Assessment of retail food environments and green spaces for healthy cities:Methodological guidance based on the experiences in Dar es Salaam, Lima, Tunis

Developing and maintaining healthy retail food environments and green spaces isof the utmost and pressing importance in urban centres. To this end, it is crucial to provide cities with tools to assess the availability, accessibility and use of food outlets and green spaces that facilitate healthy eating and living for urban dwellers. Existing tools to assess food and green environments have been developed and used mainly in high-income countries. This study shows that these tools can and should be adapted to low- and middle-income country settings. This study shows that small neighbourhood food shops are important for household food security, in particular for low- to middle-income households. At the same time, the study shows that consumers are disproportionately exposed to ultra-processed foods (UPFs) in these shops. The policy implication of this finding is that small neighbourhood shops must be incentivized to stock and sell greater amounts of fresh and minimally processed foods to make it easier for low- to middle-income households to adopt healthy diets.