernancemeansoperatingandcoordinatingbetweenandacrossKenyahasstartedtheprocessofpromotingthetwoaxesandcreatingcohesionacrossmultilevelagrifoodsystemsgovernanceusingtherural–urbancontinuum,empoweringurbanandperi-urbanagricultureasanentryalllevelsofgovernmenttotakesharedpoint.Since2011,theUrbanAreasandCitiesownership252,253(seeBox19).ActinKenyahasrequiredcountiestoregulateurbanandperi-urbanagriculture.However,ConducivepolicyframeworksformultilevelalthoughasmallnumberofcountiesinKenyagovernancearestillnotcommon,althoughtheyhavedeveloped(orareintheprocessofdoexistinahandfulofcountries.Aregionaldeveloping)holisticfoodstrategies,theshiftperspectiveofagrifoodsystemsgovernancefromsectoraltosystemicfortheestablishmentcanbecomeanopportunityforinitiatingtheofmultilevelgovernanceisstillattheearlyprocessofestablishingmultilevelagrifoodstagewithonlyinitialdiscussionsbetweensystemsgovernancemechanisms,suchasinnationalandlocalgovernmentsunderway.139CHAPTER5POLICIESANDSOLUTIONSTOLEVERAGEAGRIFOODSYSTEMSTRANSFORMATION<...>BOX20THEREGIONALSTRATEGICFOODPLANFORCATALONIA2021–2026ANDTHECATALANFOODCOUNCIL,SPAINTheregionalStrategicFoodPlanforCatalonia,Spainindustry,fooddistributors,restaurantsandcatering,2021–2026(Planestratégicodelaalimentaciónderesearchinstitutionsanduniversities,andlocal,Cataluña2021–2026–PEAC)hasbeenpromotedregionalandnationalagenciesoperatinginthebytheregionalDepartmentofClimateAction,Foodfood-relatedsector.andRuralAgendaofCatalonia,Spain.ThePEACisaregionalinterdepartamentalandintersectoralTheCatalanFoodCouncil(ConsejoCatalándelatoolthatdefinesthevision,objectivesandpriorityAlimentación),attachedtotheregionalDepartmentofinitiativesandestablishestheBasesforconstitutingClimateAction,FoodandRuralAgendaofCatalonia,theNationalAgreementfortheenergytransitionofSpainisthedrivingforceofthePEACandactsasaCataloniawhichwillservetoguidefutureregionalforumforanalysis,debateandproposalonissuespublicagrifoodsystemspolicies.ThePEACistherelatedtoCatalonianregionalagrifoodpolicies.resultofaparticipatoryprocesslastingmorethanItalsoactsasanagrifoodsystemsobservatoryforayearandinvolvingactorsoftheregionalagrifoodpolicyrecommendations,andismadeupofabroadsystems,includingprimaryproducers,thefoodrepresentationofassociationsandentitiesrelatedtoagrifoodsystemsinCatalonia,Spain.BOX21MULTILEVELPUBLICFOODPROCUREMENTNETWORKINDENMARK:NATIONAL,REGIONALANDLOCALGOVERNMENTSWORKINGTOGETHERTOINITIATETHEPROCESSOFESTABLISHINGMULTILEVELAGRIFOODSYSTEMSGOVERNANCEPublicfoodprocurementisanimportantmechanismengagestheministry,mayorsand44national,forstrengtheningagrifoodsystemslinkagesacrossregionalandlocalofficials,andisanimportanttherural–urbancontinuum,thuscatalysingsteptowardstheestablishmentofmultilevelnoticeablechangesinprimaryproduction,dietaryagrifoodsystemsgovernance.Thenetworkhaspatternsandfoodeducation.In2018,duringthebeencreatedbecauseoftheneedforcloserandpreparationofgreenpublicprocurementguidelinessystemiccollaborationbetweenthestateandthecityforfoodtendersinDenmark,theNationalFoodlevelofgovernmentregardingtheimplementationProcurementNetwork(NationaleUdbudsjuridiskeofstate-levelrulesandregulations.WithoutthisFødevarenetværk)–amultilevelfoodprocurementcollaboration,thedecisionsmadeatthestatelevelnetworkforpublicsectorofficials–wasformallymayproveunfeasibleatthelocallevel.BuildingonestablishedbytheDanishMinistryofEnvironment,theDanishprocurementnetwork,anotherpublictogetherwiththechiefprocurementlawyerofthefoodprocurementnetworkhasbeenestablishedatCityofCopenhagen,toconnectthedifferentlevelstheEuropeanandgloballevelstoshareexperienceofgovernmentandstrengthentheeffectivenessofandinitiatetheprocessofstrengtheningmultilevelpublicfoodprocurement.Thisformalcollaborationgovernanceatalllevels.140THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023InIndonesia,aftertheUnitedNationsFoodundoubtedlystimulatepolicydevelopmentSystemsSummit,thenationalgovernmentacrosstherural–urbancontinuum.However,committedtopromotingtheagrifoodsystemsthereisariskthatthevariouslocalitiesfeelapproachatalllevels.Currently,thenational,obligedtoaddressnationalprioritiesratherprovincialanddistrict/citylevelsareeachthanrespondtodifferentlocalpriorities.254requiredtodevelopafoodsecurityandNonetheless,effectiveinstitutionalmechanismsnutritionactionplaneveryfiveyears.Inacrossgovernmentlevels,inwhichthevoiceofVietNamontheotherhand,citieshavethesubnationalgovernmentsinformthenationalmandatetodevelopthenationalagrifoodpolicyagenda,cancreatebridgesacrosssystemsactionplan.Theaboveframeworksgeographiesandenhanceaccountability.n141BANGLADESHHarvestingtomatoesinasmallurbangardeninDhaka.©FAO/SaikatMojumderCHAPTER6CONCLUSIONThis2023editionofTheStateofFoodotherSDGtargets.ThereporthasrepeatedlySecurityandNutritionintheWorldhighlightedthattheintensificationandhasprovidedanupdateonglobalinteractionofconflict,climateextremesandprogresstowardsthetargetsofendingbotheconomicslowdownsanddownturns,combinedhunger(SDGTarget2.1)andallformsofwithhighlyunaffordablenutritiousfoodsmalnutrition(SDGTarget2.2).Hungerattheandgrowinginequality,arepushingusoffgloballeveldidnotworsenbetween2021andtracktomeettheSDG2targets.Whilepolicy2022,buttherearemanyplacesintheworldrecommendationshavebeenofferedtobuildwherehungerisontherise–wherepeopleareresilienceagainsttheseadversities,thisyearstillstrugglingtorecoverincomelossesinthethereportunderscorestheimportanceofalsowakeoftheCOVID-19pandemic,orhavebeenconsideringotherimportantmegatrends.hitbyrisingpricesoffood,agriculturalinputsandenergy,orwhoselivesandlivelihoodshaveUrbanizationhasfeaturedasthethemeofbeendisruptedbyconflictsorextremeweatherthisyear’sreport.Withalmostsevenintenevents.Progressonimportantindicatorsofchildpeopleprojectedtoliveincitiesby2050,thisnutritionistobecelebrated,andsomeregionsmegatrendisshapingagrifoodsystemsand,asaareontracktoachievesomeofthenutritionconsequence,theircapacitytodeliveraffordabletargetsby2030.However,risingoverweighthealthydietsforallandtohelperadicatehunger,amongchildrenunderfiveyearsofageinfoodinsecurityandmalnutrition.UrbanizationmanycountriesportendsgrowingburdensofalsohasrelevanceforSDG11(Sustainablenon-communicablediseases.CitiesandCommunities),SDG1(NoPoverty),SDG2(GoodHealthandWell-Being),SDG10The2030AgendaforSustainableDevelopment(ReducedInequalities)andSDG12(Responsibleisavisionofahealthier,morejustandequalConsumptionandProduction).Therefore,theworld–aworldwithoutpoverty,hungerandfindingsandpolicyrecommendationsfrommalnutrition.Whilethesegoalsmayseemoutanalysingurbanizationinthisreportcaninformofreach,thelackofanincreaseinhungermayeffortsofthe2030AgendaforSustainablesignalthebeginningofaturnaround,andanyDevelopment,aswellasotherongoingefforts,improvementinthenutritionofchildrenbodesincludingthoseintheframeworkoftheUnitedwellforthefuture.AchievingfoodsecurityNationsGeneralAssembly-endorsedNewUrbanandnutritiongoalsisnotonlygoodforthoseAgendaandthecoalitionsofactionestablishedsufferingfromfoodinsecurityandmalnutrition,aftertheUnitedNationsFoodSystemsSummit.itisgoodforeveryone.Ahealthier,morejustandequalworldisbetterforall.AkeyconclusionisthatthewaysinwhichurbanizationisshapingagrifoodsystemscanonlySinceits2017edition,thisreporthasofferedanbeunderstoodwitharural–urbancontinuumin-depththematicanalysisoftheunderlyinglens;thesimpleconceptofarural–urbandividecausesanddriversofobservedfoodinsecurityisnolongerusefultounderstandthegrowingandmalnutritiontrendsandhowfoodsecuritylinksacrossurban,peri-urbanandruralareas.andnutritionSDG2targetsarerelatedtoThisgrowingconnectivityacrosstherural–urban143CHAPTER6CONCLUSIONFIGURE37CHALLENGESANDOPPORTUNITIESFORAGRIFOODSYSTEMSARISINGFROMURBANIZATION,MAPPEDONTOPOLICIESACROSSTHERURAL–URBANCONTINUUMTECHNOLOGYANDINNOVATION/GOVERNANCEANDINSTITUTIONSConsumerADPromotehealthierfoodenvironmentsthroughmarketingbehaviour1235regulation,nutritionlabellingandnutritioneducationMidstreamanddownstreamAReducethedemandforenergy-densefoodshighinfoodsupplychains125fats,sugarsand/orsaltusingtaxesandﬁscalpoliciesAD1235Promotehealthyfoodoutlets,safeandnutritiousstreetfoodsandterritorialfoodmarketsBC146SupportpoorhouseholdsthroughcashtransfersandincomeopportunitiesABCSupportthedevelopmentofagrifoodsmallandmediumenterprises,46throughenhancedcapacitiesandimprovedaccesstopublicgoodsProductionACSupportsmallholderproducerstoincreaseCSupporturbanandperi-urbanfoodproducers147productionofnutritiousfoods1467andintegratetheminterritorialplanningRURALURBANOPPORTUNITIESCHALLENGESAWidespreaddiusionBMoreo-farm1Highcostofnutritious2Increaseddemandand3Fooddeserts4Lossofincomeoffoodpurchasesinemploymentopportunitiesfoodsrelativetosupplyofconvenience,andswampsopportunitiesruralareasenergy-densefoodspre-prepared,ready-to-eatforsmallholderandfastfoodsfarmersCBetterincomeDMorediversiﬁeddiets5Expansionofsupermarkets6Threatsto(peri-)urban7InsucientproductionopportunitiesforfarmersandhypermarketsagriculturallivelihoodsandhighpricesofwellconnectedtocitiessupplyingcheaphighlyfruitsandvegetablesprocessedfoodsNOTES:Theblueboxesindicatepoliciestoleverageagrifoodsystemstransformationforhealthydietsacrosstherural–urbancontinuum,discussedinChapter5.ThegreenandorangeboxesindicateopportunitiesandchallengestoaccessaffordablehealthydietsidentifiedinChapter3.Policyadequacyforleveragingandaddressingspecificopportunitiesandchallengesisindicatedwithlettersandnumbers,respectively.SOURCE:Authors’(FAO)ownelaboration.continuumisakeyaspecttodaytounderstandfundamentalactorsinleveragingmultilevelandthefunctioningofvaluechains.Onlythenmultistakeholdermechanismsthat,asshownwithcanthechallengesandtheopportunitiesthatconcreteexamplesinthisreport,haveprovedurbanizationcreatesforagrifoodsystemseffectiveinimplementingessentialpoliciesandbeclearlymappedontoappropriatepolicy,solutionsformakinghealthydietsavailableandtechnologyandinvestmentsolutions,asshownaffordableforall.inFigure37.ImplementingthesesolutionsrequiresthatagrifoodsystemsgovernancemechanismsNewempiricalevidencepresentedinthisreportforandinstitutionscrosssectoralandadministrative11Western,EasternandSouthernAfricancountriesboundariesandrelyonsubnationalandlocalalsochallengestraditionalthinkingandrevealsgovernments.Localgovernmentsinparticularareimportantfoodconsumptionpatterns,including144THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023dietaryconvergenceacrosstherural–urbanofhealthydiets,andfoodinsecurityandcontinuum.Forexample,itcallsintoquestionthemalnutritionacrosstherural–urbancontinuumtraditionalnotionthatAfrica’sruralfarmerslargelycannotcurrentlybereplicatedformoreproducetheirownfood.Theaffordabilityofacountriesandregionsoftheworld,andthathealthydietisactuallyfoundtobeacriticalissuerenewedeffortsinfoodsecurityandnutritionforruralhouseholdsinthesecountriesbecausedatacollectionandanalysisareneeded.Thetheyaremore–nottosaythemost–reliantonfoodanalysishasreliedonthenewlyavailableURCApurchases.Thenewevidencealsorunscounterglobaldataset,whichprovidesageoreferencedtoconventionalthinkingthatpurchasepatternsmappingofthespatialandfunctionalbetweenurbanandruralareasdiffermarkedly,atconnectivityacrossurban,peri-urbanandruralleastforsomefoodgroups.areas,usinglatitudinalandlongitudinaldataofhouseholdsfromthemostrecenthouseholdInthesecountries,thediffusionofprocessedsurveys.Thiscombinationhasmadeitpossiblefoods,includinghighlyprocessedfoods,toworkwithdifferentcategoriesofcatchmentassociatedwithurbanareasisnowseeninareasdefinedacrosstherural–urbancontinuumruralareasaswell.Unfortunately,low-incomeforthesaid11Africancountries.Unfortunately,householdslivinginperi-urbanandruralareasingeoreferencednationallyrepresentativethesecountrieswouldneedtomorethandoublehouseholdsurveydataarecurrentlyonlywhattheyspendonfoodtosecureahealthyavailableforahandfulofdatasetswhichhavediet.Moreover,foodinsecurityisnolongeralatitudeandlongitudeinformationthatispredominantlyruralproblem,aslevelsofbothpubliclyavailable,andallofthemareforAfrica.severeandmoderateorseverefoodinsecurityItistheninthebestinterestofgovernmentsacrossurbanareas(large,intermediateandsmallofothercountriesandregionsthatsuchdatacitiesandtowns)andperi-urbanareas(lessthanbecomeavailableforpublicuse,or,ifthe1hourtraveltolarge,intermediateandsmalldataarelacking,thatgovernmentsinvestincities)werefoundtobesimilartoorevenhigherdatadevelopmenttobridgethisimportantthanthoseinruralareasinsomeofthecountriesgap.Onlythenwilldecision-makersofthoseanalysed.Theprevalenceofstunting,wastingcountriesandregionsbeabletorelyonanandoverweightinchildrenunderfiveyearsofanalysis,similartothatpresentedinthisreport,agecanalsoshowimportantvariationsacrossthetoinformtheirpoliciesandinvestmentsinrural–urbancontinuum.waysthatleverageurbanizationtoaccelerateagrifoodsystemstransformationinthequesttoUnfortunately,wehavelearnedthroughthissecureaffordablehealthydiets,foodsecurityreportthatsuchvaluablegranularanalysisandadequatenutritionforallacrosstheoffoodconsumptionpatterns,affordabilityrural–urbancontinuum.n145MEXICOAwomanmakestortillasinherhomeinthevillageofSanLorenzo.©AlexWebb/MagnumPhotosforFAOANNEXESANNEX1AANNEX7StatisticaltablestoChapter2148SupplementaryresultsfromSection4.1228ANNEX1BMethodologicalnotesforthefoodsecurityANNEX8andnutritionindicatorsMethodologyusedforthesubnationalANNEX2MethodologiesusedinChapter2180estimationofcostandaffordabilityofANNEX3ahealthydietusinghouseholdsurveydataUpdateddataseriesofthecostandaffordabilityofahealthydiet,2017–2021forselectedcountriesinAfricainChapter4235ANNEX4194DataanddefinitionsforChapter3ANNEX9ANNEX5DataanddefinitionsforChapter4SubnationalcostandaffordabilityofANNEX6ahealthydietbyurban–ruralcatchmentUrban–ruralcatchmentareamapsshowingpatternsofurbanization206areainselectedcountriesinAfrica237forcountriesanalysedinChapter4ANNEX10213Foodinsecurityandmalnutritionacrosstherural–urbancontinuum(URCA)forselectedcountriesinAfrica241215ANNEX11Glossary244222147ANNEX1ASTATISTICALTABLESTOCHAPTER2TABLEA1.1PROGRESSTOWARDSTHESUSTAINABLEDEVELOPMENTGOALSANDGLOBALNUTRITIONTARGETS:PREVALENCEOFUNDERNOURISHMENT,MODERATEORSEVEREFOODINSECURITY,SELECTEDFORMSOFMALNUTRITION,EXCLUSIVEBREASTFEEDINGANDLOWBIRTHWEIGHTREGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT1482004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)6.826.322.35.55.611.813.128.529.937.047.715.014.77.038.732.33.13.24.96.039.139.416.115.3WORLD12.09.27.811.321.929.545.553.54.135.828.34.23.78.39.432.032.915.214.7Leastdeveloped25.321.719.824.250.459.3countries4.121.321.16.88.018.820.928.229.214.014.4Landlocked24.619.316.423.044.856.26.639.633.53.83.46.06.938.338.545.353.315.314.8developing9.735.528.14.34.57.08.241.742.120.018.5countries1.710.18.08.811.513.217.618.10.48.37.47.622.324.313.114.47.68.1SmallIsland17.515.321.520.445.546.84.04.037.042.98.08.1Developingn.a.4.03.77.18.237.837.7States36.830.514.614.0Low-income26.927.922.528.055.665.743.053.3countries39.951.828.835.8Lower-middle-18.213.510.916.227.639.6incomecountriesn.a.n.a.Upper-middle-6.9<2.53.04.612.716.2incomecountriesHigh-income<2.5<2.51.51.68.37.6countriesLow-income27.024.920.626.151.862.741.051.8food-deficitcountriesTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)5.834.430.05.04.911.512.839.238.935.444.314.513.96.323.521.711.812.323.025.231.931.140.8n.a.14.014.1AFRICA19.519.317.823.446.658.92.712.18.613.511.924.727.432.933.325.428.66.97.2NorthernAfrican.a.24.620.415.718.829.332.031.028.352.8n.a.n.a.n.a.Algeria6.16.89.810.928.632.2n.a.30.052.226.428.730.032.528.629.9n.a.n.a.n.a.n.a.Egypt2.3h15.812.89.54.923.426.129.829.927.835.016.114.8Libya6.7<2.513.05.622.919.4n.a.36.036.02.42.7n.a.n.a.36.836.541.0n.a.n.a.n.a.Morocco2.18.88.612.719.024.626.930.432.18.513.58.18.2Sudan6.47.28.48.827.828.5Tunisian.a.n.a.n.a.n.a.n.a.26.829.5n.a.n.a.n.a.n.a.NorthernAfrica4.78.411.221.229.139.8(excluding5.736.231.33.83.78.09.241.240.714.513.9149Sudan)5.56.3n.r.n.r.n.r.n.r.Sub-Saharan5.038.630.63.93.65.36.431.431.914.714.0Africa–11.913.4b18.1c41.4b51.8c4.9h56.556.52.23.64.45.431.138.515.114.8EasternAfrican.a.31.918.811.57.76.77.832.833.824.123.0Burundi4.33.09.112.618.228.510.6h29.618.71.33.212.313.531.032.3Comorosn.a.51.650.21.93.04.15.036.237.0n.a.n.a.Djibouti6.15.79.19.326.128.06.842.134.42.52.73.64.522.423.940.7n.a.15.415.2Eritrea4.928.618.44.63.85.97.128.428.7Ethiopia22.922.119.626.250.864.97.247.338.61.81.54.35.337.537.834.445.1n.a.n.a.Kenya2.643.634.04.93.94.85.830.631.410.810.0Madagascar32.728.423.228.159.067.5n.a.7.8f6.8f9.610.819.223.548.659.119.518.7Malawin.a.n.a.n.r.n.r.n.r.n.r.3.99.0f8.6f5.55.56.17.248.847.969.371.915.815.6Mauritiusn.a.n.a.42.636.411.419.118.7Mozambique16.813.5n.a.27.4n.a.79.712.4n.a.18.117.830.216.8n.a.16.5n.a.49.268.7n.a.52.0n.a.n.a.n.a.14.5n.a.56.2n.a.31.958.837.121.915.0b,c21.150.7b,c58.141.9n.a.28.427.828.0c72.3c70.854.433.751.0n.a.12.2n.a.64.964.121.917.847.7b,c52.2b,c78.1b,c82.4b,cn.a.n.a.10.513.032.040.0n.a.5.16.85.239.675.433.830.5n.a.n.a.TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)1.141.229.86.34.74.75.818.317.283.880.99.39.4n.a.7.97.29.99.112.414.023.525.1n.a.n.a.12.312.5Rwanda34.331.6n.r.n.r.n.r.n.r.n.a.27.618.03.02.77.08.344.043.15.333.7n.a.n.a.n.a.30.827.96.34.7n.a.n.a.34.735.644.5n.a.n.a.n.a.Seychelles2.64.33.2b3.3c14.3b14.7c3.633.323.43.93.54.35.331.332.862.265.5n.a.n.a.3.338.130.64.54.66.98.440.338.910.59.7Somalia70.448.7n.a.43.4n.a.79.54.240.831.46.05.46.88.130.531.548.757.812.011.22.931.121.64.62.714.315.530.028.912.211.8SouthSudan–21.4n.a.63.2bn.a.87.3b5.637.937.44.54.66.77.946.143.259.969.912.812.2n.a.31.843.63.03.96.88.245.944.531.341.915.715.5Uganda16.931.621.5c24.9c66.3c74.2c4.332.126.97.110.59.811.441.240.628.444.412.912.5UnitedRepublic5.440.639.83.52.66.47.547.946.837.415.916.4150ofTanzania28.123.520.6c26.3c48.9c58.7c8.3h38.932.32.53.25.16.149.245.4n.a.39.4n.a.n.a.Zambian.a.23.116.55.14.58.39.653.148.819.911.611.951.429.822.4c32.1c51.2c73.1c36.2Zimbabwe30.038.435.528.664.773.66.442.740.34.63.75.66.746.442.433.011.010.231.928.437.774.716.2MiddleAfrica52.621.6n.a.31.2b,cn.a.78.5b,cn.a.25.016.18.58.26.88.047.444.53.2n.a.n.a.n.a.15.821.026.766.558.53.417.213.46.25.413.515.055.352.420.214.914.6Angola6.422.349.94.118.810.02.54.710.712.445.744.210.611.1Cameroon38.948.7n.a.61.8n.a.81.3CentralAfricanRepublic38.131.4n.r.n.r.n.r.n.r.Chad34.533.342.658.882.088.2Congo28.435.3n.a.40.7n.a.76.636.453.6DemocraticRepublicofn.a.n.a.n.a.n.a.n.a.n.a.7.4n.a.theCongo14.423.05.1n.a.Equatorial10.313.1n.r.n.r.n.r.n.r.50.363.1GuineaGabonn.a.14.1n.a.54.6SaoTomeandPrincipeTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)3.523.422.812.311.425.027.128.530.3n.a.32.816.416.4n.a.24.621.610.410.117.518.931.332.520.330.017.316.8SouthernAfrica5.210.29.011.521.725.1n.a.28.021.210.17.914.916.530.030.743.8n.a.10.610.2Botswana2.137.531.87.06.914.916.628.327.952.959.014.814.4Eswatini22.922.918.4c26.7b,c46.5c56.3b,cn.a.24.016.84.25.315.117.224.725.222.1n.a.15.915.6Lesotho3.8h22.522.813.112.126.128.328.630.5n.a.31.616.616.6Namibia9.611.6n.a.18.3n.a.67.06.734.530.02.32.47.48.952.951.822.135.114.914.3SouthAfrica5.033.930.41.62.28.29.655.555.232.541.417.516.4WesternAfrica13.946.0n.a.32.9cn.a.56.7c10.633.321.81.82.04.55.653.352.538.257.919.118.5Beninn.a.12.6f9.4fn.a.n.a.10.311.826.924.359.641.8n.a.n.a.BurkinaFaso20.317.128.8c33.0c53.2c57.7c8.429.620.22.62.68.710.352.250.911.834.019.118.3CaboVerde5.122.313.61.91.88.710.356.449.533.253.613.713.2151Côted'Ivoire3.47.9n.a.9.0cn.a.20.3c6.822.012.72.31.99.410.944.235.445.742.914.914.4Gambia9.233.727.94.45.66.47.750.948.020.433.4n.a.n.a.Ghana12.114.311.621.240.164.15.129.327.72.83.37.99.549.948.138.359.321.819.5Guinea3.435.026.63.35.38.69.943.642.627.855.219.719.9Guinea-Bissau12.09.910.4c15.3c55.0c73.6c10.630.723.81.62.07.28.658.259.020.247.7n.a.n.a.Liberia13.6h26.022.11.92.011.012.745.143.326.740.9n.a.n.a.Mali17.816.210.0b,c21.241.8b,c56.910.946.647.41.12.74.55.549.149.523.325.6n.a.n.a.Mauritania6.537.734.22.52.27.48.954.955.114.728.7n.a.n.a.Niger11.218.2n.a.6.3bn.a.37.0b8.118.517.01.53.47.68.855.952.739.040.819.117.2Nigeria6.334.926.03.35.27.48.747.948.431.250.911.410.3Senegal16.97.76.2c9.7c34.1c44.2c5.727.322.31.62.27.18.447.445.762.164.315.114.3SierraLeoneTogo21.519.6n.a.27.0n.a.60.711.14.95.1b,c6.2c38.3b,c39.4c14.912.944.349.572.573.116.437.9n.a.32.0cn.a.77.8c33.538.438.637.579.781.213.612.8n.r.n.r.n.r.n.r.9.18.74.6c9.5b,c26.3c53.7b,c19.116.1n.a.30.5cn.a.71.4c7.015.911.0b,c21.3b,c34.7b,c69.7b,c18.15.77.5c11.1c39.0c49.8c46.527.826.7b,c31.975.8b,c89.228.317.416.1c19.4c60.4c62.9cTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.n.a.n.a.n.a.n.a.7.78.9n.a.n.a.n.a.n.a.Sub-Saharan22.021.719.425.950.564.434.645.1Africa(including13.68.66.79.917.724.89.328.222.34.85.16.17.331.132.717.217.2Sudan)2.114.77.78.25.015.617.728.828.139.051.56.36.0n.a.11.04.912.17.719.021.027.328.729.244.95.75.3ASIA2.016.07.96.414.416.634.135.831.837.86.46.05.625.710.35.43.012.214.231.035.256.045.69.38.7CentralAsia14.03.21.74.89.218.44.112.513.15.43.616.318.625.326.632.635.84.94.32.413.27.74.214.416.628.724.810.956.55.85.8Kazakhstan7.2<2.5n.a.0.5bn.a.2.4b1.56.76.68.315.516.123.849.55.55.51.97.76.97.08.94.96.014.815.528.435.35.15.0152Kyrgyzstan8.04.8n.a.1.1cn.a.6.9cn.a.7.64.9n.a.n.a.5.06.227.634.1n.a.n.a.n.a.n.a.4.6n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Tajikistan37.69.3n.r.n.r.n.r.n.r.n.a.n.a.n.a.n.a.27.028.4n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Turkmenistan4.25.7n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Uzbekistan14.8<2.51.96.811.226.1n.a.n.a.n.a.n.a.n.a.2.5n.a.1.62.8n.a.n.a.EasternAsia6.9<2.51.01.36.06.725.75.96.831.733.9n.a.16.81.72.111.111.3China7.0<2.5n.r.n.r.n.r.n.r.0.96.59.810.73.64.319.719.05.74.90.2h12.25.06.817.920.614.314.56.37.5China,mainland7.1<2.5n.r.n.r.n.r.n.r.6.15.413.713.51.91.74.14.7TaiwanProvince4.33.0n.r.n.r.n.r.n.r.ofChinaChina,Hong<2.5<2.5n.r.n.r.n.r.n.r.n.a.n.a.KongSARChina,Macao15.98.0n.a.n.a.n.a.n.a.n.a.n.a.SARDemocratic34.345.5n.a.n.a.n.a.n.a.68.971.4People’sRepublic<2.53.2<0.50.92.64.4n.a.n.a.ofKorea65.758.0Japann.a.n.a.Mongolia28.88.0<0.5<0.5b,c6.85.7b,cRepublic<2.5<2.5<0.5b0.84.8b5.6ofKoreaTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.EasternAsia7.830.426.46.47.45.46.725.027.212.812.5(excludingChina9.211.8<0.50.93.74.9n.a.n.a.n.a.17.010.98.69.112.114.114.816.713.213.6andJapan)9.633.822.32.23.83.13.946.147.112.711.410.234.631.09.210.65.56.927.031.210.5South-eastern17.15.22.02.414.716.433.448.39.99.040.427.72.24.04.15.336.339.517.2Asian.a.n.a.16.79.717.621.96.25.713.115.630.132.072.851.213.0Brunein.a.n.a.n.a.n.a.n.a.n.a.7.4h31.124.11.80.84.65.839.442.140.950.712.713.8Darussalamn.a.31.928.83.54.65.46.416.912.321.212.5n.a.3.03.85.66.111.513.039.744.410.621.1153Cambodia17.84.816.914.848.951.17.73.43.09.18.67.922.124.010.511.08.314.011.82.41.32.910.026.829.9n.a.40.316.810.3Indonesia19.35.90.7b<0.5b6.0b4.9b4.752.545.14.38.11.63.817.020.623.651.218.214.325.419.32.72.84.52.148.348.233.054.97.6LaoPeople's22.74.7n.a.7.2n.a.34.15.140.330.55.03.74.45.437.542.626.16.3Democratic9.844.333.11.82.12.85.535.736.7n.a.n.a.24.4Republic3.12.77.86.017.416.0n.a.39.226.46.96.55.23.639.838.612.314.0n.a.18.730.222.72.22.83.16.453.253.050.865.024.3n.a.Malaysia4.341.631.74.83.83.922.824.117.045.411.723.023.347.260.229.511.4Myanmar29.03.8n.a.5.0n.a.29.35.94.725.857.527.4gn.a.62.6n.a.Philippines14.65.2n.a.5.7b,cn.a.44.7b,c64.153.2n.a.48.763.7Singaporen.a.n.a.1.01.72.86.646.447.453.1Thailand11.95.20.7c1.3b,c4.7c7.1b,cTimor-Leste33.122.3n.a.n.a.n.a.n.a.VietNam15.25.0n.a.1.2cn.a.9.0cSouthernAsia19.615.913.119.727.641.3Afghanistan34.530.114.828.445.179.1Bangladesh13.711.213.311.032.231.1Bhutann.a.n.a.n.a.n.a.n.a.n.a.India21.416.6n.r.n.r.n.r.n.r.Iran(Islamic5.46.19.57.448.040.8Republicof)TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)9.116.413.96.03.36.78.645.652.245.363.013.813.77.740.326.71.21.73.34.135.935.769.662.120.919.7Maldivesn.a.n.a.n.a.2.2n.a.13.47.143.834.04.62.77.18.642.741.337.047.8n.a.n.a.15.116.715.91.21.34.15.233.534.675.880.918.518.0Nepal17.05.410.413.229.537.4n.a.n.a.n.a.n.a.n.a.8.29.5n.a.n.a.49.053.8n.a.n.a.Pakistan17.118.50.9c12.9b,c,d14.1c42.3b,c,d3.519.114.09.17.227.229.831.732.531.931.712.212.2SriLanka13.95.30.7c1.2c5.9c10.9c4.413.97.215.011.518.320.217.617.334.144.58.38.3n.a.17.412.210.117.719.934.735.110.8SouthernAsia15.014.17.312.227.139.9n.a.13.327.629.836.335.4n.a.11.011.0(excludingIndia)n.a.6.8f5.0fn.a.n.a.20.421.812.013.6n.a.n.a.11.612.40.6n.a.n.a.n.a.n.a.19.321.726.927.5n.a.n.a.154WesternAsia7.810.58.910.129.436.53.08.84.813.95.028.030.429.828.654.820.4n.a.n.a.n.a.19.69.99.56.424.826.111.512.919.425.86.97.4Armenia12.3<2.5n.a.<0.5bn.a.7.1b0.6n.a.n.a.n.a.n.a.33.135.530.537.7n.a.n.a.10.810.92.37.76.65.99.535.637.921.123.722.717.89.49.0Azerbaijan4.7<2.5<0.5<0.55.910.11.44.86.99.011.729.732.025.428.3n.a.n.a.17.018.99.311.77.48.58.324.327.029.029.1n.a.n.a.12.414.4Bahrainn.a.n.a.n.r.n.r.n.r.n.r.1.311.12.96.530.531.0n.a.23.212.212.6n.a.10.312.77.68.3n.a.n.a.27.128.128.738.913.313.2Cyprus7.7<2.5n.r.n.r.n.r.n.r.4.4h6.2f7.512.2f11.7f32.435.125.827.529.3n.a.9.810.411.84.4f9.310.132.835.4n.a.n.a.9.910.0Georgia3.92.97.09.731.836.5n.a.31.732.8n.a.n.a.26.412.416.611.725.127.842.628.5Iraq17.816.3n.r.n.r.n.r.n.r.1.7n.a.n.a.n.a.n.a.9.125.410.28.129.532.141.640.7Israel<2.5<2.51.3b3.1c11.0b13.2c14.012.95.5Jordann.a.n.a.n.r.n.r.n.r.n.r.Kuwait<2.5<2.54.94.512.610.9Lebanonn.a.n.a.n.a.12.6n.a.36.5Oman9.42.8n.a.n.a.n.a.n.a.Palestinen.a.n.a.n.a.4.0bn.a.28.1bQatarn.a.n.a.n.a.n.a.n.a.n.a.SaudiArabia4.93.8n.r.n.r.n.r.n.r.SyrianArab4.927.8n.a.n.a.n.a.n.a.RepublicTürkiye<2.5<2.5n.r.n.r.n.r.n.r.TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.n.a.n.a.n.a.n.a.29.031.724.024.3n.a.n.a.13.913.9n.a.46.935.12.41.714.617.161.561.5n.a.n.a.UnitedArab7.6<2.5n.a.1.2b,cn.a.9.8b,c13.739.329.42.92.94.95.947.547.5n.a.n.a.25.423.5Emirates4.216.013.96.58.05.06.218.219.546.559.48.18.7Yemen27.334.512.312.845.767.24.921.217.910.49.825.327.731.831.813.113.1CentralAsiaand19.415.412.719.226.940.5SouthernAsia1.412.711.57.48.622.224.218.217.29.59.6EasternAsiaand2.913.011.36.56.622.024.728.729.211.411.7n.a.n.a.n.a.n.a.n.a.17.118.916.717.215.115.4155South-eastern9.6<2.51.31.78.59.5n.a.n.a.n.a.n.a.n.a.29.531.613.314.530.341.515.315.48.8n.a.7.56.011.812.520.923.116.917.0Asia2.07.07.09.710.222.624.620.219.3n.a.n.a.n.a.n.a.n.a.n.a.n.a.25.627.920.120.87.27.1WesternAsiaand7.09.310.529.134.52.27.95.67.57.624.527.628.026.437.2n.a.n.a.n.a.NorthernAfrican.a.n.a.n.a.n.a.n.a.19.121.318.919.212.113.43.73.43.719.422.747.647.7n.a.n.a.LATINAMERICA3.223.819.56.95.722.324.719.519.9n.a.n.a.n.a.6.16.5n.a.n.a.18.418.814.313.7ANDTHE9.36.77.913.027.639.0n.a.n.a.n.a.n.a.34.342.6n.a.n.a.CARIBBEAN29.431.4n.a.n.a.Caribbean18.415.4n.a.28.8n.a.61.8n.a.n.a.n.a.Antiguaandn.a.n.a.n.a.7.1n.a.33.019.7Barbuda48.640.6n.a.Bahamasn.a.n.a.n.a.3.4n.a.17.2n.a.8.015.8Barbados5.9<2.5n.a.7.4n.a.31.1n.a.n.a.39.3Cuba<2.5<2.5n.a.n.a.n.a.n.a.23.839.9n.a.n.a.Dominica5.26.7n.r.n.r.n.r.n.r.n.a.Dominican19.46.324.3b22.0b,c54.2b52.1b,cRepublicGrenadan.a.n.a.n.a.6.6bn.a.21.1bHaiti51.845.0n.a.42.9n.a.82.6Jamaica7.98.325.325.648.354.4PuertoRicon.a.n.a.n.a.n.a.n.a.n.a.TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.n.a.n.a.n.a.n.a.20.422.916.015.4n.a.n.a.n.a.2.32.56.06.017.419.714.114.3n.a.n.a.15.916.3SaintKittsn.a.n.a.8.15.621.129.9andNevisn.a.n.a.n.a.n.a.n.a.21.223.717.317.03.5n.a.n.a.n.a.SaintLucian.a.n.a.4.5b4.522.2b22.2SaintVincentn.a.8.68.810.513.916.318.617.817.715.916.3andthe8.53.1n.a.10.3n.a.33.31.018.216.96.66.725.127.315.214.6n.a.n.a.10.910.9Grenadinesn.a.17.512.08.75.922.024.121.220.511.311.6156Trinidad11.212.2n.a.10.2n.a.43.31.87.67.622.925.712.313.721.5n.a.andTobago8.05.0n.a.6.49.56.26.822.224.610.621.737.78.58.7CentralAmerica5.54.96.58.029.334.30.815.510.05.14.818.921.29.914.733.210.410.24.33.0n.a.5.9bn.a.45.5b1.947.143.55.04.719.021.411.07.432.525.314.414.5Belize9.27.71.8c2.9b16.2b1.722.017.56.86.926.828.916.618.031.412.513.113.816.212.2c48.4n.a.13.312.67.38.721.523.715.915.349.6n.a.10.210.2CostaRica19.413.316.121.142.259.81.117.314.920.622.713.315.730.753.210.710.122.618.714.2c23.5b42.756.1b1.419.913.810.511.421.123.022.121.214.430.210.710.3ElSalvador<2.53.6b3.6b41.6c27.6b1.710.17.99.726.328.318.417.331.735.94.417.8n.r.n.r.25.6b9.012.711.98.68.8Guatemala22.9n.r.n.r.n.r.2.07.19.511.012.618.320.2n.a.n.a.7.27.421.65.36.013.5n.r.n.r.28.624.442.2n.a.Honduras6.55.813.1n.r.38.73.1h19.911.18.99.020.122.132.046.88.37.98.83.223.436.9n.a.26.128.018.316.1n.a.Mexico3.819.21.66.37.27.910.320.422.37.98.764.38.38.719.41.91.69.88.855.76.16.8Nicaragua27.1n.r.n.r.n.r.n.r.12.711.25.06.222.121.238.610.511.04.7n.a.45.8Panama6.52.51.99.918.332.8n.a.3.26.610.8c18.1b42.9SouthAmerica11.52.9c4.1b36.7n.r.n.r.Argentinan.r.n.r.Bolivia(PlurinationalStateof)BrazilChileColombiaTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)3.724.422.77.511.918.119.917.317.2n.a.n.a.10.910.66.514.57.66.25.717.920.234.431.731.3n.a.17.017.2Ecuador22.313.96.0b,c13.0c20.7b,c37.3c1.09.43.410.414.618.220.322.223.024.429.610.010.00.418.610.18.19.418.119.720.620.667.463.98.37.5Guyana7.1<2.5n.a.n.a.n.a.n.a.5.58.37.63.73.824.426.420.321.02.88.915.716.51.49.16.19.311.526.027.913.215.0n.a.57.78.07.8Paraguay9.34.21.2c6.1b,c8.3c25.9b,cn.a.12.110.56.26.924.025.620.924.29.09.3Peru18.77.0n.r.n.r.n.r.n.r.n.a.20.022.011.016.825.828.114.416.011.311.8Suriname9.89.0n.a.7.2n.a.35.9n.a.3.43.412.419.327.029.37.68.86.46.4n.a.3.23.413.721.826.729.07.48.56.46.6157Uruguay2.9<2.51.7c2.9b,c13.3c15.2b,cn.a.n.a.n.a.28.430.88.86.05.9n.a.n.a.10.4Venezuela8.317.9n.r.n.r.n.r.n.r.8.3a40.944.021.323.632.9n.a.n.a.17.417.9(Bolivarian9.313.933.9Republicof)6.86.62.83.511.112.7n.a.43.346.420.122.333.3n.a.n.a.17.618.0OCEANIA<2.5<2.54.68.57.19.614.427.730.231.534.27.47.4<2.5<2.52.83.410.612.0n.a.n.a.n.a.6.37.432.0n.a.n.a.n.a.n.a.Australiaand<2.5<2.5n.a.n.a.n.a.n.a.n.a.n.a.NewZealand2.83.410.811.4n.a.48.051.210.519.021.333.4n.a.n.a.n.a.19.019.4Australian.a.31.829.83.516.019.922.538.434.413.213.22.83.310.015.127.031.44.85.522.625.224.137.7n.a.n.a.12.713.1NewZealand5.128.521.119.8n.a.n.a.n.a.n.a.56.659.5Oceaniaexcluding23.421.1n.a.n.a.n.a.n.a.56.859.8Australiaand3.56.6n.a.6.3n.a.24.2n.a.42.9NewZealand4.8n.a.n.a.n.a.n.a.n.a.Melanesia10.1n.a.23.4n.a.n.a.n.a.n.a.56.1Fiji28.059.719.0n.a.n.a.n.a.n.a.73.7NewCaledonia12.09.5n.a.2.4n.a.23.339.576.2PapuaNew6.9n.a.GuineaSolomonIslandsVanuatuTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.16.313.54.44.443.245.927.929.155.359.612.412.33.516.214.22.12.043.546.031.832.666.463.69.39.0Micronesian.a.n.a.n.a.n.a.n.a.n.a.3.537.030.54.14.450.752.929.730.627.343.1n.a.n.a.Kiribati6.112.1n.a.8.0n.a.41.0n.a.n.a.n.a.n.a.n.a.42.945.822.725.0n.a.n.a.MarshallIslandsn.a.n.a.n.a.n.a.n.a.n.a.n.a.21.014.84.04.559.661.029.529.6n.a.n.a.n.a.n.a.n.a.n.a.n.a.53.155.327.328.513.713.5Micronesian.a.n.a.n.a.n.a.n.a.n.a.n.a.7.36.58.28.244.947.625.627.4n.a.n.a.16.316.8(Federatedn.a.n.a.n.a.n.a.n.a.n.a.n.a.158Statesof)n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.67.2n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.53.855.925.827.1n.a.n.a.10.110.3Naurun.a.n.a.n.a.n.a.n.a.48.13.15.07.46.07.9n.a.n.a.n.a.n.a.51.1n.a.n.a.n.a.Palaun.a.n.a.n.a.n.a.n.a.n.a.46.850.025.927.3n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.44.747.324.526.8n.a.n.a.n.a.n.a.Polynesia3.54.9n.a.n.a.n.a.n.a.n.a.n.a.1.17.21.815.010.9n.a.n.a.n.a.n.a.n.a.51.7n.a.n.a.AmericanSamoan.a.n.a.n.a.n.a.n.a.n.a.2.87.85.25.24.245.448.227.228.551.3n.a.n.a.CookIslandsn.a.n.a.n.a.n.a.n.a.n.a.n.a.4.23.89.07.648.651.626.027.5n.a.n.a.FrenchPolynesia3.95.1n.a.n.a.n.a.n.a.0.22.63.68.68.225.026.913.114.67.47.4n.a.n.a.n.a.n.a.n.a.Niuen.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.11.411.132.935.59.911.78.08.1n.a.n.a.n.a.n.a.n.a.n.a.Samoa2.84.6n.a.3.4n.a.23.68.86.26.627.129.410.4Tokelaun.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.(AssociateMember)n.a.n.a.n.a.3.7bn.a.17.6b52.239.634.743.8TongaTuvalun.a.n.a.n.a.n.a.n.a.n.a.NORTHERN<2.5<2.51.31.49.17.8n.a.n.a.AMERICAAND<2.5<2.5EUROPE1.00.79.97.825.525.8n.a.n.a.Northernn.a.n.a.AmericaBermuda19.4<2.5n.a.n.a.n.a.n.a.Canada<2.5<2.5n.a.1.2cn.a.7.7cTABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Greenlandn.a.n.a.n.a.n.a.n.a.n.a.0.12.53.68.47.933.636.210.011.825.525.88.28.3UnitedStatesof<2.5<2.51.1b0.7b10.5b7.8bn.a.5.14.09.27.321.422.914.516.0n.a.n.a.7.17.0America<2.5<2.5n.a.7.25.312.17.422.023.419.220.5n.a.n.a.7.17.01.51.78.77.8n.a.3.93.65.323.024.519.120.619.021.75.05.1Europen.a.7.15.68.03.823.225.022.523.6n.a.n.a.11.011.4n.a.2.52.57.06.124.526.020.021.1n.a.n.a.7.37.6EasternEurope<2.5<2.51.51.711.210.5n.a.n.a.n.a.5.3n.a.24.526.419.619.7n.a.n.a.8.48.3n.a.2.12.3n.a.6.021.523.1n.a.n.a.5.85.6Belarus<2.5<2.5n.r.n.r.n.r.n.r.5.6n.a.n.a.n.a.6.83.92.917.518.936.4n.a.6.56.5159Bulgaria4.8<2.51.93.514.915.85.426.026.1n.a.9.37.74.520.722.5n.a.n.a.9.58.8Czechia<2.5<2.50.72.35.88.57.922.122.7n.a.n.a.n.a.7.421.923.1n.a.n.a.7.37.3Hungary<2.5<2.51.43.011.312.612.220.021.1n.a.n.a.n.a.n.a.19.120.5n.a.n.a.7.57.8Poland<2.5<2.51.81.08.97.5n.a.18.212.3n.a.13.622.724.122.323.519.7n.a.6.05.7n.a.23.623.725.814.417.7n.a.6.36.0Republicof33.4<2.51.64.819.323.5n.a.3.73.09.718.119.710.612.0n.a.n.a.5.14.8Moldovan.a.n.a.n.a.8.7n.a.20.121.211.512.2n.a.n.a.4.54.2n.a.1.31.2n.a.5.120.722.220.721.7n.a.n.a.4.14.1Romania<2.5<2.55.65.719.316.3n.a.n.a.n.a.4.8n.a.20.321.910.9n.a.n.a.3.84.0n.a.n.a.n.a.n.a.n.a.22.825.39.710.3n.a.n.a.5.55.6Russian<2.5<2.50.7<0.5b8.25.0b1.6hn.a.n.a.n.a.n.a.22.423.69.412.1n.a.n.a.4.54.2Federation2.41.8n.a.6.410.921.6n.a.10.320.9Slovakia5.52.81.11.86.28.3Ukraine<2.54.82.04.319.828.2NorthernEurope<2.5<2.51.81.76.75.1Denmark<2.5<2.51.01.85.96.8Estonia<2.5<2.50.90.79.58.5Finland<2.5<2.52.42.69.310.5Iceland<2.5<2.51.71.66.46.1Ireland<2.5<2.53.42.48.95.4Latvia<2.5<2.50.61.09.99.4TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)4.8h5.44.58.04.725.026.318.819.9n.a.n.a.4.74.4n.a.n.a.n.a.n.a.n.a.21.323.110.712.0n.a.n.a.4.74.4Lithuania<2.5<2.52.52.115.38.5n.a.n.a.n.a.n.a.n.a.19.020.611.713.6n.a.n.a.4.24.1Norway<2.5<2.51.11.24.85.20.3hn.a.n.a.9.711.325.427.89.411.17.16.8Sweden<2.5<2.50.81.44.55.4n.a.4.63.98.78.320.421.813.515.18.08.21.616.48.322.413.419.321.721.624.86.06.0UnitedKingdom<2.5<2.51.91.66.34.1n.a.n.a.24.825.610.612.1n.a.n.a.9.19.4ofGreatBritainn.a.n.a.8.0n.a.n.a.16.317.923.824.45.25.2160andNorthernn.a.9.2n.a.18.79.422.524.420.421.05.05.0Irelandn.a.n.a.2.2n.a.23.224.912.815.110.911.4n.a.2.0n.a.n.a.14.618.719.911.813.67.17.2SouthernEurope<2.5<2.51.72.39.98.5n.a.n.a.n.a.15.8n.a.27.528.912.313.7n.a.n.a.7.07.22.2n.a.8.2n.a.21.623.316.117.237.136.56.46.2Albania8.94.110.07.538.830.23.48.43.7n.a.8.020.822.417.219.38.28.31.1h5.83.1n.a.9.919.020.812.013.2n.a.n.a.8.48.9Andorran.a.n.a.n.a.n.a.n.a.n.a.2.63.84.615.88.920.021.521.822.86.06.2n.a.5.9n.a.13.69.918.820.220.221.818.2n.a.6.26.3Bosniaand<2.5<2.51.53.19.613.4n.a.n.a.n.a.8.2n.a.22.423.812.013.49.59.6Herzegovinan.a.15.6n.a.n.a.n.a.n.a.n.a.n.a.Croatia<2.5<2.50.61.96.59.7n.a.n.a.n.a.n.a.n.a.Greece<2.5<2.52.61.5b,e15.86.3b,e19.319.5Italy<2.5<2.51.21.88.65.723.027.5Malta<2.54.61.51.95.87.2n.a.n.a.13.423.6Montenegro5.4<2.52.13.312.612.9n.a.n.a.North4.93.63.66.915.124.0n.a.n.a.MacedoniaPortugal<2.5<2.54.13.914.712.4Serbia<2.5<2.51.74.111.414.8Slovenia<2.5<2.50.90.912.37.0Spain<2.5<2.51.11.87.18.0TABLEA1.1(Continued)REGIONS/PREVALENCEOFSUBREGIONS/UNDERNOURISHMENTINCOUNTRIES/THETOTALPOPULATION1TERRITORIESPREVALENCEOFSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFMODERATEORSEVEREFOODINSECURITYINTHETOTALPOPULATION1,2,3PREVALENCEOFWASTINGINCHILDREN(<5YEARS)PREVALENCEOFSTUNTINGINCHILDREN(<5YEARS)PREVALENCEOFOVERWEIGHTINCHILDREN(<5YEARS)PREVALENCEOFOBESITYINTHEADULTPOPULATION(≥18YEARS)PREVALENCEOFANAEMIAINWOMEN(15–49YEARS)PREVALENCEOFEXCLUSIVEBREASTFEEDINGAMONGINFANTS(0–5MONTHS)PREVALENCEOFLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)(%)n.a.2.82.65.05.120.121.79.611.6n.a.n.a.7.06.8n.a.n.a.n.a.n.a.n.a.18.420.111.513.0n.a.n.a.6.76.3WesternEurope<2.5<2.51.31.45.24.9n.a.2.82.43.64.020.722.111.313.6n.a.n.a.7.06.8n.a.n.a.n.a.n.a.n.a.20.121.68.810.6n.a.n.a.7.57.4Austria<2.5<2.51.11.65.54.30.4h1.52.13.43.120.722.39.611.7n.a.n.a.6.96.7n.a.n.a.n.a.n.a.n.a.20.922.69.010.2n.a.n.a.7.57.7Belgium<2.5<2.5n.a.1.5n.a.5.8n.a.1.51.64.15.118.620.410.912.8n.a.n.a.6.15.7France<2.5<2.51.61.66.86.6n.a.n.a.n.a.n.a.n.a.18.019.59.611.3n.a.n.a.6.46.4Germany<2.5<2.51.01.44.13.8161Luxembourg<2.5<2.51.80.64.72.7Netherlands<2.5<2.51.51.45.74.5(Kingdomofthe)Switzerland<2.5<2.51.50.64.82.1NOTES:6.Regionalestimatesareincludedwhenmorethana.Consecutivelowpopulationcoverage;interpretSOURCES:Dataforundernourishmentandfood1.Regionalestimatesareincludedwhenmorethan50percentofpopulationiscovered.Forcountries,withcaution.insecurityarefromFAO.2023.FAOSTAT:Suiteof50percentofpopulationiscovered.Toreducethethelatestdataavailablefrom2005to2012areb.Basedonofficialnationaldata.FoodSecurityIndicators.In:FAO.