Food marketing strategies and prevalence of overweight and obesity among primary school children in Morogoro region, Tanzania
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Date
2023
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Sokoine University of Agriculture
Abstract
World Health Organization (2018) defines overweight and obesity as “abnormal or
excessive fat accumulation that presents a risk to health’’. Recent reports show that the
number of overweight and obese children worldwide has risen tenfold in the past four
decades and if the current trends continue, more children will be obese than the
moderately or severely underweight. This trend is rising with urbanization, changes in
lifestyles and social economic transition. This study examined food marketing strategies
and prevalence and determinants of overweight and obesity among school children of age
7-12 years old in urban and rural areas of Morogoro region, Tanzania. The specific
objectives were to determine the prevalence and determinants of overweight and obesity
among school children and to identify marketing and promotion strategies used by food
vendors in school environment. A cross sectional study was conducted to a total of 335
parent/caregiver- child pairs, of whom 165 were from Kilosa (rural) and 170 from Morogoro
(urban) districts. The main sampling unit was registered primary schools which were
stratified according to ownership, whether private or government, and sampled separately.
A total of four private and four public schools were sampled, two from each of the
categories in each of the locations. The study also involved 32 food outlets that were
purposively selected from the eight selected primary schools based on kind of foods sold.
Weight and height were measured using standard procedures and Body Mass Index (BMI)
for age was determined. Socio-demographic information was collected from parents using
structured questions. Information on food marketing and promotion strategies were
collected from food vendors through questionnaire and data for food availability and factors
influencing purchasing behavior were obtained from the children through structured
questions.
Available foods were categorized into four groups that include; unprocessed or minimally
processed foods, processed culinary ingredient, processed foods and ultra-processed
foods. In addition, observation checklist was used to collect information on food availability,
marketing and promotion strategies used by food vendors. Data was analyzed using
Statistical Package for Social Sciences (SPSSTM) version 21 software; whereby
descriptive statistics such as frequencies and percentage were calculated and a
regression model was used to explore the determinants of overweight and obesity in which
both crude (COR) and adjusted odds ratio (AOR) were reported. Chi-square test was used
to test significant difference between foods available in rural and urban school
environment. The study commenced after receiving ethical approval from the National
Institute for Medical Research and from Sokoine University of Agriculture. Permission to
conduct the study was also sought from the Regional Administrative Officer, the respective
District Executive Officers and the head teachers of the selected schools. The results
showed that age of the studied children ranged from 7 to 12 years, while those of the
parents/caregivers ranged from 18 to 72 years. About 19% (n=63) of the school children
were overweight or obese, while 3.9% (n=13) were underweight. The prevalence of
overweight and obesity was higher among private school students than those in public
schools 24.8% (n=36) vs 14.2% (n=27) and more or less similar prevalence were observed
among rural (17.6%, n=34) and urban (20.0%, n=29) areas. In a multivariate analysis,
eating breakfast before going to school was associated with overweight and obesity
(AOR 2.23, 95% CI: 1.06-4.68). Other factors associated with overweight and obesity were
school type (AOR 1.19, 95% CI: 1.55-2.60), household daily income (AOR 1.88, 95% CI:
1.68-3.15) , and provided with money to spend at school (AOR 2.89, 95% CI: 1.76-4.11).
On the other hand, the findings for marketing and promotion strategies used by food
vendors in school environment revealed that there was higher proportion of processed or
deep fried foods such as potato balls, cowpea and rice cakes, samosa, and bans in rural
areas (60%) compared to urban areas (40%). There was also higher proportion of ultra-
processed foods such as carbonated soft drinks, cookies, candies, chocolate and ice lollies
in urban areas (60.8%) compared to rural areas (39.2%). The most consumed and
purchased foods around schools were corn snacks (chama), potato balls, carbonated soft
drinks, sweet ice-lollies, candies, chocolates and ice cream. The most common marketing
and promotion strategies used around schools were posters, price reduction and
packaging. Feeling hungry, food price, environment and peer pressure were the factors
contributing to purchasing behavior for foods sold around the school premises. Generally,
the prevalence of overweight and obesity among primary school children in Morogoro
region was high particularly among children enrolled in private primary schools. Household
daily income, provision of breakfast before going to school and being given money to
spend at school were the determinants of overweight and obesity. Ultra-processed foods
were available in urban and rural schools. Marketing and promotion strategies exist in both
rural and urban areas where the commonly marketed foods were carbonated soft drinks,
candies, corn snacks (chama), potatoes balls and ice cream. Monitoring of children’s
nutrition status in schools is very crucial so as to build the foundation for healthy future
generation. Therefore, the government should ensure provision of school meals and
monitoring of foods sold around the schools. Also children should be provided with nutrition
education to make sure that they are aware of healthy food choices.
Description
Masters dissertations
Keywords
obesity, children, primary school, Food marketing, Morogoro region