Evidence and Action Towards Safe, Nutritious Food
Feed The Future's EatSafe: Evidence and Action Towards Safe, Nutritious Food is a USAID-funded, five-year programme aiming to enable lasting improvements in the safety of nutritious foods in traditional markets by focusing on behavior change.
Consolidate and generate knowledge on food safety behaviors and risks
Develop and test food safety interventions for consumers and vendors
Generate evidence of intervention effectiveness and its impact on food safety behaviors
EatSafe’s formative research aimed to aggregate the existing evidence on the interplay between foodborne disease (FBD), traditional markets, and behavior change in LMICs.
EatSafe generated knowledge across topics including the relationship between food safety, nutrition, and health; consumers’ and vendors’ perspectives on food safety; and the importance of traditional markets to food security.
EatSafe developed localised, market-based interventions to improve knowledge, attitudes, and practices (KAPs) related to food safety and the enabling environment in the countries where EatSafe operates.
Interventions are assessed to understand their impact on consumers' and vendors' knowledge, attitudes and practices (KAPs) related to food safety. They are also tested for effectiveness, feasibility, and sustainability in traditional market settings.
EatSafe conducts rapid market assessments to understand consumer characteristics, vendor practices, gender dynamics, commodity supply, food safety risks, and the enabling environment.
Drawing from the market assessments, EatSafe co-designs interventions with key stakeholders. They are tested for effectiveness, feasibility, and sustainability, with a focus on behavior change among market actors.
To find our more about EatSafe's work, browse our materials below. For additional information, please contact EatSafe@gainhealth.org.
Traditional markets provide access to highly nutritious but perishable foods. Foodborne illness can jeopardize it all.
Check out EatSafe's most-read resources.
Dive deep into EatSafe's comprehensive collection of reports and insightful publications. Crafted by experts in nutrition, food safety, and public health, each document offers valuable insights into the core areas of the program. EatSafe's portfolio of work includes groundbreaking research, insightful analyses, and innovative interventions for food safety in traditional markets.
Discover EatSafe's latest explore thought-provoking articles, stories, and reflections in EatSafe's blogs. Penned by EatSafe staff and guest contributors, these pieces provide a deeper dive into the nuances of the EatSafe program. It's more than just updates—it's a space for reflection, learning, and dialogue about the broader context in which our program operates.
Stay updated with the latest developments and happenings around the EatSafe program. The news section offers a curated blend of announcements, features, and important updates—offering information on what's new and noteworthy.
Check out EatSafe's Activity Page on Agrilinks for even more updates, resources and blogs. Agrilinks is a knowledge sharing hub and is part of the U.S. Government's Feed the Future initiative.
Achieving optimal health and nutrition requires people to be both well-nourished and protected from foodborne hazards. The Global Alliance for Improved Nutrition (GAIN) has long recognized the importance of integrating food safety into its work.
GAIN defines a “safe” food as a food that does not contain a contaminant or other attributes that increases the probability of poor health outcomes - in the context where it is consumed, and for the individual who consumes it. Foodborne hazards can be biological, chemical, or physical in nature and can occur at any stage along the supply chain.
Food safety is a major issue across food systems in low- and middle-income countries (LMICs), causing public health impacts on a scale similar to malaria and HIV/AIDS. According to WHO, unsafe food is responsible for 420,000 deaths annually, with the burden of these illnesses falling disproportionately on those living in LMICs, especially the young, elderly, and immunocompromised. Unsafe food leads to $110 billion in lost economic growth according to the World Bank.
Contaminants, which make food unsafe, can enter the food supply at various points along the value chain, and their presence is hard to detect. Like most efforts around food, safety must be a coordinated, systems-based approach to manage the risks effectively. If ignored, the proliferation of contaminated foods starts to impact other components of the food system, such as health, livelihoods, or the environment. Conversely, negative developments in other areas of the food system increase the likelihood and impacts of unsafe food.