[Cited12Julymarginoferror,estimatesarepresentedasused.c.Foryearswhenofficialnationaldataarenot2023].www.fao.org/faostat/en/#data/FS;dataforthree-yearaverages.7.Regionalestimatesareincludedwhenmorethanavailable,theestimatesareintegratedwithFAOstunting,wastingandoverweightarebasedon2.FAOestimatesofthenumberofpeoplelivingin50percentofpopulationiscovered.Forcountries,data.SeeAnnex1Bforfurtherdetails.UNICEF,WHO&WorldBank.2023.UNICEF-WHO-householdswhereatleastoneadulthasbeenfoundthelatestdataavailablefrom2015to2021areused.d.Datainformingthe2020foodinsecurityWorldBank:Jointchildmalnutritionestimates-tobefoodinsecure.WastingunderfiveyearsofageregionalestimatescomefromanationalCOVID-19impactLevelsandtrends(2023edition).[Cited27April3.Country-levelresultsarepresentedonlyforthoseaggregatesexcludeJapan.assessmentsurveywithareferenceperiodof2023].https://data.unicef.org/resources/jme-countriesforwhichestimatesarebasedonofficialTheNorthernAmericawastingestimatesare3months;therefore,comparabilitywiththerestofreport-2023,www.who.int/teams/nutrition-and-nationaldata(seenoteb)orasprovisionalderivedapplyingmixed-effectmodelswiththeseriesmaybeaffected.food-safety/monitoring-nutritional-status-and-food-estimates,basedonFAOdatacollectedthroughthesubregionsasfixedeffects;datawereavailableonlye.Basedonofficialnationaldatacollectedinsafety-and-events/joint-child-malnutrition-Gallup©WorldPoll,GeopollorKantarforcountriesfortheUnitedStatesofAmerica,preventingthe2019–2022throughEUstatisticsonincomeandestimates,https://datatopics.worldbank.org/child-whosenationalrelevantauthoritiesexpressednoestimationofstandarderrors(andconfidencelivingconditions.malnutrition;dataforobesityarebasedonWHO.objectiontotheirpublication.Notethatconsenttointervals).Furtherdetailsonthemethodologyaref.Mostrecentinputdataarefrombefore2000,2020.GlobalHealthObservatory(GHO)datapublicationdoesnotnecessarilyimplyvalidationofdescribedinDeOnis,M.,Blössner,M.,Borghi,E.,interpretwithcaution.repository.In:WHO.[Cited28April2020].https://theestimatebythenationalauthoritiesinvolvedandFrongillo,E.A.&Morris,R.2004.Estimatesofg.TheUNICEF-WHOlowbirthweightestimatesareapps.who.int/gho/data/node.main.A900A?lang=en;thattheestimateissubjecttorevisionassoonasglobalprevalenceofchildhoodunderweightin1990derivedthroughstandardmethodologyappliedtoalldataonanaemiaarebasedonWHO.2021.Globalsuitabledatafromofficialnationalsourcesareand2015.JournaloftheAmericanMedicalcountriestoensurecomparabilityandarenottheanaemiaestimates,Edition2021.In:WHOGlobalavailable.Global,regionalandsubregionalAssociation,291(21):2600–2606.ModelselectionofficialstatisticsoftheGovernmentofIndia.India’sHealthObservatory(GHO)datarepository.[Cited20aggregatesarebasedondatacollectedinisbasedonbestfit.mostrecentnationalofficiallowbirthweightApril2023].www.who.int/data/gho/data/themes/approximately150countries.prevalenceis18.2percentfromthe2019–2021topics/anaemia_in_women_and_children;datafor1624.TheestimatesreferringtothemiddleoftheNationalFamilyHealthSurvey–5(NFHS-5),whichisexclusivebreastfeedingarebasedonUNICEF.2022.projectedrangesfortheyears2020to2022wereusedasthebasisoftheUNICEF-WHOglobalInfantandyoungchildfeeding.In:UNICEF.[Cited6usedtocalculatethethree-yearaverages.estimationmodeltosupportcross-countryApril2023].https://data.unicef.org/topic/nutrition/5.Forregionalestimates,valuescorrespondtothecomparability.infant-and-young-child-feeding;anddataforlowmodelpredictedestimatesfor2022.Forcountries,h.ThisestimatehasbeenadjustedbecausethebirthweightarefromUNICEF&WHO.2023.Lowthelatestdataavailablefrom2016to2022areoriginalestimatedidnotcoverthefullagerangebirthweightjointestimates2023edition.[Cited12used.orthedatasourcewasonlyrepresentativeofJuly2023].https://data.unicef.org/topic/nutrition/ruralareas.low-birthweight;www.who.int/teams/nutrition-and-<2.5=prevalenceofundernourishmentlessthanfood-safety/monitoring-nutritional-status-and-food-2.5percent;<0.5=prevalenceofseverefoodsafety-and-events/joint-low-birthweight-estimatesinsecuritylessthan0.5percent.n.a.=datanotavailable;n.r.=notreported.TABLEA1.2PROGRESSTOWARDSTHESUSTAINABLEDEVELOPMENTGOALSANDGLOBALNUTRITIONTARGETS:NUMBEROFPEOPLEWHOAREAFFECTEDBYUNDERNOURISHMENT,MODERATEORSEVEREFOODINSECURITYANDSELECTEDFORMSOFMALNUTRITION;NUMBEROFINFANTSEXCLUSIVELYBREASTFEDANDNUMBEROFBABIESBORNWITHLOWBIRTHWEIGHTREGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHTWORLD2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Leastdeveloped786.7725.1575.7892.71626.12335.5countries45.0177.9148.137.037.0574.3675.7519.5570.824.331.221.619.8189.8238.8188.5265.9480.2652.311.1Landlocked52.551.74.25.122.530.883.6101.47.58.84.95.2developing214.3309.33.3countries93.1106.178.7126.824.722.82.93.019.324.534.342.43.84.42.32.50.2163SmallIsland10.410.914.514.530.733.41.31.30.40.58.19.54.64.90.20.30.20.2Developing7.6States121.3195.1133.4195.8330.5459.337.838.43.73.916.321.349.461.35.16.33.33.632.5Low-income490.0458.7344.0551.5869.81351.8119.394.614.315.3128.9162.9318.5355.113.517.514.412.9countries2.5156.4n.r.73.6116.7311.8411.017.512.213.912.9205.7244.4113.7113.73.94.92.82.3Lower-middle-0.2incomen.r.n.r.18.320.098.392.32.72.55.04.7206.5231.336.238.9n.a.n.a.1.11.0countriesn.a.179.6249.4177.0261.6444.5627.212.247.646.95.25.628.637.071.186.35.68.24.24.6Upper-middle-income181.0269.0213.3326.0559.7821.51.861.363.18.810.265.581.5103.1122.77.79.65.86.2countries11.517.422.427.965.482.40.12.2n.r.5.22.59.08.6n.a.6.26.33.13.630.235.717.618.91.2n.a.0.80.8High-income5.07.88.29.727.131.1n.a.countries0.30.60.71.41.82.70.50.40.60.66.27.43.43.60.10.10.10.1Low-income2.82.51.82.315.618.46.97.00.6n.a.n.a.n.a.food-deficitcountries0.20.30.20.21.21.40.50.6n.a.n.a.n.a.n.a.AFRICANorthernAfricaAlgeriaEgyptLibyaTABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Morocco1.72.3n.r.n.r.n.r.n.r.0.1h0.50.40.30.25.26.22.72.90.10.10.10.1Sudann.a.2.12.6n.a.n.a.n.a.n.a.n.a.Tunisia–5.45.1b8.2c15.8b23.7c<0.10.10.10.10.21.92.23.13.80.3<0.1<0.1<0.1NorthernAfrica(excluding0.40.41.11.62.13.5n.a.0.10.20.91.0<0.1Sudan)Sub-Saharan9.712.017.319.649.658.710.3n.a.n.a.n.a.n.a.30.235.7n.a.n.a.0.9n.a.n.a.n.a.AfricaEasternAfrica169.6251.5190.9298.1494.4739.13.555.156.85.76.635.345.985.4103.86.58.55.05.4Burundi0.1h164Comoros97.4130.791.2129.8232.3311.5n.a.23.621.82.42.69.312.726.533.83.64.32.02.1Djiboutin.a.n.a.n.r.n.r.n.r.n.r.<0.1h1.11.2<0.10.10.20.30.71.00.1Eritrea0.1n.a.0.2n.a.0.7n.a.<0.1<0.1<0.10.10.1<0.10.20.10.1Ethiopia<0.10.2n.a.0.2n.a.0.51.2<0.1<0.1<0.1<0.10.1<0.10.10.1<0.1Kenya0.3n.a.n.a.n.a.n.a.n.a.0.3<0.1<0.1<0.1<0.10.10.10.30.3<0.1n.a.<0.1<0.1Madagascarn.a.0.30.51.60.14.86.60.8Malawi26.414.925.357.669.90.10.30.20.40.31.32.43.13.90.2n.a.n.a.n.a.Mauritius28.714.77.0b,c14.8c23.8b,c38.3cn.a.6.46.30.30.10.51.82.02.50.2Mozambique10.214.8n.a.18.80.22.01.30.10.10.30.71.11.40.2n.a.<0.1<0.1Rwanda8.1b,c3.5n.a.16.4b,c<0.11.71.60.1<0.1f0.10.50.10.1n.a.Seychelles6.33.510.4b,c13.2b,cn.a.1.21.0<0.1f0.30.70.12.93.50.21.1n.a.n.a.Somalia2.8<0.1<0.10.4n.a.<0.1f<0.1f0.20.10.31.00.50.50.1SouthSudan<0.1n.a.0.10.224.2n.a.1.92.00.1<0.1<0.10.40.0n.a.n.a.0.20.1Uganda6.89.8n.r.12.7n.a.0.30.70.6<0.10.10.4<0.11.5<0.13.14.3n.r.n.r.<0.1<0.10.10.1n.a.<0.11.20.90.10.20.20.2<0.1<0.1<0.1bn.r.<0.1b<0.1c0.70.60.10.30.70.50.83.40.47.48.3n.a.<0.1cn.a.13.60.50.40.2n.a.2.50.20.10.12.3n.a.n.a.2.11.81.0–14.58.1c7.424.9c9.4bn.a.<0.1<0.14.76.8b34.0c11.4cn.a.0.20.20.2<0.1<0.1n.a.<0.1<0.10.1n.a.n.a.n.a.n.a.n.a.0.5n.a.n.a.TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)UnitedRepublic11.114.910.8c16.7c25.7c37.4c0.43.23.30.40.51.62.24.45.30.40.60.20.2ofTanzania0.1Zambia5.95.83.6c6.2c8.3c14.2c0.11.11.00.20.20.50.61.01.40.20.20.10.13.76.11.9Zimbabwe36.254.15.04.69.211.8n.a.0.70.50.10.11.01.11.01.10.10.10.10.110.27.40.2MiddleAfrica2.71.7n.a.71.7n.a.142.20.110.012.91.21.64.56.014.617.21.01.60.80.90.3hAngola5.910.8b,c18.727.1b,cn.a.1.52.70.10.20.81.12.63.3n.a.0.20.20.2165Cameroon5.17.311.515.91.01.21.20.30.51.01.42.12.50.10.20.10.1CentralAfricanRepublic1.62.7n.a.3.4n.a.4.4n.a.0.40.4<0.1<0.10.10.20.50.5<0.1<0.1<0.1<0.1Chad<0.13.85.4n.r.n.r.n.r.n.r.<0.11.01.10.10.10.30.41.41.6<0.10.1n.a.n.a.CongoDemocratic1.31.92.23.44.25.10.20.20.1<0.1<0.10.20.20.60.6<0.1n.a.<0.1<0.1Republicofthen.a.Congo16.133.8n.a.39.0n.a.73.5n.a.5.77.30.60.71.82.57.18.20.51.00.40.4Equatorial<0.1Guinean.a.n.a.n.a.n.a.n.a.n.a.n.a.0.1<0.1<0.1<0.1<0.10.10.10.1<0.1n.a.n.a.n.a.Gabon0.2hSaoTomeand0.20.5n.r.n.r.n.r.n.r.<0.1<0.1<0.1<0.10.10.20.20.3<0.1n.a.<0.1<0.1PrincipeSouthernAfrica<0.1<0.1n.a.<0.1n.a.0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.10.0<0.1<0.1<0.1<0.1Botswana2.96.95.77.813.817.11.51.60.80.89.611.24.75.5n.a.0.20.20.20.40.60.10.1<0.1<0.10.20.20.2<0.1<0.1<0.1Eswatini0.10.10.4c0.7b,c1.1c1.5b,c<0.1<0.1<0.1<0.10.10.10.10.2<0.1<0.1<0.10.31.00.10.1<0.1<0.10.20.20.1n.a.<0.1<0.1Lesotho0.40.4n.a.0.2n.a.0.80.10.1<0.1<0.10.20.20.10.1<0.1<0.1<0.1<0.11.74.71.31.39.04.2Namibian.a.0.7cn.a.1.3c0.70.710.40.2<0.1n.a.0.20.20.2SouthAfrica0.7c0.8c1.2c1.5c0.2<0.1n.a.5.3cn.a.12.1c4.8n.a.TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)WesternAfrica33.159.841.688.8143.5268.44.619.920.51.31.711.915.939.647.31.62.52.02.10.10.60.70.40.50.10.10.1Benin1.01.31.1c2.0c6.0c9.6c0.41.00.8<0.1<0.10.40.51.31.50.10.20.10.1n.a.<0.1n.a.n.a.BurkinaFaso2.53.61.9b,c4.77.8b,c12.60.4<0.1f<0.1f0.10.1<0.1<0.12.02.50.10.20.20.2<0.11.10.90.91.2<0.1<0.1<0.1CaboVerde<0.10.1n.a.<0.1bn.a.0.2b0.30.10.1n.a.n.a.0.10.1<0.10.0<0.10.20.10.10.20.90.61.31.70.1n.a.n.a.Côted'Ivoire3.22.11.5c2.7c8.0c12.1c<0.10.60.60.10.10.30.42.63.2<0.1<0.1<0.1<0.1<0.10.10.10.10.1<0.1<0.1<0.1Gambia0.40.5n.a.0.7n.a.1.60.40.20.2<0.1<0.10.20.20.30.3<0.10.2n.a.n.a.0.1h1.01.00.50.7<0.1n.a.n.a.166Ghana2.51.61.5b,c2.0c11.1b,c12.9c0.60.20.20.10.10.20.32.92.70.20.1n.a.n.a.2.21.72.40.30.51.1n.a.n.a.Guinea1.41.85.16.78.49.90.20.10.16.18.21.31.5<0.10.10.10.10.111.412.10.50.70.1<0.1<0.1Guinea-Bissau0.20.8n.a.0.7cn.a.1.6c0.10.40.4<0.1<0.10.30.30.20.2<0.10.1<0.1<0.10.40.30.20.3Liberia1.12.01.81.93.74.2n.a.0.30.3<0.1<0.10.40.5<0.1Mali1.82.8n.r.n.r.n.r.n.r.31.60.10.12.02.60.10.2Mauritania0.30.40.2c0.4b,c1.0c2.5b,cn.a.<0.1<0.10.40.5<0.1Niger2.64.1n.a.7.7cn.a.18.0c<0.1<0.10.11.82.40.1Nigeria9.834.020.3b,c45.4b,c63.8b,c148.7b,c0.80.820.925.50.5Senegal2.01.01.1c1.9c5.6c8.4c<0.10.11.82.10.1SierraLeone2.62.32.0b,c2.75.5b,c7.5<0.10.10.80.9<0.1Togo1.61.51.2c1.7c4.5c5.4c<0.1<0.10.80.90.1Sub-Saharan169.6257.0196.0306.3510.1762.8n.a.n.a.n.a.n.a.35.345.9n.a.n.a.6.88.8n.a.n.a.Africa(includingSudan)ASIA542.6404.0297.4464.2789.21164.4106.876.618.217.7181.7231.3351.9380.713.017.113.711.81.10.70.60.46.68.15.25.30.30.40.10.1CentralAsia8.32.41.23.66.414.00.20.10.20.22.22.61.31.30.10.10.10.10.10.10.50.60.50.6<0.1<0.1Kazakhstan1.1n.r.n.a.<0.1bn.a.0.5b<0.1<0.1<0.1<0.1Kyrgyzstan0.40.3n.a.<0.1cn.a.0.5cTABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Tajikistan2.60.9n.r.n.r.n.r.n.r.0.10.30.20.1<0.10.60.70.60.8<0.1<0.1<0.1<0.1<0.10.1<0.10.60.7<0.1<0.1<0.1Turkmenistan0.20.4n.a.n.a.n.a.n.a.0.4<0.1<0.12.83.50.40.4<0.1<0.1<0.10.17.70.361.177.50.2Uzbekistan3.9n.r.0.62.33.58.91.16.73.70.20.253.868.72.42.20.12.31.20.81.7n.a.3.1n.a.n.a.2.01.00.6EasternAsia105.7n.r.16.522.298.5111.6n.a.n.a.6.66.467.164.41.9n.a.n.a.n.a.n.a.China93.6n.r.n.r.n.r.n.r.n.r.6.26.056.154.02.5n.a.China,mainland92.5n.r.n.r.n.r.n.r.n.r.n.a.n.a.n.a.n.a.n.a.n.a.167TaiwanProvince1.00.7n.r.n.r.n.r.n.r.n.a.n.a.n.a.n.a.n.a.n.a.1.71.7n.a.n.a.n.a.n.a.<0.1ofChinan.a.China,Hongn.r.n.r.n.r.n.r.n.r.n.r.<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.KongSAR<0.1hChina,Macao<0.1<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.SAR4.3Democratic8.311.8n.a.n.a.n.a.n.a.0.40.3<0.1<0.11.11.32.12.20.10.1n.a.n.a.People'sn.a.RepublicofKoreaJapann.r.4.0n.r.1.23.35.50.30.20.10.13.94.65.34.8n.a.n.a.0.10.1Mongolia0.70.3n.r.n.r.0.20.2b,c<0.1<0.1<0.1<0.10.30.40.10.1<0.1<0.1<0.1<0.1Republicofn.r.n.r.n.r.0.42.4b2.9<0.1<0.10.20.11.72.01.81.6n.a.n.a.<0.1<0.1KoreaEasternAsia(excludingChina6.89.5n.r.2.18.911.6n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.andJapan)South-eastern96.335.112.616.593.9110.917.214.43.64.122.229.541.747.41.82.61.51.4Asia<0.1Brunein.a.n.a.n.a.n.a.n.a.n.a.<0.1<0.1<0.1<0.1<0.1<0.1<0.10.0n.a.n.a.<0.1DarussalamTABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Cambodia2.40.82.62.57.58.50.20.60.4<0.10.10.30.41.92.10.10.1<0.1<0.1IndonesiaLaoPeople's44.216.21.8bn.r.15.5b13.4b2.48.36.92.22.49.112.218.322.31.01.10.50.4DemocraticRepublic1.30.4n.a.0.5n.a.2.50.10.30.2<0.1<0.10.20.20.60.8<0.1<0.1<0.1<0.1Malaysia168Myanmar0.80.92.42.05.45.40.30.40.60.20.12.63.32.42.8n.a.0.10.10.1Philippines13.82.1n.a.2.7n.a.15.80.3h1.41.10.1<0.11.52.15.76.30.10.20.10.1Singapore12.65.9n.a.6.5b,cn.a.50.9b,cn.a.3.73.50.43.24.14.23.50.40.70.50.5Thailandn.a.<0.10.10.2n.a.<0.1<0.1<0.10.60.20.30.20.2n.a.n.a.<0.1<0.1Timor-Lesten.a.3.70.5c0.9b,c3.3c0.40.30.60.40.4<0.14.15.44.14.2<0.1<0.10.10.1VietNam7.80.3n.a.n.a.n.a.5.1b,c<0.10.10.1<0.1<0.1<0.10.10.1<0.1<0.1<0.1<0.1SouthernAsia0.34.9n.a.1.1cn.a.n.a.0.31.81.40.30.31.01.44.35.30.10.30.10.1Afghanistan12.6315.8243.5392.8512.68.7c25.175.353.75.0<0.149.765.4218.4241.08.310.610.28.8Bangladesh315.912.05.011.415.2822.20.32.32.20.30.60.92.53.8n.a.0.4n.a.n.a.Bhutan8.518.920.918.750.931.71.46.03.90.30.62.73.714.916.81.00.90.70.7India19.2n.a.n.a.n.a.n.a.52.7n.a.<0.1<0.1<0.14.9<0.1<0.10.10.1<0.1<0.1<0.1<0.1Iran(Islamicn.a.233.9n.r.n.r.n.r.n.a.21.952.536.12.80.225.234.3171.5187.35.97.27.76.3gRepublicof)247.2n.r.0.3Maldives5.37.86.539.20.30.40.30.3<0.112.614.85.15.50.40.3n.a.n.a.Nepal3.835.93.2Pakistann.a.n.a.<0.1n.a.<0.1<0.1<0.1<0.1<0.1<0.1<0.10.1<0.1<0.1<0.1<0.1SriLankan.a.1.62.94.08.2<0.10.21.20.8<0.10.20.50.72.63.20.20.20.10.14.542.81.9c29.6c11.22.17.522.41.11.5n.a.n.a.29.81.10.1c29.9b,c,d1.2c97.9b,c,d0.312.510.11.3<0.10.610.219.81.80.10.10.10.12.70.3c0.30.2<0.1<0.10.81.82.4c0.8<0.1TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)SouthernAsia68.781.938.770.8144.7232.2n.a.n.a.n.a.n.a.n.a.24.531.1n.a.n.a.3.13.4n.a.n.a.(excludingIndia)1.0WesternAsia16.430.423.529.277.9105.7<0.15.33.92.52.042.451.419.622.50.90.90.70.7<0.1<0.1<0.1<0.10.40.50.10.1<0.1<0.1<0.1<0.1Armenia0.4n.r.n.a.n.r.n.a.0.2bn.a.1.21.40.90.9<0.1<0.1<0.1n.a.0.20.10.10.10.30.30.10.1n.a.<0.1<0.1Azerbaijan0.4n.r.n.r.n.r.0.61.0n.a.<0.1f<0.1fn.a.n.a.0.20.20.0n.a.n.a.<0.1n.a.n.a.0.60.7<0.10.2n.a.n.a.n.a.n.a.Bahrainn.a.n.a.n.r.n.r.n.r.n.r.0.2n.a.n.a.<0.1<0.14.76.10.32.8<0.1<0.1<0.1<0.1n.a.<0.1<0.10.50.41.31.42.30.30.10.2169Cyprus<0.1n.r.n.r.n.r.n.r.n.r.<0.1n.a.n.a.1.52.00.21.0n.a.n.a.0.10.1<0.11.00.60.10.10.91.10.60.2<0.1<0.1<0.1<0.1Georgia0.20.10.30.41.21.4<0.1n.a.n.a.<0.1<0.11.11.50.20.5n.a.n.a.<0.1<0.1<0.10.10.1<0.1<0.10.60.90.40.3n.a.n.a.<0.1<0.1Iraq5.17.1n.r.n.r.n.r.n.r.<0.1<0.1<0.1<0.1<0.1n.a.n.a.0.20.4n.a.<0.1<0.1<0.1n.a.0.1<0.1<0.10.10.60.80.30.1<0.1<0.1<0.1<0.1Israeln.r.n.r.0.1b0.3c0.9b1.2c0.1h<0.10.1<0.1f<0.1f6.48.10.12.3<0.1n.a.<0.1<0.10.10.10.30.31.9n.a.n.a.<0.1<0.1Jordann.a.n.a.n.r.n.r.n.r.n.r.n.a.<0.1f<0.1f0.40.4n.a.n.a.Kuwaitn.r.n.r.0.20.20.50.50.1Lebanonn.a.n.a.n.a.0.7n.a.2.0n.a.Oman0.20.1n.a.n.a.n.a.n.a.n.a.Palestinen.a.n.a.n.a.0.2bn.a.1.4bQatarn.a.n.a.n.a.n.a.n.a.n.a.SaudiArabia1.21.4n.r.n.r.n.r.n.r.SyrianArab0.95.9n.a.n.a.n.a.n.a.0.80.50.50.23.03.01.71.50.10.1n.a.n.a.RepublicTürkiyen.r.n.r.n.r.n.r.n.r.n.r.0.60.40.70.515.117.8n.a.n.a.0.30.30.20.2UnitedArab0.3n.r.n.a.0.1b,cn.a.0.9b,cn.a.n.a.n.a.n.a.2.22.50.40.5n.a.n.a.<0.1<0.1EmiratesYemen5.811.43.54.213.022.22.01.70.10.11.82.53.74.6n.a.n.a.n.a.n.a.TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)CentralAsiaand324.2318.2244.7396.4518.9836.225.376.454.35.65.356.473.5223.5246.38.611.010.38.9SouthernAsia5.4EasternAsiaand202.0n.r.29.238.6192.3222.425.018.310.210.483.3107.0108.8111.93.65.02.72.2South-eastern2.8Asia0.7WesternAsiaand27.847.846.057.0143.3188.111.510.25.65.672.687.037.241.42.1n.a.1.51.5NorthernAfrica0.1n.a.170LATINAMERICA51.843.749.185.4172.1256.2n.a.6.85.73.94.290.8106.029.629.61.62.01.00.9ANDTHEn.a.CARIBBEAN<0.10.50.43.00.10.10.1n.a.n.a.n.a.<0.1n.a.<0.1<0.1Caribbean7.46.8n.a.12.7n.a.27.3<0.1n.a.n.a.0.20.26.37.3<0.13.10.1n.a.<0.1<0.1n.a.<0.1<0.1n.a.n.a.<0.1<0.1<0.1n.a.Antiguaandn.a.n.a.n.a.<0.1n.a.<0.1<0.1<0.1<0.1n.a.n.a.0.0n.a.<0.1n.a.n.a.Barbuda<0.1n.a.n.a.<0.1<0.10.10.10.6n.a.<0.1<0.1n.a.0.10.10.10.1<0.10.1<0.1<0.1Bahamasn.a.n.a.n.a.<0.1n.a.<0.1n.a.n.a.n.a.n.a.n.a.2.20.0n.a.n.a.n.a.n.a.n.a.0.30.20.10.12.0n.a.0.70.1<0.1<0.1Barbados<0.1n.r.n.a.<0.1n.a.<0.1<0.1<0.1n.a.n.a.n.a.1.9<0.10.0<0.1n.a.n.a.n.a.<0.1<0.11.6<0.1n.a.n.a.n.a.Cuban.r.n.r.n.a.n.a.n.a.n.a.n.a.n.a.<0.1<0.1<0.11.51.30.5<0.1n.a.n.a.n.a.<0.1<0.1n.a.n.a.1.20.50.1n.a.<0.1<0.1Dominica<0.1<0.1n.r.n.r.n.r.n.r.n.a.n.a.0.4n.a.0.20.0n.a.n.a.n.a.<0.1<0.1n.a.n.a.<0.1n.a.n.a.Dominican1.80.72.5b2.4b,c5.6b5.8b,cn.a.<0.1<0.10.7<0.1<0.1<0.1Republic<0.1Grenadan.a.n.a.n.a.<0.1bn.a.<0.1b0.0n.a.Haiti4.75.1n.a.4.9n.a.9.51.40.1Jamaica0.20.20.70.71.31.50.2<0.1PuertoRicon.a.n.a.n.a.n.a.n.a.n.a.0.1n.a.SaintKittsn.a.n.a.<0.1<0.1<0.1<0.10.0n.a.andNevisSaintLucian.a.n.a.<0.1b<0.1<0.1b<0.10.0<0.1TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)SaintVincent<0.1<0.1n.a.<0.1n.a.<0.1n.a.n.a.n.a.n.a.n.a.<0.1<0.1<0.10.0n.a.n.a.n.a.n.a.andthe171Grenadines0.20.2n.a.0.2n.a.0.7n.a.<0.1<0.1<0.1<0.10.20.20.10.1<0.1n.a.<0.1<0.1Trinidad0.1andTobago11.68.910.814.249.160.9n.a.2.92.51.11.026.130.86.77.00.30.50.40.3CentralAmerica<0.1<0.1n.a.<0.1bn.a.0.2b<0.1<0.1<0.1<0.1<0.1<0.10.1<0.10.0<0.1<0.1<0.1<0.1Belize0.6c0.8bn.a.<0.1<0.1<0.1<0.10.90.2<0.1<0.1<0.1<0.1CostaRica0.20.2<0.1c0.1b2.63.1<0.1<0.1<0.10.81.00.20.2<0.1<0.1<0.1ElSalvador0.60.50.91.06.8<0.10.10.10.92.00.20.3n.a.Guatemala2.52.32.63.73.9c10.50.20.90.80.10.11.61.20.40.50.10.10.10.1Honduras1.71.91.3c2.4b5.8bn.a.0.20.20.10.10.90.45.3<0.1<0.1<0.1<0.1Mexico4.6n.r.4.3b4.5b30.8b<0.11.51.20.80.720.624.05.10.30.3Nicaragua1.31.2n.r.n.r.n.r.35.0b0.40.10.1<0.10.10.80.90.20.20.2n.a.0.20.2Panama0.70.2n.r.n.r.n.r.n.r.0.10.10.1<0.1<0.10.50.60.219.5<0.1n.a.<0.1<0.1SouthAmerica32.828.058.5n.r.3.42.82.63.058.419.91.31.4<0.1<0.1Argentina1.51.424.75.996.8<0.10.30.30.40.47.667.91.3n.a.n.a.Bolivia2.58.3167.98.61.30.60.5(Plurinational2.52.316.70.5h0.30.10.70.10.10.1<0.1Stateof)n.a.1.4Brazil12.110.1n.r.n.r.n.r.n.r.0.11.01.00.10.11.110.10.70.10.6<0.1<0.1Chile0.50.50.1<0.1<0.133.30.4n.a.Colombia4.83.44.021.137.670.3<0.11.21.428.43.82.89.20.60.10.20.2Ecuador3.12.50.5c0.8b1.9c3.5b0.50.40.10.13.47.60.7n.a.<0.1<0.1Guyanan.r.n.r.n.r.n.r.n.r.0.40.30.20.26.42.20.10.4n.a.n.a.<0.11.0b,c2.3c3.4b,c6.6c<0.1<0.10.10.21.80.10.10.1n.a.n.a.n.a.n.a.<0.1<0.10.12.90.2<0.1<0.1<0.1<0.10.8n.a.0.1<0.1TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Paraguay0.50.3<0.1c0.4b,c0.5c1.7b,c<0.10.1<0.10.10.10.70.90.40.4<0.1<0.1<0.1<0.1Peru<0.10.60.33.54.10.20.1<0.15.32.4n.r.n.r.n.r.n.r.<0.1<0.10.20.30.10.11.61.80.2<0.1Suriname<0.1<0.1<0.10.60.7<0.1<0.1<0.1<0.1<0.1n.a.<0.1n.a.0.2<0.1<0.1<0.1<0.10.0<0.1<0.1<0.1Uruguayn.a.Venezuela<0.1n.r.<0.1c<0.1b,c0.5c0.5b,c<0.1<0.10.10.1n.a.(Bolivariann.a.Republicof)2.25.1n.r.n.r.n.r.n.r.n.a.0.40.20.20.24.65.11.61.8n.a.n.a.0.1<0.1OCEANIAn.a.172Australiaand2.32.91.11.64.55.6n.a.0.70.80.40.67.08.11.31.6n.a.n.a.0.10.1NewZealandAustralian.r.n.r.0.81.13.03.70.1a0.10.10.20.45.76.50.50.6n.a.n.a.<0.1<0.1NewZealandn.r.n.r.0.70.92.63.0n.a.<0.10.10.20.34.75.40.40.5n.a.n.a.<0.1<0.1<0.1Oceanian.r.n.r.0.10.20.50.8n.a.n.a.n.a.n.a.1.01.10.10.1n.a.n.a.<0.1<0.1excludingn.a.Australiaand2.02.7n.a.n.a.n.a.n.a.n.a.0.60.70.10.21.31.60.81.00.10.10.10.1NewZealandn.a.Melanesia1.92.6n.a.n.a.n.a.n.a.n.a.0.60.70.10.21.11.30.80.90.10.10.10.1<0.1<0.1n.a.<0.1<0.1<0.1<0.10.20.20.1<0.1<0.1<0.1Fiji<0.1<0.1n.a.<0.1n.a.0.2<0.1n.a.n.a.n.a.0.1n.a.<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.NewCaledonia1.82.3n.a.n.a.n.a.n.a.0.81.00.6n.a.n.a.PapuaNew0.50.60.10.20.1<0.1<0.1Guinea<0.10.1n.a.n.a.n.a.n.a.0.10.10.10.80.1SolomonIslands<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.1n.a.n.a.n.a.n.a.<0.1<0.1<0.1<0.1<0.10.1<0.1n.a.<0.1<0.1Vanuatun.a.n.a.<0.1<0.1<0.1<0.10.10.1<0.10.0<0.1<0.1<0.1<0.1<0.1n.a.<0.1n.a.<0.1<0.1<0.1<0.1<0.1<0.1<0.1<0.10.0<0.1<0.1<0.1<0.1Micronesia<0.1<0.1<0.1<0.10.0<0.1<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.0.0<0.1<0.1n.a.n.a.Kiribatin.a.<0.1n.a.<0.1MarshallIslandsn.a.n.a.n.a.n.a.TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Micronesian.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.<0.1<0.1<0.10.0n.a.n.a.n.a.n.a.(FederatedStatesof)n.a.n.a.Naurun.a.n.a.n.a.n.a.n.a.n.a.n.a.<0.1<0.1<0.1<0.1n.a.n.a.<0.10.0<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Palaun.a.n.a.n.a.n.a.n.a.n.a.n.a.0.2n.a.<0.10.0n.a.n.a.<0.1<0.1n.a.<0.1<0.1<0.1<0.1n.a.Polynesia<0.1<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.0.2<0.10.0<0.1<0.1<0.1<0.1<0.1n.a.n.a.n.a.n.a.n.a.AmericanSamoan.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.<0.1173CookIslandsn.a.n.a.n.a.n.a.n.a.n.a.n.a.<0.10.0n.a.n.a.<0.1<0.1<0.1<0.1<0.1<0.1<0.1FrenchPolynesia<0.1<0.1n.a.n.a.n.a.n.a.<0.1n.a.n.a.n.a.n.a.n.a.n.a.n.a.Niuen.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.<0.10.0n.a.n.a.n.a.n.a.Samoa<0.1<0.1n.a.<0.1n.a.<0.1<0.10.1<0.1<0.1<0.1<0.1n.a.n.a.n.a.Tokelaun.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.(Associaten.a.Member)<0.1Tongan.a.n.a.n.a.<0.1bn.a.<0.1b<0.1<0.1<0.1<0.1<0.1<0.1<0.10.0<0.1<0.1n.a.n.a.<0.1<0.1<0.1<0.1n.a.n.a.<0.10.0<0.1<0.1Tuvalun.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.NORTHERNn.r.n.r.14.815.6100.687.82.62.15.64.3216.2237.233.736.2n.a.n.a.0.90.8AMERICAANDEUROPENorthernn.r.n.r.3.72.735.829.40.60.71.91.787.898.78.19.80.50.50.30.3AmericaBermuda<0.1n.r.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Canadan.r.n.r.n.a.0.5cn.a.2.9cn.a.n.a.0.20.27.68.60.70.9n.a.n.a.<0.1<0.1Greenlandn.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.UnitedStatesofn.r.n.r.3.5b2.3b34.0b26.4b0.50.71.71.580.290.17.48.90.50.50.30.3AmericaTABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)128.4138.4Europen.r.n.r.11.112.964.958.4n.a.2.11.43.72.625.526.5n.a.n.a.0.60.5n.a.1.20.853.055.8n.a.0.30.2EasternEuropen.r.n.r.4.34.932.830.6n.a.<0.1<0.12.01.11.81.914.114.0n.a.<0.1<0.1<0.1n.a.<0.1<0.11.41.5n.a.<0.1<0.1Belarusn.r.n.r.n.r.n.r.n.r.n.r.n.a.<0.1<0.1<0.1<0.12.12.30.50.4<0.1n.a.<0.1<0.1n.a.n.a.n.a.2.02.1n.a.<0.1<0.1Bulgaria0.4n.r.0.10.21.11.1n.a.<0.1<0.1<0.1<0.16.77.20.40.4n.a.n.a.<0.1<0.1Czechian.r.n.r.<0.10.20.60.9n.a.<0.1<0.10.50.5n.a.Hungaryn.r.n.r.0.10.31.11.2n.a.n.a.n.a.0.50.4n.a.174Polandn.r.n.r.0.70.43.42.9n.a.0.10.1n.a.n.a.n.a.Republicof1.3n.r.<0.10.20.60.7n.a.<0.1<0.1<0.1<0.10.60.60.30.3<0.1n.a.<0.1<0.1Moldovan.a.n.a.Romanian.r.n.r.1.11.13.83.2n.a.0.10.10.1<0.13.43.61.11.0n.a.n.a.<0.1<0.1n.a.Russiann.r.n.r.1.0n.r.11.97.2bn.a.n.a.n.a.1.00.625.726.97.37.2n.a.n.a.0.10.1Federationn.a.n.a.Slovakia0.30.2<0.1<0.10.30.5<0.1hn.a.n.a.n.a.n.a.0.80.90.30.3n.a.n.a.<0.1<0.1<0.1h0.50.20.60.28.58.81.6<0.1Ukrainen.r.2.00.91.88.912.00.20.20.50.519.021.22.51.80.1n.a.<0.1n.a.n.a.n.a.n.a.0.80.90.10.1NorthernEuropen.r.n.r.1.81.86.95.4<0.1<0.1<0.1<0.10.20.20.12.8n.a.n.a.0.1<0.1n.a.n.a.n.a.n.a.0.91.00.1<0.1Denmarkn.r.n.r.<0.10.10.30.4n.a.n.a.n.a.n.a.<0.10.1<0.10.2n.a.n.a.<0.1<0.1n.a.n.a.n.a.n.a.0.80.90.1<0.1Estonian.r.n.r.<0.1<0.10.10.1<0.1<0.1<0.1<0.10.40.40.10.1n.a.n.a.<0.1<0.1<0.1<0.1<0.1<0.10.60.60.1<0.1Finlandn.r.n.r.0.10.10.50.60.1n.a.n.a.<0.1<0.1Icelandn.r.n.r.<0.1<0.1<0.1<0.10.0n.a.n.a.<0.1Irelandn.r.n.r.0.20.10.40.30.1n.a.n.a.<0.1Latvian.r.n.r.<0.1<0.10.20.20.1n.a.n.a.<0.1Lithuanian.r.n.r.<0.1<0.10.50.20.1n.a.n.a.<0.1TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)Norwayn.r.n.r.<0.1<0.10.20.3n.a.n.a.n.a.n.a.n.a.0.81.00.10.1n.a.n.a.<0.1<0.1n.a.Swedenn.r.n.r.<0.10.10.40.6n.a.n.a.n.a.n.a.1.41.60.30.3n.a.n.a.<0.1<0.1<0.1hUnitedKingdomn.a.ofGreatBritainn.r.n.r.1.21.14.12.7<0.1n.a.n.a.0.40.412.914.61.41.7n.a.n.a.0.1<0.1andNorthernn.a.n.a.Irelandn.a.n.a.SouthernEuropen.r.n.r.2.63.415.212.9n.a.0.40.20.70.525.627.54.85.0n.a.n.a.0.10.1n.a.<0.1<0.1<0.1<0.10.40.50.2<0.1<0.1<0.1175Albania0.30.10.30.21.10.9<0.1n.a.n.a.<0.10.2<0.1<0.1<0.1<0.1n.a.n.a.n.a.n.a.n.a.Andorran.a.n.a.n.a.n.a.n.a.n.a.<0.1h0.50.50.20.0n.a.<0.1<0.1<0.1<0.1<0.1<0.1<0.1n.a.Bosniaandn.r.n.r.<0.10.10.30.4n.a.0.80.80.20.2<0.1<0.1<0.1Herzegovinan.a.n.a.n.a.n.a.n.a.2.12.20.3n.a.<0.1<0.1<0.1<0.10.10.19.310.11.6n.a.<0.1<0.1Croatian.r.n.r.<0.1<0.10.30.4n.a.n.a.0.10.1<0.10.2n.a.n.a.<0.1<0.1n.a.n.a.n.a.n.a.0.10.1<0.1n.a.<0.1<0.1Greecen.r.n.r.0.30.2b,e1.70.7b,en.a.n.a.<0.1<0.10.3n.a.<0.1<0.1<0.10.30.40.1<0.1<0.1Italyn.r.n.r.0.71.15.23.4<0.1<0.11.7n.a.<0.1<0.1<0.11.61.80.3<0.1<0.1Maltan.r.<0.1<0.1<0.1<0.1<0.1<0.1<0.11.41.50.50.0n.a.n.a.<0.1<0.1<0.1<0.10.1<0.10.30.30.1<0.1<0.1<0.1Montenegro<0.1n.r.<0.1<0.1<0.1<0.1<0.1<0.1n.a.8.79.11.40.0<0.1<0.1<0.1n.a.n.a.n.a.North0.1<0.1<0.10.10.30.5n.a.n.a.n.a.0.1<0.1n.a.Macedonian.a.n.a.Portugaln.r.n.r.0.40.41.51.30.3n.a.Serbian.r.n.r.0.20.41.11.30.5<0.1Slovenian.r.n.r.<0.1<0.10.30.10.1n.a.Spainn.r.n.r.0.50.83.33.81.4n.a.TABLEA1.2(Continued)REGIONS/NUMBEROFSUBREGIONS/UNDERNOURISHEDCOUNTRIES/PEOPLE1TERRITORIESNUMBEROFSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFMODERATELYORSEVERELYFOOD-INSECUREPEOPLE1,2,3NUMBEROFCHILDREN(<5YEARS)AFFECTEDBYWASTINGNUMBEROFCHILDREN(<5YEARS)WHOARESTUNTEDNUMBEROFCHILDREN(<5YEARS)WHOAREOVERWEIGHTNUMBEROFADULTS(≥18YEARS)WHOAREOBESENUMBEROFWOMEN(15–49YEARS)AFFECTEDBYANAEMIANUMBEROFINFANTS(0–5MONTHS)EXCLUSIVELYBREASTFEDNUMBEROFBABIESWITHLOWBIRTHWEIGHT2004–062020–2242014–162020–222014–162020–222022520122022201220222012201620122019201262021720122020(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)(millions)WesternEuropen.r.n.r.2.42.810.09.5n.a.0.30.20.50.530.833.94.14.8n.a.n.a.0.10.1n.a.n.a.n.a.1.31.5n.a.<0.1<0.1Austrian.r.n.r.<0.10.10.50.4n.a.<0.1<0.1n.a.n.a.1.82.00.20.3n.a.n.a.<0.1<0.1n.a.n.a.n.a.n.a.Belgiumn.r.n.r.n.a.0.2n.a.0.7<0.1h0.10.1<0.1<0.110.010.90.30.3n.a.n.a.0.10.1n.a.n.a.n.a.14.015.3n.a.<0.10.1Francen.r.n.r.1.01.04.34.2n.a.n.a.1.21.5n.a.<0.1<0.1n.a.0.10.1Germanyn.r.n.r.0.81.23.33.20.10.11.72.0n.a.n.a.Luxembourgn.r.n.r.<0.1<0.1<0.1<0.1n.a.n.a.<0.10.0n.a.176Netherlandsn.r.n.r.0.30.21.00.8<0.1<0.1<0.1<0.12.52.80.40.5n.a.n.a.<0.1<0.1(Kingdomofthe)Switzerlandn.r.n.r.0.1<0.10.40.2n.a.n.a.n.a.n.a.1.21.30.20.2n.a.n.a.<0.1<0.1NOTES:6.Regionalestimatesareincludedwhenmorethana.Consecutivelowpopulationcoverage;interpretSOURCES:Dataforundernourishmentandfood1.Regionalestimatesareincludedwhenmorethan50percentofpopulationiscovered.Forcountries,withcaution.insecurityarefromFAO.2023.FAOSTAT:Suiteof50percentofpopulationiscovered.Toreducethethelatestdataavailablefrom2005to2012areb.Basedonofficialnationaldata.FoodSecurityIndicators.In:FAO.[Cited12Julymarginoferror,estimatesarepresentedasused.c.Foryearswhenofficialnationaldataarenot2023].www.fao.org/faostat/en/#data/FS;dataforthree-yearaverages.7.Regionalestimatesareincludedwhenmorethanavailable,theestimatesareintegratedwithFAOstunting,wastingandoverweightarebasedon2.FAOestimatesofthenumberofpeoplelivingin50percentofpopulationiscovered.Forcountries,data.SeeAnnex1Bforfurtherdetails.UNICEF,WHO&WorldBank.2023.UNICEF-WHO-householdswhereatleastoneadulthasbeenfoundthelatestdataavailablefrom2015to2021areused.d.Datainformingthe2020foodinsecurityWorldBank:Jointchildmalnutritionestimates-tobefoodinsecure.WastingunderfiveyearsofageregionalestimatescomefromanationalCOVID-19impactLevelsandtrends(2023edition).[Cited27April3.Country-levelresultsarepresentedonlyforthoseaggregatesexcludeJapan.assessmentsurveywithareferenceperiodof2023].https://data.unicef.org/resources/jme-countriesforwhichestimatesarebasedonofficialTheNorthernAmericawastingestimatesare3months;therefore,comparabilitywiththerestofreport-2023,www.who.int/teams/nutrition-and-nationaldata(seenoteb)orasprovisionalderivedapplyingmixed-effectmodelswiththeseriesmaybeaffected.food-safety/monitoring-nutritional-status-and-food-estimates,basedonFAOdatacollectedthroughthesubregionsasfixedeffects;datawereavailableonlye.Basedonofficialnationaldatacollectedinsafety-and-events/joint-child-malnutrition-Gallup©WorldPoll,GeopollorKantarforcountriesfortheUnitedStatesofAmerica,preventingthe2019–2022throughEUstatisticsonincomeandestimates,https://datatopics.worldbank.org/child-whosenationalrelevantauthoritiesexpressednoestimationofstandarderrors(andconfidencelivingconditions.malnutrition;dataforobesityarebasedonWHO.objectiontotheirpublication.Notethatconsenttointervals).Furtherdetailsonthemethodologyaref.Mostrecentinputdataarefrombefore2000,2020.GlobalHealthObservatory(GHO)datapublicationdoesnotnecessarilyimplyvalidationofdescribedinDeOnis,M.,Blössner,M.,Borghi,E.,interpretwithcaution.repository.In:WHO.[Cited28April2020].https://theestimatebythenationalauthoritiesinvolvedandFrongillo,E.A.&Morris,R.2004.Estimatesofg.TheUNICEF-WHOlowbirthweightestimatesareapps.who.int/gho/data/node.main.A900A?lang=en;thattheestimateissubjecttorevisionassoonasglobalprevalenceofchildhoodunderweightin1990derivedthroughstandardmethodologyappliedtoalldataonanaemiaarebasedonWHO.2021.Globalsuitabledatafromofficialnationalsourcesareand2015.JournaloftheAmericanMedicalcountriestoensurecomparabilityandarenottheanaemiaestimates,Edition2021.In:WHOGlobalavailable.Global,regionalandsubregionalAssociation,291(21):2600–2606.ModelselectionofficialstatisticsoftheGovernmentofIndia.India’sHealthObservatory(GHO)datarepository.[Cited20aggregatesarebasedondatacollectedinisbasedonbestfit.mostrecentnationalofficiallowbirthweightApril2023].www.who.int/data/gho/data/themes/approximately150countries.prevalenceis18.2percentfromthe2019–2021topics/anaemia_in_women_and_children;datafor1774.TheestimatesreferringtothemiddleoftheNationalFamilyHealthSurvey–5(NFHS-5),whichisexclusivebreastfeedingarebasedonUNICEF.2022.projectedrangesfortheyears2020to2022wereusedasthebasisoftheUNICEF-WHOglobalInfantandyoungchildfeeding.In:UNICEF.[Cited6usedtocalculatethethree-yearaverages.estimationmodeltosupportcross-countryApril2023].https://data.unicef.org/topic/nutrition/5.Forregionalestimates,valuescorrespondtothecomparability.infant-and-young-child-feeding;anddataforlowmodelpredictedestimatesfor2022.Forcountries,h.ThisestimatehasbeenadjustedbecausethebirthweightarefromUNICEF&WHO.2023.Lowthelatestdataavailablefrom2016to2022areoriginalestimatedidnotcoverthefullagerangeorbirthweightjointestimates2023edition.[Cited12used.thedatasourcewasonlyrepresentativeofJuly2023].https://data.unicef.org/topic/nutrition/ruralareas.low-birthweight;www.who.int/teams/nutrition-and-<0.1=lessthan100000people.food-safety/monitoring-nutritional-status-and-food-n.a.=datanotavailable;n.r.=datanotreported.Insafety-and-events/joint-low-birthweight-estimatesthecaseofthenumberofundernourishedpeople,thisisbecausetheprevalenceislessthan2.5percent.ANNEX1ATABLEA1.3PREVALENCEOFMODERATEORSEVEREFOODINSECURITY,ANDSEVEREFOODINSECURITYONLY,BYDEGREEOFURBANIZATIONIN2022PrevalenceofseverePrevalenceofmoderateorseverefoodinsecurity(%)foodinsecurity(%)RuralPeri-urbanUrbanRuralPeri-urbanUrban12.811.69.4WORLD25.923.133.328.826.0AFRICA10.18.220.2NorthernAfrica27.626.311.964.560.354.2Sub-SaharanAfrica25.726.723.044.144.020.529.923.430.0EasternAfrica15.913.135.4MiddleAfrica24.522.110.268.168.462.5SouthernAfrica10.311.020.2WesternAfrica3.768.368.960.0ASIA3.91.28.3CentralAsia1.32.44.981.182.574.0EasternAsia3.120.30.6South-easternAsia21.712.32.131.728.221.3SouthernAsia9.417.6WesternAsia10.010.267.269.365.3WesternAsiaand9.8NorthernAfrica11.026.525.121.8LATINAMERICAANDTHECARIBBEAN14.617.316.5CaribbeanLatinAmerica11.04.64.9CentralAmericaSouthAmerica17.817.112.9OCEANIANORTHERNAMERICA42.540.439.0ANDEUROPEEurope37.644.332.9EasternEuropeNorthernEurope33.932.831.6SouthernEuropeWesternEurope14.412.610.140.438.632.1NorthernAmericaCOUNTRYINCOMEGROUP28.021.720.857.848.647.3Low-incomecountries13.611.69.439.337.531.2Lower-middle-income11.95.943.537.627.8countries14.59.937.237.532.5Upper-middle-income12.310.713.611.1countries2.32.69.6High-incomecountries3.46.57.51.21.46.81.36.66.71.41.66.77.37.01.31.71.47.16.36.02.21.61.77.67.87.41.22.11.67.74.96.11.51.61.85.06.49.10.71.70.96.90.530.029.024.571.071.563.717.916.414.542.738.036.719.011.814.85.13.64.21.51.71.87.77.48.2SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS178THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA1.4PREVALENCEOFMODERATEORSEVEREFOODINSECURITY,ANDSEVEREFOODINSECURITYONLY,AMONGADULTMENANDWOMENIN2022PrevalenceofseverePrevalenceofmoderateorseverefoodinsecurity(%)foodinsecurity(%)MenWomenMenWomenWORLD9.510.625.427.8AFRICANorthernAfrica22.923.458.759.9Sub-SaharanAfrica11.312.330.932.8EasternAfricaMiddleAfrica26.026.366.066.8SouthernAfricaWesternAfrica27.127.768.170.0ASIACentralAsia39.638.478.078.4EasternAsiaSouth-easternAsia12.212.426.025.1SouthernAsiaWesternAsia21.522.066.066.4WesternAsiaandNorthernAfricaLATINAMERICAAND8.59.922.124.0THECARIBBEANCaribbean4.44.617.317.4LatinAmericaCentralAmerica1.00.96.85.6SouthAmericaOCEANIA2.42.716.116.5NORTHERNAMERICAANDEUROPEEurope17.821.037.342.7EasternEuropeNorthernEurope8.611.530.838.4SouthernEuropeWesternEurope9.811.930.935.8NorthernAmerica11.213.832.741.826.729.858.962.810.012.730.840.329.538.77.39.331.340.911.114.012.513.33.43.46.99.21.41.77.29.21.82.09.412.51.82.1n.a.n.a.n.a.n.a.7.27.61.51.75.06.41.71.96.29.20.50.9SOURCE:FAO.2023.FAOSTAT:SuiteofFoodSecurityIndicators.In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/FS179ANNEX1BMETHODOLOGICALNOTESFORTHEFOODSECURITYANDNUTRITIONINDICATORSPREVALENCEOFUNDERNOURISHMENTrequirement(MDER)(i.e.thelowestlimitoftherangeofenergyrequirementsthatisappropriateDefinition:Undernourishmentisdefinedastheforthepopulation’srepresentativeaverageconditionofanindividualwhosehabitualindividual)asintheformulabelow:foodconsumptionisinsufficienttoprovide,onaverage,theamountofdietaryenergyrequiredtoPoU=∫x<MDERf(xθ)dx,maintainanormal,activeandhealthylife.whereθisavectorofparametersthatHowitisreported:Theindicator(denominatedcharacterizestheprobabilitydensityfunction.as“prevalenceofundernourishment”[PoU])Intheactualcomputations,thedistributionisanestimateofthepercentageofindividualsisassumedtobelognormalandthusfullyinthepopulationthatareinaconditionofcharacterizedbyonlytwoparameters:themeanundernourishment.Nationalestimatesaredietaryenergyconsumption(DEC)anditsreportedasthree-yearmovingaverages,tocontrolcoefficientofvariation(CV).forthelowreliabilityoftheestimatesofsomeoftheunderlyingparametersduetoelementsDatasource:Differentdatasourcesareusedtoforwhichcomplete,reliableinformationisveryestimatethedifferentparametersofthemodel.scarce,suchastheyear-to-yearvariationinfoodcommoditystocks,oneofthecomponentsoftheMinimumdietaryenergyrequirement(MDER):HumanannualFAOFoodBalanceSheets(FBS).Regionalenergyrequirementsforanindividualinagivenandglobalaggregates,ontheotherhand,sex/ageclassaredeterminedonthebasisofarereportedasannualestimates,aspossiblenormativerequirementsforbasicmetabolicrateestimationerrorsareexpectednottobecorrelatedperkilogramofbodymass,multipliedbytheandthereforetobegreatlyreducedtoacceptableidealweightsthatahealthypersonofthatsex/agelevelswhenaggregatingacrosscountries.classmayhave,givenhisorherheight,andthenmultipliedbyacoefficientofphysicalactivityTheentireseriesofPoUvaluesisrevisedwitheachlevel(PAL)totakeintoaccountphysicalactivity.bdneweditionofthisreporttoreflectnewdataandGiventhatbothhealthybodymassindices(BMIs)informationthatFAOhasobtainedsincethereleaseandnormalPALsvaryamongactiveandhealthyofthepreviousedition.Asthisprocessusuallyindividualsofthesamesexandage,arangeofimpliesbackwardrevisionsoftheentirePoUseries,energyrequirementsappliestoeachsexandreadersareadvisedtorefrainfromcomparingagegroupofthepopulation.TheMDERfortheseriesacrossdifferenteditionsofthisreportandaverageindividualinthepopulation,whichistheshouldalwaysrefertothecurrenteditionoftheparameterusedinthePoUformula,isobtainedreport,includingforvaluesinpastyears.astheweightedaverageofthelowerboundsoftheenergyrequirementrangesforeachsexandMethodology:Tocomputeanestimateoftheagegroup,usingthesharesofthepopulationinprevalenceofundernourishmentinapopulation,eachsexandagegroupasweights.SimilartothetheprobabilitydistributionofhabitualdietaryMDER,theaveragedietaryenergyrequirementenergyintakelevels(expressedinkcalperperson(ADER)(usedtoestimatetheonecomponentofperday)fortheaverageindividualismodelledasaparametricprobabilitydensityfunction,bdApersonisconsideredhealthyifhisorherBMIindicatesneitherf(x).1,2Theindicatorisobtainedasthecumulativeunderweightnoroverweight.HumanenergyrequirementnormsperprobabilitythatthehabitualdietaryenergykilogramofbodymassaregiveninFAOandWHO(2004).3intake(x)isbelowtheminimumdietaryenergy180THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023theCVasdescribedbelow)isestimatedusingIraq,Japan,Jordan,Kenya,Liberia,Madagascar,theaveragevaluesofthePALcategory“ActiveorMalawi,Mali,Mexico,Morocco,Myanmar,Nepal,moderatelyactivelifestyle”.Nicaragua,Niger,Nigeria,Pakistan,PapuaNewGuinea,Peru,Philippines,Rwanda,SaudiInformationonthepopulationstructurebysexArabia,Senegal,SierraLeone,Somalia,SouthandageneededtocomputetheMDERisavailableAfrica,Sudan,SyrianArabRepublic,Tajikistan,formostcountriesintheworldandforeachyearThailand,Togo,Uganda,Ukraine,UnitedRepublicfromtheUNDepartmentofEconomicandSocialofTanzania,Venezuela(BolivarianRepublicof),Affairs(UNDESA)WorldPopulationProspects,VietNam,Yemen,ZambiaandZimbabwe.revisedeverytwoyears.ThiseditionofTheStateofFoodSecurityandNutritionintheWorldusestheTherevisionoftheFBSseriesthisyearreflectsthe2022revisionoftheWorldPopulationProspects.4inclusionofnewofficialdataonfoodproduction,tradeandutilizationreportedbythesecountries,Informationonthemedianheightineachsexandasusual,butitalsoreflectsasubstantialrevisionagegroupforagivencountryisderivedfromaoftheFBSseriesupto2021giventheintroductionrecentdemographicandhealthsurvey(DHS)orofimprovednutrientconversionfactors6fromothersurveysthatcollectanthropometryandadjustmentsneededtoconsiderthenewdataonchildrenandadults.EvenifsuchsurveyspopulationestimatesprovidedbytheUNDESAdonotrefertothesameyearforwhichtheWorldPopulationProspects,2022revision.4PoUisestimated,theimpactofpossiblesmallinterveningchangesinmedianheightsoverthePercapitaaverageDESin2021(forcountriesyearsontheMDER,andthereforeonthePoUotherthantheoneslistedabove)andin2022estimates,isexpectedtobenegligible.