Pre-Packaged Food Labelling And Use Among Households In Accra

Abstract

The rate of diet-related non-communicable diseases (NCDs) is increasing rapidly in Africa. Consumption of pre-packaged foods which are nutrient-poor and calorie-rich is one of the main drivers of NCDs. Food labels can guide consumers to make healthy food choices. In Ghana, there is paucity of evidence on the type of nutrition and health-related label information that consumers are exposed to, and whether consumers use such information in their purchase decisions. Therefore, this study assessed label characteristics of pre-packaged foods, and determined the drivers of label use among consumers in urban Accra. This study employed a quantitative cross-sectional multi-method design. A survey of food labels was conducted in community-based retail shops. Information on labels of pre-packaged foods were obtained by taking pictures and analysing the contents based on the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support’s (INFORMAS) taxonomy. Besides, respondents (510) were selected using a multi-stage sampling technique. Participants were interviewed, using a structured pre-tested questionnaire. Questions assessed consumers’ pre-packaged food use behaviour, their perceptions of health-related label information, understanding of food labels and socio-demographic covariates. Three hundred and fifty-one (N=351) pre-packaged foods were sampled. Out of 343 labelled products, 68.8% had nutrition declaration information. Back- of-Pack (BOP) nutrition label formats were dominant (87.3%) compared to the Front-of -Pack (FOP) format. Guideline Daily Amount (GDA) was the commonest FOP identified. Nutrition claims were twice as frequent as health claims. Most products (>84%) with health and nutrition claims complied with FDA and Codex Alimentarius standards. Although the disclosure of nutrition and health-related information was appreciable it did not meet the current recommendations set out by Codex and INFORMAS in promoting a healthy environment. Majority of survey respondents (79.4%) were females and had at least secondary school-level education (65.3%). Most households (77%) purchased pre-packaged foods from traditional markets or corner shops and a few (7%) purchased from supermarkets. Most consumers had a positive perception of food labels, and their purchase behaviour was driven more by taste and price. Although most (62%) respondents reported adequate understanding of labels, objective assessments showed a lower (9%) consumer knowledge and skill in using labels. Only a third of respondents were food label users. Labels were used mainly to ascertain product safety and less likely for nutrition and health reasons. Higher proportions (45%) of non-label users indicated technical nature of label information and limited understanding as reasons for not using labels. In multiple logistic regression modelling, being part of a larger household (AOR: 2.41; 95% CI: 1.16-4.99), having tertiary education (AOR: 6.75; 95% CI: 1.99-22.88), adequate nutrition-related knowledge of labels (AOR: 1.92; 95% CI: 1.15-3.20) and food label understanding (AOR: 2.51; 95% CI: 1.19-5.29) as well as individuals with self-reported understanding of labels (AOR: 10.06; 95% CI: 2.40-42.27) predicted food label use. However, a multiple linear regression analysis the following variables: levels of education, individuals with food allergies, those who had a previous education on the use of labels, those who perceived labels are easy to understand and individuals who self-reported adequate food label understanding showed positive association with the use of health-related label information. Therefore, these findings suggest that educational interventions and labelling policy reforms are needed to encourage, enable, and improve consumer use of nutrition and health-related information on food labels in Ghana.