Food safety and nutrition are closely interlinked. Foodborne disease can increase the risk of malnutrition, while malnutrition can increase susceptibility to foodborne disease. Highly nutritious foods like meat, poultry, fish, and fresh fruits and vegetables are often more vulnerable to foodborne hazards. Worries about foodborne disease can impact consumer choices, especially around nutritious foods. Outbreaks linked to unsafe food can adversely impact supply chain actors and the supply of nutritious foods. These bi-directional linkages show that the best way to achieve healthier diets is through integrated programming that considers both food safety and nutrition.
Food safety work has long been a part of what GAIN does. Recent efforts have been made to be more explicit, and strategic about this work – in recognition of food safety’s contributions to food systems.
Food safety is central to GAIN’s large-scale food fortification program, in terms of quality assurance and in building government and industry capacity to implement food safety systems, testing and risk mitigation plans.
GAIN’s supply chain interventions have provided food safety-related training, technologies and mentorship to SMEs along various supply chains. The launch of the Nourishing Foods Financing Facility (N3F) in 2024 adds important financial support to this work with SMEs.
Through the Dutch 3.0 work in Kenya, GAIN is promoting the adoption of Kenya Standard 1758 with its focus on food safety, through its ‘Vegetables for All’ program and creation of FitFood Zones (FFZs).
GAIN’s largest food safety programme is EatSafe (Evidence and Action Towards Safe, and Nutritious Food), funded by USAID under the Feed the Future initiative. The programme is generating evidence into how food safety in traditional markets can be improved, through stimulating behaviour change and creating consumer demand for safer foods. Work has been conducted in northwest Nigeria and Central Ethiopia.
GAIN has made significant contributions to national and international policy efforts. In Nigeria, GAIN has provided technical assistance in refining the draft Food Safety and Quality Bill to include specific food safety measures for traditional markets. This input helped it through the legislative process. It now awaits presidential assent.
GAIN Ethiopia is working with the federal government on the development of food safety standards in traditional markets as part of its Food Systems Transformation Pathway.
The development of food safety standards is also being supported at the global level, with GAIN’s involvement in the development of food safety guidelines for traditional markets under the Codex Committee for Food Hygiene.
Foodborne diseases are considered a neglected but tractable problem – quality data and insights help inform, and guide efforts to improve food safety. GAIN was successful in lobbying for food safety indicators to be included in the Food Systems Dashboard – there are currently 4 food safety indicators. There has also been much effort in knowledge management and mobilization around food safety, including the publishing of over 20 papers in scientific journals in the last few years.
GAIN is also generating evidence to understand the impact of food safety work. For example, GAIN India is working with the Food Safety and Standards Authority of India (FSSAI) to establish ‘Safe Street Food Vendors Hubs’. In addition to helping develop the training toolkit, GAIN is evaluating the pilot project and making recommendations to the Ministry of Health and Family Welfare (MoHFW) and FSSAI on the expansion of the initiative to other states.
With food safety being a new cross-cutting theme at GAIN, three different approaches are being taken to integrate and grow the food safety portfolio.
Chief Technical Officer
Food Safety Lead, Technical Advisor – Policy and Governance
At the core of GAIN's work is the understanding that women’s empowerment, and norms and institutions that enable it is essential for achieving GAIN's mission of healthier diets for all, especially for those most vulnerable to malnutrition.
GAIN is dedicated to integrating gender considerations—men's and women’s distinct needs and priorities—into all our activities, from project delivery to policy support. Women and girls are particularly vulnerable to malnutrition and food insecurity, influenced by biological factors and social norms. Malnutrition during key stages such as pregnancy and lactation not only affects women but also has lasting impacts on their children, creating a cycle of malnutrition across generations. Women's pivotal role throughout food systems is hindered by systemic barriers to productivity and to the equitable distribution of benefits. Additionally, food system policies often overlook gender dynamics and women's needs, marginalizing their voices in policy and governance processes.