(forallcountries)arenowcastonthebasisoftheshort-runmarketoutlookexercisesconductedbyDietaryenergyconsumption(DEC):Ideally,DECcouldFAOtoinformtheWorldFoodSituationPortal7beestimatedfromdataonfoodconsumptionandusedtonowcastthe2021and2022valuescomingfromnationallyrepresentativehouseholdofDECforeachcountry,startingfromthelastsurveys(suchasLivingStandardsMeasurementavailableyearoftheDESintheFBSseries.StudysurveysorHouseholdConsumptionandExpenditureSurveys).However,onlyveryfewCoefficientofvariation(CV):TheCVofhabitualcountriesconductsuchsurveysonanannualDECinthepopulationisobtainedasthebasis.Thus,inFAO’sPoUestimatesforglobalgeometricmeanoftwocomponents,labelledmonitoring,DECvaluesareestimatedfromtherespectivelyCVyandCVr:dietaryenergysupply(DES)reportedintheFBS,compiledbyFAOformostcountriesintheworld.5𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶=�(𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝑦𝑦𝑦𝑦)2+(𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝑟𝑟𝑟𝑟)2Sincethelasteditionofthisreport,theFBSThefirstcomponentreferstovariabilityindomainonFAOSTAThasbeenupdatedwithnewvaluesoftheseriesupto2020forallcountries.thepercapitaconsumptionacrosshouseholdsInaddition,atthetimeofclosingthisreport,theFBSserieswereupdatedto2021forthefollowingbelongingtodifferentsociodemographicstrata,66countries,selectedasapriorityduetothehighasexthpe�𝑎C𝑎𝑎𝑎𝑖𝑖V−“d𝑃𝑃𝑃u𝑃𝑗𝑗𝑗𝑗�econtributiontheymaketothetotalnumberofandt𝑃h𝑃𝑃𝑃e𝑟𝑟𝑟r𝑟𝑃𝑃e𝑃𝑃𝑃f𝑃𝑃𝑃o�r𝑋𝑋e𝑋𝑋𝑖𝑖is=refYeerrse�d=totoundernourishedpeopleintheworld:Afghanistan,Angola,Argentina,Bangladesh,Benin,Bolivia,𝑗𝑗𝑗𝑗(PlurinationalStateof),Brazil,BurkinaFaso,income”,whilethesecond1co+mpeoxnpe�n𝑎𝑎𝑎t𝑎𝑖𝑖c−ap𝑃𝑃t𝑃𝑃𝑗u𝑗𝑗𝑗�resCambodia,Cameroon,CentralAfricanRepublic,variabilityacrossindividuals,duetodifferencesChad,Colombia,Congo,Côted’Ivoire,DemocraticPeople’sRepublicofKorea,DemocraticRepublicofinsex,age,bodymassandPALthatcanbefoundtheCongo,DominicanRepublic,Ecuador,Egypt,Ethiopia,Ghana,Guatemala,Haiti,Honduras,amongmembersofthesamehousehold.AstheseIndia,Indonesia,Iran(IslamicRepublicof),arethesameelementsthatdetermineenergyrequirements,thesecondcomponentisreferredtoasCV“duetoreq𝐹u𝐹𝐹𝐹i𝐼𝐼r𝐿𝐿𝐿e𝐿m=e∑nt𝑝𝑝s𝑝𝑝𝑖”𝑖,.𝐿𝐿𝐿𝐿𝑤𝑤𝑤𝑤𝑖𝑖CVyWhenreliabledataonfoodconsumptionareavailablefromnationallyrepresentativeFI=∑𝑐𝑐𝑐𝑐FI𝐿𝐿𝐿𝐿,𝑐𝑐𝑐𝑐×𝑁𝑁𝑁𝑁𝑐𝑐𝑐𝑐181𝐿𝐿𝐿𝐿,𝑟𝑟𝑟𝑟∑𝑐𝑐𝑐𝑐𝑁𝑁𝑁𝑁𝑐𝑐𝑐𝑐ANNEX1Bhouseholdsurveys,theCVduetoincome(CVy)CVrcanbeestimateddirectly.SincethelasteditionCVrrepresentsthevariabilityofthedistributionofthisreport,14newsurveysfromthefollowingofdietaryenergyrequirementsofahypothetical10countrieshavebeenprocessedtoupdatetheaverageindividualrepresentativeofahealthyCVy:Argentina(2018),Armenia(2019,2020,population,whichisalsoequaltotheCVof2021),Benin(2019),Bhutan(2012),Cambodiathedistributionofdietaryenergyintakesof(2019),Guinea-Bissau(2019),Mexico(2012,2020),ahypotheticalaverageindividualifeveryoneMongolia(2020,2021),Peru(2019)andUruguayinthepopulationwereperfectlynourished.(2017).Thatmakesforatotalof129surveysfromForestimationpurposes,thedistribution65countriesforwhichtheestimateoftheCVyisofdietaryenergyrequirementsofsuchabasedondatafromnationalsurveys.hypotheticalaverageindividualisassumedtobenormalanditsstandarddeviationcanbeWhennosuitablesurveydataareavailable,estimatedfromanytwoknownpercentiles.WeFoodInsecurityExperienceScale(FIES)datausetheMDERandtheADERmentionedabovecollectedbyFAOsince2014areusedtoprojecttoapproximatethe1standthe50thpercentiles.8,thechangesintheCVyfrom2015(orfromthe9ThevalueofCVristhenderivedastheinverseyearofthelastfoodconsumptionsurvey,ifcumulativestandardnormaldistributionofthemorerecent)upto2019,basedontheobserveddifferencebetweentheMDERandtheADER.trendinseverefoodinsecurity.TheprojectionsarebasedontheassumptionthatobservedChallengesandlimitations:WhileformallythestatechangesintheextentofseverefoodinsecurityofbeingundernourishedornotisaconditionmeasuredwiththeFIESmightbeindicativeofthatappliestoindividuals,giventhedatausuallyequivalentchangesinthePoU.Totheextentavailableonalargescale,itisimpossibletothatsuchimpliedchangesinthePoUcannotbereliablyidentifywhichindividualsinacertainfullyexplainedbythe“supply-side”effectsofgroupareactuallyundernourished.Throughthechangesinaveragefoodsupplies,theycanbestatisticalmodeldescribedabove,theindicatorconfidentlyattributedtounobservedchangescanonlybecomputedwithreferencetoaintheCVythatmighthaveoccurredatthepopulationoragroupofindividualsforwhichsametime.AnalysisofhistoricalPoUestimatesasufficientlyrepresentativesampleisavailable.revealsthat,onaverage,andoncedifferencesTheprevalenceofundernourishmentisthusaninDEC,MDERandCVrhavebeencontrolledestimateofthepercentageofindividualsinthatfor,differencesintheCVyexplainaboutgroupthatareinsuchcondition,butitcannotbeone-thirdofthedifferencesinPoUacrosstimefurtherdisaggregated.andspace.Basedonallthis,foreachcountryforwhichFIESdataareavailable,thechangeDuetotheprobabilisticnatureoftheinferenceintheCVythatmayhaveoccurredfrom2015,andthemarginsofuncertaintyassociatedwithorfromthedateofthelastavailablesurvey,isestimatesofeachoftheparametersinthemodel,thereforeestimatedasthechangethatwouldtheprecisionofthePoUestimatesisgenerallygenerateone-thirdofapercentagepointchangelow.WhileitisnotpossibletoformallycomputeinthePoUforeachobservedpercentagemarginsoferroraroundPoUestimates,theypointchangeintheprevalenceofseverefoodareexpectedtoexceed5percentinmostcases.insecurity.Forallothercountries,lackinganyForthisreason,FAOdoesnotconsiderPoUsupportingevidence,theCVyiskeptconstantestimatesthatresultlowerthan2.5percentasatthelastavailableestimate.Asinlastyear’ssufficientlyreliabletobereported.report,thenowcastoftheCVyfor2020,2021and2022requiredspecialtreatmenttoaccountItisimportanttonotethattherangespresentedfortheeffectsoftheCOVID-19pandemicforthevaluesofthePoUin2020,2021and2022(seeAnnex2,SectionA).shouldnotbeinterpretedasstatisticalconfidenceintervals.Rather,theyrepresentdifferentscenariosusedtonowcastthevaluesofCVyfrom2020to2022.182THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Recommendedreadings:collectedoverthreeyearsfrom2014to2016,FAOFAO.1996.MethodologyforassessingfoodhasestablishedtheFIESreferencescale,whichisinadequacyindevelopingcountries.In:FAO.usedastheglobalstandardforexperience-basedTheSixthWorldFoodSurvey,pp.114–143.Rome.food-insecuritymeasures,andtosetthetwoFAO.2003.Proceedings:Measurementandreferencethresholdsofseverity.AssessmentofFoodDeprivationandUndernutrition:InternationalScientificSymposium.Rome.SDGIndicator2.1.2isobtainedasthecumulatedFAO.2014.Advancesinhungermeasurement:probabilitytobeinthetwoclassesofmoderatetraditionalFAOmethodsandrecentinnovations.andseverefoodinsecurity.AseparateindicatorFAOStatisticsDivisionWorkingPaper,(FIsev)iscomputedbyconsideringonlythesevereNo.14–04.Rome.foodinsecurityclass.Naiken,L.2002.Keynotepaper:FAOmethodologyforestimatingtheprevalenceofundernourishment.PaperHowitisreported:Inthisreport,FAOprovidespresentedattheMeasurementandAssessmentestimatesoffoodinsecurityattwodifferentofFoodDeprivationandUndernutritionlevelsofseverity:moderateorseverefoodInternationalScientificSymposium,Rome,26–28insecurity(FImod+sev),andseverefoodinsecurityJune2002.Rome,FAO.(FIsev).Foreachofthesetwolevels,twoWanner,N.,Cafiero,C.,Troubat,N.&Conforti,estimatesarereported:P.2014.RefinementstotheFAOmethodologyforestimatingtheprevalenceofundernourishmenttheprevalence(percent)ofindividualsintheindicator.Rome,FAO.populationlivinginhouseholdswhereatleastoneadultwasfoundtobefoodinsecure;andPREVALENCEOFFOODINSECURITYASMEASUREDBYTHEFOODINSECURITYtheestimatednumberofindividualsintheEXPERIENCESCALE(FIES)populationlivinginhouseholdswhereatleastoneadultwasfoundtobefoodinsecure.Definition:Foodinsecurityasmeasuredbythisindicatorreferstolimitedaccesstofood,attheDatasource:Since2014,theeight-questionFIES-SMlevelofindividualsorhouseholds,duetolackofhasbeenappliedinnationallyrepresentativemoneyorotherresources.Theseverityoffoodsamplesoftheadultpopulation(definedasagedinsecurityismeasuredusingdatacollectedwith15orolder)inmorethan140countriesincludedtheFoodInsecurityExperienceScaleSurveyintheGallup©WorldPoll(GWP),coveringmoreModule(FIES-SM),asetofeightquestionsthan90percentoftheworldpopulation.In2022,askingrespondentstoself-reportconditionsinterviewswereconductedinbothtelephoneandandexperiencestypicallyassociatedwithface-to-facemodality.Telephoneinterviewswerelimitedaccesstofood.ForpurposesofannualmaintainedinsomecountriesalreadycoveredSDGmonitoring,thequestionsareaskedwithwiththismodalityin2020giventhehighriskreferencetothe12monthsprecedingthesurvey.ofcommunitytransmissionfromconductingface-to-facedatacollectionduringtheCOVID-19Usingsophisticatedstatisticaltechniquesbasedpandemic.ByevaluatingdualframecoverageontheRaschmeasurementmodel,theinformation(i.e.theproportionoftheadultpopulationthatisobtainedinanFIES-SMsurveyisvalidatedcoveredbyacombinationoflandlineandmobileforinternalconsistencyandconvertedintoaphones),countrieswithaminimumof70percentquantitativemeasurealongascaleofseverity,coveragewereincludedaspartofthe2020GWPrangingfromlowtohigh.Basedontheirresponsesthroughcomputer-assistedtelephoneinterviews.tothesurveyitems,theindividualsorhouseholdsinterviewedinanationallyrepresentativesurveyGallup©traditionallyusestelephonesurveysinofthepopulationareassignedaprobabilityofNorthernAmerica,WesternEurope,somepartsofbeinginoneofthreeclasses:i)foodsecureoronlyAsia,andCooperationCouncilfortheArabStatesmarginallyinsecure;ii)moderatelyfoodinsecure;oftheGulfcountries.InCentralandEasternandiii)severelyfoodinsecure,asdefinedbyEurope,muchofLatinAmerica,andnearlyalltwogloballysetthresholds.BasedonFIESdataofAsia,theNearEastandAfrica,anareaframedesignisusedforface-to-faceinterviewing.183ANNEX1BInmostcountries,samplesincludeaboutbecomputedorthetrendofothersurveys1000individuals,withlargersamplesoforthesubregionisnotapplicabletothe3000individualsinIndia,3500inChinacountry-specificsituationconsidering(mainland)and2000intheRussianFederation.evidencefoundinsupportofthetrendNodatawerecollectedinChina(mainland)in2022.(forinstance,evolutionofpoverty,extremepoverty,employmentandfoodinflation,InadditiontotheGWP,in2022FAOcollecteddataamongothers);thisappliesalsotocountriesinsevencountriesthroughGeopoll®andKantar®wheretheprevalenceoffoodinsecuritywiththeobjectiveoffillingdatagapsonaccessisverylow(below3percentattheseveretofood.72Thecountriescoveredwere:Cameroon,level)orveryhigh(above85percentattheDemocraticRepublicoftheCongo,Guinea-Bissau,moderateorseverelevel).Haiti,Liberia,RwandaandZambia.GiventheheterogeneityofthesurveysourcesNationalgovernmentsurveydatawereusedtoandthesmallsamplesizeofsomeoftheFAOcalculatethefoodinsecurityprevalenceestimatessurveys,newdatacanoccasionallypredictafor60countries,coveringmorethanaquarterofnotablylargeincreaseordecreasefromoneyeartheworldpopulation,byapplyingFAO’sstatisticaltothenext.Insuchsituations,theprotocolismethodstoadjustnationalresultstothesametolookforexternalinformationforthecountryglobalreferencestandard.Thecountriesare:(dataand/orreports,possiblyinconsultationAfghanistan,Angola,Armenia,Belize,Benin,withcountryexpertslikeFAOcountryorBotswana,BurkinaFaso,CaboVerde,Canada,regionalofficers)toexplorewhetherbigshocksChad,Chile,CostaRica,Côted’Ivoire,Dominicanorinterventionshaveoccurred.IfthetrendRepublic,Ecuador,Fiji,Ghana,Greece,Grenada,canbejustifiedbysupportingevidence,butGuinea-Bissau,Honduras,Indonesia,Israel,seemsexcessive,thetrendiskeptbutsmoothedKazakhstan,Kenya,Kiribati,Kyrgyzstan,Lesotho,(forexample,usingthethree-yearaverage).Malawi,Mexico,Namibia,Niger,Nigeria,Pakistan,Otherwise,thesameprotocolusedformissingPalestine,Paraguay,Philippines,RepublicofKorea,yearsisapplied(i.e.keepingthelevelconstantRussianFederation,SaintKittsandNevis,Saintorapplyingthesubregionaltrend).In2022,noLucia,SaintVincentandtheGrenadines,Samoa,FIESdatawerecollectedinChina(mainland),Senegal,Seychelles,SierraLeone,SouthAfrica,thereforethetrendwaskeptconstant.SouthSudan,SriLanka,Sudan,Togo,Tonga,Uganda,UnitedArabEmirates,UnitedRepublicMethodology:ThedatawerevalidatedandusedofTanzania,UnitedStatesofAmerica,Uruguay,toconstructascaleoffood-insecurityseverityVanuatu,VietNamandZambia.CountriesareusingtheRaschmodel,whichpostulatesthattheconsideredfortheyearoryearswhennationalprobabilityofobservinganaffirmativeanswerbydataareavailable.Fortheremainingyears,therespondentitoquestionjisalogisticfunctionoffollowingstrategywasfollowed:thedistance,onanunderlyingscaleofseverity,betweenthepositionoftherespondent,ai,andWhenmorethanoneyearofnationalthatoftheitem,bj.dataisavailable,themissingyearsarelinearlyinterpolated.Prob(Xi,j=Yes)=exp(ai–bj)1+exp(ai–bj)Ifonlyoneyearofdataisavailable,missingyearsareinformedasfollows:ByapplyingtheRaschmodeltotheFIESdata,itis–usingFAOdataifconsideredcompatiblepossibletoestimatethecross-countrycomparablewiththenationalsurveys;probabilityofbeingfoodinsecure(pi,L)ateach–imputedusingthetrendsuggestedbyFAOlevelofseverityoffoodinsecurityL(moderatedataifnationaldataarenotcompatible;orsevere,orsevereonly),foreachrespondenti,–imputedusingthetrendofthesubregionifwith0<pi,L<1.nootherreliableandtimelyinformationisavailable;orTheprevalenceoffoodinsecurityateachlevel–consideredconstanttotheleveloftheofseverity(FIL)inthepopulationiscomputedasnationalsurveyifthesubregioncannot184THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023theweightedsumoftheprobabilityofbeingfoodTheproblemstemsfromthefactthat,wheninsecureforallrespondents(i)inasample:definedasalatenttrait,theseverityoffoodinsecurityhasnoabsolutereferenceagainstFIL=∑pi,Lwiwhichitcouldbeevaluated.TheRaschmodelenablesidentificationoftherelativepositionwherewiarepost-stratificationsamplingweightsthatthevariousitemsoccupyonascalethatisthatindicatetheproportionofindividualsordenominatedinlogitunitsbutwhose“zero”householdsinthenationalpopulationrepresentedisarbitrarilyset,usuallytocorrespondtothebyeachrecordinthesample.meanestimatedseverity.Thisimpliesthatthezeroofthescalechangesineachapplication.Asonlyindividualsaged15yearsormoreareToproducecomparablemeasuresovertimeandsampledintheGWP,theprevalenceestimatesacrossdifferentpopulationsrequiresestablishingdirectlyproducedfromthesedatarefertotheacommonscaletouseasareferenceandfindingpopulationaged15yearsandolder.Toarriveattheformulaneededtoconvertmeasuresacrosstheprevalenceandnumberofindividuals(ofalldifferentscales.Asisthecaseforconvertingages)inthepopulation,anestimateisrequiredofmeasuresoftemperatureacrossdifferencethenumberofpeoplelivinginhouseholdswheremeasuringscales(suchasCelsiusandFahrenheit),atleastoneadultisestimatedtobefoodinsecure.thisrequirestheidentificationofanumberofThisinvolvesamultistepproceduredetailed“anchoring”points.IntheFIESmethodology,inAnnexIIoftheVoicesoftheHungryTechnicaltheseanchoringpointsaretheseveritylevelsReport(seelinkinthe“Recommendedreadings”associatedwiththeitemswhoserelativepositionsection,below).onthescaleofseveritycanbeconsideredequaltothatofthecorrespondingitemsontheglobalRegionalandglobalaggregatesoffoodinsecurityreferencescale.The“mapping”ofthemeasuresatmoderateorsevere,andseverelevels,FIL,r,fromonescaletotheotheristhenobtainedbyarecomputedas:findingtheformulathatequatesthemeanandthestandarddeviation(SD)ofthecommonitems’FIL,r=∑cFIL,c×Ncseveritylevels.∑cNcChallengesandlimitations:Whenfood-insecuritywhererindicatestheregion,FIL,cisthevalueprevalenceestimatesarebasedonFIESdataofFIatlevelLestimatedforcountrycinthecollectedintheGWP,withnationalsamplesizesofregion,andNcisthecorrespondingpopulationabout1000individualsinmostcountries,confidencesize.WhennoestimateofFILisavailableforintervalsrarelyexceed20percentofthemeasuredacountry,itisassumedtobeequaltotheprevalence(thatis,prevalenceratesof50percentpopulation-weightedaverageoftheestimatedwouldhavemarginsoferrorofuptoplusorminusvaluesoftheremainingcountriesinthesame5percent).Confidenceintervalsarelikelytobemuchsubregion.Aregionalaggregateisproducedonlysmaller,however,whennationalprevalenceratesifthecountriesforwhichanestimateisavailableareestimatedusinglargersamplesandforestimatescoveratleast50percentoftheregion’spopulation.referringtoaggregatesofseveralcountries.Toreducetheimpactofyear-to-yearsamplingUniversalthresholdsaredefinedontheFIESvariability,country‑levelestimatesarepresentedglobalstandardscale(asetofitemparameterasthree-yearaverages,computedasaveragesofallvaluesbasedonresultsfromallcountriescoveredavailableyearsintheconsideredtriennia.bytheGWPin2014–2016)andconvertedintocorrespondingvaluesonlocalscales.TheprocessRecommendedreadings:ofcalibratingeachcountry’sscaleagainsttheFIESFAO.2016.Methodsforestimatingcomparableratesofglobalstandardcanbereferredtoasequatingfoodinsecurityexperiencedbyadultsthroughouttheandpermitstheproductionofinternationallyworld.Rome.www.fao.org/3/a-i4830e.pdfcomparablemeasuresoffoodinsecurityseverityFAO.2018.VoicesoftheHungry.In:FAO.forindividualrespondents,aswellascomparable[Cited28April2020].www.fao.org/in-action/nationalprevalencerates.voices-of-the-hungry185ANNEX1BGallup.2020.GallupKeepsListeningtotheestimates–Levelsandtrends(2023edition).WorldAmidthePandemic.In:Gallup.[Cited25[Cited27April2023].https://data.unicef.org/May2021].https://news.gallup.com/opinion/resources/jme-report-2023,www.who.int/teams/gallup/316016/gallup-keeps-listening-world-nutrition-and-food-safety/monitoring-nutritional-amid-pandemic.aspxstatus-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.STUNTING,WASTINGANDOVERWEIGHTorg/child-malnutritionINCHILDRENUNDERFIVEYEARSOFAGEMethodology:Definitionofstunting(childrenunderfiveyearsofCountry-levelestimatesage):Height/length(cm)forage(months)<−2SDoftheWHOChildGrowthStandardsmedian.TheUNICEF/WHO-WorldBankGroupJointChildLowheight-for-ageisanindicatorthatreflectsMalnutritionEstimates(JME)countrydatasetthecumulativeeffectsofundernutritionandTheUNICEF/WHO-WorldBankGroupJMEinfectionssinceandevenbeforebirth.Itmaybedatasetofcountryestimatesrequiresthetheresultoflong-termnutritionaldeprivation,collectionofnationaldatasourcesthatcontainrecurrentinfectionsandlackofwaterandinformationonchildmalnutrition–specifically,sanitationinfrastructures.dataontheheight,weightandageofchildrenunderfiveyears,whichcanbeusedtogenerateHowitisreported:Thepercentageofchildrennational-levelprevalenceestimatesforstunting,aged0to59monthswhoarebelow−2SDfromwastingandoverweight.Thesenational-levelthemedianheight-for-ageoftheWHOChilddatasourcesmainlycomprisehouseholdsurveysGrowthStandards.(e.g.MultipleIndicatorClusterSurveys[MICS],DHS).Someadministrativedatasources(e.g.Definitionofwasting:Weight(kg)forheight/lengthfromsurveillancesystems)arealsoincluded(cm)<−2SDoftheWHOChildGrowthStandardswherepopulationcoverageishigh.Asofthemedian.Lowweight-for-heightisanindicatorlatestreviewclosureon28February2023,theofacuteweightlossorafailuretogainweightprimarysourcedatasetcontained1100dataandcanbeaconsequenceofinsufficientfoodsourcesfrom162countriesandterritories,withintakeand/oranincidenceofinfectiousdiseases,nearly80percentofchildrenlivingincountriesespeciallydiarrhoea.withatleastonedatapointwithinthepastfiveyearsonstunting,wastingandoverweight.Howitisreported:ThepercentageofchildrenagedThissuggeststhattheglobalestimatesare0to59monthswhoarebelow−2SDfromthehighlyrepresentativeofthemajorityofchildrenmedianweight-for-heightoftheWHOChildacrosstheglobeforthemostrecentperiod.TheGrowthStandards.datasetcontainsthepointestimate(andwhereavailable,thestandarderror),the95percentDefinitionofoverweight:Weight(kg)forconfidenceboundsandtheunweightedsampleheight/length(cm)>+2SDoftheWHOChildsize.Wheremicrodataareavailable,theJMEGrowthStandardsmedian.Thisindicatorreflectsusesestimatesthathavebeenrecalculatedtoexcessiveweightgainforheightgenerallyadheretotheglobalstandarddefinition.Whereduetoenergyintakesexceedingchildren’smicrodataarenotavailable,reportedestimatesenergyrequirements.areused,exceptincaseswhereadjustmentsarerequiredtostandardizefor:i)useofanalternateHowitisreported:Thepercentageofchildrenagedgrowthreferencefromthe2006WHOGrowth0to59monthswhoareabove+2SDfromtheStandards;ii)agerangesthatdonotincludemedianweight-for-heightoftheWHOChildthefull0–59-monthagegroup;andiii)dataGrowthStandards.sourcesthatwereonlynationallyrepresentativeforpopulationsresidinginruralareas.FurtherDatasource:UNICEF,WHO&WorldBank.2023.detailsrelatedtodatasourcecompilation,UNICEF-WHO-WorldBank:Jointchildmalnutritionre-analysisofmicrodata,anddatasourcereviewaredescribedelsewhere.10186THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TheJMEcountrydatasetservesdifferentusedsolelyforgenerationofregionalandpurposesfordifferentindicators.Forwasting,globalaggregates.ModelledestimatesforthesetheJMEcountrydatasetservesasthecountry45countriesarenotshownbecausetheydidnotestimatesthemselves(i.e.thewastingprevalencehaveanyhouseholdsurveysintheJMEcountryintheJMEcountrydatasetfromahouseholddatasetorbecausethemodelledestimatessurveyforacountryinagivenyearistheremainedpendingfinalreviewatthetimeofwastingprevalencereportedforthatcountrypublication.Theresultsforthe205countriescaninthatyear).Forstuntingandoverweight,beusedtocalculateestimatesanduncertaintytheJMEcountrydatasetisusedtogenerateintervalsforanygroupofcountriesaggregated.country‑modelledestimateswhichserveastheTheuncertaintyintervalsareimportantinofficialJMEestimates(i.e.thestuntingprevalencemonitoringtrends,especiallyforcountrieswithfromahouseholdsurveyforagivencountryinsparsedataandwhereprimarydatasourcesagivenyearisnotreportedastheprevalencepresentlargeprimarydatasourcesamplingerrors.forthatcountryinthatyear;rather,itfeedsintoWhenonlysparsedataareavailableinthemostthemodelledestimatesdescribedinthenextrecentperiod,theinclusionofasurveycanaffectsectionbelow).asubstantialchangeinthepredictedtrajectory.Forthisreason,uncertaintyintervalsareneededCountry-levelmodelforstuntingandtoenhancetrendinterpretabilityintermsoftheoverweightestimatescautionlevelemployed.TheuncertaintyintervalsThetechnicaldetailsofthestatisticalmodelsareforthenewJMEmethodhavebeentestedandprovidedelsewhere.10Briefly,forbothstuntingandvalidatedwithvariousdatatypes.overweight,theprevalencewasmodelledatlogit(log-odds)scaleusingapenalizedlongitudinalRegionalandglobalestimatesmixedmodelwithaheterogeneouserrorterm.RegionalandglobalwastingestimatesareThequalityofthemodelswasquantifiedwithonlypresentedforthemostrecentyear,2022,model-fitcriteriathatbalancethecomplexityoftheunlikestuntingandoverweightestimates,formodelwiththeclosenessofthefittotheobservedwhichanannualtimeseriesisavailablefromdata.Theproposedmethodhasimportant2000to2022.ThisisbecausetheJMEarebasedcharacteristics,includingnon-lineartimeonnational-levelcountryprevalencedata,trends,regionaltrends,country-specifictrends,whichcomefromcross-sectionalsurveys(i.e.acovariatedataandaheterogeneouserrorterm.snapshotatonepointintime)thatarecollectedAllcountrieswithdatacontributetoestimatesofinfrequently(everythreetofiveyears)inmosttheoveralltimetrendandtheimpactofcovariatecountries.Sincestuntingandoverweightaredataontheprevalence.Foroverweight,therelativelystableoverthecourseofacalendarcovariatedataconsistedoflinearandquadraticyear,itisreasonabletotrackchangesinthesetwosociodemographicindex(SDI),beanddatasourceconditionsovertimewiththesedata,whereastype.Thesamecovariateswereusedforstunting,wastingisanacuteconditionthatcanchangeplusanadditionalcovariateoftheaveragehealthfrequentlyandrapidly.Anindividualchildcanbesystemaccessoverthepreviousfiveyears.affectedbywastingmorethanonceinacalendaryear(i.e.canrecoverbutthenbecomewastedAnnualcountry-levelmodelledestimatesfromagaininthesameyear),andtheriskofwasting2000to2022onstuntingandoverweightwereinmanycontextscanbedrivenbyseasonaldisseminatedbytheJMEin2023for160countriesvariations,whichcanresultinseasonalspikeswithatleastonedatapoint(e.g.fromahouseholdinprevalence.Forexample,wastingprevalence,survey)includedintheJMEcountrydatasetinsomecontexts,maydoublebetweenthedescribedabove.Modelledcountryestimatespost‑harvestseason(oftenassociatedwithhigherwerealsoproducedforanadditional45countries,foodavailabilityandweatherpatternsthatarelesslikelytocausedisease)andthepre-harvestbeSDIisasummarymeasurethatidentifieswherecountriesorotherseason(oftenassociatedwithfoodshortages,geographicareassitonthespectrumofdevelopment.Expressedonaheavyrainsandrelateddiseasesthatcanaffectscaleof0to1,SDIisacompositeaverageoftherankingsoftheincomenutritionstatus).Giventhatcountrysurveyscanpercapita,averageeducationalattainment,andfertilityratesofallbecollectedduringanyseason,theprevalenceareasintheGlobalBurdenofDiseasestudy.187ANNEX1BestimatefromanysurveymaybeatahighoraChallengesandlimitations:Therecommendedlow;oritmayfallsomewhereinbetweenifdataperiodicityforcountriestoreportonstunting,collectionspannedacrossseveralseasons.Thus,overweightandwastingiseverythreetofivetheprevalenceofwastingcapturesthesituationofyears;however,forsomecountries,dataarewastingataspecificpointintimeandnotoveranavailablelessfrequently.Whileeveryefforthasentireyear.Variationsinseasonsacrosssurveysbeenmadetomaximizethecomparabilityofmakeitdifficulttodrawinferencesontrends.Thestatisticsacrosscountriesandovertime,countrylackofmethodstoaccountforseasonalityanddatamaydifferintermsofdatacollectionincidentcasesofwastingarethemainreasonsmethods,populationcoverageandestimationwhytheJMEdoesnotpresentannualtrendsformethodsused.Surveyestimatescomewithlevelsthisformofmalnutrition.ofuncertaintyduetobothsamplingerrorsandnon‑samplingerrors(technicalmeasurementGenerationofregionalandglobalestimateserrors,recordingerrors,etc.).NeitherofthetwoDifferentmethodswereappliedtogeneratesourcesoferrorhasbeenfullytakenintoaccountregionalandglobalestimatesforstuntingandforderivingestimatesatthecountryorregionaloverweightcomparedtowasting,asdescribedandgloballevels.below.Inshort,resultsfromthenewcountry-levelmodelwereusedtogeneratetheregionalandFortheprevalenceofwasting,assurveysareglobalestimatesforstuntingandoverweight,generallycarriedoutduringaspecificperiodwhiletheJMEsubregionalmultilevelmodeloftheyear,theestimatescanbeaffectedbywasusedtogeneratetheglobalandregionalseasonality.Seasonalfactorsrelatedtowastingestimatesforwasting.includefoodavailability(e.g.pre-harvestperiods)anddisease(rainyseasonanddiarrhoea,Stuntingandoverweightmalaria,etc.),whilenaturaldisastersandconflictsGlobalandregionalestimatesforallyearsfromcanalsoshowrealshiftsintrendsthatwould2000to2022werederivedastherespectiveneedtobetreateddifferentlyfromaseasonalcountryaveragesweightedbythecountries’variation.Hence,country-yearestimatesforunder-fivepopulationfromtheUNDESAwastingmaynotnecessarilybecomparableoverWorldPopulationProspects,2022revision,4usingtime.Consequently,onlyestimatesfromthemostmodel-basedestimatesfor204countries.Thisrecentyear(2022)areprovided.includes155countrieswithnationaldatasources(e.g.householdsurveys)includedintheJMERecommendedreadings:countrydatasetdescribedabove.ItalsoincludesdeOnis,M.,Blössner,M.,Borghi,E.,Morris,R.&49countrieswithmodelledestimatesgeneratedFrongillo,E.A.2004.Methodologyforestimatingfordevelopmentofregionalandglobalaggregatesregionalandglobaltrendsofchildmalnutrition.butforwhichcountrymodelledestimatesareInternationalJournalofEpidemiology,33(6):notshown,eitherbecausetheydidnothaveany1260–1270.https://doi.org/10.1093/ije/dyh202householdsurveysintheJMEcountrydatasetGBD2019RiskFactorsCollaborators.2020.Globalorbecausethemodelledestimatesremainedburdenof87riskfactorsin204countriesandpendingfinalreviewatthetimeofpublication.territories,1990–2019:asystematicanalysisfortheConfidenceintervalsweregeneratedbasedonGlobalBurdenofDiseaseStudy2019.TheLancet,bootstrappingmethodology.396(10258):1223–1249.https://doi.org/10.1016/s0140-6736(20)30752-2WastingUNICEF,WHO&WorldBank.2021.TechnicalThewastingprevalencedatafromnationaldatanotesfromthebackgrounddocumentforsourcesdescribedintheabovesectionaboutcountryconsultationsonthe2021editionofthetheJMEcountrydatasetwereusedtogenerateUNICEF-WHO-WorldBankJointMalnutritiontheregionalandglobalestimatesfor2020usingEstimates.SDGIndicators2.2.1onstunting,2.2.2atheJMEsubregionalmultilevelmodel,applyingonwastingand2.2.2bonoverweight.NewYork,populationweightsforchildrenunderfiveyearsUSA,UNICEF.data.unicef.org/resources/ofagefromtheUNDESAWorldPopulationjme-2021-country-consultationsProspects,2022revision.188THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023UNICEF,WHO&WorldBank.2023.ThisindicatorincludesbreastfeedingbyawetnurseUNICEF-WHO-WorldBank:Jointchildmalnutritionandfeedingexpressedbreastmilk.estimates–Levelsandtrends(2023edition).[Cited27April2023].https://data.unicef.org/Theindicatorisbasedonarecallofthepreviousresources/jme-report-2023,www.who.int/teams/day’sfeedingtoacross-sectionofinfants0tonutrition-and-food-safety/monitoring-nutritional-5monthsofage.status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.In2012,theregionalandglobalexclusiveorg/child-malnutritionbreastfeedingestimatesweregeneratedusingtheWHO.2014.ComprehensiveImplementationPlanonmostrecentestimateavailableforeachcountrymaternal,infantandyoungchildnutrition.Geneva,between2005and2012.Similarly,2020estimateswereSwitzerland.www.who.int/publications/i/item/developedusingthemostrecentestimateavailableWHO-NMH-NHD-14.1foreachcountrybetween2014and2020.GlobalWHO.2019.NutritionLandscapeInformationSystemandregionalestimateswerecalculatedasweighted(NLIS)countryprofileindicators:interpretationaveragesoftheprevalenceofexclusivebreastfeedingguide.Geneva,Switzerland.www.who.int/ineachcountry,usingthetotalnumberofinfantspublications/i/item/9789241516952aged0to5monthsfromtheWorldPopulationProspects,2022revision4(2012forthebaselineand2021fortheEXCLUSIVEBREASTFEEDINGcurrent)asweights.EstimatesarepresentedonlywheretheavailabledataarerepresentativeofatleastDefinition:Exclusivebreastfeedingforinfants50percentofcorrespondingregions’totalnumberofundersixmonthsofageisdefinedasreceivingbirths,unlessotherwisenoted.onlybreastmilkandnoadditionalfoodordrink,notevenwater.ExclusivebreastfeedingisaChallengesandlimitations:Whileahighproportionofcornerstoneofchildsurvivalandisthebestcountriescollectdataforexclusivebreastfeeding,feedingoptionfornewborns,asbreastmilkshapesdataarelackinginhigh-incomecountriesinthebaby’smicrobiome,strengthenstheimmuneparticular.Therecommendedperiodicityofsystemandreducestheriskofdevelopingreportingonexclusivebreastfeedingiseverythreechronicdiseases.tofiveyears.However,forsomecountries,dataarereportedlessfrequently,meaningchangesinBreastfeedingalsobenefitsmothersbypreventingfeedingpatternsareoftennotdetectedforseveralpostpartumhaemorrhageandpromotinguterineyearsafterthechangeoccurs.involution,decreasingriskofiron-deficiencyanaemia,reducingtheriskofvarioustypesofRegionalandglobalaveragesmaybeaffectedcancerandprovidingpsychologicalbenefits.dependingonwhichcountrieshaddataavailablefortheperiodsconsideredinthisreport.Howitisreported:Percentageofinfantsaged0to5monthswhoarefedexclusivelyonbreastmilkUsingthepreviousday’sfeedingasabasismaywithnoadditionalfoodordrink,notevenwater,causetheproportionofexclusivelybreastfedinfantsinthe24hoursprecedingthesurvey.11tobeoverestimated,assomeinfantswhomayhavebeengivenotherliquidsorfoodsirregularlymayDatasource:UNICEF.2022.Infantandyoungnothavereceivedtheseonthedaybeforethesurvey.childfeeding.In:UNICEF.[Cited6April2023].data.unicef.org/topic/nutrition/Recommendedreadings:infant-and-young-child-feedingUNICEF.2022.Infantandyoungchildfeeding:exclusivebreastfeeding.In:UNICEF.