Marketing strategies used in retail food environments in Azerbaijan, Kazakhstan, and North Macedonia

• Online food retail environments are in various stages of development and growth across Europe and Central Asia. • Unhealthy foods frequently promoted through online marketing strategies. • Food retailers expressed some willingness and capacity to modify food retail marketing strategies. Food retail environments are an important influence over dietary behaviours. Food retail marketing strategies that promote less healthy foods endanger the rights of children to good health. However, limited evidence exists on food retail marketing practices in Europe and Central Asia (ECA). We aimed to describe the online food retail marketing environment in three ECA countries – Azerbaijan, Kazakhstan, and North Macedonia – and explore retailer perspectives of strategies to improve the healthiness of food retail environments. Online food retail marketing environments were assessed using the INFORMAS protocol for monitoring marketing practices for foods and beverages within online grocery stores . Retailers and other key informants (n = 16) were interviewed to understand their perceptions of the barriers and enablers to creating a child rights-friendly food retail (online and in-store) environment in each country. Online food retail environments are developing at different rates across the three countries. In all three countries, unhealthy foods were more frequently promoted through online marketing strategies compared to healthy products. Retailers showed some willingness and capacity to modify food retail marketing strategies to promote children’s health, however cited challenges including profit-driven business models and dependence on suppliers and manufacturers. Food retail environments in Azerbaijan, Kazakhstan, and North Macedonia could be modified to better support children’s rights and health. Initial efforts by governments, researchers, NGOs, and UN agencies could focus on co-designing interventions with retailers that align health and profit goals. Government-led regulations may also be necessary to ensure consistent standards across retailers.