Incentivizing Fruit and Vegetable Consumption in Urbanizing India

Abstract

Low fruit and vegetable consumption contributes to substantial global morbidity/mortality. This is particularly so in India where 75% of the population do not meet World Health Organization consumption targets, with statistics worse for rural India. People’s food choices are shaped by their food environments – the food sources/products available in their lives. Food price is a key barrier to healthy diets. Financial incentives may have an important role to play. However, little research exists on food environments and effects of financial incentives on food choice in low-and-middle-income countries. For rural India such evidence is non-existent. Incentive schemes depending solely on government support are unlikely to be sustainable, but private-sector resources in emerging economies suggest public-private-partnership opportunities. We identified a successful South African scheme offering rebates for healthy food purchased at partnered retailers, which requires adaptation to the rural Indian context. We will examine whether incentivizing fruit and vegetable consumption can improve food choice in urbanizing India by developing a financial incentives scheme for rural India based on the South African model, and evaluating its feasibility as a prelude to a longer-term trial including clinical outcomes. Care will be taken to ensure the scheme developed encourages women’s control of household resources.

Lead Institution

London School of Hygiene and Tropical Medicine

Collaborating Institutions

National Institute of Nutrition of Indian Council of Medical Research; Public Health Foundation of India; Duke – National University of Singapore Graduate Medical School; Indian School of Business; St. John’s Research Institute, India

Principal Investigator(s)

> Sanjay Kinra, MBBS, MD, MRCP, MSc, PhD, FFPH, Assistant Professor at LSHTM / ILRI/ Leverhulme Centre for Integrative Research on Agriculture and Health

Co-Investigator(s)

> Bharati Kulkarni, MBBS, Deputy Director of National Institute of Nutrition, India

> Eric Finkelstein, PhD, Professor of Health Services & Systems Research, Duke-NUS Graduate Medical School, Singapore

> Nanda Kishore Kannuri, PhD, Associate Professor, Indian Institute of Public Health and Public Health Foundation of India

> Sarang Deo, PhD, Associate Professor and Executive Director, Max Institute of Healthcare Management at Indian School of Business

> Helen Walls, PhD, Assistant Professor, London School of Hygiene & Tropical Medicine, and Leverhulme Centre for Integrative Research on Agriculture & Health

> Anura Kurpad, Head of Department of Physiology, St John’s Medical College

> Shilpa Aggarwal, PhD, Assistant Professor of Economics, Indian School of Business