[Cited6Methodology:April2023].data.unicef.org/topic/nutrition/infant-and-young-child-feedingInfants0–5monthsofagewhoreceivedonlyWHO.2014.ComprehensiveImplementationPlanonbreastmilkduringthepreviousdaymaternal,infantandyoungchildnutrition.Geneva,Switzerland.www.who.int/publications/i/item/Infants0–5monthsofageWHO-NMH-NHD-14.1189ANNEX1BWHO.2019.NutritionLandscapeInformationSystemi.abirthweightinthedatasetforaminimumof(NLIS)countryprofileindicators:interpretation30percentofthesample;guide.Geneva,Switzerland.www.who.int/publications/i/item/9789241516952ii.aminimumof200birthweightsinthedataset;WHO&UNICEF.2021.Indicatorsforassessingiii.noindicationofseveredataheaping–thisinfantandyoungchildfeedingpractices:definitionsandmeasurementmethods.https://meansthat:a)≤55percentofallbirthweightsapps.who.int/iris/rest/bitstreams/1341846/retrievecanfallonthethreemostfrequentbirthweights(i.e.if3000g,3500gand2500gLOWBIRTHWEIGHTwerethethreemostfrequentbirthweights,whenaddedtogether,theywouldhavetoDefinition:Lowbirthweightisdefinedasaweightmakeup≤55percentofallbirthweightsintheatbirthoflessthan2500g(lessthan5.51lbs),dataset);b)≤10percentofallbirthweightsareregardlessofgestationalage.Anewborn’sweight≥4500g;andc)≤5percentofbirthweightsfallatbirthisanimportantmarkerofmaternalandontailendsof500gand5000g;andfoetalhealthandnutrition.12iv.undergoneanadjustmentformissingbirthweightsandheaping.12Howitisreported:Thepercentageofnewbornsweighinglessthan2500g(lessthan5.51lbs)atbirth.EstimatesoflowbirthweightprevalenceatthenationallevelwerepredictedfromaBayesianDatasource:UNICEF&WHO.2023.Lowmultilevel-regressionmodel.13Themodelisbirthweightjointestimates2023edition.[Citedfitonthelogit(log-odds)scaletoensurethat12July2023].https://data.unicef.org/topic/proportionsareboundedbetweenzeroandone,nutrition/low-birthweight;www.who.int/andthenback-transformedandmultipliedby100teams/nutrition-and-food-safety/monitoring-ntoobtainprevalenceestimates.utritional-status-and-food-safety-and-events/joint-low-birthweight-estimatesHierarchicalrandomcountry-specificintercepts(countrieswithinregionswithinglobal)accountedMethodology:Nationallyrepresentativeestimatesofforthecorrelationwithinandbetweentheregions.lowbirthweightprevalencecanbederivedfromThesixSDGregionswereadaptedandusedinarangeofsources,broadlydefinedasnationalthemodelling.Penalizedsplineswereusedasadministrativedataorrepresentativehouseholdtemporalsmoothingacrossthetimeseries26–28,surveys.Nationaladministrativedataarethosemeaningthatcountry-levelnon-lineartimetrendscomingfromnationalsystemsincludingcivilwerecapturedwithoutrandomvariationaffectingregistrationandvitalstatisticssystems,nationalthetrend.Country-levelcovariateswerealsohealthmanagementinformationsystemsandincludedinthemodelling.Thefinalcovariatesbirthregistries.Nationalhouseholdsurveysincludedinthemodelwere:grossnationalincomewhichcontaininformationaboutbirthweightasperpersonpurchasingpowerparity(constantwellaskeyrelatedindicatorsincludingmaternal2017internationaldollars),theprevalenceofperceptionofsizeatbirth(MICS,DHS)arealsounderweightamongfemaleadults,theadultfemaleanimportantsourceofdataonlowbirthweightliteracyrate,themoderncontraceptionprevalenceespeciallyincontextswheremanybirthsarerateandthepercentageofurbanpopulation.unweighedand/ordataheapingisaproblem.Priortoentryintothecountrydataset,countryAlongsidethis,dataqualitycategories(TableA1.5)dataarereviewedforcoverageandqualitywereusedtoapplybiasshiftsandadditionalandadjustedwherethesourceisahouseholdvarianceterms.Thebiasshiftwasappliedtosurvey.Tobeincluded,availablebirthweightsadministrativedatafromlowerqualitycategories,fromadministrativedataneedtocoveratleastwhichapproximatedtheexpectedbiasfrom80percentoftheUNDESAWorldPopulationheapingthatwasalreadyaccountedforintheProspectsestimatedlivebirthsforthatyear.Tobesurveyadjustment.Theadditionalvarianceincludedinthedataset,surveydataneedtohave:wasbasedon1)thedataqualitycategoryoftheadministrativedata,and2)theweightingbetweenadministrativeandsurveydataifthecountryhadboth.190THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA1.5DATAQUALITYCATEGORIESFORADMINISTRATIVESOURCESDQCCriteria1–CoverageCriteria2–DataCriteria3–Criteria4–OmissionCriteria5–WhethercomparedtoWorldsourcetypeDenominatorusedtoofbabiesaroundcountryhasonlyAPopulationProspectscalculatelowthresholdofviabilityadmindataoradminestimatedlivebirthsCivilregistrationandbirthweightratedataandsurveysB1≥90%recordedvitalstatisticsor<1000/<2500g≥4%–B2birthweightmedicalbirthregistryLivebirthswithorif<1000/<2500gC1coverageand≥90%birthweightforallisunavailable,<1Admindata+surveyC2facilitybirthsCivilregistrationandcountry-years,andnot500/<2500gAdmindataonlyvitalstatisticsorreportedprevalence≥12.5%NotmeetingcriteriamedicalbirthregistryoflowbirthweightAdmindata+surveyforcategoryANotappliedasAdmindataonlyAnydenominatorORDenominatorisliverelevantdatanotNotmeetingcriteriareportedlowbirthsonlyortotalavailableforallyearsforcategoryAbirthweightonly(i.e.births,andnotforthesecountriesnodenominator)reportedprevalenceoflowbirthweightNotappliedasrelevantdatanotAnydenominatoravailableforallyearsforthesecountriesNOTES:DQC–dataqualitycategory.Franceincludedasanexception.RecordedbirthweightcoveragewascalculatedbydividingthenumberoflivebirthswithabirthweightintheadministrativedatasourcebytheWorldPopulationProspects2022editionestimatedlivebirths.Across≥80percentofthetimeseries2000–2019(i.e.≥16country-years).SOURCE:Okwaraji,Y.B.,Krasevec,J.,Bradley,E.,Conkle,J.,Stevens,G.A.,Gatica-Domínguez,G.,Ohuma,E.O.etal.2023.National,regional,andglobalestimatesoflowbirthweightin2020,withtrendsfrom2000:asystematicanalysis.TheLancet(inpress).Standarddiagnosticcheckswereusedtoassessforhavingalowbirthweight,estimatesthatdoforconvergenceandthesamplingefficiency.notwellrepresentthesechildrenmaybelowerCross-validationwasimplemented,averagingthanthetruevalue.Furthermore,poorqualityofover200randomsplitsof20percenttestdata,availabledatawithregardtoexcessiveheapingon80percenttrainingdata.Sensitivityanalysesweremultiplesof500gor100gexistsinthemajorityofundertakenincludingchecksoncovariates,biasavailabledatafromLMICs13andcanfurtherbiasmethod,temporalsmoothingandnon-informativelowbirthweightestimates.Themethodsappliedpriors.AllmodelswerefittedinRstatisticaltoadjustformissingbirthweightsandheapingsoftwareandtheRpackages“rjags”and“R2jags”.forsurveyestimatesinthecurrentdatabase13aremeanttoaddresstheproblem.ArecentvalidationThemodelincludedall2040country-yearsofdatastudyfoundthattheadjustedlowbirthweightmeetingtheinclusioncriteriaandgeneratedannualestimatewassimilartothetrueprevalencewhileestimatesfrom2000to2020with95percentcredibletheunadjustedvaluedidn’tcaptureevenhalfofintervalsfor195countriesandareas.bfOnlyestimatesthelow-weightbirthsinonepopulation.14forcountriesandareaswithdataarereported.Forthe37(outof195)countrieswithnodataordataTheadministrativeinputdataalsohavenotmeetinginclusioncriteria,thefinalmodelwaslimitations,includingalackofindividual-levelusedtopredictestimatesoftheprevalenceoflowdata,andlimitedinformationonheapingbirthweightbasedoncountryinterceptsandtimeandmissingbirthweights.Thedataqualitytrendsestimatedfromtheregion-andcountry-levelcategorization(TableA1.5)attemptedtoaccountcovariatesforallcountry-years.Regionalandglobalforthisbygroupingcountriesaccordingtodataaggregateswerethenproducedusingestimatesfromqualityindicators,butmorerobustmethodsneedall195countriesandareas.tobedevelopedtoadjustforadministrativedataqualitydifferencesatanindividualcountrylevelChallengesandlimitations:Amajorlimitationofasopposedtohavingasinglebiasadjustmentmonitoringlowbirthweightgloballyisthelackofforagroupofcountries.Furthermore,forbirthweightdataformanyoftheworld’schildren.surveys,thestandarderrorsarelargerthanthoseHerethereisanotablebias,withchildrenborndevelopedfortheadministrativeinputdataduetopoorer,lesseducated,ruralmothersbeingtothenatureofsamplinginhouseholdsurveys.lesslikelytohavearecordedbirthweightwhenThesedifferencesinstandarderrorsbetweencomparedtotheirricher,urbancounterpartsadministrativeandsurveydatamayaffectthewithmorehighlyeducatedmothers.13Asthemodeloutcomeartificially.characteristicsoftheunweighedareriskfactorsTheSDGgeographicalgroupingsusedinbfWhiletheworldcomprises203countriesintheFAOregionalthemodellingmaynotbeappropriateforgrouping,eightcountriesdidnothavelowbirthweightinputdataorepidemiologicaloreconomicregionaloutliers.Incovariatedata.Itwasthereforenotpossibletogenerateanyestimatesall,theestimatesfor37(of195)countrieswithoutforthesecountries,andtheyarenotincludedintheregionalandinputdatamayhavebeenaffected.Forexample,globalestimates.191ANNEX1BthepredictedprevalenceforHaiti,acountryHowitisreported:Percentageofthepopulationoverwithoutinputdatameetinginclusioncriteria,18yearsofagewithBMI≥30.0kg/m2standardizedwasbasedoncountry-levelcovariatesaswellasbyageandweightedbysex.15countryinterceptsandtimetrendsfromtheLatinAmericaandtheCaribbeanregionwhichmaynotDatasource:WHO.2020.GlobalHealthObservatorybeappropriateforthisparticularcountry.(GHO)datarepository.In:WHO.[Cited28April2020].apps.who.int/gho/data/node.main.Inaddition,theconfidencelimitsoftheregionalA900A?lang=en(1698population-basedstudiesandglobalestimatesmaybeartificiallysmallwithmorethan19.2millionparticipantsagedgiventhatabouthalfofthemodelledcountries18yearsorolder,measuredin186countries).16hadacountry-specificeffectgeneratedatrandomforeachbootstrapprediction,someofwhichwereMethodology:ABayesianhierarchicalmodelwaspositiveandothersnegative,makingtherelativeappliedtoselectedpopulation-basedstudiesthatuncertaintyattheregionalandgloballeveltendhadmeasuredheightandweightinadultsagedtobelessthanthatattheindividualcountrylevel.18yearsandoldertoestimatetrendsfrom1975to2014inmeanBMIandintheprevalenceofBMIRecommendedreadings:categories(underweight,overweightandobesity).Blanc,A.&Wardlaw,T.2005.MonitoringlowThemodelincorporatednon-lineartimetrendsbirthweight:Anevaluationofinternationalandagepatterns,nationalversussubnationalandestimatesandanupdatedestimationprocedure.communityrepresentativeness,andwhetherdataBulletinWorldHealthOrganization,83(3):178–185.coveredbothruralandurbanareasversusonlywww.ncbi.nlm.nih.gov/pmc/articles/PMC2624216oneofthem.ThemodelalsoincludedcovariatesBlencowe,H.,Krasevec,J.,deOnis,M.,Black,thathelppredictBMI,includingnationalincome,R.E.,An,X.,Stevens,G.A.,Borghi,E.,Hayashi,C.,proportionofthepopulationlivinginurbanareas,Estevez,D.,Cegolon,L.,Shiekh,S.,PonceHardy,V.,meannumberofyearsofeducation,andsummaryLawn,J.E.&Cousens,S.2019.National,regional,measuresofavailabilityofdifferentfoodtypesforandworldwideestimatesoflowbirthweightinhumanconsumption.2015,withtrendsfrom2000:asystematicanalysis.TheLancetGlobalHealth,7(7):e849–e860.Challengesandlimitations:Somecountrieshadfewdatahttps://doi.org/10.1016/S2214-109X(18)30565-5sources,andonly42percentofincludedsourcesChang,K.T.,Carter,E.D.,Mullany,L.C.,Khatry,reporteddataforpeopleolderthan70years.S.K.,Cousens,S.,An,X.,Krasevec,J.,LeClerq,S.C.,Munos,M.K.&Katz,J.2022.ValidationRecommendedreadings:ofMINORMIXapproachforestimationoflowNCD-RisC(NCDRiskFactorCollaboration).2016.birthweightprevalenceusingaruralNepalTrendsinadultbody-massindexin200countriesfromdataset.TheJournalofNutrition,152(3):872–879.1975to2014:apooledanalysisof1698population-basedhttps://doi.org/10.1093/jn/nxab417measurementstudieswith19.2millionparticipants.Okwaraji,Y.B.,Krasevec,J.,Bradley,E.,Conkle,J.,TheLancet,387(10026):1377–1396.https://doi.Stevens,G.A.,Gatica-Domínguez,G.,Ohuma,E.O.org/10.1016/S0140-6736(16)30054-Xetal.2023.National,regional,andglobalestimatesWHO.2019.NutritionLandscapeInformationSystemoflowbirthweightin2020,withtrendsfrom2000:(NLIS)countryprofileindicators:interpretationguide.asystematicanalysis.TheLancet(inpress).Geneva,Switzerland.www.who.int/publications/i/item/9789241516952ADULTOBESITYANAEMIAINWOMENDefinition:BMI≥30.0kg/m2.ThebodymassindexAGED15TO49YEARS(BMI)istheweight-to-heightratiocommonlyusedtoclassifythenutritionalstatusofadults.Definition:Percentageofwomenaged15to49yearsItiscalculatedasthebodyweightinkilogramswithahaemoglobinconcentrationoflessthandividedbythesquareofthebodyheightin120g/Lfornon-pregnantwomenandlactatingmetres(kg/m2).Obesityincludesindividualswithwomen,andlessthan110g/Lforpregnantwomen,BMIequaltoorhigherthan30kg/m2.adjustedforaltitudeandsmoking.192THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023Howitisreported:Percentageofwomenaged15tomaynotcapturethefullvariationacrosscountries49yearswithahaemoglobinconcentrationbelowandregions,thustendingto“shrink”towards110g/Lforpregnantwomenandbelow120g/Lglobalmeanswhendataaresparse.fornon-pregnantwomen.Recommendedreadings:Datasource:Stevens,G.A.,Finucane,M.M.,De-Regil,WHO.2021.Globalanaemiaestimates,editionL.M.,Paciorek,C.J.,Flaxman,S.R.,Branca,2021.In:WHOGlobalHealthObservatory(GHO)F.,Peña-Rosas,J.P.,Bhutta,Z.A.&Ezzati,M.datarepository.[Cited20April2023].www.who.2013.Global,regional,andnationaltrendsinint/data/gho/data/themes/topics/anaemia_in_haemoglobinconcentrationandprevalencewomen_and_childrenoftotalandsevereanaemiainchildrenandpregnantandnon-pregnantwomenfor1995–2011:Methodology:The2021editionofanaemiaestimatesasystematicanalysisofpopulation-representativeinwomenaged15to49years,bypregnancystatus,data.TheLancetGlobalHealth,1(1):e16–e25.includeddatasourcesfromtheMicronutrientshttps://doi.org/10.1016/s2214-109x(13)70001-9Database,partoftheWHOVitaminandStevens,G.A.,Paciorek,C.J.,Flores-Urrutia,M.C.,MineralNutritionInformationSystemandfromBorghi,E.,Namaste,S.,Wirth,J.P.,Suchdev,anonymizedindividual-leveldatawhichspanP.S.,EzzatI,M.,Rohner,F.,Flaxman,S.R.&from1995to2020.AdjustmentsofdataonbloodRogers,L.M.2022.National,regional,andglobalhaemoglobinconcentrationsforaltitudeandestimatesofanaemiabyseverityinwomensmokingwerecarriedoutwheneverpossible.andchildrenfor2000–19:apooledanalysisofBiologicallyimplausiblehaemoglobinvaluespopulation-representativedata.TheLancetGlobal(<25g/Lor>200g/L)wereexcluded.ABayesianHealth,10(5):e627–e639.https://doi.org/10.1016/hierarchicalmixturemodelwasusedtoestimateS2214-109X(22)00084-5haemoglobindistributionsandsystematicallyWHO.2011.Haemoglobinconcentrationsfortheaddressmissingdata,non-lineartimetrends,anddiagnosisofanaemiaandassessmentofseverity.representativenessofdatasources.Briefly,theVitaminandMineralNutritionInformationSystem.modelcalculatesestimatesforeachcountryandGeneva,Switzerland.https://apps.who.int/iris/year,informedbydatafromthatcountryandyearbitstream/handle/10665/85839/WHO_NMH_themselves,ifavailable,andbydatafromotherNHD_MNM_11.1_eng.pdfyearsinthesamecountryandinothercountriesWHO.2014.ComprehensiveImplementationPlanonwithdataforsimilartimeperiods,especiallyMaternal,InfantandYoungChildNutrition.Geneva,countriesinthesameregion.ThemodelborrowsSwitzerland.www.who.int/publications/i/item/data,toagreaterextent,whendataarenon-existentWHO-NMH-NHD-14.1orweaklyinformative,andtoalesserextentforWHO.2021.Globalanaemiaestimates,editiondata-richcountriesandregions.Theresulting2021.In:WHOGlobalHealthObservatory(GHO)estimatesarealsoinformedbycovariatesthatdatarepository.[Cited20April2023].www.who.helppredictbloodhaemoglobinconcentrationsint/data/gho/data/themes/topics/anaemia_in_(e.g.sociodemographicindex,meatsupplywomen_and_children[kcal/capita],meanBMIforwomen,andlogofWHO.2021.VitaminandMineralNutritionunder-fivemortalityforchildren).TheuncertaintyInformationSystem(VMNIS).In:WHO.ranges(credibilityintervals)reflectthemajor[Cited20April2023].www.who.int/teams/sourcesofuncertainty,includingsamplingerror,nutrition-food-safety/databases/vitamin-and-minnon-samplingerrorduetoissuesinsampledesign/eral-nutrition-information-systemmeasurement,anduncertaintyfrommakingWHO.2021.NutritionLandscapeInformationestimatesforcountriesandyearswithoutdata.System(NliS)CountryProfile.In:WHO.[Cited20April2023].www.who.int/data/nutrition/nlis/Challengesandlimitations:Despiteahighproportioncountry-profileofcountrieshavingnationallyrepresentativeWHO.2023.NutritionDataPortal.In:WHO.surveydataavailableforanaemia,thereisstilla[Cited20April2023].https://platform.who.int/lackofreportingonthisindicator,especiallyinnutrition/nutrition-portalsnhigh‑incomecountries.Asaresult,theestimates193ANNEX2ANNEX2METHODOLOGIESUSEDINCHAPTER2A.MethodologyforestimatingthePoUforoftheFIsev(which,formostcountries,isbased2020,2021and2022onrelativelysmallsamplesofFIESdata)andisconsistentwithanassumptionthatCVyfollowsAsinpreviouseditionsofthisreport,duetolackarelativelystabletrend.Theexceptionalnatureofdirectinformationonthemostrecentvaluesofof2020and2021madeitdifficulttomaintaineachoftheelementsthatcontributetocomputingthatlastassumption.Becauseofthat,thechangestheprevalenceofundernourishment(PoU)andbetweenthe2017–2019averageandthe2020numberofundernourishedpeople(NoU)(seeannualvaluesofFIsevwereusedtonowcasttheAnnex1B),estimatesreferringtothemostrecent2020valuesofCVy,andthechangesbetweentheyearsarenowcasted;inotherwords,theyare2020and2021annualvaluesofFIsevwereusedtopredictionsoftheveryrecentpast.nowcastthe2021valuesofCVy.Asalreadynotedinlastyear’seditionofthisAnotherparameterthatneededattentiontoreport,2020and2021wereuniqueinmanynowcastthe2020valueofPoUwasthepercentagerespectsduetotheCOVID-19pandemicandofchangeinFIsev(usedasaproxyfortheitslingeringeffects.ThisdemandedspecialexpectedchangeinthePoU)thatisattributedconsiderationswhennowcastingthevaluesoftoCVy.Normally,thishadbeenassumedtothePoU,especiallywithrespecttoestimatingbeequaltoone-third,basedonaneconometricthelikelychangeinthecoefficientofvariationanalysisofpastvaluesofPoU,DECandCVy.(CV)andtomodellingthewayinwhichTheexceptionalnatureof2020and2021calledinequalityinaccesstofoodcontributestoratesofintoquestionthatregularity.Asnonationalundernourishment.Bothaspectsrequiredspecialhouseholdconsumptionandexpendituresurveytreatmentinconsiderationoftheveryspecialdatain2020orin2021wereavailable,thereisconditionsunderwhichfoodsystemsoperatedstillnoempiricalbasistodeterminehowtoduringthepandemic.properlymodifyit.ThesolutionwastoconductasensitivityanalysismodifyingthepercentageThestrategyusedtoprojectvaluesoftheCVyofchangeinFIsevthatisattributedtoCVyfromfrom2019to2021andtherangesofglobalPoUaminimumofone-thirdtoamaximumofone.andNoUestimatesfollowedthesameapproachThisdefinedthelowerandupperboundsoftheasinlastyear’seditionofthisreport,whileestimatedseriesfor2020and2021.additionalconsiderationsweremadefor2022.Botharedescribedbelow.Specialconsiderationsfor2022WhilethemaineffectsoftheCOVID-19pandemicProjectingCVyupto2021haverecededanddatacollectionbegantoWhilethevaluesofdietaryenergyconsumptionnormalizein2022,thereisstillconsiderable(DEC)arenowcastedusingthetraditionaluncertaintyregardingtheextentofthechangesapproachbasedoninformationprovidedbyininequalityinaccesstofoodthatmayhavetheMarketsandTradeDivisionofFAO,usedtooccurredthatyear.ItisnotyetknownwhetherinformFAOAgriculturalOutlooks,thetraditionalthepandemicandallotherdisruptiveeventsthatapproachusedtonowcasttheCVhadtobehaveaffectedagrifoodsystemsworldwideinthemodifiedtoreflectthepeculiarconditionsoflastthreeyearshavehadanypersistingeffect2020and2021.Normally,changesinCVy(theontherelativerolesofdemandandsupplysidecomponentoftheCVassociatedwithdifferenceselementsinpeople’saccesstofood.This,inturn,inhouseholds’economicconditions)arederiveddemandedaslightmodificationoftheapproachfromdifferencesinthree-yearaveragesofthetoproducenowcastsoftheCVy,andhenceofprevalenceofseverefoodinsecuritybasedonthePoU,in2022.theFIES(FIsev)thatarenotexplainedbychangesinfoodsupplies.Useofthethree-yearaverageInparticular,thevalueof33percentasprobableaddressedtheneedtocontrolforpossibleexcesscontributionofchangesintheCVtotheobservedsamplingvariabilityincountry-levelestimates194THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA2.1RANGESOFPoUANDNoUNOWCASTEDIN2020,2021AND2022202020212022PoUNoUPoUNoUPoUNoU(%)(millions)(%)(millions)(%)(millions)LowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperboundboundboundboundboundboundboundboundboundboundboundboundWORLD8.49.5656.6743.78.510.1674.6796.98.79.8690.6783.1AFRICA17.619.8238.4270.017.720.9247.1291.919.020.5271.6291.9NorthernAfrica5.66.415.116.06.47.417.619.07.08.118.221.1Sub-SaharanAfrica20.322.9224.3254.020.323.9231.0272.821.723.2253.5270.9EasternAfrica26.429.8118.3134.026.030.6119.8141.527.129.4128.1139.0MiddleAfrica26.029.247.754.029.230.749.558.529.029.456.857.6SouthernAfrica8.910.06.06.89.110.76.27.310.811.57.47.9WesternAfrica12.914.552.359.213.315.655.565.614.215.561.166.3ASIA8.09.0370.8420.18.19.5378.0446.67.99.1372.2431.0CentralAsia3.13.52.32.62.93.42.22.63.03.52.32.7EasternAsia<2.5<2.5n.r.n.r.<2.5<2.5n.r.n.r.<2.5<2.5n.r.n.r.South-easternAsia4.95.632.937.34.95.732.938.84.95.333.236.2SouthernAsia14.716.5288.0326.315.017.6297.6351.614.316.9286.9338.7WesternAsia9.811.128.031.89.311.027.031.910.411.230.432.9WesternAsiaand7.98.942.247.87.99.343.150.98.89.848.654.06.939.644.86.37.541.649.25.87.738.551.0NorthernAfricaLATINAMERICAAND6.1THECARIBBEANCaribbean14.316.16.37.113.415.85.97.017.118.07.68.0LatinAmerica5.56.233.337.85.86.935.742.25.07.030.943.0CentralAmerica4.65.18.09.14.65.49.19.64.95.38.99.5SouthAmerica5.96.625.328.76.47.527.632.65.17.722.133.5OCEANIA5.76.42.52.86.07.12.73.26.97.23.13.2NORTHERNAMERICA<2.5<2.5n.r.n.r.<2.5<2.5n.r.n.r.<2.5<2.5n.r.n.r.ANDEUROPENOTES:n.r.=notreported,astheprevalenceislessthan2.5percent.ForNoU,regionaltotalsmaydifferfromthesumofsubregions,duetoroundingandnon-reportedvalues.Forcountrycompositionsofeachregional/subregionalaggregate,seeNotesongeographicregionsinstatisticaltablesattheendofthereport.SOURCE:Authors’(FAO)ownelaboration.changesinthePoUwasusedtoproducetheinCVy.Combiningthesetofalllowestandthemid-pointoftheestimatedseries,reflectingsetofallhighestcountryestimates,weobtain,whatwouldbea“back-to-normal”situationrespectively,lowerandupperboundsforthe(seeAnnex1B).Then,additionalvaluesofglobalandregionalseries.Overall,theresultis50,67and100percentwereused,separatelyaslightlynarrowerrangeofglobalPoUandNoUforeachcountry,reflectingpossibledifferentestimatesin2022comparedtotheprevioustwoassumptionsaboutthewayinwhichCVymightyears(TableA2.1).havecontributedtoPoUin2022.Notehoweverthat,contrarytowhatwasthecasein2020andTableA2.1presentsthelowerandupperbounds2021,whenFIES-basedestimatesrevealedfoodofthePoUin2020,2021and2022attheglobal,insecurityworseningpracticallyeverywhere,theregionalandsubregionallevels.implicationsofassuminggreatercontributionofchangesintheCVtowardschangesinthePoUareB.MethodologyforprojectionsofPoUsomehowoppositeforthe2022value.Consideringto2030thatestimatesoftheprevalenceofseverefoodinsecurityshowedanimprovementformanyToprojectPoUvaluesto2030,weprojectthecountriesfrom2021to2022,forthosecountriesthreefundamentalvariablesthatenterintheweprojectareduction,ratherthananincreasePoUformula(DEC,CVandMDER)separately,195ANNEX2basedondifferentinputs,dependingontheInotherwords,wetakethemodelprojectedscenarioconsidered.seriesofDES_KcalandadjustitslevelsothatthevalueforyearTmatchestheactualvalue.(ThisisThemainsourceofinformationistheoutputofnecessaryastheMIRAGRODEPmodelhasbeentheMIRAGRODEPrecursive,dynamiccomputablecalibratedtoanolderFBSseries.)generalequilibriummodel,whichprovidesseriesofprojectedvalues,atthecountrylevel,for:ProjectionsofMDERToprojecttheMDER,wesimplycomputeitbasedrealpercapitaGDP(GDP_Vol_pc);onthedataonthecompositionofthepopulationincomeGinicoefficient(gini_income);bysexandageasprojectedbythe2019Worldanindexofrealfoodprice(Prices_Real_Food);PopulationProspects4(mediumvariant).extremepovertyheadcountrate(thatis,the𝐷𝐷𝐷𝐷𝐶𝐶=𝐷𝐷𝐷𝐷𝐷𝐷×𝐷𝐷𝐷𝐷𝐷,𝐷_𝐾𝐾𝐾𝐾𝐾𝐾𝑙𝑙!×(1−𝑊𝑊𝑊𝑊𝑊𝑊𝑊𝑊𝐸𝐸),∀𝑡𝑡>𝑇𝑇percentageofthepopulationwithrealdaily!"Pro𝐷𝐷j𝐷e𝐷c𝐷,𝐷_t𝐾io𝐾𝐾𝐾n𝐾𝐾s𝑙𝑙"oftheCV!incomebelowUSD2.15(x215_ALL);andAsexplainedinthemethodologicalnoteonthedailypercapitafoodconsumption(DES_Kcal).PoUinAnnex1B,thetotalCViscomputedas𝐶𝐶𝐶𝐶=5(𝐶𝐶𝐶𝐶𝑦𝑦)#+(𝐶𝐶𝐶𝐶𝑟𝑟)#,wherethetwocomponentsTheMIRAGRODEPmodelwascalibratedtotherefertovariabilityinthepercapitahabitualpre-pandemicsituationoftheworldeconomydietaryenergyconsumptionduetodifferencesin2018andwasusedtogenera𝐶,t𝐶𝐶e𝐶p𝑦𝑦!ro=je𝛼𝛼ct+io𝛽n𝛽$s𝐺𝐺𝐺o𝐺f𝐺𝐺_𝑣𝑣𝑣𝑣𝑣𝑣_𝑝𝑝𝑐𝑐!+a𝛽𝛽c#r𝑔o𝑔𝑔𝑔s𝑔𝑔s𝑔𝑔_h𝑖𝑖𝑖o𝑖𝑖𝑖u𝑖𝑖s𝑖𝑖e𝑒h𝑒!o+ld𝛽𝛽s%𝑃𝑃i𝑃n𝑃𝑃𝑃𝑃t𝑃𝑃e𝑃𝑃r𝑃_m𝑅𝑅𝑅s𝑅𝑅𝑅𝑅o𝑅_f𝐹𝐹i𝐹n𝐹𝐹𝐹c𝑑𝑑o!m+e𝛽𝛽&le𝑥𝑥v1e9l0_𝐴𝐴𝐴𝐴𝐿𝐿!macroeconomicfundamentalsinto2019–203+0𝛽𝛽'𝑐𝑐𝑐𝑐𝑟𝑟!+𝛽𝛽(𝑝𝑝a𝑝𝑝n𝑝𝑝!dvariabilityacrossindividualsbasedonunderthreescenarios:1)“beforeCOVID-19”,differencesinsex,age,bodymassandphysicalwhichaimstocapturetheimplicationsforfoodactivitylevel.TheprojectedvaluesforCVinavailabilityandaccess(andthereforethePoU)2025and203𝐶0𝐶-𝐶a𝐶r𝑦e𝑦!obtainedbyapplyingtheoftheworldeconomicprospectsasseenbefore𝐶𝐶𝐶𝐶𝑦𝑦!fo=rm𝐶𝐶𝐶u𝐶l𝑦a𝑦"a×bo,v𝐶𝐶e-𝐶𝐶to𝑦𝑦t.he,∀C𝑡𝑡V>r𝑇𝑇andCVyprojectedtheeruptionofthepandemicbytheIMFWorldseparately.Projec"tedCVriscomputedbasedEconomicOutlookpublishedinOctober2019;ontheprojectedpopulationstructuresbysex2)“beforethewarinUkraine”,whichdoestheandageasprovidedbytheWorldPopulationsamebutconsideringtheWorldEconomicOutlook#$(#$&'(P(r_os+p+e/#c-t-s)(("s#i$m%&$i(l%a#r)ly+#&t%o,-.w%(h%#a)t)wedofortheMDER),#$(#$w+/h0i_le+t+h/e#-p-r)(o01je21ct+e#d&%,-C.%V(%#y))isc,omputedasalinearpublishedinOctober2021;and3)“currentprospects”,whichisbasedonthelatestWorldcombinationofrelevantprojectedmacroeconomicEconomicOutlookpublishedinApril2023.17Aanddemographicvariablesasfollows:moredetaileddescriptionoftheMIRAGRODEP𝐶%𝐶𝐶𝐶𝑦𝑦!!𝐷𝐷=𝐷𝐷𝐷𝐷𝐷𝛼𝐷𝛼𝐶𝐶+𝐶𝐶𝐶𝐶𝐶𝛽𝐶𝛽""(𝐿𝐺𝐿𝐺𝐿𝐺𝐿𝐺𝐿𝐺𝐿𝐺)_1𝑣-𝑣𝑣#𝑣2𝑣𝑣_∗𝑝𝑝;𝑐𝑐(!!𝑓𝑓+)𝐶𝐶𝛽𝐶𝛽𝐶##𝐶𝐶1𝑔-𝑔𝑔1𝑔𝑔-𝑔𝑔𝑔?_𝑖𝑖𝑖𝑖𝑖𝑖𝑜𝑜𝑚𝑚𝑒𝑒!!+𝛽𝛽$$𝑥𝑥215_𝐴𝐴𝐴𝐴𝐿𝐿!!model,aswellastheassumptionsusedtobuildthevario𝐶%𝐶u𝐶𝐶s𝑦s𝑦!ce=na𝛼𝐶𝛼%r𝐶i𝐶+o𝐶s𝑦,𝛽𝑦!𝛽c"=a𝐺𝐺n𝐺𝐺𝛼𝛼𝐺b𝐺e_+𝑣𝑣f𝑣o𝛽𝑣𝛽𝑣u"𝑣_𝐺n𝑝𝐺𝑝𝐺d𝑐𝑐𝐺!𝐺i𝐺+n_𝑣𝑣L𝛽𝑣𝛽𝑣#a𝑣𝐷𝑣𝐷_b𝑔𝐷𝑝𝐷𝑔o𝐷𝑝𝑔𝐷𝑔𝑐𝐷𝑔r𝑐𝐷𝑔!d𝑔𝐶𝑔𝐶+_e𝐶𝑖𝐶𝑖𝐶𝑖𝛽𝐶𝑖𝐶𝛽𝑖𝐶#𝑖𝑜(𝑜𝑔𝑈𝑚𝑔𝑈𝑚𝑔𝑈𝑔𝑈𝑔𝑒𝑈𝑒𝑔!𝑈𝑔𝑔)_+𝑖1𝑖-𝑖𝑖𝛽1𝑖𝛽𝑖-$𝑜𝑜=𝑚𝑥𝑥𝑚2𝑒𝑒1!5+_𝐴𝛽𝐴𝛽𝐴$𝐴𝐿𝑥𝐿𝑥!2+15𝛽𝛽_%%𝐴𝑃𝐴𝑃𝑃𝐴𝑃𝑃𝐴𝑃𝑃𝐿𝑃𝑃𝑃𝐿𝑃𝑃!𝑃𝑃𝑃𝑃𝑃𝑃_𝑅𝑅(𝑅𝑅𝑓𝑅𝑓𝑅)𝑅𝑅𝐶_𝐶𝐹𝐶𝐹𝐶𝐹𝐶𝐶𝐹1𝐹-𝐹#𝑑𝑑2!!+𝛽𝛽&&𝑐𝑐𝑐𝑐𝑟𝑟!!+𝛽𝛽''𝑝𝑝𝑝𝑝𝑝𝑝!!andTorero(2023).18+𝛽𝛽%𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃+𝑃𝑃𝑃𝑃𝛽_𝛽𝑅%𝑅𝑅𝑃𝑅𝑃𝑅𝑃𝑅𝑃𝑅𝑅𝑃_𝑃𝑃𝐹𝑃𝐹𝑃𝑃𝐹𝑃𝐹𝑃𝐹_𝐹𝑅𝑑𝑅𝑑𝑅!𝑅𝑅+𝑅𝑅𝑅_𝛽𝐹𝛽𝐹&𝐹𝐹𝑐𝐹𝑐𝐹𝑐𝑑𝑐𝑑𝑟!𝑟!++𝛽𝛽𝛽𝛽&'𝑐𝑝𝑐𝑝𝑐𝑝𝑐𝑝𝑟𝑟𝑝!𝑝!+𝛽𝛽'𝑝𝑝𝑝𝑝𝑝𝑝!1-1-Inaddition,weusethemedianvariantprojectionsTfoorDmeiseut𝐷til𝐷mac𝐷𝐷𝐷o,𝐷a𝐷si𝐷tnt𝐶e𝐶(𝐶t𝐶tP𝐶hh𝐶𝐶Pi𝐶esP(𝐿ce𝐿do𝐿d𝐿oe𝐿i𝐿flt)lfiaiocrnsie)on((∗ft=;sth(u𝑓De𝑓s)ier𝐶e𝐶ed𝐶tp𝐶𝐶ci𝐶o1no-rs#tt3thw(?eLeaCbUo)v##))e""∗(f)CPIratio((oftotalpopulation(bothsexes),itscompositionbygenderDainedtcaogset,(DaPinPedtPctdohoseltlca(rPrusPd)P(e=dboilrDltaihrestr)𝐷ac𝐷to𝐷𝐷e=𝐷s𝐷𝐷ta𝐷𝐶s(D𝐶L𝐶i𝐶C𝐶e𝐶𝐶tU𝐶(c)𝑈o#𝑈)s𝑈𝑈"t𝑈𝑈()L∗1C-c(#Ufo3)n)C=#sP)i"Idrea∗rte(idof)(aClPteIrrnaatitoiv(1e-#m2ode(𝑓l𝑓s)𝐶t𝐶h𝐶𝐶a𝐶𝐶1t-r#e2presePntPP((providedbythe2022revisionoftheUND(ESAPPP(anPiPmPp(r((o,,)v)..e//m00!entco𝑃𝑃m𝑃𝑃𝑃p𝑃1a-r#e3dtothemodel(𝑓𝑓)𝐶𝐶𝐶𝐶𝐶𝐶𝑟𝑟𝑟𝑟𝑟𝑟𝑟u𝑟𝑟𝑟s!!e=d]in((,,)2)..0//200"2#!.$%A^s.summarizedinTableA2.2,theWorldPopulatio(n,)P.r/o0spects.4"#$%(𝑓𝑓)𝐶𝐶𝐶𝐶𝐶𝐶𝑟𝑟𝑟(𝑟𝑟𝑓𝑟𝑟𝑓𝑟)𝑟𝑟𝐶!𝐶𝐶=𝐶𝐶𝐶]𝑟𝑟(𝑟,𝑟𝑟)𝑟.𝑟𝑟/𝑟𝑟!0!]^.(,)./0!^.coefficientsinthethreealternativemodelsare="#$%(,)./0"#$%vIemrypustiemdilCaorsatn(PdPtPhedroelfloarres)g(((e𝑓=𝑓n)𝐶e𝐶]𝐶r𝐶2a2;𝐶33𝐶1t<e-446#55=v4>((6e6?77r6y888999s:::i(((m^ilar∗AverageCost((ProjectionsofDECToprojecImttphuetesedrCiIemossptouf(tPDePdEPCCdowosltela(uPrssP)eP(t=dhoel]la2𝐷;3r𝐷<𝐷s𝐷46𝐷)𝐷5=𝐷(𝐷>(6𝐶?=𝐶76𝐶𝐶88𝐶𝐶9]9𝐶𝐶::2(3((𝑈^4𝑈𝑈5𝑈𝑈(𝑈6)7∗8Ap9:rv(ee=^draic𝐷g𝐷te𝐷i𝐷∗𝐷o𝐷C𝐷nA𝐷o𝐶sv𝐶s𝐶etw𝐶𝐶r(𝐶𝐶ah𝐶g(e𝐿en𝐿𝐿C𝐿f𝐿oe𝐿)ds1t-(w#2it∗h;t(h𝑓𝑓e)𝐶s𝐶𝐶a𝐶;m𝐶𝐶1<-6e#=2>s?e?6r8ie9s:(of((@@""followingformula:;<6(=@>"?618-p9#r:4(oje(@c"tedindepend𝑃𝑃e𝑃𝑃n𝑃𝑃t1-v#a4riablesobtainedfrom𝐷𝐷𝐷𝐷𝐷,𝐷_𝐾𝐾𝐾𝐾𝐾𝐾𝑙𝑙!theMIRAGRODEPmodelandfromtheWorld𝐷𝐷𝐷𝐷𝐶𝐶!=𝐷𝐷𝐷𝐷𝐷𝐷"×𝐷𝐷𝐷𝐷𝐷,𝐷_𝐾𝐾𝐾𝐾𝐾𝐾𝑙𝑙"×(1−𝑊𝑊𝑊𝑊𝑊𝑊𝑊𝑊𝐸𝐸!),∀𝑡𝑡>𝑇𝑇PopulationProspects,2022revision.4whereT=2019for“beforeCOVID-19”,T=2021Whiletheestimationstrategy,basedonafor“beforethewarinUkraine",andT=2022forrandom-effectslinearregression,remainsthe“currentprosp𝐶e𝐶𝐶c𝐶t=s”5.(𝐶𝐶𝐶𝐶𝑦𝑦)#+(𝐶𝐶𝐶𝐶𝑟𝑟)#sameasinpreviousyears,themaindifferencescomparedtothemodelusedtogenerate𝐶,𝐶𝐶𝐶𝑦𝑦!=𝛼𝛼+𝛽𝛽$𝐺𝐺𝐺𝐺𝐺𝐺_𝑣𝑣𝑣𝑣𝑣𝑣_𝑝𝑝𝑐𝑐!+𝛽𝛽#𝑔𝑔𝑔𝑔𝑔𝑔𝑔𝑔_𝑖𝑖𝑖𝑖𝑖𝑖𝑖𝑖𝑖𝑖𝑒𝑒!+𝛽𝛽%𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃_𝑅𝑅𝑅𝑅𝑅𝑅𝑅𝑅_𝐹𝐹𝐹𝐹𝐹𝐹𝑑𝑑!+𝛽𝛽&𝑥𝑥190_𝐴𝐴𝐴𝐴𝐿𝐿!+𝛽𝛽'𝑐𝑐𝑐𝑐𝑟𝑟!+𝛽𝛽(𝑝𝑝𝑝𝑝𝑝𝑝!196THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA2.2REGRESSIONCOEFFICIENTSFROMTHREEALTERNATIVEMODELSESTIMATEDONHISTORICALCVyVALUES(2000–2018)ANDCOMPARISONWITHTHEMODELUSEDIN2022Regressionmodelcoefficients(standarderrorinparentheses)RegressorsVariableusedModelusedModel1Model2Model3toprojectin2022RealGDPpercapitaIncomeGinicoefficientGDP_vol_pc−0.0625(0.0654)−0.1809(0.1003)−0.2503(0.0979)−0.2572(0.0994)Povertyheadcountgini_incomeRealfoodCPIX215_ALL0.1523(0.0839)0.2489(0.1183)0.3277(0.1200)0.3286(0.1210)CrudebirthratePrices_Real_FoodTotalpopulation0.1630(0.1387)0.1839(0.2798)0.1231(0.1341)0.0904(0.1205)ConstantcbrNpop0.0611(0.0568)0.0723(0.0865)0.0819(0.0705)0.0786(0.0700)r2r2_between0.4102(0.1481)0.4545(0.2474)0.5376(0.1552)0.5634(0.1552)−0.1626(0.0851)−0.2647(0.0546)−0.2564(0.0539)−0.2557(0.0539)−0.0254(0.1033)−0.0155(0.1055)−0.0113(0.0995)−0.0102(0.0997)1196975750.45890.4990.58540.58450.50440.56230.59080.5877SOURCE:Authors’(FAO)ownelaboration.projectionsofCVyin2022resideinthesetofestimatesofincomeGiniandpovertyheadcounthistoricaldatausedtofeedtheestimationmodel.areavailable.ThatbringsthenumberofdatapointswecanusetoestimateourmodeldowntoFirst,thisyearweusedthenewseriesof75fromthe119usedin2022.historicalvaluesofCVythatinformthecurrentseriesofPoUestimatespresentedinTable1andInaddition,alleconomicseriesavailablethroughTableA1ofthisreport,whichincludearevisionPIPandIMFWorldEconomicOutlookhavebeenofsomeestimatesobtainedfromdatafromfoodupdatedtoreflectthe2017-basedrevisionofconsumptionsurveysthathadbeenusedbeforepurchasingpowerparity(PPP)publishedbythebutthathavebeenreprocessedbyconsideringInternationalComparisonProgram(ICP).19improvedandupdatedfoodcompositiontables,andvaluesderivedfromthebrandnewanalysisAstherehavebeenvariousdataupdatesandof14additionalsurveys(seethemethodologicalthedifferencesintheestimatedcoefficientsnoteforthePoUinAnnex1B).betweenthemodelusedin2022andthemodelusedthisyear(Model3)arequiterelevant,Mostimportantly,though,thisyearweusenewlyleadingtoslightlydifferentandmoreoptimisticsourcedseriesofhistoricaldataonrealGDPprojectionsofreductionsinCVy,weestimatedpercapita,incomeGinicoefficient,realfoodtwoadditionalintermediatemodelstoconsumerpriceindex(CPI),povertyheadcount,disentanglethereasonsforthedifferentresults.crudebirthrateandtotalpopulation.ForpovertyWefirstestimatedamodel(Model1inTableA2.2)headcountandincomeGiniwerestrictedourusingtheoldsetofdataforbothdependentsampletohouseholdsurvey-basedestimatesthatandindependentvariablesbutlimitedtothearepublishedonthenewPovertyandInequality69country/yearcombinationsthatoverlapPlatform(PIP)oftheWorldBank,whichreplacesbetweenthe119usedin2022andthe75usedbothPovcalNetandthePovertyandEquitythisyear.Then,wemovedtousingthenewlyDataPortalthatwerephasedoutinMarch2022.sourceddatafromPIPbutkeepingthepovertyThemajorconsequenceofrelyingonlyontheheadcountvaluesfromthe2011-basedPPPhouseholdsurvey-basedvaluesintheseries(Model2),beforeadoptingallnewversionsofthesourcedfromthePIPisareductioninthenumbervariablesinthemodelweultimatelyuseforourofcountry/yearcombinationsforwhichdirectprojections(Model3).197ANNEX2Bycomparingthevaluesoftheestimateddirectlyfromindividualrespondentsinnationallycoefficientsincolumns3–6ofTableA2.2,werepresentativesamples.InChapter2,foodnotethatthemainimpactderivesfromhavinginsecurityestimatesarepresenteddisaggregateddroppedcountry/yearcombinationsthatreliedonbysexoftherespondent(adultmenorwomen)interpolatedormodelledpovertyheadcountandandbyDegreeofUrbanization(DEGURBA)incomeGinicoefficients:whenmovingfromthe(i.e.urban,peri-urbanorruralresidency).modelusedin2022toModel1,thecoefficientsofrealGDPpercapitaandofincomeGiniincrease,Themethodologytodisaggregatethebothinabsolutevalueandintheleveloftheirindicatorbyanyindividualorhouseholdstatisticalsignificance.Anothernoticeableeffectcharacteristicsisasfollows:canbelinkedtotheupdatesofdatatotheir2023versionandtheadditionofsixmorecountry/yearThecross-countrycomparableprobabilitycombinations:thecoefficientsofrealGDPperoffoodinsecurityforeachrespondentiscapita,incomeGiniandofrealfoodCPIfurthercomputedattwolevelsofseverity:moderateincrease,whiletheoneonthepovertyheadcountorsevere,andsevereonly.TheprobabilitiesdecreasesinModel2comparedtoModel1.areaggregatedforeachcategoryoftheFinally,updatingthepovertyheadcounttothecharacteristicofinterest,bycomputingthe2017-basedPPPhasoverallnegligibleeffectsasweightedaverage(usingsamplingweights)thecoefficientsinModel2andModel3areveryacrossallrespondentsinthatcategory,closetoeachotherforallvariables(withtheobtainingtheprevalenceoffoodinsecuritypartialexceptionofthepovertyheadcount,whosewithinthatgroup(forexample,amongcontributiontoexplainingCVydropsfurther).femalerespondents).TheprevalenceoffoodinsecurityinagivenOuroverallassessmentisthatCVyprojectionscategoryisweightedbythecorrespondingthisyeararemorerobust.Thenewlyestimatedpopulation(forexample,thenumberofcoefficientspointtocontributionsofthefemaleadultsinthecountry)toobtainexplanatoryvariablesinpredictingtheCVyinthesubregional/regional/globalestimateth𝐷e𝐷𝐷𝐷s𝐶𝐶am=e𝐷𝐷d𝐷𝐷i𝐷r𝐷e×ct𝐷io𝐷𝐷n𝐷𝐷,𝐷_a𝐾s𝐾𝐾𝐾e𝐾𝐾s𝑙𝑙!ti×m(a1te−d𝑊𝑊b𝑊e𝑊𝑊f𝑊𝑊o𝑊𝐸r𝐸e)b,∀u𝑡t𝑡>th𝑇e𝑇(forexample,theprevalenceoffoodinsecuritysame!model"now𝐷𝐷𝐷𝐷f𝐷,i𝐷t_s𝐾𝐾𝐾t𝐾𝐾h𝐾𝑙e𝑙"data!better,inthefemaleadultpopulationinNorthernconsiderablyascapturedbytheincreasedr2coefficientandAfrica),ifreliablepopulationdataareavailableincreasedratiosbetweenestimatedcoefficientsandifthereissufficientgeographicalcoverageandstandard𝐶𝐶e𝐶𝐶r=ro5rs(,𝐶𝐶e𝐶𝐶s𝑦p𝑦)e#c+ia(l𝐶l𝐶y𝐶𝐶f𝑟o𝑟)r#realGDPperintermsofpercentageofthepopulation.capitaandincomeGini.Thecomputationoftheprevalenceoffood𝐶,𝐶𝐶𝐶𝑦𝑦!=𝛼𝛼+𝛽𝛽$𝐺T𝐺𝐺h𝐺𝐺e𝐺_s𝑣𝑣e𝑣𝑣r𝑣𝑣_i𝑝e𝑝𝑐s𝑐!o+f𝛽C𝛽#V𝑔𝑔𝑔𝑔𝑔y𝑔𝑔𝑔_v𝑖𝑖a𝑖𝑖l𝑖𝑖u𝑖𝑖𝑖e𝑖s𝑒𝑒!p+re𝛽d𝛽%i𝑃c𝑃𝑃𝑃t𝑃e𝑃𝑃𝑃d𝑃𝑃𝑃𝑃b_𝑅y𝑅𝑅𝑅t𝑅𝑅h𝑅𝑅_e𝐹𝐹𝐹𝐹𝐹𝐹𝑑𝑑!+𝛽𝛽&𝑥𝑥190_i𝐴n𝐴𝐴𝐴s𝐿e𝐿!curitybysexispossiblebecausedataare+fo𝛽𝛽r'm𝑐𝑐𝑐u𝑐𝑟𝑟l!a+s𝛽e𝛽(p𝑝a𝑝𝑝r𝑝a𝑝𝑝!telyforeachcountryfortheyearscollectedfromindividualrespondents(adultsT+1to2030isthencalibratedtothevalueforaged15yearsorolder)byFAOviadatacollectionyearT,similarlytowhatisdonefortheDES:serviceproviders(seeAnnex1B).Forcountries𝐶𝐶-𝐶𝐶𝑦𝑦!forwhichnationalgovernmentsurveydataare𝐶𝐶𝐶𝐶𝑦𝑦!=𝐶𝐶𝐶𝐶𝑦𝑦"×,𝐶𝐶-𝐶𝐶𝑦𝑦".,∀𝑡𝑡>𝑇𝑇usedtocalculatetheprevalenceestimatesoffoodinsecurity(seeAnnex1B),itisgenerallywhereT=2019for“beforeCOVID-19”,T=2021notpossibletodisaggregatetheindicatorbyfor“beforethewarinUkraine”,andT=2022forsex,asdataarecollectedatthehousehold“curre#n$t(##p$$r(&o#'$s(+p(_/e0c_t+s+”+/.#+-/-#)-(-")#($0%1&2$1(%+#)#&%+,#-.&%%,(-.