Presentation by Delia Grace at an EatSafe webinar on 'The art of application: Food safety innovations for traditional markets', 13 December 2022.

1. Scaling food safety innovations in traditional
markets
Delia Grace
Natural Resources Institute, UK and International Livestock Research
Institute, Kenya
GAIN Seminar: The art of application – Food safety innovations for traditional markets
13 December 2022

2. 2
Traditional food markets
• Traditional, wet, informal markets: selling dry, fresh
(and sometimes live) food all over the world.
• Wet markets: selling mainly fresh foods such as meat,
fish and vegetables, mostly used in Asia.
• Often poor infrastructure, inadequate health and safety
regulation, sell traditional products, traditional
processing, not licensed, not tax paid, often some form
of compliance with regulation
Most FBD from fresh food in informal markets

3. Outline
Does it scale? Is it sustainable?
What doesn’t work
What might
Take home messages

4. o Not by Before and After
o MVP mid-term evaluation report highlights “Proportion of households that own a
mobile phone increased fourfold” as one of the project’s “biggest impacts” in Bar-
Sauri.
http://blogs.wor
ldbank.org/afric
acan/the-
millennium-
villages-project-
continues-to-
systematically-
overstate-its-
effects
Does it scale? How can we tell?

5. Observational studies
Manzi summarized: 90% of large RCT replicated as
compared to only 20% of non-RCT
Young and Carr looked at 52 claims made in medical
observational studies
NONE (zero) of the claims replicated in RCTs,
5 claims were stat-sig in the opposite direction in the RCT
Their summary: any claim coming from a non-RCT is most likely
to be wrong
Even well-controlled, published non-RCT have been
reversed by RCT

6. Does it scale? How can we tell?
Gold standard: multiple RCTs
Non experimental designs can only suggest causality
o Can’t control completely with a regression model or propensity
score
• Models can only say might
o Can’t get causality from a cross sectional (with –without) study
o Can’t get causality from a before and after study

7. Outline
What to do?
How do we know if it works?
Doing it wrong. Doing it right.
Some ILRI success and failures

8. 8
Along the
value chain
Technologies Training &
information
New processes Organisational
arrangements
Regulation Infrastructure
Farmer +++ +++ + +++ + ++++
Processor &
transporter
+++ +++ +++ ++ ++ +++
Retailer + ++ + ++ ++ +++
Consumer + +++ + + + +++
Government +++ ++ ++ +++
Population level:
• Incorporating food safety into other health programs such as mother and child care or HIV treatment
• Medical interventions such as vaccination for cholera or norovirus or binders for aflatoxins
• Dietary diversity to reduce exposure and vulnerability to toxins
• Water treatment
Reviews of food safety interventions in LMICs

9. Little evidence of scaling or continuing
• Failure to evaluate large scale investments
• Interventions without measuring outcomes – yet some
interventions make things worse
• Near-term, easy, un-important outcomes measured e.g.,
changes in knowledge
• Reliance on self-reporting (e.g., diarrhea)
• Short-term follow ups – no attention to sustainability
• Limited information on economic aspects – many likely
unaffordable
• Lack of attention to incentives
• Limited cover of un-intended consequences especially
gender and nutrition

10. Can we regulate our way to food safety?
A modern and appropriate regulatory framework is essential
But
o Regulation – implementation gap
o Regulation often not appropriate
o Major consumer of time
o Perverse incentives

11. Can we train our way to food safety?
o FFS good for farmers but doesn’t scale or sustain
o Domestic GAP has limited effect
• In 4 years VietGAP reached 0.06%
• In Thailand GAP farmers have no better pesticide use than non-GAP
o Safe veggies in Vietnam over 10 years less than 10%
o Biosecurity never scales for smallholders
o Increasing knowledge of health benefits of handwashing does not
change behaviour

12. Three -legged stool approach to scaling

13. The 3-legged stool approach: ECM (enabling, capacitating, motivating)
Vietnam
1. training & minor equipment
Slaughter Retail
Slaughter: Grid, separate clean/dirty area,
cleaning/disinfection (300-1000$)
Retail: Hygienic cutting board, separate
(fresh/cooked), cleaning/disinfection (35$)
Cambodia
1. training & minor equipment
Retail
Hygienic cutting board, separate
(fresh/cooked), cleaning/disinfection, easy to
clean surface (25$)
2. Incentives & Nudges
Scoring system, auction survey indicates 15 % higher
WTP of consumers for improved market stalls
2. Incentives & Nudges: Certificate and poster
Different coloured cloths and chopping boards
3. Enabling authorities & infrastructure
Limited support by local authorities
3. Enabling environment
Strong support by national & local authorities
Improved food safety outcome (Salmonella) in both countries but more
prominent in Cambodia due to stronger support by local authorities
Photo credit: Unger, Chi
Nguyen, R Chea /ILRI
Supporting tools:
- Manuals, briefs, nudges
- Formative research

14. Grid
Hand disinfection liquid
Faucet
Installed grid
Re-organized water and
electrical system
Not sustained until large foreign
company required use of grids
Photo credit: Sinh Dang Xuan/Chi Nguyen ILRI 2020
Training, Technologies and Nudges in slaughterhouses

15. Technology, training, nudges
Sustained because storage reduced
waste and loss and made work easier

16. Policy impact: translational research for interventions in modernizing food system
o CGIAR/ILRI niche - risk assessment and policy /
regulatory analysis for fresh foods in domestic
markets
o World Bank convenes overall support to
government: ILRI led technical works
o Upcoming projects based on WB report we led will
improve food safety for 20 million people in major
cities of Vietnam

17. Photo Credit Goes Here
EatSafe in Ethiopia

18. 1. Clean Fingers: Proper hand washing, short nails, handwashing stations, hand
sanitiser
2. Clean Water: chloride tablets, clean container, cover
3. Clean Surfaces: Disinfectants, bleach revealed, frequent wiping, sheeting or
other surface control
4. Clean Cloths & clothes: Different colours for different purposes, 2 buckets,
wash & dry, antimicrobial cloths. Apron, clean light coloured clothes
5. Clean Tools: Cleaning, disinfection, storage
6. Fly free: fly traps and pest control
7. Off floor: All food stored off the floor in appropriate containers
8. Fridge use: fridge thermometer
9. Separate offal from meat, hot from cold
10. Sequence new before old: first in first out principle
11. Avoid raw beef, if not possible do not give raw beef to YOPI, harm reduction
for raw beef
Few behaviours to change

19. 1. Economic: marketing, customer service, looking clean & nice, being polite
2. Economic: mystery consumer (team member) who will evaluate them and give
them structured feedback
3. Economic: simple record keeping, importance of keeping business & personal,
business micro-incentives (reminders & small payments for record keeping &
marketing)
4. Social: Tell and show customers the importance of training
5. Social: Proof of training, photo of training, why training is needed (germs,
illness, use of glo)
6. Moral: explain how training will improve their family health
7. Moral: pre-commitment, promise to follow behaviours
8. Mixed: “scores on doors” cards which will show hygiene to attract consumers
and be in good standing with authorities
9. Mixed: why technologies will prevent spoilage and waste, keep meat safe,
attract consumers
Many motivations to draw on

20. 1. Many food safety interventions in LMICs do not scale
2. Scaling must be incorporated from the start
3. We know the critical success factors for scaling
4. We need change only a small number of behaviours
5. Behaviours can be changed by a wide range of incentives and nudges
6. Authorities must be on board (or at least not anti informal market)
Take home messages

21. THANK YOU