Measuring sustainable healthy diets in Ethiopia

Current food systems fail to deliver sustainable healthy diets and leading to poor food system outcomes, including malnutrition in all its forms. However, clear and comprehensive measures of what constitutes sustainable healthy diets, which can support effective policymaking regarding the transformation of food systems towards sustainable and healthy diets, are lacking. Based on a review of recent literature, we find that of the existing frameworks to measure healthy diets, and sustainability thereof, focus on nutritional and environmental dimensions, yet much less on the economic and sociocultural dimensions. This study integrates all these dimensions in order to provide a broader food system assessment framework for sustainable healthy diets; and identifies potential indicators that can help capture those dimensions in empirical assessments. The study then implements the assessment framework at the level of sub-national food systems in Ethiopia, based on data that predate major shocks experienced in recent years, including the COVID-19 pandemic and the northern Ethiopia conflict. Findings point out that the nutrition security dimension of sustainable healthy diets goes beyond food production alone. Moreover, the most urbanized regions in the country with little to no food production ranked fairly better in terms of food affordability and accessibility, and underweight prevalence in the population, suggesting that food system outcomes and sustainability could rather be the result of connections and relationships among all food system components. This finding means that a comprehensive analysis of sustainable, healthy diets considers multiple dimensions, requiring substantial data collection and analysis at various levels within the food system.