%%#)()%#)),level.Thisyear,forthefirsttime,aprotocolwasdevelopedtoaddressthisissue.Thus,inC.Methodologyfortheanalysisoffoodsuchcases,thesamerelativedifferencebysexestimatedbasedondatacollectedbyFAOisinsecuritybydegreeofurbanizationandappliedtotheprevalenceoffoodinsecurityinthe𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶(𝐿𝐿𝐿𝐿𝐿𝐿)1-#2∗;((𝑓𝑓𝑓𝑓))𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶1-1-?totalpopulationbasedonnationaldata.Thisisbygenderanapproximation,asthedifferenceintheFAOdataappliestoadultrespondents,andnottothe𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐷T𝐶h𝐶𝐶𝐶e𝐶𝐶𝐶p𝐶(r𝑈e𝑈v𝑈𝑈a𝑈𝑈l)e1n-c1e-=offoodinsecuri𝑃t𝑃y𝑃𝑃𝑃c𝑃anbe1-#21-1-disaggregatedbyrespondent/householdcharacteristicswhenthedataarecollectedwholepopulation.However,thebenefitisthatthe𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶(𝐿𝐿𝐿𝐿𝐿𝐿)1-#2∗;((𝑓𝑓𝑓𝑓))𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶1-#3?198𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐷𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶(𝑈𝑈𝑈𝑈𝑈𝑈)1-#3=1-#2𝑃𝑃𝑃𝑃𝑃𝑃1-#3THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023statisticsbysexareconsistentintermsoflevelsThismappingwasjustifiedwiththerationaleandtrendswiththoseoftheoverallpopulation.thatDEGURBAclassifiesareaswithincreasingTheentireserieswasrevisedinthiseditionurbanizationbasedonpopulationdensityandofthereportresultinginminorupdatestothesize.Toensurethatnosignificantbiaswaslevelsoftheprevalenceoffoodinsecuritybysexinducedbythisapproach,thesamemappingattheregionalandgloballevelscomparedtowasvalidatedasaccurateforotherAsianthe2022edition.countrieswheredatawerecollectedin2022.ThedisaggregationbyDEGURBAispossibleforD.MethodologyforthecostandthefirsttimethisyearbecauseGallup©begantoaffordabilityofahealthydietgeoreferenceeachinterviewincountriescollectedusingface-to-facemodein2021.In2022,countriesFAOwithsupportfromtheWorldBankDatacoveredbytelephoneinterviewswerealsoGroupsystematicallymonitorsthecostandgeoreferenced,providingenoughgeographicalaffordabilityofahealthydiet(CoAHD)indicatorsrepresentationtoproducesubregional/regional/andrecentlybegantodisseminatetheupdatedglobalfoodinsecurityestimatesbyDEGURBA.seriesontheFAOSTATdatabase.22Estimatesareupdatedfor2021(seesectionsbelow,Withineachcountry,itispossibletolinkeachUpdatingthecostofahealthydietandUpdatinggeoreferencedobservationtotheDEGURBAtheaffordabilityofahealthydiet).Inaddition,dataset,definingwhethertheobservationperiodicrevisionsoftheentiredataseriesare(respondent)islocatedinacity,townorruralcarriedoutbyFAOtocontinuouslyimprovethearea,basedonpopulationdensityandsize,methodologyandproviderobustestimatesontheaccordingtointernationallycomparablecriteriaCoAHDindicators.developedbyEUROSTAT,ILO,FAO,OECD,UN-HabitatandtheWorldBankandapprovedatThecostofahealthydietthe51stsessionoftheUNStatisticalCommissionThecostofahealthydietisdefinedasthecostinMarch2020.20Theprevalenceoffoodinsecurityoftheleastexpensivelocallyavailablefoodstoiscomputedforeachcategoryofurbanizationmeetrequirementsforenergyandfood-basedandthenaggregatedatthesubregional/dietaryguidelines(FBDGs)forarepresentativeregional/globallevelusingthe2020updatedpersonwithinanenergybalanceof2330kcal/DEGURBApopulationdistributionpublishedbyday.TheFBDGsanalysedexplicitlyrecommendEUROSTAT.21Forcountrieswhereofficialfoodfoodquantitiesforeachfoodgroupandprovideinsecuritystatisticsareinformedbynationaldata,awideregionalrepresentation.Althoughitthesameapproximationmethoddescribedfortheisnotselectedbasedonnutrientcontentbutdisaggregationbysexisapplied.isdeterminedbyFBDGs,thisdietmeetsonaveragenearly95percentofnutrientneeds,soAsnoFIESdatawerecollectedbyFAOinChinaitcanthereforealmostalwaysbeconsideredasin2022,andthedatacollectedin2021werenotnutrientadequate.georeferenced,theestimatesoffoodinsecuritybyDEGURBAinChinawereapproximatedasTheavailabilityandpricesofitemsineachfoodfollows:theprevalenceoffoodinsecurityforgroupneededforahealthydietwereobtained2021wasdisaggregatedbyareaofresidencefromtheWorldBank-ledICPasnationalaveragesasdefinedintheGallup©WorldPoll,wherefor2017.Itemdefinitionsareinternationallyrespondentsreportiftheylivein:aruralareaorstandardized,allowingclassificationbyfoodonafarm;asmalltownorvillage;alargecityorgroupandcalculationoftheleastcoststoreachthesuburbofalargecity.Then,thesecategoriesFBDGrequirementsineachcountry,representingweremappedtotheDEGURBAbyconsideringanaverageacrossmarketsandthroughoutthepeoplelivinginaruralareaoronafarmasyear.19Thecostofahealthydietindicatorispartofthe“rural”population,thoselivinginacalculatedusingastandardbasket,calledthesmalltownorvillageaspartofthe“peri-urban”HealthyDietBasket,whichconsistsofsixfoodpopulationandthoselivinginalargecityandgroupsandreflectsthecommonalitiesacrossinthesuburbofalargecityas“urban”residents.tenidentifiedFBDGs.Foradetaileddescription199ANNEX2ofthehealthydietandrelatedmethodology,see2021forallcountriesexcepttheCentralAfricanHerforthetal.(2020,2022).23,24RepublicandGuyana,forwhichthegeneralCPIisused.ThecostofahealthydietisestimatedforAffordabilityofahealthydietthecompleteseries(2018–2021)bym𝐶%u𝐶𝐶l𝐶ti𝑦𝑦p!l=yin𝛼𝛼g+𝛽𝛽"𝐺𝐺𝐺𝐺𝐺𝐺_𝑣𝑣𝑣𝑣𝑣𝑣_𝑝𝑝𝑐𝑐!+Inthisreport,todetermineaffordability,ecuacrhrecnocuynutrnyit’ss2(L01C7Ua)c,twuaitlhcothset,CexPpIrreastsioedanindloca+l𝛽𝛽%𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃𝑃_𝑅𝑅𝑅𝑅𝑅𝑅thecostofahealthydietiscomparedwithfinallydividingbypurchasingpowerparities:country-specificincomedistributionsthatarederivedfromtheWorldBank’sPIP.25TheresultingDietcost(PPPdollars)!=Dietcost(LCU)"#$%×Di(ef)tCcPoIsrta(tiPoP!Pdollars)(=DmeasuresofaffordabilityincludethepercentageandnumberofpeopleunabletoaffordahealthyPPP!dietinagivencountry,in2021.Ahealthydietisconsideredunaffordablewhenitscostexceedswheret=2018,...,2021and(𝑓𝑓)𝐶𝐶𝐶𝐶𝐶𝐶𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟!=](,)./0!^.52percentoftheincomeinacountry.ThisImputedCost(,)./0"#$%percentageaccountsforaportionofincomeImputedCost(PPPdollars)!=:AverageCost>×AverageCost!thatcanbecrediblyreservedforfood,basedonThecostofthehealthydietisfirstup!I&md$aptuetdedinCoLsCtU(PPPdollars)(=observationsthatthepopulationinlow-incomeandthenconvertedintointernationaldollarsusingcountriesspend,onaverage,52percentoftheirincomeonfood,asderivedfromthe2017ICPtheWDIPPPforprivateconsumptionconversionnationalaccountshouseholdexpendituredata.factors,28tocomparethecostacrosscountriesandBasedonthisthresholdandcomparingthecostofthedietwithcountryincomedistributions,wepoliticalentities.Foradetaileddescriptionoftheobtainthepercentageofpeopleforwhomthecostofthedietisunaffordable.Theseproportionsaremethodology,seeBaietal.(forthcoming).29thenmultipliedbythe2021populationineachcountryusingtheworlddevelopmentindicatorsThecostofthehealthydietwascomputed(WDI)oftheWorldBank,26toobtainthenumberfor169countriesandterritoriesin2017andofpeopleunabletoaffordahealthydietinaupdatedfor2018–2021forallofthemexceptgivencountry.ForadetaileddescriptionoftheAnguilla,Montserrat,andTaiwanProvinceaffordabilityindicatorsandrelatedmethodology,ofChinathathaveinformationneitheronseeAnnex3ofFAO,IFAD,UNICEF,WFPCPIsnoronPPPs.Outoftheremaining166andWHO(2020).27countriesandterritories,thereare24countrieswithmissingPPPdatainanyyearbetweenUpdatingthecostofahealthydiet2018and2021,bgandoneterritorywithmissingTheICPiscurrentlytheonlysourceofretailfoodCPIdata(TurksandCaicosIslands).Forthepricedataforinternationallystandardizeditems,24countries,PPPimputationswereappliedaspartofalargerefforttocomputePPPexchangeusinganAutoregressiveIntegratedMovingratesacrossallcountriesoftheworld.However,AveragewithExternalExplanatoryVariablethesedataareonlyavailableonceeverythreeto(ARIMAX)model.InlinewiththeWorldBank’sfiveyears,whichdoesnotallowforyearlyglobalWDImethodologyforPPPextrapolations,monitoringofdietcoststoguideprogrammestheratiobetweenacountry’sgeneralCPIandandpolicies.IntheabsenceofupdatedfoodpricetheCPIforthebasecountry(inthiscasethedata,inthisreport,themethodofupdatingtheUnitedStatesofAmerica)isincludedinthecostindicatorbetweenICPpublicationyearsmodelspecificationasakeypredictorofPPPreliesonconsumerpriceindices(CPIs)publishedvalues.Furthermore,percapitaGDPandperbyFAO.ThisdatasettrackschangeinmonthlycapitahouseholdconsumptionexpendituregeneralandfoodCPIsatthenationallevelwitharealsoaddedasexternalcovariates,andthereferencetoabaseyearof2015.TheannualHolt-WintersmoothingmethodologyisappliedCPIsarecomputedassimpleaveragesofthetoboththeseriestofillthegaps,ifneeded.12monthlyCPIswithinayear.Inparticular,TheARIMAXapproachallowstoestimate,CPIdataforfoodandnon-alcoholicbeveragesareusedtoupdatethecostofahealthydietinbgThe24countriesandterritoriesforwhichPPPswereimputedarethefollowing:Argentina,Aruba,Bermuda,BritishVirginIslands,CaymanIslands,Curaçao,DemocraticRepublicoftheCongo,Djibouti,Dominica,EquatorialGuinea,Eswatini,Gabon,Kazakhstan,Liberia,Malawi,Myanmar,SaoTomeandPrincipe,Senegal,Seychelles,SintMaarten(Dutchpart),Suriname,Tajikistan,UnitedArabEmiratesandZimbabwe.200THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023foreachcountry,severalmodelspecificationsThroughcontinuousupdatesbasedonincomingthatincludeanautoregressivecomponent,annationalsurveysanddataimputations,theintegrationcomponent,amovingaverage,andaincomedistributionsinthePIPdatabase25arecombinationofthethree.Thebestspecificationnowavailableandupdatedfortheyears2020isselectedwhenatleasttheestimatedand2021inmanycountriesandterritories.TocoefficientoftheCPIratioisstatisticallyupdateaffordabilityintheseyears,distributionssignificant,followedbythestatisticalinthePIPdatabasewereusedfor78ofthesignificanceoftheARIMAXparameters.For142countries/territoriesin2020,andfor27incountriesandterritoriesshowingabnormal2021.Fortheremainingones(64in2020;115inPPPseriesovertime,theCPIratioisfoundto2021),affordabilitywasestimatedbythePIPbetheonlystatisticallysignificantcoefficientteamusingprojecteddistributions,30obtainedbytoaffectthevariabilityofthePPPvalues.applyingtheWorldBank’sstandardmethodsforOnthecontrary,forcountriesandterritoriesnowcastingpoverty.31Finally,theproportionofwithalessvolatilePPPseries,thehistoricalpeopleunabletoaffordahealthydiet,estimatedPPPtrendplaysalsoaroleinpredictingPPPusingbothmethods,wasmultipliedbyeachvalues,aswellasthecoefficientestimatesofcountry/territory’spopulationusingtheWDIofpercapitaGDPand/orpercapitaexpenditure.theWorldBank,toobtainthenumberofpeopleTheARIMAXcomputesthepredictedvalueswhocouldnotaffordahealthydiet.Thelatestonthebestspecificationselectedforeachestimatesoftheaffordabilityindicatorswerecountry/territory.performedon26April2023.AsthePIPdatabaseiscurrentlyundergoingcontinuousupdatesofForoneterritorywithmissinginformationonincomedistributions,affordabilityestimationsCPIs(TurksandCaicosDiIestlcaonstd(Ls)C,Uc)o"#s$%t×im(fp)CuPtIarattiioon!safterthisdatemaymarginallychange.weDrieetacposptl(iPePdPduosllianrsg)!t=heaveragediPePtP!costinthecorrespondingsubregion:Inthisyear’sedition,arevisionofthemethodologyinvolvestheaffordabilitydataImputedCostseries.FollowingtherecentreleaseofnewPPPImputedCost(PPPdollars)!=:AverageCost>!&$×AverageCost!for2017,theWorldBankadoptedtheselatestconversionfactorstoexpressitscollectionofSubregionalcostaverageswerecomputedmonetaryindicatorsin2017PPPterms,includingexcludingtheTurksandCaicosIslands.incomedistributionsinthePIPdatabase.25ItimpliesthattheindicatorsofaffordabilityarenoAlimitationofthismethodusedtoupdatethelongerexpressedin2011PPPasinpreviousyearscostofahealthydietin2018–2021isthatchangesbutratherin2017PPP.Shiftingthebaseyearhasinthecostdependon(food)CPIsanddonotledtoconsiderablevariationsinaffordabilityreflectitem-specificchangesinfoodprices,norforcertaincountries.Nonetheless,thischangeanydifferentialchangesinthepriceofdifferentisassociatedwithimprovementsinthequalityfoodgroups,duetothelackofnewitem-levelofPPPsandbetterreflectsthecurrenteconomicfoodpricedataformorenutritiousfooditems.situationsworldwide.32Specifically,forsevenFAOisexploringhowtoexpandreportingofcountries,theshareofpeopleunabletoafforditem-levelpricestoallowmorefrequentandahealthydietwasatleast7percentagepointsrobustmonitoringofthecostofahealthydiet.lowerin2021whenexpressedin2017PPPinsteadof2011PPP(Angola,PlurinationalStateUpdatingtheaffordabilityofahealthydietofBolivia,Egypt,Iraq,Jordan,SaoTomeandInthisreport,affordabilitywasupdatedforPrincipe,andSuriname).Conversely,itwas14theyears2018to2021.Ofthe169countriesandand7percentagepointshigherinGhanaandterritorieswithcostinformationin2017,theBelize,respectively.TheWorldBankhasalsoaffordabilityindicatorswereestimatedfor143acknowledgedlargechangestothemeasurewithincomedistributionsavailableinthePIPofpovertyratesforthesamecountrieslisted,database.Thisinformationwasupdatedforallfollowingtheadoptionof2017PPP.Thesecountriesandterritoriesfor2018–2021,exceptwerecarefullyevaluatedandfoundtoreflectTaiwanProvinceofChinaforwhichfoodCPIsimprovementsinthequalityofthePPPs.32Inarenotavailable.201ANNEX2someofthesecountries,the2017PPPsarebasedF.Methodologyforassessmentofonpricedatafromabroaderlistofitemsthanprogressagainstnutritiontargetsattheinthe2011PPPround;inothercountries,priceregionalandgloballevelsdatawerecollectedforthefirsttimein2017,overcomingthelimitationofimputedPPPspriorThesemethodologicalnotespertaintoresultstothisround.Inthecaseofupper-middle-incomepresentedinTable6inSection2.3ofthereportcountriessuchasGhanaandBelize,thecostwhichdepictstheregionalandsubregionalthresholdshaverisenbetween2011and2017,andassessmentofprogresstowardsthe2030nutritionhencetheshareandnumberofthepopulationtargets.Progresswasassessedagainstthewhoseincomefallsbelowthethresholds(i.e.are2030nutritiontargetsestablishedbyUNICEF/unabletoaffordahealthydiet)islarger.33WHO34andanadaptedversionofrulesfromtheWHO-UNICEFTechnicalExpertAdvisoryGroupE.Methodologyfortherural–urbanonNutritionMonitoring35forallindicatorswhereanalysisofnutritionoutcomes2030targetsorprogressassessmentruleshavenotbeenestablished.Arural–urbananalysisinSection2.3wascarriedoutaccordingtourbanandruralresidenceasTodeterminewhichprogressassessmentappliedtofournutritionindicatorsusingregionalcategorytouseforeachindicatorandeachestimateswiththeirconfidenceintervals.Theregion,first,twodistinctaverageannualratesanalysiswasperformedacrossregionsbasedonofreduction(AARR)bhwerecalculated:i)thedataavailabilityforcountrieswithineachregion.AARRrequiredfortheregiontoreachthe2030target;andii)theactualAARRthattheregionTheweightedanalysiswasappliedusingthehasexperiencedtodate.ThevalueoftheactuallatestavailabledatafromnationalsurveysAARRexperiencedtodateisthenusedtobetween2015and2021.Thelistofcountriesdeterminewhichprogressassessmentcategorycontributingtoeachregionispresentedintheregionisassigned,whilealsoconsideringTableA2.3;datasourcesareincludedintablenotes.therequiredAARR.SeeTableA2.4forAARRrangesandprevalencethresholdsappliedforTheregionalurbanandruralresultspresentedeachcategoryandforeachindicator,briefly:arebasedonapopulation-weightedanalysisofasubsetofcountrieswithdisaggregateddataOntrack:regionswithanactualAARRthatisavailablebyplaceofresidenceusingthelatestgreaterthantherequiredAARRarecategorizedavailabledatafromnationalsurveysbetweenasbeing“ontrack”(green)toachievethetarget.2015and2021forexclusivebreastfeedingandAstaticthresholdforthelatestprevalence,between2016and2022forstunting,wastingasnotedforeachindicatorinTableA2.4,isalsoandoverweight.Theregionalruralandusedtocategorizeregionsasbeing“ontrack”;urbanestimatesarepresentedonlywhentheforexample,anyregionforwhichthemostregionalestimatebyresidencehasapopulationrecentoverweightprevalenceisbelow3percentcoverageof50percentormorebyruralorurbanisconsidered“ontrack”,eveniftheiractualresidence.PopulationcoverageiscalculatedAARRislessthantheirrequiredAARR.bydividingthesumofthepopulationofchildrenunderfiveyearsforcountrieswithatOfftrack:regionswithanactualAARRleastonedatapointfromhouseholdsurveysthatislessthantherequiredAARRandforwithinthespecifiedyearrangebythetotalwhichthelatestprevalenceisabovethe“onpopulationofchildrenunderfiveyearsforalltrack”staticthresholdnotedinTableA2.4arecountriesintheregion.considered“offtrack”.The“offtrack”categoryisbrokendownintodifferentsubcategoriesdependingontheindicator.Fortheindicatorsofchildstunting,childoverweightandchildbhSeetechnicalnoteonhowtocalculateAARRat:https://data.unicef.org/resources/technical-note-calculate-average-annual-rate-reduction-aarr-underweight-prevalence202THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA2.3COUNTRIESANDTERRITORIESWITHNUTRITIONOUTCOMEDATAFROMNATIONALSURVEYSBETWEEN2015AND2021FOREXCLUSIVEBREASTFEEDINGANDBETWEEN2016AND2022FORSTUNTING,WASTINGANDOVERWEIGHTTHATCONTRIBUTEDTOTHERURAL–URBANANALYSISRegionExclusivebreastfeedingStuntingWastingOverweightAfrica(82)(89)(89)(89)AsiaAlgeria,Angola,Benin,Algeria,Benin,Burundi,Algeria,Benin,Burundi,Algeria,Benin,Burundi,Burundi,Cameroon,Cameroon,CentralCameroon,CentralCameroon,CentralLatinAmericaCentralAfricanRepublic,AfricanRepublic,Chad,AfricanRepublic,Chad,AfricanRepublic,Chad,andtheCaribbeanChad,Côted'Ivoire,Côted'Ivoire,DemocraticCôted'Ivoire,DemocraticCôted'Ivoire,DemocraticDemocraticRepublicofRepublicoftheCongo,RepublicoftheCongo,RepublicoftheCongo,NorthernAmerica,theCongo,Ethiopia,Djibouti,Ethiopia,Djibouti,Ethiopia,Djibouti,Ethiopia,Europe,AustraliaGambia,Ghana,Guinea,Gambia,Ghana,Guinea,Gambia,Ghana,Guinea,Gambia,Ghana,Guinea,andNewZealandGuinea-Bissau,Lesotho,Guinea-Bissau,Kenya,Guinea-Bissau,Kenya,Guinea-Bissau,Kenya,OceaniaexcludingLiberia,Madagascar,Lesotho,Liberia,Lesotho,Liberia,Lesotho,Liberia,AustraliaMalawi,Mali,Mauritania,Madagascar,Malawi,Madagascar,Malawi,Madagascar,Malawi,andNewZealandNigeria,Rwanda,SaoMali,Mauritania,Mali,Mauritania,Mali,Mauritania,TomeandPrincipe,Morocco,Mozambique,Morocco,Mozambique,Morocco,Mozambique,Senegal,SierraLeone,Niger,Nigeria,Rwanda,Niger,Nigeria,Rwanda,Niger,Nigeria,Rwanda,SouthAfrica,Togo,SaoTomeandPrincipe,SaoTomeandPrincipe,SaoTomeandPrincipe,Tunisia,Uganda,UnitedSenegal,SierraLeone,Senegal,SierraLeone,Senegal,SierraLeone,RepublicofTanzania,SouthAfrica,Togo,SouthAfrica,Togo,SouthAfrica,Togo,Zambia,ZimbabweTunisia,Uganda,UnitedTunisia,Uganda,UnitedTunisia,Uganda,UnitedRepublicofTanzania,RepublicofTanzania,RepublicofTanzania,Armenia,Bangladesh,Zambia,ZimbabweZambia,ZimbabweZambia,ZimbabweBhutan,Georgia,India,Indonesia,Iraq,Jordan,Afghanistan,Armenia,Afghanistan,Armenia,Afghanistan,Armenia,Kazakhstan,Kyrgyzstan,Bangladesh,Cambodia,Bangladesh,Cambodia,Bangladesh,Cambodia,LaoPeople'sDemocraticGeorgia,India,Indonesia,Georgia,India,Indonesia,Georgia,India,Indonesia,Republic,Malaysia,Iraq,Jordan,Kyrgyzstan,Iraq,Jordan,Kyrgyzstan,Iraq,Jordan,Kyrgyzstan,Maldives,Mongolia,LaoPeople'sDemocraticLaoPeople'sDemocraticLaoPeople'sDemocraticMyanmar,Nepal,Republic,Malaysia,Republic,Malaysia,Republic,Malaysia,Pakistan,Palestine,SriMaldives,Mongolia,Maldives,Mongolia,Maldives,Mongolia,Lanka,Tajikistan,Myanmar,Nepal,Myanmar,Nepal,Myanmar,Nepal,Thailand,Timor-Leste,Pakistan,Palestine,Pakistan,Palestine,Pakistan,Palestine,Turkmenistan,RepublicofKorea,SriRepublicofKorea,SriRepublicofKorea,SriUzbekistan,VietNamLanka,Tajikistan,Lanka,Tajikistan,Lanka,Tajikistan,Thailand,Timor-Leste,Thailand,Timor-Leste,Thailand,Timor-Leste,Belize,BoliviaTürkiye,Turkmenistan,Türkiye,Turkmenistan,Türkiye,Turkmenistan,(PlurinationalStateof),UzbekistanUzbekistanUzbekistanBrazil,Colombia,CostaRica,Cuba,DominicanBolivia(PlurinationalBolivia(PlurinationalBolivia(PlurinationalRepublic,Guatemala,Stateof),CostaRica,Stateof),CostaRica,Stateof),CostaRica,Haiti,Honduras,Mexico,Cuba,DominicanCuba,DominicanCuba,DominicanParaguay,Peru,SurinameRepublic,Ecuador,Republic,Ecuador,Republic,Ecuador,Guyana,Haiti,Honduras,Guyana,Haiti,Honduras,Guyana,Haiti,Honduras,Belarus,Montenegro,Jamaica,Mexico,Jamaica,Mexico,Jamaica,Mexico,NorthMacedonia,SerbiaPanama,Paraguay,Peru,Panama,Paraguay,Peru,Panama,Paraguay,Peru,Suriname,TurksandSuriname,TurksandSuriname,TurksandFiji,Kiribati,MarshallCaicosIslandsCaicosIslandsCaicosIslandsIslands,PapuaNewGuinea,Samoa,Tonga,Albania,Germany,Latvia,Albania,Germany,Latvia,Albania,Germany,Latvia,TuvaluMontenegro,NorthMontenegro,NorthMontenegro,NorthMacedonia,SerbiaMacedonia,SerbiaMacedonia,SerbiaFiji,Kiribati,MarshallFiji,Kiribati,MarshallFiji,Kiribati,MarshallIslands,Samoa,Tonga,Islands,Samoa,Tonga,Islands,Samoa,Tonga,TuvaluTuvaluTuvaluSOURCES:Dataforstunting,wastingandoverweightarebasedonUNICEF,WHO&WorldBank.2023.UNICEF-WHO-WorldBank:Jointchildmalnutritionestimates-Levelsandtrends(2023edition).[Cited27April2023].https://data.unicef.org/resources/jme-report-2023,www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates,https://datatopics.worldbank.org/child-malnutrition;dataforexclusivebreastfeedingarebasedonUNICEF.2022.Infantandyoungchildfeeding.In:UNICEF.[Cited6April2023].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding203ANNEX2TABLEA2.4RULESFORPROGRESSASSESSMENTAGAINSTTHEGLOBALNUTRITIONTARGETSIndicatorStuntingOverweightWastingLowNon-exclusive(<5years)(<5years)(<5years)birthweight1breastfeeding1,2(<6months)2030targetReducethenumberReduceandmaintainReduceandmaintainReducelowReducenon-exclusiveofchildren<5yearschildhoodoverweightchildhoodwastingtobirthweightbreastfeedingOntrackwhoarestuntedbytolessthan3%lessthan3%prevalenceby30%prevalence50%(<6months)to30%Offtrack–AARR>required5AARR>required5AARR>requiredsomeAARR>required3orprevalenceorprevalence(i.e.1.96)7orAARR>required9progressorprevalence<3%6<3%6prevalence<5%8orprevalenceOfftrack–<3%4<30%10noprogressAARR<required,AARR<required,AARR<1.96butAARR<required,Offtrack–AARR<required,but>1.5but>2.0>0.5but>0.8worseningbut>0.5AssessmentAARR<0.8notpossible-0.5≤AARR<0.5-1.5≤AARR<1.5-2.0≤AARR<2.0AARR<0.5Forregions:AARR<-0.5AARR<-1.5AARR<-2.0assessmentnotpossiblewhenForregions:Forregions:Forregions:Forregions:regionalassessmentassessmentassessmentnotassessmentpopulationpossibleforallpossibleforallpossiblewhenpossibleforallcoverage<50%15regions11regions11regionalregions11Forcountries:Forcountries:Forcountries:populationForcountries:notapplicableassessmentnotassessmentnotcoverage<50%13notapplicablepossiblewhenpossiblewhenForcountries:dataaredataareassessmentnotinsufficient12insufficient12possiblewhendataareinsufficient14NOTES:1.Forlowbirthweightandexclusivebreastfeeding,thecategoriesof“offtrack–noprogress”and“offtrack–worsening”arecombinedintoonecategoryof“offtrack–noprogressorworsening”becausethereisinsufficientvariationincurrentprogresstosplitthesecategoriesfortheseindicators.2.Forexclusivebreastfeeding,theactualtargetistoincreasetheprevalenceofexclusivebreastfeeding(undersixmonths)to70percentby2030;however,ithasbeenrevisedheretoreflecttheprevalenceofnon-exclusivebreastfeedingsothattheconceptoftheAARRcanbeappliedasitisfortheothersixtargets.3.TherequiredAARRisbasedonthechangeinstuntingprevalencecorrespondingtoa50percentreductioninthenumberofchildrenaffectedbystuntingbetween2012and2030,consideringthepopulationgrowthestimatedbytheUnitedNationsWorldPopulationProspects.ActualAARRiscalculatedusingallyearsofdatabetween2012and2022.4.Regionsconsideredontrackarethosewherethestuntingprevalencepointestimateorthelower95percentconfidenceintervalfor2022isbelow3percent.5.TherequiredAARRisbasedontherequiredchangeinoverweightorwastingprevalencetoreducefromthebaseline(2012)prevalenceto3percentby2030.ActualAARRiscalculatedusingallyearsofdatabetween2012and2022.Notethatforwasting,unpublishedtrendestimatesfromtheJMEareusedtogeneratetheactualAARR.6.Regionswheretheoverweightorwastingprevalencepointestimatefor2022isbelow3percentareconsideredontrack.7.TherequiredAARRisbasedonthechangerequiredtoreducethelowbirthweightprevalenceby30percentbetween2012(baselineyear)and2030.ThesameAARRof1.96isrequiredforallregionssincethetargetrequiresarelativechange(reductionby30percent)inthebaselinevalue.ActualAARRiscalculatedusingallyearsofdatabetween2012and2020.8.Regionswherethelowbirthweightprevalencepointestimatefor2020isbelow5percentareconsideredontrack.9.TherequiredAARRisbasedontherequiredchangetodecreasethenon-exclusivebreastfeedingprevalenceto30percentbetween2012(baselineyear)and2030.ActualAARRiscalculatedusingonlytwoestimatesfortheyearsof2012and2021,wheretheregionalaveragesarepopulationweightedusingthemostrecentestimateforeachcountrybetween2005and2012forthe2012estimate,andbetween2016to2021forthe2021estimate.10.Regionswherethenon-exclusivebreastfeedingprevalencepointestimatefor2021isbelow30percent(i.e.whereexclusivebreastfeedingis≥70percent)areconsideredontrack.11.Theglobaldatabasesfortheindicatorsofstunting,overweightandlowbirthweightarebasedoncountry-levelmodelswhichprovideannualestimatesforallcountriesforgenerationofregionalandglobalestimates(i.e.annualestimatesareevenavailableforcountrieswithoutanyhouseholdsurveydata,evenincaseswherecountry-modelledestimatesarenotreleasedtothepublicandusedonlyforgenerationofglobalandregionalestimates),thusmakingprogressassessmentpossibleforallregions.12.Progressassessmentagainstthechildstuntingandchildoverweighttargetsisnotconductedforcountrieswhichdidnothaveanyinputdata(e.g.householdsurveydata)touseinthecountrymodelwhichweremorerecentthan2022,orforwhichmodelledestimatesremainpendingfinalreview.13.Progressassessmentisnotpossibleforwastingforregionswherepopulationcoverageislessthan50percent.Populationcoverageiscalculatedbydividingthesumofthepopulationofchildrenunderfiveyearsforcountrieswithatleastonedatapointfromhouseholdsurveysbetween1990and2020bythetotalpopulationofchildrenunderfiveyearsforallcountriesintheregion.Sincewastingestimatesaregeneratedwithasubregionalmodel,evenoneyearofdatabetween1990and2020countstowardstheregionalpopulationcoverage.14.Progressassessmentagainstthechildwastingtargetisnotconductedforcountrieswhichdonothaveatleasttwodatapoints(e.g.householdsurveys)between2005and2022,withatleastonepointbeingmorerecentthan2012.15.Progressassessmentisnotpossibleforexclusivebreastfeedingwherethepopulationcoverageofcountrysurveydatafortheregionislessthan50percentforthe2012and/orthe2021estimate.For2012,populationcoverageiscalculatedbydividingthesumofthepopulationofchildrenunderfiveyearsforcountrieswithatleastonedatapointfromhouseholdsurveysbetween2005and2012bythetotalpopulationofchildrenunderfiveyearsforallcountriesintheregion.For2021,populationcoverageiscalculatedbydividingthesumofthepopulationofchildrenunderfiveyearsforcountrieswithatleastonedatapointfromhouseholdsurveysbetween2016and2021.SOURCE:Elaboratedusinginformationfrom:WHO&UNICEF.2017.Methodologyformonitoringprogresstowardstheglobalnutritiontargetsfor2025–technicalreport;andWHO&UNICEF.2017.Theextensionofthe2025Maternal,InfantandYoungChildnutritiontargetsto2030.WHOandUNICEF.204THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023wasting,therearethreeofftracksubcategories:Theyearsofdatausedtocalculatetheactual“offtrack–someprogress”(yellow),“offtrackAARRexperiencedtodateattheregionallevel–noprogress”(lightred)and“offtrack–varybyindicatorasspecifiedinthefootnotesworsening”(darkred).ForlowbirthweightforTableA2.4.TheactualAARRsforeachregionandexclusivebreastfeeding,thecategoriesarecalculatedusingatrendlinecomprisingof“offtrack–noprogress”(lightred)andallestimatesavailablebetween2012(baseline)“offtrack–worsening”(darkred)arecombinedandthelatestestimateforeachindicator,intoonecategoryof“offtrack–noprogressexceptforexclusivebreastfeedingforwhichorworsening”whichisrepresentedwithanmodelledestimatesarenotavailableandwhichorangecolour,becausethereisinsufficientiscalculatedusingonlytwoestimates:thevariationintheprogresstodatetousethetwobaseline(2012)andthelatestyearavailablecategoriesfortheseindicators.(2019).TherequiredAARRiscalculatedAssessmentnotpossible:Fortheindicatorsusingthebaselineprevalencefortheregionbasedoncountry-modelleddata(childin2012andthetargetprevalenceasnotedinstunting,childoverweight,lowbirthweight),the2030MaternalInfantandYoungChildanassessmentispossibleforallregionsNutritiontargets34(e.g.forchildoverweight,becauseamodelledestimateexistsforalltherequiredisAARRis3.41percentperyearcountriesmeaningthereareenoughdataatthegloballevel,whichistheannualrateoftogeneraterepresentativeestimatesforallchangeneededtogofromthe2012baselineregionsandforallyears.Forindicatorswhereprevalenceof5.6percenttothetargetedcountry-modelledestimatesarenotavailable3.0percentin2030).n(childwastingandexclusivebreastfeeding),assessmentisnotpossibleforregionswherepopulationcoverageislessthan50percent(seefootnotes16and17toTableA2.4).205ANNEX3UPDATEDDATASERIESOFTHECOSTANDAFFORDABILITYOFAHEALTHYDIET,2017–2021Thecostandaffordabilityofahealthydiet,andthecostsin2018–2021,PPPexchangeratesthechangeoftheseindicatorsfrom2019to2021,forbothcountriesareimputed,buttheymayarereportedinTable5byregion,subregionandnotthoroughlyreflecttheseverecurrencycountryincomegroup,followingtheWorldBankdevaluationand/oreconomicinstabilitythattheclassificationofcountriesbyincomelevelforcountrieshaveexperienced.TableA3.2provides2022,basedonpercapitagrossnationalincomerangesoftheaffordabilityindicatorsglobally,in2021.Incomeclassificationisprovidedforaswellasbyregion,subregionandcountryallcountriesandterritoriesexceptAnguillaincomegroup,whichshowthepercentageandandMontserrat.numberofpeopleunabletoaffordahealthydietin2021.Lower-boundestimatesassumethatCostandaffordabilityarealsoreportedatthe80percentofincomeisallocatedtofood,asthiscountrylevelinTableA3.1forthereferenceyearrepresentsthelargestexpenditureshareonfood2017whentheICPdatawerereleased,aswellobservedintheICP2017data(inGuinea-Bissau).asfor2018–2021whenthetwoindicatorsareUpper-boundestimatesassumethattheshareupdatedusingthemethodologydescribedofincomereservedforfoodvariesbycountryinAnnex2,SectionD.In2018–2021,theincomegroup.FollowingICP2017nationalcostindicatorwasupdatedfor166oftheaccountsdata,foodexpendituresrepresent,on169countriesandterritorieswithinformationaverage,14percent,27percent,38percentandavailablein2017,whileaffordabilitywas52percentoftotalexpendituresinhigh-incomeupdatedfor142ofthe143countriesandcountries,upper-middle-incomecountries,territories.ForArgentinaandZimbabwe,costlower-middle-incomecountriesandlow-incomeandaffordabilityin2018–2021areusedtocountries,respectively.ForafulldescriptionestimateaggregateindicatorsshowninTable5ofthemethodologyusedtodeterminethesebutarenotreportedinTableA3.1.Toupdateranges,seeHerforthetal.(2020).23n206TABLEA3.1THECOSTANDAFFORDABILITYOTFHEASHTEAATLETOHFYFDOIEOTDBSYECRUEGRIITOYNA,SNUDBNRUETGRIOITNIO,CNOINUNTTHREYWAONRDLD2022COUNTRYINCOMEGROUP,2017–2021Regions/CostofahealthydietPeopleunabletoaffordahealthydietsubregions/20172018201920202021countries/2017201820192020202120172018201920202021territories(PPPdollarsperpersonperday)(%)(millions)WORLD3.2953.3553.4313.5113.66243.841.841.243.342.23124.93019.13005.53191.93139.5Low-income3.0843.1103.1383.2173.36988.887.586.786.986.1440.9447.6456.8471.0480.0countriesLower-middle-3.3973.4783.5493.6523.87972.369.368.371.070.22246.42184.32180.72296.82299.6incomecountriesUpper-middle-3.4983.5553.6483.7213.91217.315.214.416.614.1416.1368.2350.5406.4345.5incomecountriesHigh-income3.1523.2103.2943.3633.4321.91.71.51.51.321.418.917.417.614.3countriesAFRICA3.2223.2743.3093.3833.57178.578.077.477.977.5954.6973.4989.41020.71040.5NorthernAfrica3.4163.5123.5983.5753.47454.656.054.754.051.7126.1131.8131.3131.9128.5Algeria3.7633.8223.7963.7604.04332.531.229.231.132.413.413.112.513.514.3Egypt3.4573.5073.5033.3693.50667.470.167.263.261.668.672.770.967.967.3Morocco2.7102.7522.7592.7972.90517.716.815.717.715.5Sudan3.6743.9214.3064.3083.08188.490.993.694.185.46.36.05.76.55.7Tunisia3.4763.5593.6283.6393.83315.514.914.418.017.136.038.240.541.839.0Sub-SaharanAfrica1.81.81.72.22.13.1993.2463.2753.3613.58284.183.282.683.383.4828.5841.7858.1888.8912.1EasternAfrica2.9322.9743.0063.0883.29485.684.784.284.784.6328.8334.2341.3352.7361.9Burundi2.9882.8042.7832.9433.13895.895.095.095.795.910.710.911.311.712.0Djibouti2.7972.8662.9853.1123.250a65.866.465.266.765.30.70.70.70.70.7Ethiopia3.1083.1473.2903.4073.70685.884.183.483.383.8Kenya2.8462.8232.9072.9683.18977.474.573.774.574.092.993.495.297.6100.8Madagascar2.9873.1223.1543.1813.38297.197.397.197.897.837.937.237.638.739.2Malawi2.7242.8092.9893.1493.365a94.594.995.495.895.925.426.126.727.628.3Mauritius3.3133.3963.4393.6043.78510.914.714.016.917.418.018.619.1Mozambique3.0312.9883.0573.2283.54891.29.58.691.992.50.2Rwanda2.6092.4832.5372.6982.71887.090.690.884.682.00.10.10.10.229.7Seychelles4.0103.9593.9483.7844.131a83.981.926.126.727.528.711.0Uganda2.7492.7122.6792.6712.7749.17.57.310.610.510.511.10.0UnitedRepublic84.57.87.282.681.737.5ofTanzania83.482.90.00.00.00.0Zambia33.934.635.636.7ZimbabweMiddleAfrica2.5982.6482.6812.7362.86685.985.584.885.185.048.349.750.852.554.13.0853.1503.2453.3003.61688.588.288.689.690.015.315.716.317.017.52.200n.r.n.r.n.r.n.r.67.8n.r.n.r.n.r.n.r.10.0n.r.n.r.n.r.n.r.3.2923.2873.3013.3733.55184.7141.183.182.182.281.9143.0145.7150.5154.5Angola4.3274.2934.3524.5855.03181.482.783.986.788.124.625.827.129.030.42.6162.6842.7442.8082.99759.258.858.759.860.514.414.715.115.816.5Cameroon3.4233.5073.5703.6153.78494.694.594.494.594.62.8312.7352.6662.8272.94182.780.979.382.483.14.74.84.95.05.2CentralAfrican3.3433.3853.3653.4213.62688.690.090.090.891.512.512.612.813.714.3Republic2.9212.580a2.393a2.242a2.253a94.291.088.987.185.54.74.95.05.25.3Chad3.5263.5993.6353.6763.751an.a.n.a.n.a.n.a.n.a.79.479.379.980.982.0Congo3.3583.4033.4853.5533.704a28.528.628.429.929.93.2883.3943.503a3.634a3.869a76.676.376.777.378.2n.a.n.a.n.a.n.a.n.a.Democratic0.60.60.60.70.7Republicof0.20.20.20.20.2theCongoEquatorialGuineaGabonSaoTomeandPrincipe207TAABNLNEEAX3.13(Continued)Regions/CostofahealthydietPeopleunabletoaffordahealthydietsubregions/20172018201920202021countries/2017201820192020202120172018201920202021territories(PPPdollarsperpersonperday)(%)(millions)65.2SouthernAfrica3.6353.6503.7143.8394.06265.660.865.467.467.042.542.743.445.345.675.8Botswana3.6223.5753.5913.7013.82963.283.459.863.460.31.51.51.51.61.655.2Eswatini3.4283.3493.3953.406a3.537a77.164.975.075.373.80.90.90.90.90.984.7Lesotho3.7703.8784.0104.2664.61883.286.883.887.087.91.81.81.92.02.079.7Namibia3.2553.3003.3783.5203.76155.442.256.659.059.51.31.31.41.51.573.4SouthAfrica4.1024.1474.1994.2994.56565.370.865.167.066.737.037.237.839.439.678.6WesternAfrica3.2473.3403.3653.4483.71085.589.084.185.185.4316.1321.7327.6340.3350.184.9Benin3.5503.6703.6643.7074.04190.691.682.482.182.610.510.410.110.410.774.5BurkinaFaso3.1733.2963.2403.3453.61183.061.176.877.677.616.516.316.116.717.291.4CaboVerde3.3583.4133.4843.5633.68344.591.139.744.041.20.30.20.20.30.248.0Côted’Ivoire3.2733.3573.5063.6103.90977.784.272.072.872.919.318.718.819.520.044.2Gambia2.9423.0083.0543.1103.32472.621.969.671.872.21.71.71.71.81.9Ghana3.7673.8603.9424.0364.23780.01.777.078.177.424.224.324.325.125.447.2Guinea3.6553.8634.0014.1274.44388.544.688.888.789.110.811.211.411.712.112.4Guinea-Bissau3.1643.2543.3353.4343.69484.413.682.983.984.61.61.61.61.71.7Liberia4.0184.0323.852a3.907a4.447a91.8n.a.91.491.692.84.44.54.64.74.8Mali2.9003.0352.9603.0533.23077.3n.a.69.771.472.014.914.914.315.215.8Mauritania3.4513.5743.6543.6923.94861.72.759.760.962.42.62.62.62.72.955.2Niger2.8502.8122.7922.9023.15592.990.490.992.020.220.621.222.123.22.0Nigeria3.5653.7243.8704.0164.32590.291.893.193.5174.6180.6186.7194.0199.554.1Senegal2.1902.2502.2782.3302.443a53.545.946.245.08.17.57.37.67.6n.a.SierraLeone2.8422.9522.8472.8933.16784.2n.a.81.382.583.56.56.66.56.87.071.0ASIA3.4123.4823.5723.7053.89747.343.246.444.22021.31905.81877.42031.41949.973.6CentralAsia2.7962.7962.9073.1023.32425.321.324.624.48.47.47.38.68.72.5Kazakhstan2.3912.4262.5372.6572.852a2.566.61.62.62.30.50.30.30.50.470.0Kyrgyzstan2.9702.9312.9913.1803.51056.3n.a.45.055.358.23.53.02.93.63.9Tajikistan3.0273.030a3.194a3.468a3.610a49.844.046.844.34.44.14.14.54.3EasternAsia4.1684.3434.4474.6744.86615.111.214.510.0238.7197.0177.8230.9159.4China,mainland2.5712.6302.7922.9832.96016.612.215.910.9232.2190.8171.9224.4153.9TaiwanProvince3.990n.a.n.a.n.a.n.a.0.2n.a.n.a.n.a.0.1n.a.n.a.n.a.n.a.ofChinaChina,HongKong3.6593.8194.1474.5134.718n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.SARJapan5.5295.7015.5655.6475.6382.72.52.72.03.43.43.13.42.555.060.064.11.81.71.82.02.1Mongolia4.5444.6664.9005.1155.67658.51.72.21.51.21.00.91.20.8RepublicofKorea4.7124.9004.8315.1115.3402.2South-eastern3.6763.7753.8553.9944.18555.652.354.054.9348.6343.0335.1349.0357.4AsiaBruneiDarussalam4.1264.2634.3274.4054.641n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Cambodia3.6183.7063.7783.8884.064n.a.69.570.270.8192.5189.6187.4190.9193.7Indonesia4.1294.2734.2684.4664.72972.8LaoPeople’s3.7763.8383.9594.1414.30575.372.774.774.05.35.25.25.55.5DemocraticRepublicMalaysia3.2243.3193.4123.5383.6793.02.12.82.51.00.80.70.90.863.362.373.837.135.133.533.339.7Myanmar3.7063.7863.8613.925a4.206a71.068.474.274.074.876.075.583.284.3n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Philippines3.8433.9954.0544.1184.36470.1Singapore2.7752.8672.9363.0643.186n.a.208TABLEA3.1(Continued)THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2022Regions/CostofahealthydietPeopleunabletoaffordahealthydietsubregions/20172018201920202021countries/2017201820192020202120172018201920202021territories(PPPdollarsperpersonperday)(%)(millions)Thailand3.9714.0424.1814.3214.46320.521.019.119.818.014.515.013.614.112.9VietNam3.5863.6633.7764.0724.21624.922.419.821.821.023.421.319.021.120.5SouthernAsia3.4893.5653.6633.8164.08175.671.170.273.872.21411.31343.91340.61425.91408.5Bangladesh2.8822.9713.0243.0643.20175.372.570.868.766.1121.8118.7117.1115.0111.9Bhutan4.3834.5874.7125.0205.33951.245.542.345.745.20.40.30.30.40.4India2.8242.8302.8772.9703.06678.873.271.476.274.11066.81001.9986.91064.01043.0Iran(Islamic3.0053.2123.6423.6054.16714.416.625.725.530.012.214.322.222.326.4Republicof)Maldives3.5813.6343.6623.8614.0953.42.01.15.31.20.00.00.00.00.0Nepal4.1274.1844.2624.4034.62180.377.275.077.176.422.622.021.622.622.9Pakistan3.4083.3953.4603.6853.89381.079.881.483.582.8175.3175.4181.8189.7191.6SriLanka3.7023.7053.6673.9234.26856.652.048.554.055.512.111.310.611.812.3WesternAsia2.9893.0643.1483.2183.3638.58.69.79.79.014.314.616.717.015.9Armenia3.0963.1663.2373.2473.52737.137.940.039.041.41.11.11.11.11.2Azerbaijan2.3482.3992.4592.5332.6900.00.00.00.00.00.00.00.00.00.0Bahrain3.3793.4633.5733.8354.036n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Cyprus2.8462.8802.9472.9912.9550.10.10.30.10.00.00.00.00.00.0Iraq3.3783.4643.5343.5403.66516.816.815.519.218.46.76.86.48.28.0Israel2.4362.5002.4822.4732.5241.91.21.21.21.20.20.10.10.10.1Jordan3.4123.4543.5003.6143.7376.15.76.57.47.10.60.60.70.80.8Kuwait3.3443.4073.4683.6063.997n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Oman2.8152.8382.9213.0213.141n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Palestine3.3423.3983.4933.3563.28518.018.418.020.015.40.80.80.81.00.8Qatar2.3752.4262.4842.5772.708n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.SaudiArabia3.4413.6633.8884.1484.441n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Türkiye2.8732.9973.1892.9973.1096.16.28.96.96.05.05.17.55.85.1UnitedArab2.7552.8352.9023.1113.269a0.10.10.00.20.10.00.00.00.00.0EmiratesLATIN3.6193.6923.7753.8764.08122.020.920.820.922.7124.5119.5120.0121.9133.4AMERICAANDTHECARIBBEANCaribbean3.8373.9534.0644.2004.41152.451.151.655.257.013.613.413.714.815.4Antiguaand4.1124.3024.3914.5044.684n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.BarbudaAruba3.4183.6203.9074.007a4.116an.