Understanding how to increase women’s acceptance and access to palm weevil larvae in peri-urban communities in the Ashanti region in Ghana

In low-and middle-income countries like Ghana, women are disproportionately affected by iron-deficiency anemia.Various strategies can effectively reduce iron-deficiency anemia at the population level, including food fortification, supplementation, and dietary improvement.Unfortunately, due to cultural, economic, and resource-related challenges, those have failed to reach Ghanaian women adequately and equitably, resulting in many not meeting their nutritional needs.There is a growing consensus that edible insects could serve as a complementary nutrition-sensitive strategy to alleviate nutritional deficiencies in low-and-middle-income countries.No study has yet examined the factors influencing the feasibility of this strategy for women in Ghana.The first study was formative research providing a general understanding of Ghanaians' perceptions on the consumption of palm weevil larvae.For the aforementioned strategy to be effective, women need to be willing to consume palm weevil larvae and feed it to their families.Mind mapping and focus group discussions were conducted on 121 Ghanaian women in five peri-urban communities in the Ashanti region and sought insight on the facilitators of palm weevil larvae's consumption, its socio-cultural and economic barriers, as well as women's general knowledge of iron-rich foods and anemia.An inductive thematic analysis of the focus group discussions and mind maps showed that women were generally motivated to consume palm weevil larvae for its nutritional and health benefits.Scarcity, difficult access and disgust, however, were the major barriers to the consumption of palm weevil larvae. ` iiiThe second study focused on investigating factors influencing locals' access to palm weevil larvae.Using a mixed-methods approach, the subsequent analysis included: a qualitative assessment of the barriers and facilitators of palm weevil larvae's sale and purchase, and an examination of the relationship between customers' socio-economic and demographic characteristics and their palm weevil larvae purchasing frequency.A total of 97 customers were interviewed at seven markets in the Ashanti region.Findings revealed that storage, distribution, and factors from customers' food environments (including transit time to markets and means of transportation) were the major barriers to palm weevil larvae's access.Over 70% of respondents required at least 15 minutes to reach the closest market with 11% needing over an hour.Further, crosstabulations results showed that men [χ 2 (3, N=97)=15, p=.05)] and respondents with high educational attainment [χ 2 (12, N=97)=32, p=.038)] were more likely to purchase palm weevil larvae frequently (daily or weekly) than women and respondents with lower educational attainments.Tomato paste's fortification with palm weevil larvae could help with overcoming access and acceptance barriers.The third study evaluates: 1) consumers' willingness to consume and purchase the fortified product, 2) the sensory attributes responsible for consumers' choices, and 3) whether knowledge about the importance of iron influences consumers' willingness to purchase and consume the fortified tomato paste.A consumer acceptability study was conducted among 88 participants from five communities in Kumasi.Binary logistic regression showed that out of all sensory attributes, color (OR=3.76,95% CI [1.11, 12.6]) and overall liking (OR=14.6,95% CI [2.26, 95.1]) are the ones influencing consumers' willingness to pay for the fortified tomato paste and accept it for consumption.Furthermore, over 90% of participants preferred the tomato sauce with the highest concentration of palm weevil larvae (30% w/w), suggesting that a ` iv higher fortification level should be tested.The addition of palm weevil larvae improved significantly (p<0.05)tomato paste's iron and zinc contents (wet basis).Finally, brief nutrition education on palm weevil larvae's benefits was shown to influence consumers' willingness to purchase the fortified tomato paste.This dissertation offers a nuanced understanding of the factors influencing Ghanaian women's acceptance and access to palm weevil and sheds light on the growing demand for palm weevil larvae and women's desire to be involved in its value chain.With adequate governmental funding to support the domestication of palm weevil larvae and nutrition education interventions, we believe that our findings could promote the feasibility of a community-based food-to-food fortification approach led by women.Women would farm their larvae, add them to their tomato stews for nutritional enhancement and sell them at local markets to generate income, subsequently increasing access and consumption of the insect and improving women's status.