At GAIN, we work toward both gender equity and equality by tackling the barriers that prevent women and men from having a fair chance to lead healthy and prosperous lives with agency. According to UNFPA, gender equity means taking targeted steps to address historical and social disadvantages that prevent women and men from starting on a level playing field. This is accomplished by identifying and addressing men's and women’s distinct needs and priorities in food systems. Equity is often an important approach to reach gender equality, where women and men have equal access to opportunities, resources, and benefits, and can exercise control over their lives.
Women's empowerment is central to this process. Access to nutritious food, health knowledge and care, and productive resources, provides women and girls with tools they need to take charge of their lives.
Women’s empowerment is directly tied to GAIN's mission of healthier diets for all: When women and girls are empowered, they are better equipped to make informed decisions about nutrition and health, ensuring healthier families and communities. In turn, their contributions strengthen food systems and drive sustainable development, creating a ripple effect that advances equity, equality, and well-being for all.
GAIN aims to equip women and girls with the knowledge and increased agency they need to eat healthier diets. For instance, Transform Nutrition and Okhokelamo Ni Solha projects in Mozambique are engaging adolescent girls in the Jogo das Heroínas (Heroines’ games) to engage adolescent girls in positive habits related to nutrition, hygiene, and personal development, establishing a foundation for lifelong health and well-being.
By promoting healthy, safe, and supportive work environments in female dominated sectors, our Workforce Nutrition Programme addresses some of the structural challenges women face in formal sector employment while improving diets directly, as presented in this impact story. Programme activities comprise of improved access to healthy food, breastfeeding support, nutrition related health checks with follow-up dietary counselling, and nutrition education in the workplace.
By amplifying women’s and girl’s voices in food systems policy at local and national levels, GAIN promotes more inclusive and equitable food system policy landscapes. Through the Nourishing Food Systems Pathways Programme, GAIN works to strengthen the gender-responsiveness of food systems policies. Applying a novel analytical tool, we identify gaps in the national policy landscape for supporting women’s participation in and benefits from the food system and propose policy recommendations to respond to the gaps. The programme also supports inclusion of youth—girls and boys—voices in food systems policy development and implementation, led by the Youth Team. As well as supporting women’s voices in food system governance, and integrating gender considerations in social protection initiatives.
By supporting improved coordination of local policymakers and stakeholders and inclusion of women and informal food actors in local food system policies and processes, the Food systems Governance Theme works towards inclusive resilient local food systems that work for all genders.
The CASCADE programme (a CARE & GAIN consortium) works with community leaders and women’s groups to address restrictive gender norms and increase women’s nutrition sensitive productive capacity, while also supporting coordination, capacity, & accountability of local govt and service providers.
The integration of gender considerations into all our activities is led by the Gender Team, through technical guidance and programmatic support to ensure that gender is effectively considered throughout the project lifecycle. GAIN’s 2019 Programmatic Gender Strategy sets out the rationale for and overview of actions needed to integrate gender into GAIN’s programming. Building on this strategy, the team has developed a set of screening tools for project design, delivery, and monitoring based on the Reach-Benefit-Empower-Normalize framework.
Strategic Focus: The Gender Team supports a results-oriented approach to institutional mainstreaming, integrating gender-specific indicators into project results frameworks, aligning them with GAINs Performance Management Framework (PMF). Project indicators and institutional key performance indicators are based on the Reach-Benefit-Empower-Normalize framework, ensuring accountability and effective progress monitoring. We track both project-level performance against gender-related targets and overall institutional progress toward our vision that all projects reach, benefit, and empower people of different genders and/or promote gender-equitable norms.
Research Lead, Food Systems Governance and Inclusion Unit, Knowledge Leadership
We seek to intentionally, specifically, and equitably promote consumption of healthier diets for people experiencing poverty and related vulnerabilities.
The Global Alliance for Improved Nutrition (GAIN) seeks to intentionally, specifically, and equitably promote consumption of healthier diets for people experiencing poverty and related vulnerabilities. GAIN’s 2023-2027 Strategy firmly emphasises reaching the very poor as a central goal, highlighting that individuals experiencing poverty are especially vulnerable to system shocks that can jeopardise nutrition security.