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Bahamas4.2764.3874.3644.4884.661n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.BritishVirgin3.2353.087a3.281a3.220a3.425an.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.IslandsCaymanIslands2.9282.866a2.701a2.910a3.050an.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Curaçao2.8662.9883.1443.236a3.495an.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Dominica4.0004.1464.2364.3454.561an.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Dominican3.5213.6083.7443.8844.12824.921.720.625.025.82.62.32.22.72.9RepublicGrenada5.3825.5365.6255.7966.097n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.Haiti3.9304.0754.2754.4904.81484.784.786.988.992.69.29.39.710.110.6Jamaica5.9756.1416.3986.6817.03357.957.157.964.062.61.61.61.61.81.8SaintKitts2.9983.1793.3103.4053.526n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.andNevisSaintLucia3.2633.4003.5173.5953.67320.920.621.231.627.20.00.00.00.10.0209TAABNLNEEAX3.13(Continued)Regions/CostofahealthydietPeopleunabletoaffordahealthydietsubregions/20172018201920202021countries/2017201820192020202120172018201920202021territories(PPPdollarsperpersonperday)(%)(millions)n.a.n.a.SaintVincentand4.1314.2324.2934.4544.697n.a.n.a.n.a.n.a.n.a.n.a.n.a.n.a.theGrenadinesn.a.n.a.SintMaarten4.4624.713a4.835a5.094a5.273an.a.7.0n.a.n.a.n.a.n.a.n.a.n.a.n.a.0.2(Dutchpart)n.a.n.a.Trinidadand3.9284.0284.0834.2244.5246.524.97.19.19.90.10.10.10.134.2Tobago50.716.30.2TurksandCaicos2.8092.8932.9743.0753.229n.a.48.0n.a.n.a.n.a.n.a.n.a.n.a.n.a.0.7Islands23.14.634.438.337.335.738.725.6CentralAmerica3.3683.4193.4543.4823.62525.815.523.625.422.20.20.20.20.22.317.449.457.053.00.80.80.81.10.7Belize2.4762.5172.5742.6322.79750.916.321.014.24.74.74.65.083.8n.r.46.549.744.8n.r.CostaRica3.9614.0004.0483.8893.92516.021.623.120.229.928.727.029.119.135.637.034.22.12.32.42.51.8Honduras3.3603.4153.4043.4863.59548.515.218.917.00.70.60.60.818.517.717.020.648.1Mexico2.9933.0713.0393.0743.20524.34.572.568.870.668.40.7n.r.n.r.n.r.3.0n.r.n.r.n.r.Nicaragua3.1913.2453.2793.3353.54032.324.316.118.33.5Panama4.2254.2684.3824.4764.68717.544.50.118.31.4SouthAmerica3.4173.4393.5043.5893.81818.623.58.645.00.4Argentina3.341n.r.n.r.n.r.n.r.6.80.23.00.8Bolivia3.5513.6483.7693.7553.92720.92.316.017.215.12.42.21.92.10.2(Plurinational0.70.6Stateof)45.8n.a.n.a.Brazil2.8092.8002.8823.0843.35019.618.812.722.441.038.939.927.114.91.94.75.93.50.80.80.91.1Chile3.0533.1803.2763.3493.3874.64.11.625.433.731.312.012.012.717.2n.a.Colombia2.8632.8932.9323.0803.30124.8n.a.19.825.119.72.93.13.44.40.20.742.024.918.50.30.30.30.24.0Ecuador2.7882.8162.8612.9283.03517.61.717.720.320.41.31.21.21.310.72.021.434.225.78.47.67.06.0Guyana4.6294.7424.8284.8875.11745.03.043.954.358.60.30.30.311.40.01.10.10.10.10.30.3Paraguay3.4303.5113.5193.5433.86719.98.63.35.35.20.60.60.70.20.00.12.62.72.90.20.20.20.70.1Peru3.0843.0623.0983.1333.33426.62.40.70.70.70.40.40.50.20.21.552.956.863.7n.a.n.a.n.a.0.50.1Suriname4.9695.311a5.3375.7396.09044.52.8n.a.n.a.n.a.n.a.Uruguay3.0733.1703.2543.4143.5432.8Oceania2.8472.8502.9583.0403.1972.3Australia2.2592.2832.2962.3892.4370.7Fiji3.6123.6773.8583.9144.35844.9NewZealand2.6712.5892.7222.8172.797n.a.NORTHERN3.0263.0863.1863.2043.2242.31.71.61.423.919.718.117.2AMERICAANDEUROPENorthernAmerica3.3863.3133.3433.3733.3201.91.41.21.16.86.05.24.4n.a.n.a.n.a.n.a.n.a.n.a.n.a.Bermuda4.0723.789a3.834a3.718a3.395an.a.0.70.70.40.30.30.30.3Canada2.8632.9112.9273.0173.0650.71.51.21.26.55.74.94.1UnitedStatesof3.2253.2403.2683.3833.5002.01.81.81.517.213.712.912.7America2.82.82.59.07.46.87.01.40.70.50.20.10.10.1Europe2.9983.0683.1743.1903.2172.58.15.84.20.80.60.60.40.20.10.10.00.00.00.0EasternEurope3.0683.1373.2613.3123.3683.62.22.01.50.40.20.20.21.11.30.50.40.60.40.5Belarus3.1773.2283.3103.3103.4712.13.37.03.80.10.10.10.2Bulgaria3.7803.8764.0364.1294.15110.6Czechia2.8992.9213.0253.0032.9850.2Hungary3.3023.3833.4903.5073.4183.7Poland2.9092.9863.1623.2103.1551.0Republicof2.4602.5712.6872.8142.9983.5Moldova210TABLEA3.1(Continued)THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2022Regions/CostofahealthydietPeopleunabletoaffordahealthydietsubregions/20172018201920202021countries/2017201820192020202120172018201920202021territories(PPPdollarsperpersonperday)(%)(millions)Romania2.9212.9703.1333.2073.25311.97.28.88.47.22.31.41.71.61.4Russian3.1493.1973.2643.4203.6783.32.92.52.82.64.74.23.64.03.7FederationSlovakia3.0133.1023.2423.2113.1982.12.81.41.42.30.10.20.10.10.1NorthernEurope2.7022.7482.8222.8322.8020.60.60.50.50.40.60.60.50.60.4Denmark2.3762.4402.4912.5082.5000.20.20.40.30.20.00.00.00.00.0Estonia3.1253.1883.2843.3503.2901.00.81.31.10.80.00.00.00.00.0Finland2.5452.6242.7042.7322.7160.10.20.10.10.00.00.00.00.00.0Iceland2.2132.2472.3142.4202.4160.00.00.00.00.10.00.00.00.00.0Ireland2.3972.3412.3402.2042.1500.40.10.10.20.10.00.00.00.00.0Latvia3.1243.1303.2453.2693.2543.42.41.91.91.50.10.00.00.00.0Lithuania3.0033.0423.1483.1323.1083.32.31.21.10.70.10.10.00.00.0Norway3.3253.4323.4793.4883.3610.60.40.40.50.30.00.00.00.00.0Sweden3.0863.1643.2743.3093.2790.61.20.60.80.60.10.10.10.10.1UnitedKingdomofGreatBritainand1.8221.8731.9371.9111.9500.50.50.50.50.40.30.30.30.30.3NorthernIrelandSouthernEurope3.3483.4233.5603.5373.6044.53.53.33.12.66.75.34.94.63.9Albania3.9524.0694.2624.2804.38831.323.022.219.915.90.90.70.60.60.4Bosniaand3.8473.9074.0433.9614.1054.74.03.93.03.00.20.10.10.10.1HerzegovinaCroatia4.1684.2204.2734.3014.2906.24.13.43.31.80.30.20.10.10.1Greece3.0373.1023.1673.1403.1743.82.12.92.72.20.40.20.30.30.2Italy2.8852.9793.1213.1543.1682.82.82.11.81.51.71.71.21.10.9Malta3.4943.6453.8663.8243.9170.30.30.70.80.80.00.00.00.00.0Montenegro3.3973.4283.6443.5113.67315.917.217.417.314.90.10.10.10.10.1NorthMacedonia3.3183.3243.4643.4273.61620.117.716.617.515.50.40.40.30.40.3Portugal2.5132.5962.6732.6422.6511.11.10.51.41.20.10.10.10.10.1Serbia4.0704.1664.3344.2684.34627.213.116.213.010.91.90.91.10.90.7Slovenia2.7982.9023.0233.0953.0380.10.10.10.00.00.00.00.00.00.0Spain2.6992.7412.8452.8412.8791.71.91.82.01.80.80.90.81.00.9WesternEurope2.7312.8262.9042.9512.9510.40.20.30.30.20.80.40.60.60.4Austria2.7722.8482.9153.0043.0270.60.80.81.00.90.10.10.10.10.1Belgium2.8622.9623.0473.1593.1250.30.20.20.20.10.00.00.00.00.0France2.9363.0193.1773.2383.2540.10.10.30.30.20.00.10.20.20.1Germany2.7862.9172.9843.0383.0820.70.20.20.20.20.60.20.20.20.2Luxembourg2.4922.6272.6192.5762.5900.40.40.10.00.00.00.00.00.00.0Netherlands2.7432.8212.9323.0002.9630.40.30.20.20.10.10.00.00.00.0(Kingdomofthe)Switzerland2.5232.5912.6542.6392.6190.00.00.00.00.00.00.00.00.00.0NOTES:Thetableshowsthecostandaffordabilityofahealthydietatthecountrylevel,aswellasbyregion,subregion,andcountryincomegroupin2017–2021.Foreachregion,subregionandcountryincomegroup,theunaffordabilityestimatedasthepercentageofthepopulationunabletoaffordahealthydietispopulationweighted.The2022WorldBankclassificationofcountriesbyincomegroupisusedforallyearsfrom2017to2021andforallcountriesandterritoriesexceptAnguillaandMontserrat,forwhichincomeclassificationisnotprovided.n.a.=datanotavailable.n.r.=datanotreportedbecauseofinsufficientorunreliabledatatoupdatecostandaffordability.CostandaffordabilityofahealthydietincludeZimbabwe.CostandaffordabilityofahealthydietincludeArgentina.aPPPwasimputedinthisyear.SOURCE:FAO.2023.FAOSTAT:CostandAffordabilityofaHealthyDiet(CoAHD).In:FAO.[Cited12July2023].www.fao.org/faostat/en/#data/CAHD211ANNEX3TABLEA3.2LOWER-ANDUPPER-BOUNDESTIMATESOFTHEPERCENTAGEANDNUMBEROFPEOPLE(INMILLIONS)UNABLETOAFFORDAHEALTHYDIET,BYREGION,SUBREGIONANDCOUNTRYINCOMEGROUPIN2021PeopleunabletoaffordahealthydietLowerboundUpperbound(%)Totalnumber(%)Totalnumber25.8(millions)(millions)WORLD1915.560.24471.1AFRICA59.1793.984.41132.9NorthernAfrica24.560.868.5170.1Sub-SaharanAfrica67.0733.188.0962.7EasternAfrica68.0290.987.6374.6MiddleAfrica66.4125.385.4161.2SouthernAfrica52.235.582.656.2WesternAfrica68.7281.490.5370.8ASIA23.71045.665.92903.4CentralAsia9.73.553.619.0EasternAsia1.422.843.8697.3South-easternAsia33.3216.771.7467.3SouthernAsia41.0799.485.01658.1WesternAsia1.83.334.861.711.869.551.1299.8LATINAMERICAAND42.111.480.9THECARIBBEAN21.9CaribbeanLatinAmerica10.458.149.6277.8CentralAmerica10.015.453.181.6SouthAmerica10.542.748.3196.3OCEANIA1.50.45.61.5NORTHERNAMERICAANDEUROPE0.66.112.5133.6COUNTRYINCOMEGROUPLow-incomecountries69.6388.286.1480.0Lower-middle-incomecountries42.91404.582.82714.3Upper-middle-incomecountries45.01103.74.7115.3High-incomecountries0.77.515.1173.1SOURCE:Authors’(FAO)ownelaboration.212ANNEX4DATAANDDEFINITIONSFORCHAPTER3A.URCAdatadefinitionsandframeworkareas;andiii)adoptingagriddedapproachthatiseasilycomparableacrosscountries,developingTheUrbanRuralCatchmentAreas(URCA)isaadatasetforthewholeworld.publiclyavailableglobalgeospatialdatasetwhichprovidesaglobalmappingoftherural–urbanAdditionally,theURCAapproachallowsforthecontinuum.36,37ItisbasedontheGlobalHumanidentificationoftheshareofthepopulationthatSettlementLayer21andplacesurbancentresonfallsinaspecificcategoryoftherural–urbanagradientbasedonpopulationsizeanddensity.continuumwithinanadministrativeunit,ratherAsshowninChapter3(FigureAofBox2)ruralthanplacingallthepopulationinoneterritorylocationsareassignedagradientoftheirown,orfunctionalarea.Thiscategorizationallowsforusingtheshortesttraveltimetourbancentresofmoredetailedanalysesregardingconsumptionvarioussizes.Thus,theURCAdisaggregatesruralandproductionacrossthecontinuum.TableA4.1areasintomultiplecategories,distinguishing,describesthebasicurbanURCAcategories;forexample,betweenlocationsthatarelessthanconsequently,differentcategoriesofruralare1hourfromanurbancentreandthosethatareattributedtourbanareasofdifferentsizes,fartheraway.InChapter4,theURCAdatasetise.g.ruralareaslessthan1hourtraveltoacityofcombinedwithhouseholdsurveydataforthemorethan5millionpeople.countrycasestudies.IndefiningtheruralURCAcategoriesbasedonTheURCAapproachbuildsuponthecentraltraveltimetoanurbanagglomerations,thetimeplacetheory,whichisasetofassumptionsandintervalistobeconsideredasaclosedintervalonpropositionsthatexplainwhyhierarchicallytheright.Inparticular,fortheURCAcategoriestieredcentresarefoundatcertainfavouredusedinthereportitmeansthat:locationsontheeconomiclandscape.Forexample,retailtradeandserviceactivitiesoften“<1hour”toanyurbancentreincludesareastendtocluster.TheURCAapproachassumesthatlocated1hourorlesstoacityofanysizeorcitysizeisaproxyforthebreadthofservicestown:areas≤1hour.andopportunitiesprovidedbyanurbancentre.Itusestraveltimetolocationsasaproxyfor“1–2hours”toanyurbancentreincludescostandadoptsanurbanhierarchybasedonareaslocatedmorethan1hourbutlessorcitysizetoclassifyrurallocationsasgravitatingequalto2hourstoacityofanysizeortown:aroundaspecificurbancentre.Thisapproach1hour<area≤2hours.allowsfor:i)capturingtheurbanhierarchythatexistsbetweenurbancentresofdifferentsizes“>2hours”toanyurbancentreincludesareasintermsofaccesstoservicesandemploymentlocatedmorethan2hourtoacityofanysizeoropportunitiesforrurallocations;ii)definingtown:areas>2hours.urban–ruralcatchmentareas(URCAs)intermsoftheinterconnectionbetweenurbancentresNotethatforimprovedreadabilityofthetextand(ofdifferentsizes)andtheirsurroundingruralfiguresinChapter4,thisdegreeofspecificityapplies,butisnotwrittenatthislevelofdetail.213ANNEX4TABLEA4.1URCADEFINITIONOFCATEGORIESACROSSTHERURAL–URBANCONTINUUMRURALURBANAgglomerationsbasedonpopulationsizeHourstraveltimetooneofsevenurbanagglomerations>33–22–1<1>51–50.5–1250–500100–25050–10020–50hourshourshourshourmillionmillionmillionthousandthousandthousandthousandpeoplepeoplepeoplepeoplepeoplepeoplepeopleNOTE:Consideredaseitherhinterlandordispersedtowns,beingthattheydonotgravitatearoundanyurbanagglomeration,andarehencenotpartoftherural–urbancontinuum.SOURCE:FAO.2021.GlobalUrbanRuralCatchmentAreas(URCA)Grid–2021.In:FAO.[Cited4May2023].https://data.apps.fao.org/?share=g-3c88219e20d55c7ce70c8b3b0459001aB.Methodologicalapproachandtoolforlogisticregression,whichisaclassificationthesystematicstructuralliteraturereviewalgorithmusedtosolvebinaryclassificationproblems.ThelogisticregressionclassifierusesThesystematicreviewofevidencefromscientificaweightedcombinationoftheinputfeaturesstudiesusedforChapter3,designedfollowingthe(thetermsintheTf-idfmatrix)andpassesthemPreferredReportingItemsforSystematicReviewsthroughasigmoidfunctionthattransformsandMeta-analysis(PRISMA),4wasimplementedanyrealnumberinputtoanumberbetween0usinganintegratedresearchtool,ExpertSearchand1.TheweightsofthecombinationsarethenSemanticENriChmEnt(Essence),developedbyestimatedtominimizethedistancebetweentheFAODataLab.theoutputofthefunctionandtheuser’sspecificationoftherelevanceofthereviewedEssenceisbasedonawebapplicationthatoffersdocuments.Afterthisstep,theresultingthepossibilityofautomaticallyqueryingscientificfunctionwasappliedtoallthedocumentsthatarticlesfrommultipledatasources(Googleweredownloaded(andalsothosenotreviewed),Scholar,WorldBank,InternationalMonetarywhichwereassociatedtoa“scoreofrelevance.”Fund,etc.).Thesearticles,includingtheirfulltext,Athresholdmadeitpossibletoclassifyallarethenstoredandmadeavailableforreviewthedocumentsthatweredownloadedandnotthroughasemanticsearchengineutilizingthemanuallyreviewedas“relevant”.ApacheSolrdatabaseatitscore.ThisallowsfortheaggregationandfilteringofresultsbyThroughthisiterativeprocess,itwaspossibletoselectingvaluesautomaticallyidentifiedwhenrevisetheliteratureinfewpassagesandrelyonthedocumentsaredownloadedorbyexploitingthefeaturesavailabledirectlyfromtheEssenceannotationsaddedcollaboratively.Webinterface.Thisisbecausetheproposedrelevancescoreforthenon-user-evaluatedAdvancedmethodswereusedfromthetool’sdocumentsbecomesafilter,permittinguserswebinterface,whichpermittedthefilteringoftoquicklyidentifyandreviewthemostlikelydownloadeddocumentsthroughanalgorithmrelevantdocumentsandaddnewexamplesthatbasedonanartificialintelligencemethodthatcouldhelpthealgorithmtobetteridentifythoselearnsandextendsuserselectionsofrelevantthatarerelevanttothesetofdocumentsusedarticles.Theapproachreliesonthemanualinthelearningstep.Thisiterativeprocesshelpsrevisionofasmallsubsetofdocumentsthatareusersfilteroutthemostrelevantdocumentsidentifiedasrelevant,ornot,bytheuserstobeandhelpsimprovetheaccuracyofthemodelsousedasasourceofgroundtruth.Apreliminarythatitisbetterabletomakepredictionsonthetextpre-processingandlearningstepwasthenrelevanceofadocument.executeddirectlyfromthewebinterface,inordertoestimateandgeneralizethelinkingForafulldescriptionoftheimplementationoffunctionbetweenthecontent(i.e.terms)ofthePRISMAprotocol,andthemethodologicaltherevieweddocumentsandtheirrelevanceapproachforthesystematicstructuralliteraturestatus.Thelearningstepwasbasedonlinearreview,seedeBruinandHolleman(2023).18n214ANNEX5DATAANDDEFINITIONSFORCHAPTER4A.HouseholdsurveysallURCAstoconducttheanalyses.FormoredetailsontheURCAcategories,seeBox2andBox3ThedemandanalysisconductedinSection4.1inChapter3.TableA5.2reportsthenumberofandtheestimationofsubnationalcostofahealthyhouseholdsinterviewedineachURCAandthedietinSection4.2usegeoreferenceddatafromnumberofhouseholdsforwhichgeoreferencednationalrepresentativeLSMSsurveys(TableA5.1).variableswerenotavailable,andforwhichitwasThesurveyscaptureapparenthouseholdfoodthusnotpossibletoassigntoanyURCA.consumptionusingquantitativeseven-dayrecalls.ThesamesurveyscontainaseparatemoduleThesurveysareallnationallyrepresentative,witheightquestionsregardingpeople’saccesstobuttheyarenotmeanttoberepresentativeatadequatefood,whichwasusedfortheestimationtheURCAlevel.Forthisreason,thedistributionoftheprevalenceofmoderateorseverefoodofpopulationsurveyedacrossURCAswasinsecurityinSection4.2.comparedwiththeactualpopulationdistribution(estimatedbasedonthe2020GlobalHumanFinally,malnutritionindicatorsamongchildrenSettlementPopulation[GHS-POP]datasetandtheunderfiveyearsofageassessedinSection4.2URCAdataset),anditwasfoundtobesufficientlywerederivedusinggeoreferenceddatafromsimilarsoastoexcludethatanycatchmentareanationalrepresentativedemographicandhealthwasunder-oroverrepresentedineachsurvey.surveys(TableA5.1).TheURCAdatasetwasdevelopedbasedonB.URCAcategoriesusedinthei)theGHSSettlementModel(GHS-SMOD)gridrural–urbancontinuumanalysistoidentifycitiesandtowns;ii)theGHS-POPgridfor2015tocalculatetheurbanpopulationFortheanalysesconductedinChapter4,theineachcity;andiii)traveltimeclassificationsURCAcategoriesweresimplifiedandgroupedbasedonNelsonetal.(2019)38withupdatedcostintotencategories,withafurtheraggregationtosurfacefromWeissetal.(2020).39Accordingly,theurban,peri-urbanandruralcategories(seeTable9matchingbetweentheURCAdatasetandsurveysinChapter4).ThisaggregationallowedforainTableA5.1presentssometimeinconsistencies,sufficientnumberofobservationsinalmost215ANNEX5TABLEA5.1HOUSEHOLDSURVEYSUSEDINCHAPTER4CountryYearSurveySectionswheresurveysareusedBenin2018/19HarmonizedSurveyonHouseholdsLivingStandardsBurkinaFaso2018/19HarmonizedSurveyonHouseholdsLivingStandardsCôted’Ivoire2018/19HarmonizedSurveyonHouseholdsLivingStandardsEthiopia2018/19SocioeconomicSurveyPanelIIDemandanalysisGuinea-Bissau2018/19HarmonizedSurveyonHouseholdsLivingStandards(Section4.1),costandMalawi2019/20FifthIntegratedHouseholdSurveyaffordabilityofhealthyMali2018/19HarmonizedSurveyonHouseholdsLivingStandardsdiet(Section4.2),Niger2018/19HarmonizedSurveyonHouseholdsLivingStandardsfoodinsecuritybasedonFIES(Section4.2)Nigeria2018/19GeneralHouseholdSurvey-Panel,Wave4Senegal2018/19HarmonizedSurveyonHouseholdsLivingStandardsTogo2018/19HarmonizedSurveyonHouseholdsLivingStandardsBenin2017/18DemographicandHealthSurveyinBeninMalnutritionNigeria2018NigeriaDemographicandHealthSurveyestimationsSenegal2018Senegal:ContinuousDemographicandHealthSurvey(Section4.2)SOURCES:WorldBank.2023.LivingStandardsMeasurementStudy(LSMS).In:WorldBank.[Cited19May2023].www.worldbank.org/en/programs/lsms;USAID(UnitedStatesAgencyforInternationalDevelopment).2023.TheDemographicandHealthSurveys(DHS)Program.[Cited19May2023].https://dhsprogram.comassurveysareforaone-yearperiodandwerejumpfromsmalltointermediatecity,orfromconductedbetween2018and2019(exceptMalawi,intermediatetolargecity.conductedbetween2019and2020).However,theinformationonroadandinfrastructureusedinC.FoodprocessingandfoodgrouptheURCAdatasetwasthemostupdatedattheaggregatesusedinfooddemandanalysestimethedatasetwasdeveloped,whichisaroundthesametimethesurveyswereconducted.ExplanatorynoteonprocessedfoodsandfoodThus,weexpectthatthetraveltimeintheURCAprocessingclassificationsystemsdatasetdoesnotdivergesignificantlyfromTheterm“foodprocessing”involvesapplyingthetraveltimefacedbythehouseholdsinthescientificandtechnologicalprinciplestosurveysanalysed.preservefoodsbyslowingdownorstoppingthenaturalprocessesofdecay.40PurposesoffoodToidentifytheurbancentresintheURCAprocessingincludeconvertinginedibleintoedibledataset,the2015GHS-POPwasused.Accordingly,foods,increasingthedigestibilityofrawfoodsitispossiblethatsomeperi-urbanareasare(e.g.throughcooking),alteringtheshelf-lifemisclassifiedintheanalysisofChapter4(i.e.if(e.g.throughfermentation,canningorfreezing),acityhasexpanded,someareasthatwereinsimplifyingmealpreparation,orincreasing2015classifiedas“lessthan1hourfromthethepalatabilityoffoodproducts(e.g.throughcity”couldhavebecomepartofthecityintheadditionofflavourings).Thedegreeof2018/19).Thisishoweveronlythecaseifthefoodprocessingcanvaryfromunprocessedcityhadexpandedgeographicallyandnotjustrawfoods(e.g.freshfruiteatenassuch)toinpopulationsize.Inaddition,itispossiblethatfoodproductswhoseingredientsarederivedanurbancentremayhavegrowninpopulationfromfoodbutcontainlittleornowholefoodsizebetween2015and2018/19andmadethe(e.g.extrudedcereals).41Certainfoodprocessing216THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA5.2HOUSEHOLDSAMPLESIZESBYURCAFORTHESURVEYSUSEDINCHAPTER4Largecity(>1millionpeople)Intermediatecity(0.25–1millionpeople)Smallcity(50–250thousandpeople)Town(20–50thousandpeople)<1hourtoalargecity<1hourtoanintermediatecity<1hourtoasmallcity<1hourtoatown1–2hourstoacityortown>2hourstoacityortownMissinggeoreferencedinformation(number)High-food-budget38942081376314733444403184521222706411552057countries1079Senegal74399139463694811882478060313Ethiopia704517837158362944177058752411257Côted’Ivoire671348828468635815380649234421403Mali810120720312480216612187084Nigeria630353387141133111088163622056284Low-food-budget31688720countries281832131295644878238Guinea-Bissau11673468604411393827Benin10931066236243615272350Togo49755236011863761196659131BurkinaFaso5886070614113614422866245679650Malawi27596932419225798412Niger3206372853027294432050320103124562834651447553662213684366635919466811511332132152311801291137SOURCE:AdaptedfromDolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.methodscanhelptoincreasefoodavailabilityprocessedfoods,theirimpactonoveralldietbyallowingtransportoffoodsacrosstheglobe,qualityanddiseaseoutcomes(inseveralthusextendingseasonalavailabilitybeyondcountries),theplaceswherethesefoodsarewhatisproducedlocallyinaspecificseason,purchased,ortheiravailabilityinurbanfoodandalsomakingfoodsafertoeat.42Foodsandenvironmentsinparticular.41,43foodproductsprocessedinindustrialsettingsdifferfromthosepreparedbyhandathomeTheNOVAfoodclassificationisoneoftheorinartisanalsettings;theyemploydifferentavailablefoodprocessingclassificationsystemsingredientsandmethods.41thathasbeenconsideredindifferentscenariosforpublichealth,nutritionandepidemiologicalDuringthelasttwodecades,numerousresearch.However,thereareimportantclassificationsystems,takingintoaccountlimitationsinthisclassification.Thedefinitionvariousdegreesoffoodprocessing,havebeenoflevelsoffoodprocessing,asproposedbydeveloped.AmongthemarefoodclassificationNOVA,iscomplexandmultidimensional,whichsystemsthatemphasizeindustrialfoodincreasestheriskofmisclassificationoffoodprocessing,wherebyfoodsarecategorizeditems.43Inaddition,thefirstcategorycombinesaccordingtoprocessing-relatedcriteria,unprocessedandminimallyprocessedfoods,eachemployingdifferentcriteriaandmetrics.whichmakesitdifficulttounambiguouslyTheyhavebeenusedtodescribeandmonitorinterpretthefindings.Ithasbeensuggestedthatlevelsofconsumptionofdifferenttypesoftheremaybefewadvantagesfromusingthe217ANNEX5TABLEA5.3NOVAFOODGROUPSWITHDESCRIPTIONSANDEXAMPLESNOVAfoodgroupDescriptionExamples1.UnprocessedandUnprocessedfoodsareofplantorigin(leaves,stems,roots,Fresh,chilled,frozen,vacuum-packedminimallyprocessedtubers,fruits,nuts,seeds),oranimalorigin(meat,othervegetablesandfruits;grains(cereals)foodsflesh,tissueandorgans,eggs,milk),consumedshortlyafterincludingalltypesofrice;fresh,frozenandharvesting,gathering,slaughterorhusbanding.Minimallydriedbeansandotherlegumes(pulses),processedfoodsareunprocessedfoodsalteredinwaysthatrootsandtubers;fungi;driedfruitsanddonotaddorintroduceanysubstance,butthatmayinvolvefreshlypreparedorpasteurizednon-subtractingpartsofthefood.Minimalprocessesincludereconstitutedfruitjuices;unsaltednutsandcleaning,scrubbing,washing;winnowing,hulling,peeling,seeds;fresh,dried,chilled,frozenmeats,grinding,grating,squeezing,flaking;skinning,boning,poultry,fish,seafood;dried,fresh,carving,portioning,scaling,filleting;pressing;drying,pasteurizedfull-fat,low-fat,skimmedmilk,skimming,fatreduction;pasteurizing,sterilizing;chilling,fermentedmilksuchasplainyoghurt;eggs;refrigerating,freezing;sealing,bottling(assuch);simpleflours,“raw”pastasmadefromflourandwrapping,vacuum-andgas-packing.Malting,whichaddswater,teas,coffee,herbinfusions;tap,water,isaminimalprocess,asisfermenting,whichaddsfiltered,spring,mineralwater.Alsoincludeslivingorganisms,whenitdoesnotgeneratealcohol.foodsmadefromtwoormoreitemsinthisThemainaimoftheseprocessesistoextendthelifeofgroup,suchasdriedmixedfruits,granolaunprocessedfoods,enablingtheirstorageforlongeruse,madefromcereals,nutsanddriedfruitsortomakethemedible,and,often,tomaketheirwithnoaddedsugars,honeyoroils;pasta,preparationeasierormorediverse.couscousandpolentamadewithflours,flakesorgritsandwater;andfoodswithvitaminsandmineralsaddedgenerallytoreplacenutrientslostduringprocessing,suchaswheatorcornflourfortifiedwithironandfolicacid.2.ProcessedculinaryProcessedculinaryingredientsarefoodproductsextractedVegetableoilscrushedfromseeds,nutsoringredientsandpurifiedbyindustryfromconstituentsoffoods,orelsefruits(notablyolives);butterandlardobtainedfromnature,suchassalt.Stabilizingor“purifying”obtainedfrommilkandpork;sugarandagentsandotheradditivesmayalsobeused.Theymaymolassesobtainedfromcaneorbeet;containadditivesthatprolongproductduration,protecthoneyextractedfromcombsandsyruporiginalpropertiesorpreventproliferationoffrommapletrees;starchesextractedfrommicroorganisms.cornandotherplants,andsaltminedorfromseawater,vegetableoilswithaddedantioxidants,andtablesaltwithaddeddryingagents.Includesproductsconsistingoftwogroup2items,suchassaltedbutter,andgroup2itemswithaddedvitaminsorminerals,suchasiodizedsalt.3.ProcessedfoodsThesefoodsaremanufacturedbyaddingsaltorsugarsCannedorbottledvegetablesandlegumes(orothersubstanceofculinaryusesuchasoilsorvinegar)to(pulses)preservedinbrine;peeledorslicedwholefoods,tomakethemmoredurableandsometimesfruitspreservedinsyrup;tinnedwholeoralsotomodifytheirpalatability.Theyaredirectlyderivedpiecesoffishpreservedinoil;saltednuts;fromfoodsandrecognizableasversionsoftheoriginalun-reconstitutedprocessedmeatandfishfoods.Theyaregenerallyproducedtobeconsumedaspartsuchasham,bacon,smokedfish;cheese;ofmealsordishes,ormaybeused,togetherwithhighlyandfreshunpackagedbreadswhenmadeprocessedproducts,toreplacefood-basedfreshlypreparedfromwheatflour(orothercerealflours),dishesandmeals.Processesincludecanningandbottlingwater,fermentsandsalt.usingoils,sugarsorsalt,andmethodsofpreservationsuchassalting,saltpickling,smoking,curing.Processesandingredientsherearedesignedtoincreasethedurabilityofgroup1foodsandmakethemmoreenjoyablebymodifyingorenhancingtheirsensoryqualities.Theymaycontainadditivesthatprolongproductduration,protectoriginalproperties,orpreventproliferationofmicroorganisms.Whenalcoholicdrinksareidentifiedasfoods,thoseproducedbyfermentationofgroup1foodssuchasbeer,ciderandwine,areclassifiedhereingroup3.218THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA5.3(Continued)NOVAfoodgroupDescriptionExamples4.Ultra-processedTheseproductsareformulatedmostlyorentirelyfromChips(crisps),manytypesofsweet,fattyorfoodsanddrinksubstancesderivedfromfoodsorotherorganicsources,saltysnackproducts;icecream,productsandtypicallycontainlittleornowholefoods.Theyarechocolates,candies(confectionery);durable,convenient,accessible,highlyorultra-palatable,Frenchfries(chips),burgersandhotdogs;andoftenhabit-forming.Thesefoodsaretypicallynotpoultryandfish“nuggets”or“sticks”recognizableasversionsoffoods,althoughmayimitatethe(“fingers”);massmanufacturedbreads,appearance,shapeandsensoryqualitiesoffoods.Manybuns,cookies(biscuits);breakfastcereals;ingredientsarenotavailableinretailoutlets.Somepastries,cakes,cakemixes;“energy”bars;ingredientsaredirectlyderivedfromfoods,suchasoils,preserves(jams);margarines;desserts;fats,flours,starchesandsugars;othersareobtainedbycanned,bottled,dehydrated,packagedfurtherprocessingoffoodconstituentsorsynthesizedfromsoups,noodles;sauces;meat,yeastotherorganicsources.Numericallythemajorityofextracts;soft,carbonated,cola,“energy”ingredientsarepreservatives;stabilizers,emulsifiers,drinks;sugared,sweetenedmilkdrinks,solvents,binders,bulkers;sweeteners,sensoryenhancers,condensedmilk,sweetenedincludingcoloursandflavours;processingaidsandotheradditives;“fruit”yoghurts;fruitand“fruitnectar”bulkmaycomefromaddedairorwater.Micronutrientsmaydrinks;instantcoffee,cocoadrinks;“fortify”theproducts.Mostaredesignedtobeconsumedno-alcoholwineorbeer;pre-preparedbythemselvesorincombinationassnacks.Processesmeat,fish,vegetable,cheese,pizza,pastaincludehydrogenation,hydrolysis;extruding,moulding,dishes;infantformulas,follow-onmilks,re-shaping;pre-processingbyfrying,baking.Processesandotherbabyproducts;“health”,“slimming”ingredientsusedtomanufacturehighlyprocessedfoodsareproductssuchaspowderedor“fortified”designedtocreatehighlyprofitableproducts(low-costmealanddishsubstitutes.ingredients,longshelf-life,emphaticbranding),convenience(ready-to-consume)hyper-palatableproductsliabletodisplacefreshlyprepareddishesandmealsmadefromallotherNOVAfoodgroups.Whenalcoholicdrinksareidentifiedasfoods,thoseproducedbyfermentationofgroup1foodsfollowedbydistillationoftheresultingalcohol,suchaswhisky,gin,rum,vodka,areclassifiedhereingroup4.SOURCES:MonteiroC.A.,Cannon,G.,Levy,R.B.,Moubarac,J-C.,Iouzada,M.L.C.,Rauber,F.,Khandpur,N.,Cediel,G.Neri,D.,Martinez-Steele,E.,Baraldi,L.G.&Jaime,P.C.2019.Ultra-processedfoods:whattheyareandhowtoidentifythem.PublicHealthNutrition,22(5):936-941.https://doi.org/10.1017/s1368980018003762;Monteiro,C.A,Cannon,G.,Jaime,P.,Canella,D.,Louzada,M.L.,Calixto,G.,Machado,P.etal.2016.Foodclassification.PublichealthNOVA.Thestarshinesbright.WorldNutrition.7(1–3).https://worldnutritionjournal.org/index.php/wn/article/view/5/4;FAO.2015.Guidelinesonthecollectionofinformationonfoodprocessingthroughfoodconsumptionsurveys.Rome.www.fao.org/3/i4690e/i4690e.pdfNOVAclassificationcomparedwiththecurrentoftheindustrialprocessingtheyundergo.epidemiologicapproach,whichreliesontheTheseprocessesinvolvephysical,biologicallinkageofnutrientintakestochronicdisease,and/orchemicalmethodsusedduringthefoodwithsubsequentidentificationoffoodsthatmanufacturingprocess.41,45meritconsiderationinpublichealthnutritionstrategies.44Therefore,resultspresentedinAccordingtotheNOVAclassification,methodsusedChapter4shouldbeinterpretedwiththeseinhouseholdsandsimilarplacessuchasrestaurantslimitationsandconsiderationsinmind.orartisanalsettingswherefreshculinarypreparationsarepreparedfromscratchbyhandorFoodprocessingandfoodgroupclassificationswithsimpletools,arebydefinitionnotindustrialusedinSection4.1processingmethods.Home-preparedandartisanalTheNOVAclassificationsystemwasdevelopedpreparationsofalltypesshouldasfaraspossiblebyresearchersfromtheUniversityofSãoPaulo,bedisaggregatedintotheircomponentssothateachBrazil.45Thesystemwaspublishedmorethancanthenbeclassifiedintooneofthefourgroups.tenyearsagoandhasbeenusedindifferentsettingsandpopulationssince.46ForthefoodNOVAclassifiesallfooditemsintofourmaindemandanalysesbyleveloffoodprocessing,agroups:1)unprocessedandminimallyprocessedfoodclassificationsystemadaptedfromNOVAfoods;2)processedculinaryingredients;wasused,wherebyallfoodswereclassified3)processedfoods;and4)highlyprocessedaccordingtothenature,extentandpurposefoodsanddrinkproducts.45,46Thefourmain219ANNEX5TABLEA5.4FOODPROCESSINGLEVELAGGREGATESUSEDINSECTION4.1ADAPTEDFROMNOVANOVAUsedinFooditems–examplefoodgroupthisreport1.UnprocessedFresh/raw:Dried:cerealsFlourfromUnsweetenedUnprocessedandminimallycereals,roots,(rice,maize,starches:wheat,drinks:bottledandminimallyprocessedtubers,wheat,barley,maize,cassavawater,tea,processedplantains,millet,sorghum),coffee,fruitpulses,seeds,pulses(groundnut,juice,milknuts,animalsoybean,cowpea),(fresh,proteins,tubers,vegetables,fermented,vegetables,fruitstinned,fruitspowder)2.ProcessedLowFatsandSeasonings:spices,PastesandDried/smoked:Flour-Beerculinaryprocessedoils:cookingsalt,sugars,honeypurees:groundnut,fish(includingbasedandingredientsoil,butter,tomato,sesametinned)goods:winemargarine,bread,3.Processedghee,sheachapati,foodsbutter,pastagroundnutoil,coconutoil4.Ultra-HighlySweetsandIndustrialCanned/processedOtherdrinks:Mealsatprocessedprocessedconfectionary:products:modernmeats:sausagesoftdrinks,restaurantsbiscuits,bread,breakfastspiritscakes,cereals,infantpastries,jamsformulaSOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TABLEA5.5FAO/WHOGIFTFOODGROUPLEVELAGGREGATESFoodgroupsCerealsandtheirRoots,tubers,plantainsPulses,seeds,nutsandVegetablesandtheirFruitsandtheirproductsproductsandtheirproductstheirproductsproductsMilkandmilkproductsEggsandtheirproductsFish,shellfishandtheirMeatandmeatproductsInsects,grubsandtheirproductsproductsFatsandoilsSweetsandsugarsSpicesandcondimentsBeveragesFoodsforparticularnutritionalusesFoodsupplementsFoodadditivesCompositedishesSavourysnacksNOTE:ThefollowingFAO/WHOGIFTfoodgrouplevelaggregateshaveanegligiblepresenceintheLSMSdata:insects,grubsandtheirproducts;foodsforparticularnutritionaluses;foodsupplements;foodadditives;andcompositedishes.SOURCE:FAO.2022.FAO/WHOGlobalIndividualFoodconsumptiondataTool(FAO/WHOGIFT):methodologicaldocument.Rome.www.fao.org/3/cb8809en/cb8809en.pdfgroupsandtheirdescriptionsaregivenintheirproducts”and“roots,tubers,plantainsTableA5.3.FortheanalysisinSection4.1,foodandtheirproducts”.Thegroup“animalsourceitemswereclassifiedaccordingtothefourfoods”iscomposedofthesubgroups“milkNOVAgroups;45,46butforthepurposesofandmilkproducts”,“eggsandtheirproducts”,presentation,thesewerereducedtothree“fish,shellfishandtheirproducts”,“meatandgroups,withgroups2and3combinedasonemeatproducts”and“insects,grubsandtheirgroup.Thethreemaingroups(withfooditemproducts”andsoforth.Thegroup“sweets,examplesineach)andthenamesusedinthiscondimentsandbeverages”iscomposedofthereportareshowninTableA5.4.subgroups“sweetsandsugars”,“spicesandcondiments”and“beverages”.“FoodawayfromForthepurposeoftheanalysisinSection4.1,thehome”comprisespreparedfoodsconsumedFAO/WHOGlobalIndividualFoodconsumptionawayfromhome,whichisspecificallyidentifieddataTool(GIFT)foodgrouping(TableA5.5)47wasinhouseholdsurveys.TableA5.6showsthefoodadaptedtoformeightfoodgroupsasshowngroupaggregatesusedinSection4.1,alongwithinTableA5.6.Forsimplicityofpresentation,atheirfoodgroupnameswhicharesimplifiedfornumberofthefoodgroupswerecombinedintopresentationpurposesinfiguresandtables.broadergroups.Forinstance,thegroup“staplefoods”includesthesubgroups“cerealsand220THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA5.6SUMMARYOFFOODGROUPAGGREGATESANDTERMINOLOGYOFFOODGROUPSUSEDINSECTION4.1FoodgroupsStaplePulses,AnimalVegetablesFruitsFatsandoilsSweets,FoodawayusedinfoodsseedssourcecondimentsfromhomefiguresandandnutsfoodsandtablesinbeveragesChapter4FooditemCerealsSoybean,Freshmilk,Cabbage,Mango,Palmoil,Pastries,Savouryexamples(rice,wheat,groundnut,powderedlettuce,orange,vegetablecakes,snacks,maize,cowpea,milk,tomato,papaya,oils,biscuits,fullmealsmaizeflour,sesamecheese,okra,onionsweetcottonseedsweets,sorghum,eggs,fish,banana,oil,butterjams,millet,shellfish,avocado,sugars,salt,bread,chicken,apple,ginger,pasta)beef,pork,coconutmayonnaise,Roots,muttonbeer,wine,tubersandwater,softplantainsdrinks,(potato,coffee,tea,cassava,juicestaro,yam,plantains,other)NOTE:ThefooddemandanalysisinChapter4usesafoodgroupingoriginallyadaptedfromtheFAO/WHOGIFTclassification,butisfurtheraggregatedforpresentationpurposes.