` vii auprès de 88 participants issus de cinq communautés dans la région d'Ashanti.La régression logistique binaire a montré que, parmi tous les attributs sensoriels, la couleur (OR=3,76, IC 95 % [1,11, 12,6]) et l'appréciation générale (OR=14,6, IC 95 % [2,26, 95,1]) sont ceux ayant influencé les consommateurs à vouloir payer pour le concentré de tomate enrichi et l'accepter pour la consommation.En outre, plus de 90 % des participants ont préféré la sauce tomate contenant la plus forte concentration de larves de charançon du palmier (30 % p/p), ce qui suggère qu'un niveau de fortification plus élevé devrait être testé.L'ajout de larves de charançon du palmier a amélioré de manière significative (p<0,05) les teneurs en fer et zinc de la pâte de tomate.Enfin, il a été démontré qu'une brève éducation nutritionnelle sur les avantages des larves de charançon de palmier a influencé la volonté des consommateurs d'acheter le concentré de tomates fortifié.Cette thèse offre une compréhension nuancée des facteurs influençant l'acceptation et l'accès des femmes ghanéennes aux larves de charançon du palmier et met en lumière la demande croissante des larves et l'intérêt des femmes d'être impliquées dans sa chaîne de valeur.Avec un financement gouvernemental adéquat permettant de soutenir la domestication des larves de charançon du palmier et des interventions d'éducation nutritionnelle, nous pensons que nos résultats pourraient soutenir la domestication communautaire des larves de charançons qui serait menée par les femmes, pour les femmes.Les femmes élèveraient leurs larves, les utiliseraient pour enrichir leurs concentrés de tomates en fer et les vendraient sur les marchés locaux pour générer des revenus, augmentant ainsi l'accès et la consommation de l'insecte et améliorant le statut en fer des femmes. ` viii Contributions to knowledgeThis thesis has contributed to an improved understanding of the factors influencing the access and consumption of palm weevil larvae in a peri-urban context in Ghana.These factors can be extrapolated to similar settings.This dissertation builds the rationale of using edible insects as food-based strategies to alleviate micronutrient deficiencies in low-and-middle-income countries. Chapter 3This chapter assessed women's perceptions and beliefs about the consumption of palm weevil larvae in peri-urban communities and identified the facilitators and barriers to its use.Findings revealed that women viewed palm weevil larvae as a nutritious and tasty food source.Women were also in favor of processing strategies aiming at increasing palm weevil larvae's accessibility, should health professionals support them.Women revealed an interest to be involved in palm weevil larvae's value chain to generate an additional income stream.Contrary to the narrative commonly found in the literature, our results highlighted that palm weevil larva's limited consumption and use in Ghana were associated with its scarcity and difficult access, mainly, followed by neophobia.Our findings also showed no significant differences in women's perceptions about palm weevil larvae based on their proximity to palm trees. Chapter 4Acknowledging access as the main barrier to the consumption of palm weevil larvae in the Ashanti region in Ghana and seeing sale and marketability as a means to increase accessibility, this chapter assessed the contextual, economic, and socio-demographic factors influencing Ghanaian locals' access to palm weevil larvae.In addition, this chapter identified strategies to ` ix maximize the sale and, as a result, accessibility of palm weevil larvae for Ghanaian women.Results from the cross-tabulations showed that gender and educational attainment were significantly associated with frequent purchasing of palm weevil larvae.This finding confirmed that palm weevil larvae were still a delicacy for Ghanaians.In addition, our findings revealed that internal and external factors from customers' food environments had the highest influence on their palm weevil larvae purchasing frequency.These factors included customers' trust and familiarity with the larva's origin, customers' food literacy, awareness of palm weevil larvae purchasing locations, available infrastructure to travel to these locations, and palm weevil larvae's taste, quality and price.Results from Chapters 3 and 4 support the need for a community-based domestication of palm weevil larvae. Chapter 5Drawing from the previous chapters' findings, this chapter explored the effectiveness of fortifying tomato paste with palm weevil larvae on increasing both women's access and consumption of palm weevil larvae and women's iron intake.Our findings confirmed that fortifying tomato paste with palm weevil larvae would increase women's willingness to consume and purchase the insect and feed it to their households.In addition, we found that the addition of 30% (w/w) palm weevil larvae increased significantly tomato paste's iron and zinc contents.This chapter displayed tomato paste as an adequate fortification vehicle for palm weevil larvae that could be made widely available and accessible in Ghana.Our findings therefore could provide the Ghanaian government a rationale for the fortification of tomato products

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