GAIN acknowledges that the various programmatic and policy contexts in which we work have distinct characteristics, and that the appropriate definition of ‘poverty’ may differ dependent on context. Thus, instead of prescribing a single poverty line or threshold to be used across programmes, GAIN typically utilizes one or more of the following measures of poverty:
GAIN’s approach to reaching the very poor is community-oriented and human-centered, emphasizing the critical roles of policy, market systems, and social factors in creating an enabling environment for improved access to nutritious foods for people living in poverty.
Affordability prevents people experiencing poverty from accessing nutritious food and they may be excluded from resources necessary to buffer against food system shocks. Therefore, addressing inequities in the production, distribution, and consumption of food is critical for promoting consumption of nutritious foods among this population.
Much of GAIN’s work to reach the very poorest consumers is situated within the Social Protection programme, which is currently working to improve the nutrition-sensitivity of social protection systems in Bangladesh, Ethiopia, India, Indonesia, Kenya, Nigeria, and Pakistan. Under Nourishing Food Pathways, GAIN is supporting governments and other stakeholders to improve nutrition-sensitive social protection policy, promote integration of nutritious food value chains in social protection systems, and to design more nutrition-sensitive social protection programmes.
GAIN strives to be sensitive to the needs of people living in poverty across our entire programmatic portfolio. To ensure that GAIN’s projects and programmes are adequately reaching the very poor, we take the following actions:
Technical Officer
At GAIN, we view the resilience of food systems as the cornerstone to ensure access to nutritious and sustainable diets for all, especially for the most vulnerable.
At GAIN, we view the resilience of food systems as the cornerstone to ensure access to nutritious and sustainable diets for all, especially for the most vulnerable. Food system resilience is the capacity of these systems to withstand shocks and stresses, maintain essential functions, adapt or transform sustainably, while preserving food security and nutrition for current and future generations.
Systems as a high priority. Our goal is to strengthen resilience by focusing on strategies and actions that enhance the adaptability and responsiveness of food systems in the face of a changing world. This commitment ensures food security and nutrition even in the face of adversity.
Resilient food systems play a significant role in ensuring the availability and accessibility of nutritious food, safeguarding against food insecurity and malnutrition, especially during crises. The connection between the resilience of food systems, nutrition, and policy pathways is profound and multifaceted.
Public policies are essential in reinforcing the resilience of the food system by promoting sustainable agriculture, investing in disaster-resistant infrastructure, and creating safety nets for vulnerable populations. These policies create an environment that supports both food security and nutrition. Recognizing this interconnection is crucial for a holistic approach to food systems, aligned with international agendas such as the Sustainable Development Goals.
The GAIN Food System Resilience Strategy is built around three pillars: Programs, Advocacy, and Operations.
At GAIN, we recognize that resilience is the foundation for ensuring that food systems can withstand shocks and stresses while continuing to provide nutritious and sustainable diets. We believe in promoting resilience at various levels within food systems:
Our programmatic interventions prioritize strengthening the resilience of food systems. This involves:
Our advocacy efforts aim to influence policies that enhance the resilience of food systems. We work to:
In our own operations, we strive to set an example of resilience by:
By incorporating resilience into every facet of our approach, from program implementation to policy advocacy and internal operations, we aim to strengthen food systems against the challenges of a dynamic and uncertain world.
Director of Programme Services
Research Lead, Food Systems Governance and Inclusion Unit, Knowledge Leadership
The Global Alliance for Improved Nutrition (GAIN) considers the specific needs and capacities of youth to foster their holistic development, empower them as agents of change, and contribute to building healthier and more sustainable food systems.
The Global Alliance for Improved Nutrition (GAIN) considers the specific needs and capacities of youth to foster their holistic development, empower them as agents of change, and contribute to building healthier and more sustainable food systems. GAIN typically categorizes youth into three profiles based on their roles and age groups:
GAIN follows a positive youth development approach, which emphasizes providing opportunities for skill-building, fostering positive relationships and contribution to society. GAIN adopts youth-led and participatory approaches ensuring that youth perspectives are considered and that interventions are tailored to meet their specific needs.