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.D.DataandmethodologybehindanalysisFIES,48whichwereavailablefor21countries.bjTheinBox6FIESsurveymodulewasused,composedofeightquestionsaboutrespondents’experiencesfacingTheanalysisofmoderateorseverefoodinsecurityconstrainedaccesstofoodduringthe12monthsbasedontheFIESacrosstherural–urbanprecedingdatacollection.Respondentswerecontinuum(URCA)isbasedondatacollectedclassifiedintothreecategories:1)foodsecureorbyIFADbetween2019and2021onsmall-scaleonlymildlyfoodinsecure;2)moderatelyfoodproducerhouseholdsandcommunitiesincludinginsecure;and3)severelyfoodinsecure,followingbeneficiariesaswellasnon-beneficiaries(thatstandardmethodology.49nareusedascounterfactualgroups)inexpostruralprojectimpactassessments.biThedatabjTheprojectsrepresentedinclude:AsiaandthePacificRegion(APR)arecomprehensivehousehold-leveldatawith(1)thePost-TsunamiSustainableLivelihoodsProgrammefortheCoastaldetailedGPScoordinatescollectedfrom21ruralCommunitiesofTamilNadu(PTSLP)inIndia,(2)theProductivedevelopmentprojectsimplementedincountriesPartnershipsinAgricultureProject(PPAP)inPapuaNewGuinea,(3)thefrommostregionsoftheworld.SecondCordilleraHighlandAgriculturalResourceManagementProject(CHARMP2)inthePhilippines,(4)theRuralDevelopmentProgramme–TheprojectsareselectedforimpactassessmentsPhaseII(RDPII)inSolomonIslands,(5)theProjectforAdaptiontotoberepresentativeofIFAD’soverallprojectClimateChangeintheMekongDeltainBenTreandTraVinhProvincesinportfolio.Samplesizesrangebetween1500VietNam;EasternandSouthernAfricaRegion(ESA)(1)theRuraland3000householdsandaround150to300FinancialIntermediationProgrammeII(RUFIPII)inEthiopia,(2)thecommunitiesperproject.TheyconsistofdetailedUpperTanaCatchmentNaturalResourceManagementProjectinformationrelatedtosociodemographic,(UTaNRMP)inKenya,(3)theSmallholderAgricultureDevelopmenteconomic,andsocialcapitalvariables,includingProject(SADP)inLesotho,(4)theSustainableAgriculturalProductioninformationonhouseholddietarydiversityandProgramme(SAPP)inMalawi,(5)theMarketingInfrastructure,ValuefoodinsecurityexperiencesascapturedbytheAdditionandRuralFinanceSupportProgramme(MIVARF)intheUnitedRepublicofTanzania,(6)theSmallholderProductivityPromotionbiDatafromIFAD’sImpactAssessment(2019–2021)arecollectedProgramme(S3P)inZambia;LatinAmericaandtheCaribbeanRegionusingtheCAPIapproachwithSurveySolutionsandcover(LAC)(1)theInclusiveRuralDevelopmentProgramme(PRODERI)insociodemographic,economic,andsocialcapitalvariables,aswellasaArgentina,(2)theEconomicInclusionProgrammeforFamiliesandRurallargesetofvariablesthatdetermineagriculturalandnon-agriculturalCommunities(ACCESOS)intheTerritoryofthePlurinationalStateofproductionandincomes.MoreinformationaboutthesedatasetscanbeBolivia,(3)theAdaptingtoMarketsandClimateChangeProjectfoundonthefollowingwebpage:www.ifad.org/ifad-impact-assessment-(NICADAPTA)inNicaragua,(4)theStrengtheningLocalDevelopmentinreport-2021/index.htmltheHighlandsandHighRainforestAreasProject(PSSA)inPeru;NearEast,NorthAfrica,EuropeandCentralAsiaRegion(NEN)(1)theProgrammetoReduceVulnerabilityinCoastalFishingAreas(PRAREV-Pêche)inDjibouti,(2)theLivestockandMarketDevelopmentProgrammeII(LMDPII)inKyrgyzstan,(3)theLivestockandPastureDevelopmentProjectII(LPDPII)inTajikistan,(4)theAgropastoralDevelopmentandLocalInitiativesPromotionProgrammefortheSouth-East–PhaseII(PRODESUDII)inTunisia;WestandCentralAfricaRegion(WCA)(1)theRuralEnterprisesProgramme(REP)inGhana,(2)thePovertyReductionProjectinAftoutSouthandKarakoro–PhaseII(PASKII)inMauritania,(3)theValueChainDevelopmentProgramme(VCDP)inNigeria.221ANNEX6URCAMAPSSHOWINGPATTERNSOFURBANIZATIONFORCOUNTRIESANALYSEDINCHAPTER4FigureA6.1presentsURCAmapsfor9ofthe11towndispersedurbanizationpattern(exampleWestern,EasternandSouthernAfricancountriesEthiopia).Foreachfigure,thetopleftmapshowsanalysedinChapter4.TheothertwocountriestheoverlayofallURCAcategoriesandthetoparepresentedinFigure23inChapter4.Therightmapshowsthelocationofurbancentres.mapsshowdifferentpatternsofurbanization,Thebottommapsshow,movinglefttoright,thefromadensermetropolitanurbanizationareasthatarelessthan1hour,1to2hours,andpattern(exampleSenegal)toasmallcityormorethan2hourstraveltoanyurbancentre.n222FIGUREA6.1URBAN–RURALCATCHMENTTAHREESATSATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023A)BENINURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELB)CÔTED'IVOIREURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlands223AFNIGNUERXEA66.1(Continued)C)ETHIOPIAURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELD)GUINEA-BISSAUURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlands224FIGUREA6.1(Continued)THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023E)MALAWIURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELF)MALIURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlands225AFNIGNUERXEA66.1(Continued)G)NIGERURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELH)SENEGALURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlands226FIGUREA6.1(Continued)THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023I)TOGOURBANCENTRES<1HOURTRAVEL1–2HOURSTRAVEL>2HOURSTRAVELLargecity(>1millionpeople)<1hourtoalargecity1–2hourstoalargecity>2hourstoalargecity<1hourtoanintermediatecity1–2hourstoanintermediatecity>2hourstoanintermediatecityIntermediatecity(0.25–1millionpeople)<1hourtoasmallcityortown1–2hourstoasmallcityortown>2hourstoasmallcityortownSmallcitiesandtowns(0.02–0.25millionpeople)DispersedtownsHinterlandsNOTES:Inallpanels,thetopleftmapdisplaysallurban–ruralcatchmentsareas.Thetoprightmapshowsonlythethreecategoriesofurbancentres(large,intermediateandsmallcityortown).Thebottomleftmapdisplaysareas1hourtravelorlesstoanyurbancentre,roughlycorrespondingtowhataredefinedasperi-urbanareasinChapter4.Thebottomcentremapdisplaysareas1to2hourstraveltoanyurbancentre,andthebottomrightmapdisplaysareasmorethan2hourstraveltoanyurbancentre.ThebottomcentreandbottomrightmapsroughlycorrespondtowhataredefinedasruralareasinChapter4.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.227ANNEX7SUPPLEMENTARYRESULTSFROMSECTION4.1FIGUREA7.1AVERAGESHARESOFTOTALHOUSEHOLDFOODCONSUMPTIONVALUESFORANIMALSOURCEFOODSANDFOODAWAYFROMHOMEBYURBAN,PERI-URBANANDRURALAREAFORSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAA)AVERAGECONSUMPTIONSHARESOFANIMALSOURCEFOODS25ANIMALSOURCEFOODSCONSUMPTIONSHARE20(PERCENTAGE)151050PERI-URBANRURALURBANB)AVERAGECONSUMPTIONSHARESOFFOODAWAYFROMHOME18FOODAWAYFROMHOMECONSUMPTIONSHARE16(PERCENTAGE)14121086420PERI-URBANRURALURBANHigh-food-budgetcountriesLow-food-budgetcountriesNOTES:Averageconsumptionsharesofanimalsourcefoods(FigureA)andfoodawayfromhome(FigureB)asapercentageshareoftotalhouseholdfoodconsumption(atmarketvalue)inurban,peri-urbanandruralareasbyhigh-andlow-food-budgetcountrygroup.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable9forthedefinitionofurban,peri-urbanandruralareas,andTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SeeTableA5.6forthedefinitionofanimalsourcefoodsandfoodawayfromhome,andTableA5.1forthelistof11Western,EasternandSouthernAfricancountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.228THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TablesA7.1toA7.5presenttheeconometricinSection4.1,withtheomissionofthetownresultsshowingthemarginaleffectsbkofthecategorytoserveasareferencecategorytowhichdeterminantsofthedifferentfoodconsumptiontheotherURCAvariablesarecompared,i.e.thesharesoftotalfoodconsumption(atmarketmarginaleffectofthe“largecity”categoryisvalue)for:i)consumptionsharesofpurchasedinterpretedasrelativetotheomittedURCAfood,forhomeconsumptionandfoodawayfromtownvariable.Themarginaleffectofpricesandhome(TableA7.1);ii)consumptionsharesofhighlyhomeassetsisnotshown(seesourceforfullprocessedfoods(TableA7.2);iii)consumptionsharespresentationofresults).Countriesincludedinofanimalsourcefoods(TableA7.3);iv)consumptiontheanalysis:Benin,BurkinaFaso,Côted’Ivoire,sharesoffoodawayfromhome(TableA7.4);andEthiopia,Guinea-Bissau,Malawi,Mali,Niger,v)consumptionsharesofvegetables(TableA7.5).Nigeria,SenegalandTogo.Allsurveysare2018/19,exceptMalawi(2019/20).Onlystatisticallysignificantmarginaleffects(at10percentorlower)arepresented.TheeffectForthefulldetailsonthedatasources,oflocationacrosstherural–urbancontinuumismethodologyandinterpretationseeDolislagercapturedbythetenURCAcategoriesdefinedetal.(2023).52nbkMarginaleffectsarepartialderivativesoftheregressionequationwithrespecttoeachvariableinthemodelforeachunitinthedata;averagemarginaleffectsaresimplythemeanoftheseunit-specificpartialderivativesoversomesample.Inordinaryleastsquaresregressionwithnointeractionsorhigher-orderterm,theestimatedslopecoefficientsaremarginaleffects.50Marginaleffectstellushowadependentvariable(outcome)changeswhenaspecificindependentvariable(explanatoryvariable)changes.Othercovariatesareassumedtobeheldconstant.Marginaleffectsareoftencalculatedwhenanalysingregressionanalysisresults.51229TABLEA7.1THENON-PRICEDETERMINANTSOFPURCHASEDFOODCONSUMPTIONSHARES(FORHOMECONSUMPTIONANDFOODAWAYFROMHOME)INSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAANNEX7High-food-budgetcountriesLow-food-budgetcountries230AllHigh-food-SenegalEthiopiaCôteMaliNigeriaLow-food-Guinea-BeninTogoBurkinaMalawiNigercountriesbudgetbudgetBissauFasocountriesd’IvoirecountriesLargecity0.0960.0950.0540.1620.1130.0660.0740.1180.1360.0980.1770.131(>1millionpeople)Intermediatecity0.0470.0340.0740.0400.0800.1030.2350.1960.102(0.25–1millionpeople)Smallcity0.0450.0460.0340.1690.0580.1360.2290.065(50–250thousandpeople)<1hourtoalargecity−0.103−0.1150.016−0.163−0.032-0.081−0.061−0.049−0.0590.256<1hourtoanintermediatecity−0.143−0.151−0.040−0.101−0.123-0.109−0.116−0.059−0.042−0.1010.057−0.114<1hourtoasmallcity−0.153−0.149−0.027−0.160−0.104−0.152-0.065−0.155−0.069−0.180−0.046−0.081<1hourtoatown−0.146−0.135−0.165−0.160−0.1771–2hourstoacityortown−0.193−0.202−0.027−0.140−0.136−0.172-0.119−0.149−0.098−0.140−0.157−0.056−0.108>2hourstoacityortown−0.194−0.215−0.142−0.044−0.149−0.139−0.118−0.129Totalincome(logofannual0.0250.0150.019−0.0380.0470.0510.0400.0370.0460.0490.0860.0200.043percapitaexpenditure)Malefull-timenon-farm0.0440.0400.0090.0680.0510.0080.0320.0520.0150.0460.0440.0320.0450.063employmentFemalefull-timenon-farm0.0210.0180.0230.0170.028−0.0130.0260.0110.0340.078employmentPrimaryschoolingof0.0200.0170.0180.0310.011householdheadSecondaryschoolingof0.0300.0280.0220.0370.0490.0150.0260.039householdheadFemale-headedhouseholds0.0150.0190.0170.0220.0230.0280.0480.023−0.0370.051Householdsize(adult−0.004−0.005−0.002−0.024−0.011-0.004−0.005−0.007−0.008−0.007−0.004−0.006equivalents)Dependencyratio−0.037−0.0220.0210.042Cultivatedland(ha)−0.015−0.029−0.005−0.079−0.015−0.034-0.035−0.006−0.001−0.002−0.026−0.028−0.173−0.017Tropicallivestockunits−0.017−0.014−0.020−0.005−0.015−0.022−0.011−0.014−0.009−0.099−0.008NOTES:Regressionsoftheshareoffoodpurchases(forhomeconsumptionandfoodawayfromhome)intotalfoodconsumption(atmarketvalue):marginaleffects;significantresultsonly(at10percentorlower);statisticalsignificanceisreportedforp<0.01,p<0.05,p<0.1.Marginaleffectsofpricesandhomeassetsarenotshown(seesourceforadiscussionofresults).Allsurveysare2018/19,exceptMalawi(2019/20).SeeTableA5.6forthedefinitionoffoodawayfromhome,TableA5.1forthelistof11Western,EasternandSouthernAfricancountries,andTable10forthedefinitionofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TABLEA7.2THENON-PRICEDETERMINANTSOFCONSUMPTIONSHARESOFHIGHLYPROCESSEDFOODSINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesAllHigh-food-SenegalEthiopiaCôteMaliNigeriaLow-food-Guinea-BeninTogoBurkinaMalawiNigercountriesbudgetbudgetBissauFasocountriesd’IvoirecountriesLargecity0.0060.0090.0090.0080.015−0.00400.0130.027(>1millionpeople)Intermediatecity0.0050.0080.0300.018(0.25–1millionpeople)Smallcity0.0110.0310.0160.023(50–250thousandpeople)<1hourtoalargecity0.019−0.0090.007−0.0080.009−0.013<1hourtoanintermediatecity−0.011−0.010−0.020−0.015−0.009−0.007−0.023<1hourtoasmallcity−0.011−0.012−0.009−0.0070.010−0.011−0.010<1hourtoatown−0.008−0.009−0.011−0.010−0.014−0.0081–2hourstoacityortown−0.005−0.011−0.025−0.005−0.014−0.0080.012−0.012−0.020231>2hourstoacityortown−0.017−0.0230.0180.022−0.010Totalincome(logofannual0.0140.014−0.0060.0080.0090.0170.0040.0190.0470.0140.0060.0150.027percapitaexpenditure)Malefull-timenon-farm0.0050.0050.0030.0050.0050.0020.0040.0040.0030.0060.005employmentFemalefull-timenon-farm0.0040.0050.0050.0020.0020.0020.0030.0050.007employmentPrimaryschoolingof0.0040.0060.012−0.004−0.003−0.0090.0040.006householdheadSecondaryschoolingof−0.004−0.004householdheadFemale-headedhouseholds0.0020.0030.017−0.0030.0040.0060.005−0.0040.007−0.007Householdsize(adult−0.000−0.001−0.003−0.0030.0000.002−0.001−0.0010.003−0.003equivalents)Dependencyratio0.0140.0130.0230.0090.0190.0120.0150.0280.0170.0060.0150.007Cultivatedland(ha)0.0020.004−0.005−0.001−0.005−0.012Tropicallivestockunits−0.005−0.006−0.002−0.001−0.003−0.003NOTES:Regressionsoftheshareofhighlyprocessedfoodsintotalfoodconsumption(atmarketvalue):marginaleffects;significantresultsonly(at10percentorlower);statisticalsignificanceisreportedforp<0.01,p<0.05,p<0.1.Marginaleffectsofpricesandhomeassetsarenotshown(seesourceforadiscussionofresults).Allsurveysare2018/19,exceptMalawi(2019/20).SeeTableA5.4forfulldefinitionofhighlyprocessedfoods,TableA5.1forthelistof11Western,EasternandSouthernAfricancountries,andTable10forthedefinitionofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TABLEA7.3THENON-PRICEDETERMINANTSOFCONSUMPTIONSHARESOFANIMALSOURCEFOODSINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesAllHigh-food-SenegalEthiopiaCôteMaliNigeriaLow-food-Guinea-BeninTogoBurkinaMalawiNigercountriesbudgetbudgetBissauFasocountriesd’IvoirecountriesLargecity0.0140.017−0.014−0.0280.021−0.024(>1millionpeople)Intermediatecity0.023(0.25–1millionpeople)Smallcity−0.0170.0190.018(50–250thousandpeople)<1hourtoalargecity−0.0160.0240.015−0.032<1hourtoanintermediatecity0.0130.011−0.0250.030−0.0240.0230.025-0.026<1hourtoasmallcity0.0100.0120.0390.025−0.028<1hourtoatown0.0380.045−0.02701–2hourstoacityortown0.0210.028−0.0180.0360.020232>2hourstoacityortown0.0200.064−0.0150Totalincome(logofannual0.0610.0560.1130.0510.1080.1120.0350.0810.1050.0690.0570.0580.0830.123percapitaexpenditure)Malefull-timenon-farm0.0020.0060.005employmentFemalefull-timenon-farm0.0090.0090.004−0.0050.0050.0070.0050.0060.0080.005employmentPrimaryschoolingof0.0140.0120.0110.009householdheadSecondaryschoolingof0.0080.006−0.0100.010−0.0090.015householdheadFemale-headedhouseholds0.008−0.012−0.013−0.010−0.018−0.019Householdsize0.0030.0040.0040.0130.0070.0030.0020.0030.0020.0020.0080.004(adultequivalents)Dependencyratio0.0430.0450.0730.0470.0760.0520.0160.0330.0220.0420.0480.0480.0260.046Cultivatedland(ha)0.0040.009−0.007−0.034−0.005−0.024Tropicallivestockunits0.0040.0040.0110.0080.0060.0030.0050.0110.0080.0230.012NOTES:Regressionoftheshareofanimalproductsintotalfoodconsumption(atmarketvalue):marginaleffects;significantresultsonly(at10percentorlower);statisticalsignificanceisreportedforp<0.01,p<0.05,p<0.1.Marginaleffectsofpricesandhomeassetsarenotshown(seesourceforadiscussionofresults).Allsurveysare2018/19,exceptMalawi(2019/20).SeeTableA5.6fordetailsoncompositionofanimalsourcefoods,seeTableA5.1forthelistof11Western,EasternandSouthernAfricancountries,andTable10forthedefinitionofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TABLEA7.4THENON-PRICEDETERMINANTSOFTHECONSUMPTIONSHARESOFFOODAWAYFROMHOMEINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesAllHigh-food-SenegalEthiopiaCôteMaliNigeriaLow-food-Guinea-BeninTogoBurkinaMalawiNigercountriesbudgetbudgetBissauFasocountriesd’IvoirecountriesLargecity0.0220.0240.0440.0380.0080.0300.0350.0270.057(>1millionpeople)Intermediatecity0.0200.0300.0160.0330.0360.023(0.25–1millionpeople)Smallcity0.0960.0140.040−0.0130.0150.014(50–250thousandpeople)<1hourtoalargecity0.0700.0100.013−0.0120.0130.024<1hourtoanintermediatecity0.082−0.0090.012−0.029−0.021−0.0320.015<1hourtoasmallcity−0.0130.089−0.017−0.019−0.024−0.047−0.009<1hourtoatown−0.033−0.0360−0.033−0.0181–2hourstoacityortown−0.022−0.0200.219−0.023−0.024−0.028−0.040−0.009233>2hourstoacityortown−0.041−0.042−0.0050−0.017−0.019−0.007Totalincome(logofannual0.0250.026−0.0170.028−0.0180.0120.0930.002−0.014−0.014−0.0140.0130.010−0.010percapitaexpenditure)Malefull-timenon-farm0.0150.0160.0080.0130.0120.0040.0160.0090.0080.0100.0140.0110.0020.007employmentFemalefull-timenon-farm−0.0110.003−0.0090.0040.005employmentPrimaryschoolingof0.0310.0320.0070.0070.0030.0040.0110.0100.0070.005householdheadSecondaryschoolingof0.005−0.002householdheadFemale-headedhouseholds−0.022−0.026−0.014−0.035−0.003−0.017−0.009−0.0020.006Householdsize(adult−0.004−0.005−0.006−0.004−0.0070.000−0.003−0.002−0.002−0.006−0.003−0.001−0.003equivalents)Dependencyratio−0.023−0.025−0.076−0.013−0.058−0.015−0.020−0.054−0.028−0.047−0.034−0.014Cultivatedland(ha)−0.003−0.007−0.003−0.017−0.012−0.011−0.015Tropicallivestockunits−0.014−0.017−0.005−0.001−0.006NOTES:Regressionoftheshareoffoodawayfromhomeintotalfoodconsumption(atmarketvalue):marginaleffects;significantresultsonly(at10percentorlower);statisticalsignificanceisreportedforp<0.01,p<0.05,p<0.1.Marginaleffectsofpricesandhomeassetsarenotshown(seesourceforadiscussionofresults).Allsurveysare2018/19,exceptMalawi(2019/20).Foodawayfromhomeispreparedfoodconsumedawayfromhome.SeeTableA5.6fordetailsondefinitionoffoodawayfromhome,seeTableA5.1forthelistof11Western,EasternandSouthernAfricancountries,andTable10forthedefinitionofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.TABLEA7.5THENON-PRICEDETERMINANTSOFTHECONSUMPTIONSHARESOFVEGETABLESINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesAllHigh-food-SenegalEthiopiaCôteMaliNigeriaLow-food-Guinea-BeninTogoBurkinaMalawiNigercountriesbudgetbudgetBissauFasocountriesd’IvoirecountriesLargecity0.0250.0270.0960.0220.0310.0160.027(>1millionpeople)Intermediatecity0.0170.0150.0230.0200.0200.036(0.25–1millionpeople)Smallcity0.0210.0240.0180.0270.0130.0310.021(50–250thousandpeople)<1hourtoalargecity0.0120.0190.0240.0090.0360.0060.0310.026<1hourtoanintermediatecity0.0130.0200.0080.0290.0230.0180.021<1hourtoasmallcity−0.0080.012<1hourtoatown0.011−0.0221–2hourstoacityortown−0.020-0.009−0.017−0.014234>2hourstoacityortown−0.0120.039Totalincome(logofannual−0.016−0.012−0.033−0.0130.007−0.017−0.0230.009−0.015−0.023−0.0590.024percapitaexpenditure)Malefull-timenon-farm−0.003−0.004−0.0050.004−0.004employmentFemalefull-timenon-farm0.0020.0020.0020.0030.003employmentPrimaryschoolingof−0.006−0.0030.007−0.006householdheadSecondaryschoolingof−0.006−0.004−0.007householdheadFemale-headedhouseholds0.0130.0120.0090.0070.0090.0170.0060.0110.0130.0140.0070.017Householdsize−0.004−0.0030.001−0.011−0.001−0.002−0.003−0.003−0.002−0.004−0.002−0.011(adultequivalents)Dependencyratio0.0270.0130.011−0.008−0.010−0.0220.016Cultivatedland(ha)0.0190.0020.0050.028Tropicallivestockunits−0.004−0.001−0.003−0.003−0.004−0.004−0.012NOTES:Regressionoftheshareofvegetablesintotalfoodconsumption(atmarketvalue):marginaleffects;significantresultsonly(at10percentorlower);statisticalsignificanceisreportedforp<0.01,p<0.05,p<0.1.Marginaleffectsofpricesandhomeassetsarenotshown(seesourceforadiscussionofresults).Allsurveysare2018/19,exceptMalawi(2019/20).SeeTableA5.6forthedefinitionofvegetables,seeTableA5.1forthelistof11Western,EasternandSouthernAfricancountries,andTable10forthedefinitionofhigh-andlow-food-budgetcountries.SOURCE:Dolislager,M.J,Holleman,C.,Liverpool-Tasie,L.S.O.&Reardon,T.2023.Analysisoffooddemandandsupplyacrosstherural–urbancontinuuminselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-09.Rome,FAO.ANNEX8METHODOLOGYUSEDFORTHESUBNATIONALESTIMATIONOFCOSTANDAFFORDABILITYOFAHEALTHYDIETUSINGHOUSEHOLDSURVEYDATAFORSELECTEDCOUNTRIESINAFRICAINCHAPTER4ThecostandaffordabilityofahealthydietinageometricmeanbnoftherevealedpricesineachselectedcountriesinAfricawereestimatedacrossURCAofeachcountry.NotethatfooditemsnotURCAsapplyingtheFAOHealthyDietBasketreportedinaspecificspatialunitwereconsidered(HDB)methodology,whichcomprisessixfoodasnotavailableinthatarea.groups.blHowever,resultsarenotcomparablewiththeglobalCoAHDindicatorspresentedinInthethirdstage,thefooditemsfortheChapter2(seeBoxA8.1).Foodpricesandincomesubnational(i.e.attheURCAlevel)HDBweredistributionswereobtainedfrom11householdselected.TheHDBcompositionwasfixedinconsumptionandexpendituresurveysconductedtermsofdailycaloriccontributionofthesixbetween2018and2019(TableA5.1).foodgroups,aspertheHDBoftheglobalCoAHDmonitoringindicators,butthespecificTheanalysistookplaceinfourstages.InthefooditemsintheHDBwereallowedtochangefirststage,thehouseholdconsumptionandacrossURCAs.Morespecifically,theleast-costexpendituresurveydataweregeoreferenceditemineachfoodgroupwasselectedineachusingtheURCAdataset.Inthesecondstage,theURCAforeachcountry.Inthisway,thepricesoffooditemswerederivedfromhouseholdcompositionoftheHDBaccountsforspatialfoodexpendituremodulesreportingthequantityvariationintermsofpricesandavailability,boughtandamountspentbyhouseholdsbasedaswellasreflectsitemsconsumedbytheonseven-dayrecall.bmValueswerereportedforpopulationineachURCA.boTocomputethespecificfooditems,thusallowingforcomputingoftherevealedprice(i.e.theunitcost)byfoodbnGeometricmeanwaschosenbecauseofthehighfluctuationintheitem.ThepriceforeachfooditemwasobtainedasdistributionoftheunitcostsofafooditemacrosshouseholdsinaspecificURCA.NoticethathighfluctuationsforthesamefooditemareblForinformationontheHDBdataandmethodologyandtheHDBnotnecessarilyduetohighvolatilityofmarketprices;rather,unitcostcontentbyfoodgroupintermsofkcal,seeFAO(2023).53reflectsprice,quantity,andqualityofafooditem.Inhouseholdsurveys,bmExpenditureswerecollectedacrossdifferentmonths,thustheitemsarenotstandardizedasinthepricedatacollectionrunbyeffectofseasonalityonthepricelevelisaveragedout.Theleast-costgovernment,thusthequalityandvarietyofafooditempurchasedlikelyitemschosenfortheHDBarethereforetheleast-costitemsduringchangeacrosshouseholds,reflectingaccess,availabilityandtheyear.preferences.boForexample,porkisselectedasoneofthetwoitemsintheanimalsourcefoodsgroupinintermediateandsmallcitiesinNigeria,butitisnotinthebasketsofperi-urbanareas(<1houraway)where“cheese(wara)”waspicked.235ANNEX8BOXA8.1METHODOLOGY–GLOBALANDSUBNATIONALESTIMATIONOFTHECOAHDTheestimationoftheglobalmonitoringindicatoroffromtheWorldBank’sPovertyandInequalitythecostandaffordabilityofahealthydiet(CoAHD)Platform(PIP);whereastotalhouseholdexpenditure(Chapter2)andthesubnationalestimationbyusedintheanalysispresentedinChapter4isURCAinSection4.2followthesamemethodology.computedfromhouseholdsurveydatatoestimateHowever,resultsarenotcomparableforthreeitsdistributionasaproxyforincomedistribution.mainreasons:Percentageofincomethatcanbecrediblyreservedforfood.Intheglobalmonitoring,thispercentageFooditemprices.Intheglobalmonitoring,pricesissetequalto52percent–thatis,theaveragefromtheWorldBankInternationalComparisonpercentageofincomespentonfoodinlow-incomeProgram(ICP)areused,whereaspricesusedinthecountriesbasedonthenationalaccountanalysispresentedinChapter4arecomputedfromexpendituredatafromtheWorldBankICP.Inhouseholdsurveys.theanalysisofChapter4,ontheotherhand,theaveragefoodexpendituresharesofhouseholdsIncomedistribution.Intheglobalmonitoring,thebelongingtothelowestexpenditurequintileineachaffordabilityindicatoriscomputedusingtheURCAareapplied.estimatedincomedistributioninagivencountrycostofanitemneededtomeettheHDBcaloricaveragefoodexpenditureshareofhouseholdsrequirement,prices(asdescribedabove)andbelongingtothelowestquintileoftheincomethenutrientconversiontabledevelopedforeachdistributionofeachURCA.Thechoicei)alignssurvey(basedmainlyontheFAO/INFOODSwiththeglobalCoAHDindicatormethodologyFoodCompositionTableforWesternAfricawheretheaveragefoodexpenditureshareof[2019])wereused.low-incomecountriesisadopted,andii)takesintoaccountdifferentlevelsofeconomicInthefinalstage,themeasureofaffordabilitydevelopmentacrosstherural–urbancontinuum.ofahealthydietwasobtainedbycomparingthedailycostoftheHDBwiththedailyperWhensummaryresultsarepresented,averagescapitahouseholdincomeavailableforfood.acrosstherural–urbancontinuumURCA-definedTotalhouseholdexpenditure,includingvaluecategoriesarepopulationweightedaverages,forownproduction,wasusedasaproxyforwhileaverageacrosscountriesaresimpleincome.Theshareofexpenditurethatcanbeaverages,followingthemethodologyusedincrediblyreservedforfoodwassetequaltotheChapter2forthecalculationofregionalCoAHD.n236ANNEX9SUBNATIONALCOSTANDAFFORDABILITYOFAHEALTHYDIETBYURBAN–RURALCATCHMENTAREAINSELECTEDCOUNTRIESINAFRICAPresentedbelowarecomplementaryresultsFigureA9.1showstheaveragesharecostofeachfortheanalysisofthecostandaffordabilityoffoodgroupinasubnationalhealthydietbasketsubnationalhealthydietbasketsin11Western,acrosstenURCAcategoriesforhigh-andEasternandSouthernAfricancountrieslow-food-budgetcountries.n(seeTableA5.1forlistofcountries).FIGUREA9.1COSTCONTRIBUTIONOFEACHFOODGROUPASSHAREOFTOTALCOSTOFAHEALTHYDIETINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAACROSSTHERURAL–URBANCONTINUUM(URCA)A)HIGH-FOOD-BUDGETCOUNTRIESURBANCENTRESPERI-URBANAREASRURALAREAS100666667768669087677667641AVERAGESHARECOSTOFEACHFOODGROUP80INAHEALTHYDIET(PERCENTAGE)127035383937343538323818601650Town14151311131340141413(20–50thousand30181718people)18202119212120101818181717182019170<1hour1–2hours>2hourstoatowntoacitytoacityLargecityIntermediatecitySmallcity<1hour<1hour<1hourortownortowntoalargetoanintermediatetoasmall(>1million(0.25–1million(50–250citycitycitypeople)people)thousandpeople)StaplefoodsVegetablesFruitsAnimalsourcefoodsPulses,seedsandnutsFatsandoils237AFNIGNUERXEA99.1(Continued)B)LOW-FOOD-BUDGETCOUNTRIESURBANCENTRESPERI-URBANAREASRURALAREAS100677878878679066666768635AVERAGESHARECOSTOFEACHFOODGROUP80INAHEALTHYDIET(PERCENTAGE)1370333535173532313532396020Town5018(20–50131310thousand1413people)131313403018181920202219172020101721212021212021200<1hour1–2hours>2hourstoatowntoacitytoacityLargecityIntermediatecitySmallcity<1hour<1hour<1hourortownortowntoalargetoanintermediatetoasmall(>1million(0.25–1million(50–250citycitycitypeople)people)thousandpeople)StaplefoodsVegetablesFruitsAnimalsourcefoodsPulses,seedsandnutsFatsandoilsNOTES:Allsurveysare2018/19,exceptMalawi(2019/20).SeeTableA5.1forthelistof11Western,EasternandSouthernAfricancountries.SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.TABLEA9.1COMPARISONOFAVERAGEFOODEXPENDITUREANDCOSTOFAHEALTHYDIETBASKETFORSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICATotalhouseholdAveragecostofRatioofcostofahealthyfoodconsumptionahealthydietdiettoaveragefoodconsumption(PPPdollarsperpersonperday)0.86HIGH-FOOD-BUDGETCOUNTRIES2.342.00Senegal2.571.890.74Ethiopia2.442.360.97Côted’Ivoire2.291.940.85Mali2.291.980.86Nigeria2.261.830.81LOW-FOOD-BUDGETCOUNTRIES1.621.611.00Guinea-Bissau2.061.750.85Benin2.001.160.58Togo1.691.310.77BurkinaFaso1.572.151.37Malawi1.521.250.82Niger1.462.031.39NOTES:Averagehouseholdfoodconsumptionandaveragecostofahealthydietbyhigh-andlow-food-budgetcountryandbycountry,expressedinPPPdollarsperpersonperday(PPP=purchasingpowerparity),andtheratioofthecostofahealthydietandaveragehouseholdfoodconsumption.Aratiogreaterthan1showshowmanytimesahealthydietismoreexpensivethantheaveragefoodexpenditure.Allsurveysare2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.238THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA9.2SUBNATIONALCOSTOFAHEALTHYDIETINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAACROSSTHERURAL–URBANCONTINUUM(URCA)High-food-budgetcountriesLow-food-budgetcountriesSenegalEthiopiaCôteMaliNigeriaGuinea-BeninTogoBurkinaMalawiNigerd’IvoireBissauFaso(PPPdollarsperpersonperday)(PPPdollarsperpersonperday)URBAN2.063.152.072.232.151.841.441.722.501.722.20Largecity2.193.242.182.232.23–1.621.842.74–1.84(>1millionpeople)Intermediatecity1.803.601.982.202.091.851.461.952.141.712.09(0.25–1millionpeople)Smallcity1.932.871.992.252.161.791.271.332.341.682.39(50–250thousandpeople)Town(20–50thousand1.983.031.872.132.00–1.051.582.201.762.19people)PERI-URBAN1.752.211.911.901.731.951.051.032.091.212.03<1hourtoa1.812.652.052.202.032.061.221.092.111.752.25largecity<1hourtoan1.622.131.822.401.622.101.011.512.081.211.91intermediatecity<1hourtoa1.842.191.901.691.531.830.980.962.091.182.07smallcityRURAL1.712.281.851.871.641.571.001.071.971.181.98<1hourtoatown––1.762.222.042.591.05–2.401.791.861–2hourstoa1.672.091.851.741.571.540.991.071.961.121.93cityortown>2hourstoacity2.292.702.162.202.701.53––1.802.162.06ortownNOTES:PPP=purchasingpowerparity.CostinURCAswithfewerthan30observationsisnotshown.InEthiopia,costofhealthydietbasketinareas1hourtravelorlesstoatownwasnotcomputedforpriceunavailability.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.239ANNEX9TABLEA9.3AFFORDABILITYOFAHEALTHYDIETINSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAACROSSTHERURAL–URBANCONTINUUM(URCA)High-food-budgetcountriesLow-food-budgetcountriesSenegalEthiopiaCôteMaliNigeriaGuinea-BeninTogoBurkinaMalawiNigerd’IvoireBissauFaso(%)(%)URBAN18.257.118.418.335.929.912.833.352.654.247.4Largecity18.051.313.919.227.6–20.235.852.6–16.2(>1millionpeople)Intermediatecity14.973.423.614.947.930.57.446.855.051.137.3(0.25–1millionpeople)Smallcity21.345.821.918.632.526.26.723.848.652.958.0(50–250thousandpeople)Town(20–50thousand22.277.125.414.241.3–7.826.156.367.568.3people)PERI-URBAN41.572.239.733.848.453.610.925.679.268.876.7<1hourtoa35.961.227.932.739.747.113.926.779.467.163.1largecity<1hourtoan42.070.439.752.351.656.313.127.268.970.568.6intermediatecity<1hourtoa45.674.742.331.254.552.99.224.980.265.685.7smallcityRURAL45.370.140.838.551.740.316.433.574.967.884.9<1hourtoatown––47.345.466.775.319.3–68.185.483.01–2hourstoa44.060.739.935.950.642.615.833.574.766.283.3cityortown>2hourstoacity64.791.047.146.051.628.6––79.495.387.5ortownNOTES:CostinURCAswithfewerthan30observationsisnotshown.InEthiopia,costofhealthydietbasketinareas1hourtravelorlesstoatownwasnotcomputedforpriceunavailability.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Holleman,C.&Latino,L.2023.VariationsinthesubnationalcostandaffordabilityofahealthydietforselectedcountriesinAfrica.BackgroundpaperforTheStateofFoodSecurityandNutritionintheWorld2023.FAOAgriculturalDevelopmentEconomicsWorkingPaper23-10.Rome,FAO.240ANNEX10FOODINSECURITYANDMALNUTRITIONACROSSTHERURAL–URBANCONTINUUM(URCA)FORSELECTEDCOUNTRIESINAFRICATABLEA10.1MODERATEORSEVEREFOODINSECURITYBASEDONTHEFOODINSECURITYEXPERIENCESCALEACROSSTHERURAL–URBANCONTINUUM(URCA)FORSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesSenegalCôteNigeriaGuinea-BeninTogoBurkinaMalawiNigerd’IvoireBissauFaso(%)(%)URBANLargecity36.243.352.664.550.844.437.8(>1millionpeople)(±6.1)(±7.2)(±6.4)(±5.0)(±5.2)(±6.3)(±8.)Intermediatecity45.036.844.751.774.856.637.455.942.2(0.25–1millionpeople)(±6.9)(±8.8)(±9.3)(±5.0)(±7.1)(±21.2)(±10.0)(±6.6)(±6.9)Smallcity37.136.934.254.563.161.333.957.448.2(50–250thousand(±4.1)(±7.2)(±7.0)(±10.0)(±7.5)(±6.7)(±8.3)(±9.7)(±6.8)people)Town45.839.625.167.968.262.334.952.751.5(20–50thousand(±6.2)(±8.0)(±14.0)(±9.3)(±14.7)(±9.0)(±11.7)(±16.2)people)PERI-URBAN<1hourtoalargecity35.140.243.664.167.762.236.260.650.4(±6.0)(±8.3)(±4.7)(±15.1)(±4.3)(±6.3)(±8.3)(±14.6)(±7.5)<1hourtoan43.339.951.466.875.859.241.383.950.8intermediatecity(±6.1)(±6.5)(±5.2)(±6.6)(±9.9)(±12.3)(±10.2)(±2.2)(±7.6)<1hourtoasmallcity40.540.541.861.164.261.834.678.245.8(±5.2)(±2.8)(±6.4)(±5.7)(±3.0)(±3.5)(±4.0)(±2.0)(±6.3)RURAL<1hourtoatown18.841.061.473.565.156.645.579.262.5(±9.2)(±15.8)(±16.6)(±31.8)(±19.7)(±6.8)(±22.3)1–2hourstoacity40.440.437.866.570.866.041.981.242.5ortown(±6.4)(±2.9)(±11.3)(±4.9)(±6.4)(±8.1)(±5.9)(±1.5)(±5.2)>2hourstoacity22.644.737.768.863.973.435.587.643.3ortown(±16.4)(±22.3)(±16.5)(±5.5)(±17.5)(±6.1)NOTES:Marginsoferrorareshowninparenthesesandarenotshownforsamplesize<100.Theyarenotcomputedforsamplesize<30,exceptforMalawi,wherethesamplesizeis80.