Youth are both consumers and contributors to food systems. Younger youth or adolescents are at a critical stage of growth and development and their nutritional needs are unique. Adequate nutrition during adolescence can have long-lasting effects on their health and well-being throughout their lifespans. Youth are engaged across the food system from sustainable agriculture and food production to actively participating in finding solutions to food systems challenges and driving positive change.
Governments and policymakers have a responsibility to create environments that support healthy eating, ensure food security, and promote opportunities for youth engagement and employment in the food system. Engaging youth in the policymaking process, advocating for youth-friendly policies, and promoting youth leadership and participation in decision-making can lead to more inclusive and effective policies that address the needs and priorities of young people.
GAIN’s youth work is housed in the Children and Young People theme of the Empowering Food Systems Actors Programme which supports projects the directly target and benefit youth in Bangladesh, Indonesia, Mozambique, Pakistan and Tanzania. Through the Nourishing Food Pathways portfolio GAIN is seeking to ensuring youth voices are included in food system pathway development and implementation. GAIN supports the ACT4FOOD youth movement. The Transform Nutrition and Okhokelamo Ni Solha projects are engaging adolescent girls in the Jogo das Heroínas (Heroines’ games) to improve nutrition outcomes. The Food Investigator Game was an idea from a group of junior high school students and was brought to life by GAIN to help adolescents better understand food labels.
Beyond the Children and Young People theme, GAIN supports staff to integrate youth-focused activities across its programmatic portfolio. This includes:
Programme Lead, Children and Young People
GAIN works to shape food systems that better protect and cater to the needs of children and young people as they evolve and grow by innovating and scaling a range of age specific solutions.
GAIN emphasises involving various stakeholders, including children, young people and their communities, in decision-making processes throughout the project cycle, creating solutions that are more sustainable, relevant, and effective for their specific needs.
GAIN began working on adolescent nutrition in 2017 and has expanded its work to take a broader food systems approach. Our programming is adapted according to children and young people’s ages and Interests, and interaction with the food system and is themed around three areas:
GAIN uses activity-based nutrition and food education to support families with infants and young children and adolescents (age 10-19 years) to learn more about food and make healthier food choices.
GAIN's Youth Leadership Programme strives to create a common space for young people (aged 18-24) to learn, collaborate and act to create healthier, just, and more sustainable nutritious food systems through youth-led campaigns.
GAIN supports SMEs to increase their capacity to safely produce and sell nutritious foods for children, and young people to develop entrepreneurship and employment skills.
Programme Lead, Children and Young People
Food Systems need to be intentionally governed for sustainable transformation (Herens et al., 2022). A 'whole of society' approach guided by good governance principles, evidence, best practices and the promotion of agency is essential for accelerated, locally owned, contextual, coherent and sustained food systems transformation (Trevenen-Jones et al., in publication, 2024).
Food systems transformation requires multiple food systems actors - across levels of government, sectors, and communities - are heard and participate as change agents. This enables the necessary conditions in which livelihoods and access to a diversity of safe and nutritious foods for all can be advanced.
In an increasingly urban world, cities with their mandates and governance tools are active sites of food systems transformation. City government administrations and the multiple actors that routinely engage with food systems have the capacity to pull and push change, influence national and global agenda, and implement context specific food system and nutrition policies and pathways alongside localised sustainable development goals.
Beyond city boundaries, the surrounding peri-urban areas, along with their connections to secondary cities, both formal and informal food sectors, infrastructure, rural communities, and broader regions, are acknowledged as cornerstones for rapid, significant, and sustainable transformations in food systems. (HLPE-CFS., V0 UPU report in review, 2024). This space for change has the potential for multiple co-benefits including access to affordable and healthy diets, biodiverse ecosystems, climate change, land and freshwater use (FAO et al., 2023; Rockstrom et al., 2023).