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Authors’(FAO)ownelaboration.241ANNEX10TABLEA10.2SEVEREFOODINSECURITYBASEDONTHEFOODINSECURITYEXPERIENCESCALEACROSSTHERURAL–URBANCONTINUUM(URCA)INSELECTEDHIGH-ANDLOW-FOOD-BUDGETCOUNTRIESINAFRICAHigh-food-budgetcountriesLow-food-budgetcountriesSenegalCôteNigeriaGuinea-BeninTogoBurkinaMalawiNigerd’IvoireBissauFaso(%)(%)URBANLargecity7.311.015.214.510.788.1(>1millionpeople)(±2.6)(±4.3)(±4.0)(±2.5)(±2.6)(±1.3)(±2.9)Intermediatecity9.16.313.86.423.414.85.729.29.3(0.25–1millionpeople)(±1.8)(±5.4)(±8.1)(±2.7)(±5.0)(±17.5)(±2.3)(±5.1)(±2.2)Smallcity7.28.06.56.513.516.46.531.98.4(50–250thousand(±0.8)(±2.9)(±4.8)(±6.0)(±5.9)(±2.5)(±6.0)(±9.5)(±2.8)people)Town12.18.05.44.617.414.24.729.28.1(20–50thousandpeople)(±1.3)(±2.9)(±5.9)(±6.2)(±4.8)(±3.9)(±11.2)(±4.0)PERI-URBAN<1hourtoalargecity7.511.212.36.616.214.04.837.99.6(±1.8)(±3.9)(±2.9)(±4.8)(±3.2)(±4.0)(±3.9)(±13.1)(±1.5)<1hourtoan11.19.716.010.920.915.67.253.811.0intermediatecity(±2.3)(±4.0)(±4.5)(±3.1)(±4.3)(±4.8)(±4.9)(±2.6)(±3.3)<1hourtoasmallcity7.59.310.97.115.916.65.248.58.2(±2.4)(±1.2)(±5.8)(±3.0)(±2.3)(±2.0)(±1.9)(±3.0)(±2.0)RURAL<1hourtoatown3.611.420.18.514.817.19.751.317.2(±2.6)(±7.3)(±11.1)(±10.2)(±10.1)(±8.0)(±6.0)1–2hourstoacityor9.59.113.910.918.917.96.951.08.2town(±3.1)(±1.5)(±9.3)(±4.0)(±4.4)(±3.5)(±3.2)(±2.9)(±3.0)>2hourstoacityor7.611.99.612.57.418.06.953.09.4town(±4.3)(±1.1)(±13.8)(±11.7)(±8.0)(±3.3)NOTES:Marginsoferrorareshowninparenthesesandarenotshownforsamplesize<100.Theyarenotcomputedforsamplesize<30,exceptforMalawi,wherethesamplesizeis80.Allsurveysarefor2018/19,exceptMalawi(2019/20).SeeTable10forthedefinitionandlistofhigh-andlow-food-budgetcountries.SOURCE:Authors’(FAO)ownelaboration.242THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023TABLEA10.3PREVALENCEOFMALNUTRITIONINCHILDRENUNDERFIVEYEARSOFAGEACROSSTHERURAL–URBANCONTINUUM(URCA)FORTHREECOUNTRIESINAFRICASenegalStuntingBeninSenegalWastingBeninSenegalOverweightBeninNigeriaNigeriaNigeria(%)(%)(%)URBANLargecity13.323.221.15.05.05.52.02.51.6(>1millionpeople)Intermediatecity12.525.223.67.53.84.71.82.31.9(0.25–1millionpeople)Smallcity15.828.921.97.06.55.32.72.62.9(50–250thousandpeople)Town7.831.029.17.15.35.90.01.51.8(20–50thousandpeople)PERI-URBAN<1hourtoalargecity19.336.431.98.46.14.11.01.21.4<1hourtoan24.739.535.57.17.55.01.72.41.4intermediatecity<1hourtoasmallcity21.450.135.48.19.44.51.22.01.9RURAL<1hourtoatown4.562.537.79.10.04.44.50.02.91–2hourstoacity25.151.734.512.27.76.40.72.72.0ortown>2hourstoacity23.244.253.111.63.12.01.30.00.0ortownNOTE:PrevalenceofmalnutritioninchildrenunderfiveyearsofageinthreeWesternAfricancountries,byURCA(2018).SOURCE:Authors'(UNICEF)ownelaboration.243ANNEX11GLOSSARYAcutefoodinsecuritybasedontheCentralPlaceTheory(CPT),56whichFoodinsecurityfoundinaspecifiedareaatincorporatesthefunctionalinterdependenceaspecificpointintimeandofaseveritythatbetweenacentralplace(i.e.atownoranurbanthreatenslivesorlivelihoods,orboth,regardlesscentre)anditssurroundingruralareaalongofthecauses,contextorduration.Hasrelevancewiththehierarchicallevelofthecentralplace’sinprovidingstrategicguidancetoactionsthatgoodsandservices.36focusonshort-termobjectivestoprevent,mitigateordecreaseseverefoodinsecurity.54ClimateClimateinanarrowsenseisusuallydefinedasAffordabilitytheaverageweather,ormorerigorously,astheAffordabilityreferstotheabilityofpeopletobuystatisticaldescriptionintermsofthemeanandfoodsintheirlocalenvironment.Inthisreport,variabilityofrelevantquantitiesoveraperiodcostreferstowhatpeoplehavetopaytosecureoftimerangingfrommonthstothousandsorahealthydiet,whileaffordabilityreferstothemillionsofyears.57costrelativetoaperson’sincome,minusotherrequiredexpenses.InSection2.2,affordabilityClimatechangeisdeterminedbycomparingthecostofahealthyClimatechangereferstoachangeinthestatedietwithincomedistributionsavailableinoftheclimatethatcanbeidentified(e.g.bythePovertyandInequalityPlatform(PIP)ofusingstatisticaltests)bychangesinthemeantheWorldBank.Thisallowstocomputetheand/orthevariabilityofitsproperties,andpercentageandnumberofpeopleineachcountrythatpersistsforanextendedperiod,typicallywhoarenotabletoaffordahealthydiet.bpdecadesorlonger.57AgrifoodsystemsClimateextreme(extremeweatherorclimateevent)Agrifoodsystems,atermincreasinglyusedinTheoccurrenceofavalueofaweatherorclimatethecontextoftransformingfoodsystemsforvariableabove(orbelow)athresholdvaluenearsustainabilityandinclusivity,arebroaderastheytheupper(orlower)endsoftherangeofobservedencompassbothagriculturalandfoodsystemsvaluesofthevariable.Forsimplicity,bothextremeandfocusonbothfoodandnon-foodagriculturalweathereventsandextremeclimateeventsareproducts,withclearoverlaps.Agrifoodsystemsreferredtocollectivelyas“climateextremes”.58encompasstheentirerangeofactorsandtheirinterlinkedvalue-addingactivitiesinvolvedintheClimateshocksproduction,aggregation,processing,distribution,Climateshocksincludenotonlythoseconsumptionanddisposaloffoodproducts.Theydisturbancesintheusualpatternofrainfallcompriseallfoodproductsthatoriginatefromandtemperaturesbutalsocomplexeventslikecropandlivestockproduction,forestry,fisheriesdroughtsandfloods.Equivalenttotheconceptandaquaculture,aswellasthebroadereconomic,ofanaturalhazardorstress,theyareexogenoussocietalandnaturalenvironmentsinwhichtheseeventsthatcanhaveanegativeimpactondiverseproductionsystemsareembedded.foodsecurityandnutrition,dependingonthevulnerabilityofanindividual,ahousehold,aAnimalsourcefoodscommunity,orsystemstotheshock.59,60,61,62Alltypesofmeat,poultry,fish,shellfish,insects,grubs,eggs,milk,cheese,yoghurtandotherClimatevariabilitymilkproducts.47,55Referstovariationsinthemeanstateandotherstatistics(standarddeviations,theoccurrenceCatchmentareasofextremes,etc.)oftheclimateonallspatialInthisreport,catchmentareasrefertoruralandtemporalscalesbeyondthatofindividuallocationsthatgravitatearoundaspecificurbanweatherevents.Variabilitymaybeduetocentreintermsofaccesstomarkets,servicesnaturalinternalprocesseswithintheclimateandemploymentopportunities.Theconceptissystem(internalvariability),ortovariationsinnaturaloranthropogenicexternalforcingbpSeeAnnex2,SectionDforthefulldescriptionofthemethodology.(externalvariability).57244THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023ConflictEconomicshockConflictasusedinthisreportisdefinedasAnunexpectedorunpredictableeventthatisstrugglesbetweeninterdependentgroupsthatexternaltothespecificeconomyandcaneitherhaveeitheractualorperceivedincompatibilitiesharmorboostit.Aglobalfinancialcrisiscausingwithrespecttoneeds,values,goals,resourcesorbanklendingorcredittofall,oraneconomicintentions.Thisdefinitionincludes(butisbroaderdownturninamajortradingpartnerofacountrythan)armedconflict–thatis,organizedcollectivereflectdemand-sideshocksthatcanhavemultipleviolentconfrontationsbetweenatleasttwoeffectsonspendingandinvestment.Asteepgroups,eitherstateornon-stateactors.riseinoilandgasprices,naturaldisastersthatresultinsharpfallsinproduction,orconflictthatDietqualitydisruptstradeandproduction,areexamplesofComprisedoffourkeyaspects:varietysupply-sideshocks.and/ordiversity(withinandacrossfoodgroups),adequacy(sufficiencyofnutrientsorfoodgroupsEconomicslowdowncomparedtorequirements),moderation(foodsReferstoeconomicactivitythatisgrowingataandnutrientsthatshouldbeconsumedwithslowerpacecomparedwiththepreviousperiod.restraint)andoverallbalance(compositionofAneconomicslowdownoccurswhenrealGDPmacronutrientintake).Exposuretofoodsafetygrowthdeclinesfromoneperiodtoanother,hazardsisanotherimportantqualityaspect.butitisstillpositive.Intheanalysesandfigurespresentedinthisreport,aneconomicslowdownDietaryenergyrequirementsisidentifiedusingtheyearastheperiodofTheamountofdietaryenergy,measuredinreference,althoughitisusuallymeasuredinkilojoulesorkilocalories(oftenreferredtoasquartersofayear.calories),requiredbyanindividualtomaintainbodyfunctions,healthandnormalactivity.Energy-densefoodsDietaryenergyrequirementsaredependentFoodwithahighcontentofcalories(energy)withuponage,sex,bodysizeandlevelofphysicalrespecttoitsmassorvolume.activity.AdditionalenergyisrequiredtosupportoptimalgrowthanddevelopmentinchildrenExtremepovertyandinwomenduringpregnancy,andforReferstothepercentageofpeoplelivingonlessmilkproductionduringlactation,consistentthanUSD2.15aday(2017PPPprices)inacountrywiththegoodhealthofmotherandchild.inagivenyear.33DownstreamfoodsupplychainsExtremeweatherorclimateeventDownstreamfoodsupplychainsinvolvethoseTheoccurrenceofavalueofaweatherorclimatesegmentsmoredirectlyrelatedtoconsumervariableabove(orbelow)athresholdvaluenearpurchases,thatismarketing,retailandtrade.theupper(orlower)endsoftherangeofobservedvaluesofthevariable.ManyweatherandclimateDroughtextremesaretheresultofnaturalclimateAperiodofabnormallydryweatherlastinglongvariability,andnaturaldecadalormulti-decadalenoughtocauseaserioushydrologicalimbalance.57variationsintheclimateprovidethebackdropforanthropogenicclimatechanges.EvenifthereEconomicdownturnwerenoanthropogenicchangesinclimate,awideReferstoaperiodofdeclineineconomicactivityvarietyofnaturalweatherandclimateextremesornegativegrowthasmeasuredbythegrowthwouldstilloccur.rateinrealGDP.Itisasynonymforeconomicrecession,atemporaryorshort-termdownturnFiscalsubsidiesineconomicgrowth,usuallyoccurringoveratFiscalsubsidiesarebudgettransfersmadebyleasttwoconsecutivequartersofdecline.Inthegovernmentsinthecontextofpolicymeasures,analysesandfigurespresentedinthisreport,anprojectsandprogrammestoindividualactorsofeconomicdownturnisidentifiedusingtheyearasthefoodandagriculturesector,suchasfarmersaperiodofreference.(fiscalsubsidiestoproducers)orconsumers245ANNEX11(fiscalsubsidiestoconsumers).FiscalsubsidiesFoodenvironmenttoproducersaimtoreduceproductioncostsThefoodenvironmentisthephysical,economic,orincreasefarmincomeandcanbegrantedpoliticalandsocioculturalcontextinwhichdependingonoutput,inputuseoruseofconsumersengagewithagrifoodsystemstootherfactorsofproduction.Fiscalsubsidiesmakedecisionsaboutacquiring,preparingandtoconsumersincludetransfersundersocialconsumingfood.63protectionprogrammes(giventofinalconsumers)andfoodsubsidiestolowerthecostoffoodFoodInsecurityExperienceScale(FIES)(providedtointermediariessuchasprocessors,Anexperience-basedfoodsecurityscaleusedtotraders,transporters).produceameasureofaccesstofoodatdifferentlevelsofseveritythatcanbecomparedacrossFloodcontexts.ItreliesondataobtainedbyaskingTheoverflowingofthenormalconfinesofastreampeople,directlyinsurveys,abouttheoccurrenceorotherbodyofwater,ortheaccumulationofofconditionsandbehavioursthatareknowntowateroverareasnotnormallysubmerged.Floodsreflectconstrainedaccesstofood.includeriver(fluvial)floods,flashfloods,urbanfloods,pluvialfloods,sewerfloods,coastalfloodsFoodsecurityandglaciallakeoutburstfloods.57Asituationthatexistswhenallpeople,atalltimes,havephysical,socialandeconomicaccessFoodandagriculturalmarketingtosufficient,safeandnutritiousfoodthatmeetsThisincludescollectiveschemesfortheirdietaryneedsandfoodpreferencesforanpost-productionfacilitiesandotherservicesactiveandhealthylife.Basedonthisdefinition,designedtoimprovethemarketingenvironmentfourfoodsecuritydimensionscanbeidentified:forfoodandagriculture–itincludesallthestagesfoodavailability,economicandphysicalaccesstoofaproductvaluechain,fromfarminputsupplyfood,foodutilizationandstabilityovertime.Thetoretailmarkets.Forexample,theseservicesmayconceptoffoodsecurityisevolvingtorecognizeincludecommoditygradingschemesoragriculturalthecentralityofagencyandsustainability.machineryservices.TheymaybeservicesrelatedSeebelowforthedefinitionofthesetwotopost-harvestlosses,lowertransactioncosts,additionalelements.facilitatingmarketexchangeandtrade,andstrengtheningorexpandingsupplynetworks.FoodsecuritydimensionsInthisreport,foodsecuritydimensionsrefertoFoodawayfromhomethefourtraditionaldimensionsoffoodsecurity:Foodawayfromhomeincludesallmeals(breakfastandbrunch,lunch,dinnerandsnacksa.Availability–Thisdimensionaddressesandnon-alcoholicbeverages)–includingfastwhetherornotfoodisactuallyorpotentiallyfood,takeoutsanddeliveries–consumedatphysicallypresent,includingaspectsofconcessionstands,buffetsandcafeterias,andproduction,foodreserves,marketsandfull-servicerestaurants,andmealspurchasedattransportation,andwildfoods.vendingmachinesorfrommobilevendors.Alsoincludedareboard(includingatschool);mealsasb.Access–Iffoodisactuallyorpotentiallypay;specialcateredevents,suchasweddings,barphysicallypresent,thenextquestionismitzvahsandconfirmations;schoollunches;andwhetherornothouseholdsandindividualsmealsawayfromhomeontrips.bqhavesufficientphysicalandeconomicaccesstothatfood.bqPleaseseeAnnex5,SectionCforthedefinitionoffoodawayfromhomeusedintheanalysispresentedinChapter4.c.Utilization–Iffoodisavailableandhouseholdshaveadequateaccesstoit,thenextquestioniswhetherornothouseholdsaremaximizingtheconsumptionofadequatenutritionandenergy.Sufficientenergyandnutrientintakebyindividualsistheresultofgoodcareandfeedingpractices,foodpreparation,dietarydiversityandintra-householddistributionof246THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023food,andaccesstocleanwater,sanitationandresearchanddevelopmentandknowledgehealthcare.Combinedwithgoodbiologicaltransfer,inspectionservices,agriculturalrelatedutilizationoffoodconsumed,thisdeterminesinfrastructure,publicstockholding,andfoodandthenutritionalstatusofindividuals.agriculturalmarketing,andpromotion.d.Stability–Ifthedimensionsofavailability,accessandutilizationaresufficientlymet,GovernancestabilityistheconditioninwhichthewholeGovernancereferstoformalandinformalrules,systemisstable,thusensuringthathouseholdsorganizations,andprocessesthroughwhicharefoodsecureatalltimes.Stabilityissuespublicandprivateactorsarticulatetheirinterestscanrefertoshort-terminstability(whichcanandmakeandimplementdecisions.65leadtoacutefoodinsecurity)ormedium-tolong-terminstability(whichcanleadtoHazardchronicfoodinsecurity).Climatic,economic,Aprocess,phenomenonorhumanactivitythatsocialandpoliticalfactorscanallbeasourcemaycauselossoflife,injuryorotherhealthofinstability.impacts,propertydamage,socialandeconomicdisruptionorenvironmentaldegradation.66ThereportalsoreferstotwoadditionaldimensionsoffoodsecuritythatareproposedHealthcarebytheHighLevelPanelofExperts(HLPE)ofTheorganizedprovisionofmedicalcaretotheCommitteeonWorldFoodSecurity(CFS);individualsoracommunity.Thisincludeshowever,theyarenotformallyagreeduponservicesprovidedtoindividualsorcommunitiesbyFAOorothers,andthereisnotanegotiatedbyhealthserviceprovidersforthepurposeagreeduponlanguage.However,duetotheirofpromoting,maintaining,monitoringorrelevanceinthecontextofthisreport,theyarerestoringhealth.includedhere.ThesetwoadditionaldimensionsoffoodsecurityarereinforcedinconceptualandHealthydietslegalunderstandingsoftherighttofoodandareHealthydiets:1)startearlyinlifewithcurrentlyreferredtoanddefinedasfollows:earlyinitiationofbreastfeeding,exclusivebreastfeedinguntilsixmonthsofage,ande.Agencyreferstothecapacityofindividualscontinuedbreastfeedinguntiltwoyearsoforgroupstomaketheirowndecisionsaboutageandbeyondcombinedwithappropriatewhatfoodstheyeat;whatfoodstheyproduce;complementaryfeeding;2)arebasedonagreathowthatfoodisproduced,processedandvarietyofunprocessedorminimallyprocesseddistributedwithinfoodsystems;andtheirfoods,balancedacrossfoodgroups,whileabilitytoengageinprocessesthatshapefoodrestrictinghighlyprocessedfoodanddrinksystempoliciesandgovernance.64products;3)includewholegrains,legumes,nutsandanabundanceandvarietyoffruitsandf.Sustainabilityreferstothelong-termabilityvegetables;4)canincludemoderateamountsofoffoodsystemstoprovidefoodsecurityandeggs,dairy,poultryandfish,andsmallamountsnutritioninawaythatdoesnotcompromiseofredmeat;5)includesafeandcleandrinkingtheeconomic,socialandenvironmentalbaseswaterasthefluidofchoice;6)areadequatethatgeneratefoodsecurityandnutritionfor(i.e.reachingbutnotexceedingneeds)inenergyfuturegenerations.64andnutrientsforgrowthanddevelopmentandmeettheneedsforanactiveandhealthylifeGeneralservicessupport(GSS)acrossthelifecycle;7)areconsistentwithWHOReferstopublicexpenditure(orbudgettransfers)guidelinestoreducetheriskofdiet‑relatedfortheprovisionofpublicorcollectivegoodsnon-communicablediseasesandensurehealthandservicesthataimtocreateenablingandandwell-beingforthegeneralpopulation;andenvironmentallysustainableconditionsfor8)containminimallevelsornone,ifpossible,ofthefoodandagriculturesector.Theseservicespathogens,toxinsandotheragentsthatcancauseconnectalleconomicactorsoffoodsupplyfoodbornedisease.AccordingtoWHO,healthychainsandsupportthenexusbetweenproducersdietsincludelessthan30percentoftotalenergyandconsumers.Themostcommoninclude247ANNEX11intakefromfats,withashiftinfatconsumptionMalnutritionawayfromsaturatedfatstounsaturatedfatsandAnabnormalphysiologicalconditioncausedtheeliminationofindustrialtransfats;lessthanbyinadequate,unbalancedorexcessiveintake10percentoftotalenergyintakefromfreesugarsofmacronutrientsand/ormicronutrients.(preferablylessthan5percent);consumptionofatMalnutritionincludesundernutrition(childleast400goffruitsandvegetablesperday;andstuntingandwasting,andvitaminandmineralnotmorethan5gperdayofsalt(tobeiodized).deficiencies)aswellasoverweightandobesity.HighlyprocessedfoodsMicronutrientsHighlyprocessedfoodsarefoodsthathavebeenMicronutrientsincludevitaminsandmineralsindustriallyprepared,includingthosefromandarerequiredinverysmall(micro)butspecificbakeriesandcateringoutlets,andwhichrequireamounts.Vitaminsandmineralsinfoodsarenoorminimaldomesticpreparationapartfromnecessaryforthebodytogrow,developandheatingandcooking(suchasbread,breakfastfunctionproperly,andareessentialforourhealthcereals,cheese,commercialsauces,cannedfoodsandwell-being.Ourbodiesrequireanumberofincludingjams,commercialcakes,processeddifferentvitaminsandminerals,eachofwhichmeats,biscuitsandsauces).41Highlyprocessedhasaspecificfunctioninthebodyandmustbefoodscancontainveryhighquantitiesofsalt,suppliedindifferent,sufficientamounts.freesugarsandsaturatedortransfatsandtheseproducts,whenconsumedinhighamounts,canMidstreamfoodsupplychainsunderminedietquality.brMidstreamfoodsupplychainscomprisethepost-farmgateactivitiesrelatedtothelogistics,Hungerprocessingandwholesaleoffood.ThisincludesHungerisanuncomfortableorpainfulphysicalcleaning,sorting,packaging,transportation,sensationcausedbyinsufficientconsumptionofstorageandwholesalingofagriculturaldietaryenergy.Inthisreport,thetermhungerandfoodproducts.issynonymouswithchronicundernourishmentandismeasuredbytheprevalenceofModeratefoodinsecurityundernourishment(PoU).Referstothelevelofseverityoffoodinsecurity,basedontheFoodInsecurityExperienceScale,atInputsubsidieswhichpeoplefaceuncertaintiesabouttheirabilityGovernmenttransferstoagriculturalproducerstoobtainfoodandhavebeenforcedtoreduce,arisingfrompolicymeasuresbasedonfarmattimesduringtheyear,thequalityand/oruseofinputs,ormeasuresrelatedtothequantityoffoodtheyconsumeduetolackofprovisionofinputs.moneyorotherresources.Itthusreferstoalackofconsistentaccesstofood,whichdiminishesMacronutrientsdietaryquality,disruptsnormaleatingpatterns,Macronutrientsareneededinlargerquantities(inandcanhavenegativeconsequencesfornutrition,gramrange)andarethemajorsourceofenergyhealthandwell-being.andbulk(volume)inourdiets.Theyincludecarbohydrates,proteinandfats.TheyareamainNutritiontransitionsourceofdietaryenergy,whichismeasuredinAsincomesriseandpopulationsbecomemorecalories.Gettingsufficientenergyisessentialurban,dietshighincomplexcarbohydratesandforeveryoneinordertomaintainbodygrowth,fibregivewaytomoreenergy-densedietshighdevelopmentandgoodhealth.Carbohydrates,infats,sugarsand/orsalt.Theseglobaldietaryproteinandfats,inadditiontoprovidingenergy,trendsareaccompaniedbyademographiceachhaveveryspecificfunctionsinthebodyandtransitionwithashifttowardsincreasedlifemustbesuppliedinsufficientamountstocarryexpectancyandreducedfertilityrates.Attheoutthosefunctions.sametime,diseasepatternsmoveawayfrominfectiousandnutrient-deficiencydiseasesbrFormoredetails,pleaseseeAnnex5,SectionC.towardshigherratesofoverweightandobesityanddiet-relatednon-communicablediseases248THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLD2023includingcoronaryheartdisease,stroke,diabetesRiskandsometypesofcancer.TheprobabilityorlikelihoodofoccurrenceofhazardouseventsortrendsmultipliedbytheNutritionalstatusimpactsiftheseeventsortrendsoccur.RiskThephysiologicalstateofanindividualthattofoodinsecurityistheprobabilityoffoodresultsfromtherelationshipbetweennutrientinsecurityresultingfrominteractionsbetweenaintakeandrequirementsandthebody’sabilitytonaturalorhuman-inducedhazard/shock/stressdigest,absorbandusethesenutrients.andvulnerableconditions.NutritiousfoodsRural–urbancontinuumThesearereferredtoassafefoodsthatcontributeRepresentsadifferentwayofexaminingessentialnutrientssuchasvitaminsandmineralsrural–urbanspatialrelationshipsacrossa(micronutrients),fibreandothercomponentscontinuum,ratherthanthemoreconventionaltohealthydietsthatarebeneficialforgrowth,rural/urbandistinction.Therural–urbanandhealthanddevelopment,guardingagainstcontinuumviewsruralandurbanareasnotasmalnutrition.Innutritiousfoods,thepresenceseparatespaces,butastwoendsofaspectrumofofnutrientsofpublichealthconcernincludingsettlementsandcatchmentareasofdifferentsizessaturatedfats,freesugars,andsalt/sodiumisandtheirlinkages.minimized,industriallyproducedtransfatsareeliminated,andsaltisiodized.SeverefoodinsecurityThelevelofseverityoffoodinsecurityatwhichOverweightandobesitypeoplehavelikelyrunoutoffood,experiencedDefinedasbodyweightthatisabovenormalforhungerand,atthemostextreme,goneforheightasaresultofanexcessiveaccumulationofdayswithouteating,puttingtheirhealthandfat.Itisusuallyamanifestationofexpendinglesswell-beingatgraverisk,basedontheFoodenergythanisconsumed.Inadults,overweightisInsecurityExperienceScale.definedasabodymassindex(BMI)of25kg/m2ormore,andobesityasaBMIof30kg/m2ormore.StaplefoodsInchildrenunderfiveyearsofage,overweightStaplefoodsarethoseeatenregularly,andinisdefinedasweight-for-heightgreaterthan2suchquantitiesastoconstitutethedominantstandarddeviationsabovetheWHOChildGrowthpartofthedietandsupplyamajorproportionStandardsmedian,andobesityasweight-for-heightoftotaldietaryenergy.Themainkindsofstaplegreaterthan3standarddeviationsabovetheWHOfoodsarecereals(e.g.rice,maize,wheat,rye,ChildGrowthStandardsmedian.67barley,oats,millet,sorghum),rootsandtubers(e.g.potatoes,cassava,yams)andlegumesPrevalenceofundernourishment(PoU)(e.g.beans,lentils,soybean).55Anestimateoftheproportionofthepopulationthatlacksenoughdietaryenergyforahealthy,Structuraltransformationactivelife.ItisFAO’straditionalindicatorusedtoThetheoryofstructuraltransformationdescribesmonitorhungerattheglobalandregionallevel,thetransformationofeconomies,initiatedwithanaswellasSDGIndicator2.1.1.increaseinagriculturalproductivityinruralareasleadingtoanagriculturalsurplus.TheadditionalResilienceincomefromthissurplusthengeneratesdemandResilienceistheabilityofindividuals,forothergoodsandservicesstimulatingthehouseholds,communities,cities,institutions,off-farmsectorsoftheeconomy.Asaresult,asystemsandsocietiestoprevent,resist,absorb,gradualshiftofjobsfromtheprimaryagricultureadapt,respondandrecoverpositively,efficientlysectortothesecondaryandtertiarysectorstakesandeffectivelywhenfacedwithawiderangeofplace,typicallylocatedinurbanareas.Thisrisks,whilemaintaininganacceptablelevelofencouragesrural-to-urbanmigration,resultingfunctioningandwithoutcompromisinglong-terminaneconomictransformationfromamainlyprospectsforsustainabledevelopment,peaceandagrariantoamorediversifiednationaleconomy,security,humanrightsandwell-beingforall.68attractingruralpeopletourbanareas.69249ANNEX11StuntingUrbanizationLowheight-for-age,reflectingapastepisodeorUrbanizationisamultifacetedsocial,cultural,episodesofsustainedundernutrition.Inchildreneconomicandphysicalprocessthatistheresultunderfiveyearsofage,stuntingisdefinedasofgrowingurbanpopulations,thephysicalheight-for-agelessthan−2standarddeviationsexpansionofcities(i.e.thereclassificationbelowtheWHOChildGrowthStandardsmedian.ofruraltourban)andmigrationfromruraltourbanareas.ThisprocessisfickleandUndernourishmentcontext-dependent,drivenbyintertwinedfactorsUndernourishmentisdefinedastheconditioninincludingdiverseeconomicdevelopmentssuchaswhichanindividual’shabitualfoodconsumptionthegrowthofagriculture,policychoices,naturalisinsufficienttoprovidetheamountofdietaryresourceavailabilityandothereventssuchasenergyrequiredtomaintainanormal,active,conflictorenvironmentaldegradation.69healthylife.Forthepurposesofthisreport,hungerisdefinedasbeingsynonymouswithVulnerabilitychronicundernourishment.TheprevalenceofReferstotheconditionsdeterminedbyphysical,undernourishmentisusedtomeasurehunger.social,economicandenvironmentalfactorsorprocessesthatincreasethesusceptibilityofanUndernutritionindividual,community,assetsorsystemstoTheoutcomeofpoornutritionalintakeintermsoftheimpactsofhazards.66Vulnerabilitytofoodquantityand/orquality,and/orpoorabsorptioninsecurityistherangeofconditionsthatincreasesand/orpoorbiologicaluseofnutrientsconsumedthesusceptibilityofahouseholdtotheimpactonasaresultofrepeatedinstancesofdisease.Itfoodsecurityincaseofashockorhazard.includesbeingunderweightforone’sage,tooshortforone’sage(stunted),dangerouslythinWastingforone’sheight(sufferingfromwasting)orLowweight-for-height,generallytheresultofdeficientinvitaminsandminerals(sufferingfromweightlossassociatedwitharecentperiodofmicronutrientdeficiency).inadequatedietaryenergyintakeand/ordisease.Inchildrenunderfiveyearsofage,wastingisUrbanandperi-urbanagriculture(UPA)definedasweight‑for‑heightlessthan−2standardUrbanandperi-urbanagriculturecanbedeviationsbelowtheWHOChildGrowthdefinedaspracticesthatyieldfoodsandotherStandardsmedian.outputsfromagriculturalproductionandrelatedprocesses(transformation,distribution,Weathermarketing,recycling,etc.),takingplaceonlandWeatherdescribesconditionsoftheatmosphereandotherspaceswithincitiesandsurroundingoverashortperiodoftime(minutestodays),regions.Theseinvolveurbanandperi-urbanwhereasclimateishowtheatmosphereactors,communities,methods,places,policies,behavesoverrelativelylongerperiodsoftimeinstitutions,systems,ecologiesandeconomies,(thelong-termaverageofweatherovertime).largelyusingandregeneratinglocalresourcesThedifferencebetweenweatherandclimatetomeetthechangingneedsoflocalpopulationsisameasureoftime(seeabovedefinitionsforwhileservingmultiplegoalsandfunctions.70climate,climatechange,climatevariabilityandclimateextremes).71n250NOTESCHAPTER15FAO.2023.FAOFoodPriceIndex.In:FAOWorldFoodSituation.[Cited4May2023].1FAO.2017.TheStateofFoodandAgriculture2017.www.fao.org/worldfoodsituation/foodpricesindexLeveragingFoodSystemsforInclusiveRuralTransformation.www.fao.org/3/I7658e/I7658e.pdf6Schmidhuber,J.&Qiao,B.2022.Globalfoodimportbillsettoincreaseataslowerpacein2022,neverthelessto2Cattaneo,A.,Adukia,A.,Brown,D.L.,Christiaensen,L.,anotherrecordlevel.In:FAO,ed.FoodOutlook–BiannualEvans,D.K.,Haakenstad,A.,McMenomy,T.etal.2022.ReportonGlobalFoodMarkets,November2022,Economicandsocialdevelopmentalongtheurban–ruralpp.76–78.Rome.www.fao.org/3/cc2864en/cc2864en_continuum:newopportunitiestoinformpolicy.Worldindicator_1.pdfDevelopment,157:105941.https://doi.org/10.1016/j.worlddev.2022.1059417FAO.2022.FoodOutlook–BiannualReportonGlobalFoodMarkets.November2022.Rome.3UNDESA(UnitedNationsDepartmentofEconomicandhttps://doi.org/10.4060/cc2864enSocialAffairs).2018.WorldUrbanizationProspects2018.In:UnitedNations.[Cited9May2023].https://population.8WorldBank.2023.GlobalEconomicProspects,Januaryun.org/wup2023.Washington,DC.http://hdl.handle.net/10986/380304UNDESA.2022.WorldPopulationProspects2022.In:9ILO(InternationalLabourOrganization).2023.WorldUnitedNations.[Cited9May2023].https://population.un.EmploymentandSocialOutlook.Trends2023.Geneva,org/wppSwitzerland.www.ilo.org/wcmsp5/groups/public/---dgreports/---inst/documents/publication/wcms_865387.pdf5Tefft,J.,Jonasova,M.,Adjao,R.&Morgan,A.2018.Foodsystemsforanurbanizingworld.Rome,WorldBank10WorldBank.2022.PovertyandSharedProsperity2022.andFAO.www.fao.org/3/i8346en/i8346en.pdfCorrectingcourse.Washington,DC.www.worldbank.org/en/publication/poverty-and-shared-prosperityCHAPTER211WorldBank.2023.MacroPovertyOutlookforsub-1FAO.2023.Globalfoodsecuritychallengesanditsdrivers:SaharanAfrica.Country-by-countryanalysisandprojectionsconflictsandwarsinUkraineandothercountries,slowdownsforthedevelopingworld.AnnualMeetings2023.anddownturns,andclimatechange.Council,HundredandWashington,DC.www.worldbank.org/en/publication/Seventy-secondSession,Rome,24–28April2023.CLmacro-poverty-outlook/mpo_ssa172/5.Rome.www.fao.org/3/nl652en/nl652en.pdf12WorldBank.2023.MacroPovertyOutlookforMiddle2FSIN(FoodSecurityInformationNetwork)&GlobalEastandNorthAfrica.Country-by-countryanalysisandNetworkAgainstFoodCrises.2023.GlobalReportonFoodprojectionsforthedevelopingworld.AnnualMeetings2023.Crises(GRFC)2023.Rome.www.fsinplatform.org/global-Washington,DC.www.worldbank.org/en/publication/report-food-crises-2023macro-poverty-outlook/mpo_mena3IMF(InternationalMonetaryFund).2023.World13WorldBank.2023.MacroPovertyOutlookforSouthEconomicOutlook(WEO)database,April2023.In:IMF.Asia.Country-by-countryanalysisandprojectionsforthe[Cited10May2023].www.imf.org/en/Publications/WEO/developingworld.AnnualMeetings2023.Washington,DC.weo-database/2023/April/download-entire-databasewww.worldbank.org/en/publication/macro-poverty-outlook/mpo_sar4FAO.2023.FAOSTAT:Cropsandlivestockproducts.In:FAO.[Cited18May2023].www.fao.org/faostat/14WorldBank.2023.MacroPovertyOutlookforLatinen/#data/TCLAmericaandtheCaribbean.Country-by-countryanalysisandprojectionsforthedevelopingworld.AnnualMeetings2023.Washington,DC.www.worldbank.org/en/publication/macro-poverty-outlook/mpo_lac251NOTES15IMF.2019.WorldEconomicOutlook(WEO)database,26WorldBank.2023.PovertyandInequalityPlatformOctober2019.In:IMF.[Cited10May2023].www.imf.org/(PIP).In:WorldBank.[Cited10May2023].en/Publications/WEO/weo-database/2019/Octoberhttps://pip.worldbank.org16IMF.2021.WorldEconomicOutlook(WEO)database,27UNDE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esnotimplyanyassumptionregardingpoliticalorIsleofMan,andSvalbardandJanMayenIslands.otheraffiliationofcountriesorterritoriesbytheUnitedSouthernEurope:ThisgroupingexcludesGibraltar,Nations.PleaserefertothelistbelowforthecountryHolySeeandSanMarino.However,anaemia,childcompositionofeachregioninthetablesofAnnex1andstunting,overweightandlowbirthweightestimatesAnnex2,aswellasinTables1–4inSection2.1.includeSanMarino.WesternEurope:ThisgroupingexcludesLiechtensteinCountries,areasandterritoriesforwhichtherewereandMonaco.However,childstunting,overweight,insufficientorunreliabledataforconductingtheanaemiaandlowbirthweightestimatesincludeMonaco.assessmentarenotreportedandnotincludedintheaggregates.Specifically,withrespecttotheM49Othergroupingsclassification:Leastdevelopedcountries,landlockeddevelopingNorthernAfrica:InadditiontothecountrieslistedincountriesandSmallIslandDevelopingStatesgroupingsthetable,PoUandfoodinsecuritybasedontheFIESincludethecountriesaspresentedbytheStatisticsincludeanestimateforWesternSahara.Childwasting,DivisionoftheUnitedNations(https://unstats.un.org/stuntingandoverweight,lowbirthweight,adultunsd/methodology/m49).obesity,exclusivebreastfeedingandanaemiaestimatesexcludeWesternSahara.SmallIslandDevelopingStates:Estimatesforchildstunting,wastingandoverweight,adultobesity,exclusiveEasternAfrica:ThisgroupingexcludesChagosbreastfeedingandlowbirthweightexcludeAnguilla,Archipelago,FrenchSouthernTerritories,Aruba,Bonaire,SintEustatiusandSaba,BritishVirginMayotteandRéunion.Islands,Curaçao,FrenchPolynesia,Montserrat,NewCaledoniaandSintMaarten(Dutchpart).Inaddition,WesternAfrica:ThisgroupingexcludesSaintHelena.estimatesforchildwasting,adultobesity,exclusiveAsiaandEasternAsia:LowbirthweightandchildwastingbreastfeedingandlowbirthweightalsoexcludeAmericanSamoaandPuertoRico.aggregatesexcludeJapan.Caribbean:ThisgroupingexcludesAnguilla,Aruba,High-income,upper-middle-income,lower-middle-incomeandlow-incomecountriesincludethecountriesaspresentedbytheBonaire,SintEustatiusandSaba,BritishVirginWorldBankclassificationforthe2022/23fiscalyearIslands,CaymanIslands,Curaçao,Guadeloupe,(https://datahelpdesk.worldbank.org/knowledgebase/Martinique,Montserrat,SaintBarthélemy,Saintarticles/906519).Martin(FrenchPart),SintMaarten(Dutchpart),andTurksandCaicosIslands.Adultobesity,childwasting,Low-incomefood-deficitcountries(2023):Afghanistan,Benin,lowbirthweightandexclusivebreastfeedingexcludeBurkinaFaso,Burundi,Cameroon,CentralAfricanPuertoRicoandUnitedStatesVirginIslands.Republic,Chad,Comoros,Congo,DemocraticPeople’sSouthAmerica:ThisgroupingexcludesBouvetIsland,RepublicofKorea,DemocraticRepublicoftheCongo,FalklandIslands(Malvinas),FrenchGuyana,andEritrea,Ethiopia,Gambia,Guinea,Guinea-Bissau,Haiti,SouthGeorgiaandtheSouthSandwichIslands.Kenya,Kyrgyzstan,Lesotho,Liberia,Madagascar,Malawi,AustraliaandNewZealand:ThisgroupingexcludesMali,Mauritania,Mozambique,Nepal,Nicaragua,Niger,ChristmasIsland,Cocos(Keeling)Islands,HeardRwanda,SaoTomeandPrincipe,Senegal,SierraLeone,IslandandMcDonaldIslands,andNorfolkIsland.Somalia,SouthSudan,Sudan,SyrianArabRepublic,Melanesia:Anaemia,childwasting,stuntingTajikistan,Togo,Uganda,UnitedRepublicofTanzania,andoverweight,lowbirthweightandexclusiveUzbekistan,YemenandZimbabwe.breastfeedingestimatesexcludeNewCaledonia.Micronesia:Adultobesity,anaemia,childwasting,lowbirthweightandexclusivebreastfeedingestimatesexcludeGuam,NorthernMarianaIslandsandCompositionofgeographicregionsAFRICANorthernAfrica:Algeria,Egypt,Libya,Morocco,Sudan,TunisiaandWesternSahara.Sub-SaharanAfricaEasternAfrica:Burundi,Comoros,Djibouti,Eritrea,Ethiopia,Kenya,Madagascar,Malawi,Mauritius,Mozambique,Rwanda,Seychelles,Somalia,SouthSudan,Uganda,UnitedRepublicofTanzania,ZambiaandZimbabwe.MiddleAfrica:Angola,Cameroon,CentralAfricanRepublic,Chad,Congo,DemocraticRepublicoftheCongo,EquatorialGuinea,Gabon,andSaoTomeandPrincipe.SouthernAfrica:Botswana,Eswatini,Lesotho,NamibiaandSouthAfrica.WesternAfrica:Benin,BurkinaFaso,CaboVerde,Côted’Ivoire,Gambia,Ghana,Guinea,Guinea-Bissau,Liberia,Mali,Mauritania,Niger,Nigeria,Senegal,SierraLeoneandTogo.ASIACentralAsia:Kazakhstan,Kyrgyzstan,Tajikistan,TurkmenistanandUzbekistan.EasternAsia:China,DemocraticPeople’sRepublicofKorea,Japan,MongoliaandRepublicofKorea.South-easternAsia:BruneiDarussalam,Cambodia,Indonesia,LaoPeople’sDemocraticRepublic,Malaysia,Myanmar,Philippines,Singapore,Thailand,Timor-LesteandVietNam.SouthernAsia:Afghanistan,Bangladesh,Bhutan,India,Iran(IslamicRepublicof),Maldives,Nepal,PakistanandSriLanka.WesternAsia:Armenia,Azerbaijan,Bahrain,Cyprus,Georgia,Iraq,Israel,Jordan,Kuwait,Lebanon,Oman,Palestine,Qatar,SaudiArabia,SyrianArabRepublic,Türkiye,UnitedArabEmiratesandYemen.LATINAMERICAANDTHECARIBBEANCaribbean:AntiguaandBarbuda,Bahamas,Barbados,Cuba,Dominica,DominicanRepublic,Grenada,Haiti,Jamaica,PuertoRico,SaintKittsandNevis,SaintLucia,SaintVincentandtheGrenadines,andTrinidadandTobago.LatinAmericaCentralAmerica:Belize,CostaRica,ElSalvador,Guatemala,Honduras,Mexico,NicaraguaandPanama.SouthAmerica:Argentina,Bolivia(PlurinationalStateof),Brazil,Chile,Colombia,Ecuador,Guyana,Paraguay,Peru,Suriname,UruguayandVenezuela(BolivarianRepublicof).OCEANIAAustraliaandNewZealand:AustraliaandNewZealand.OceaniaexcludingAustraliaandNewZealandMelanesia:Fiji,NewCaledonia,PapuaNewGuinea,SolomonIslandsandVanuatu.Micronesia:Kiribati,MarshallIslands,Micronesia(FederatedStatesof),NauruandPalau.Polynesia:AmericanSamoa,CookIslands,FrenchPolynesia,Niue,Samoa,Tokelau,TongaandTuvalu.NORTHERNAMERICAANDEUROPENorthernAmerica:Bermuda,Canada,GreenlandandUnitedStatesofAmerica.EuropeEasternEurope:Belarus,Bulgaria,Czechia,Hungary,Poland,RepublicofMoldova,Romania,RussianFederation,SlovakiaandUkraine.NorthernEurope:Denmark,Estonia,Finland,Iceland,Ireland,Latvia,Lithuania,Norway,Sweden,andUnitedKingdomofGreatBritainandNorthernIreland.SouthernEurope:Albania,Andorra,BosniaandHerzegovina,Croatia,Greece,Italy,Malta,Montenegro,NorthMacedonia,Portugal,Serbia,SloveniaandSpain.WesternEurope:Austria,Belgium,France,Germany,Luxembourg,Netherlands(Kingdomofthe)andSwitzerland.2023THESTATEOFFOODSECURITYANDNUTRITIONINTHEWORLDURBANIZATION,AGRIFOODSYSTEMSTRANSFORMATIONANDHEALTHYDIETSACROSSTHERURAL–URBANCONTINUUMThisreportprovidesanupdateonglobalprogresstowardsthetargetsofendinghunger(SDGTarget2.1)andallformsofmalnutrition(SDGTarget2.2).Itshowsthathungeratthegloballevelremainedrelativelystablebetween2021and2022,butisstillfarabovepre-COVID-19-pandemiclevelsandisalsorisinginmanyplaceswherepeoplearestillstrugglingtorecoverincomelossesinthewakeofthepandemicorhavebeenaffectedbyincreasingpricesoffood,agriculturalinputsandenergy,conflictsand/orextremeclimateevents.Thereportalsoprovidesupdatedestimatesonthebillionsofpeoplewhoareunabletoaccessnutritious,safeandsufficientfoodallyearround.Overall,thereportshowsthatwearefarofftracktomeetallnutritiontargets.Whileprogressonimportantindicatorsofchildnutritionisrevealed,risingoverweightamongchildrenunderfiveyearsofageinmanycountriesportendsgrowingburdensofnon-communicablediseases.Sinceits2017edition,thisreporthasrepeatedlyhighlightedthattheintensificationandinteractionofconflict,climateextremesandeconomicslowdownsanddownturns,combinedwithhighlyunaffordablenutritiousfoodsandgrowinginequality,arepushingusofftracktomeettheSDG2targets.However,otherimportantmegatrendsmustalsobefactoredintotheanalysistofullyunderstandthechallengestoandopportunitiesformeetingtheSDG2targets.Onesuchmegatrend,andthefocusofthisyear’sreport,isurbanization.Urbanizationisincreasinginmanycountriesandthisreportshowsitischangingagrifoodsystemsinwayswecannolongerunderstandusingthesimplerural–urbandivide.Thechangingpatternofpopulationagglomerationsacrossarural–urbancontinuumanditsinterfaceasaplaceofexchangeandsocioeconomicinteractions,isreshapingandbeingreshapedbyagrifoodsystems,withimplicationsfortheavailabilityandaffordabilityofhealthydiets,andinturn,forfoodsecurityandnutrition.Newevidenceshowsthatfoodpurchasesinsomecountriesarenolongerhighonlyamongurbanhouseholdsbutalsoamongruralhouseholds.Consumptionofhighlyprocessedfoodsisalsoincreasinginperi-urbanandruralareasofsomecountries.Thesechangesareaffectingpeople’sfoodsecurityandnutritioninwaysthatdifferdependingonwheretheyliveacrosstherural–urbancontinuum.ThistimelyandrelevantthemeisalignedwiththeUnitedNationsGeneralAssembly-endorsedNewUrbanAgenda,andthereportprovidesrecommendationsonthepolicies,investmentsandactionsneededtoaddressthechallengesofagrifoodsystemstransformationunderurbanizationandtoenableopportunitiesforensuringaccesstoaffordablehealthydietsforeveryone.

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