GAIN works together with multiple local, national and global actors to re-shape food systems with attention to context, inclusion, equitability, innovation and scaling. Design thinking and 'whole of society' participation are key principles with particular emphasis on evidence, local agency, gender transformation and engagement of those most vulnerable to malnutrition e.g. low income communities and those who live, lead and shop in informal (traditional) food markets.
Examples of our work and resources: Food Action Cities platform; Markets and Local Government Policy Option Toolkits; Transforming Urban and Rural Food Systems (TURFS); Nourishing Food Pathways (workstream 2. governance, markets and women).
Technical Lead, Food Systems Governance Programme
CASCADE(CAtalyzing Strengthened policy aCtion for heAlthy Diets and resiliencE)' is a multi-country project implemented by a consortium led by CARE with GAIN, both organisations with long-standing experience in addressing malnutrition at the community and household levels and advocating for greater government engagement for sustainable food systems.
CASCADE leverages CARE’s and GAIN's experience and expertise in systems strengthening and food systems transformation to achieve its main objectives:
The five-year, 60 million EUR award from the Dutch Ministry of Foreign Affairs is implemented between 2022-2026. CASCADE engages in collaborative efforts with government bodies, private service providers, and communities around five domains
CASCADE employs multiple advocacy strategies, from sub-national to national and global level, to strengthen policy implementation of nutrition related policies. It draws on CARE’s and GAIN’s approaches, focusing on social accountability, good governance, health system’s strengthening, multisectoral coordination, resource mobilisation, private sector engagement and climate-resilient agricultural practices.
It also strengthens community structures through community mobilisation and civil society engagement for collective pressure for changes in the food system and collaborates with the Scaling Up Nutrition (SUN) networks across the six countries to address malnutrition. Gender, social norm transformation and behaviour change are cross cutting strategies, both an essential goal and a means to magnify impact.
This webinar explores the intersection of women's empowerment and food security, highlighting CASCADE's approaches to improving nutrition and building resilience for women of reproductive age and children.
Food systems are a foundation of human and planetary well-being and central to achieving the Sustainable Development Goals. Yet they also contribute to ill health, inequity, environmental degradation, and greenhouse gas emissions. These challenges demand urgent food systems transformation. Such a transformation requires understanding the status of food systems across their diverse functions.
The Food Systems Countdown Initiative (“the Countdown”) aims to enable this understanding by monitoring the state of food systems transformation through relevant data. The Countdown is an interdisciplinary collaboration of scientists that emerged from the 2021 United Nations Food Systems Summit. It seeks to provide food system actors and stakeholders (e.g., civil society, governments, and international organisations) with actionable evidence to make decisions that can bring about food system transformation.
Over a two-year process, the Countdown collaborators developed a framework to monitor food systems across five themes: (1) diets, nutrition, and health; (2) environment, natural resources, and production; (3) livelihoods, poverty, and equity; (4) governance; and (5) resilience. The Countdown then used a rigorous, multistakeholder process to arrive at indicators to monitor change across these five themes. The first annual Countdown paper and report, showcasing these indicators, were released in December 2023. They depict the current state of national food systems, providing a baseline that can be used to guide priorities for investment, research, and policymaking and assess future progress.
The baseline data provide a starting point for global monitoring of food systems and serve as inputs for considering what changes in indicator values are achievable, along which time frames.
The five Countdown themes map closely to the national food system transformation pathways from the UNFSS process, so they can facilitate harmonized monitoring of these pathways across countries, supporting priority setting and tracking of UNFSS commitments.
While this indicator framework is intended for global monitoring of food systems transformation, it offers a menu of indicators relevant to the design of policies and actions at the country level. It can thus be used as a point of reference for developing national monitoring systems adapted to country needs.
Going forward, the Countdown will provide annual analysis to inform priorities and actions in the policy sphere, for the private sector, and for the development community. In this way, it supports the transformation of food systems, so they become equitable, sustainable, and resilient and positively contribute to achieving the 2030 SDGs and other global goals.
Senior Technical Specialist
