Are Secondary Cities in Asia and Africa Ready for Food System Transformation? Policy Insights from Bangladesh, Kenya, Rwanda, and the Philippines
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1
Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
 
2
Faculty of Medicine, University of Basel, Basel, Switzerland
 
 
Popul. Med. 2026;8(Supplement Supplement 1):
 
ABSTRACT
INTRODUCTION:
Low-and middle-income countries are experiencing rapid urbanisation, population movements increasingly directed toward secondary cities that function as emerging economic hubs and rural–urban connectors. Nearly 90% future urban population growth will occur in Africa and Asia, secondary cities absorbing much of this expansion.¹ These cities face distinct governance challenges, limited institutional capacity and complex decentralisation, yet they play critical role in shaping food environments and climate-resilient urban food systems.² Despite calls for multisectoral, integrated food system governance to promote healthier amore sustainable diets,³ significant gaps remain how secondary cities address nutrition, food systems, and environmental determinants of health. This study examines policy landscapes across Asia and Africa to assess readiness for food system transformation.

METHODS:
A systematic policy mapping and qualitative content analysis were conducted across eight secondary cities in Bangladesh, Kenya, Rwanda, and the Philippines. Documents were screened, coded, and analysed using a food systems framework covering policy type, nutrition focus, food value chain domains, governance mechanisms, and decentralisation features. Coding categories were informed by established methodologies for document analysis and food systems research.⁴,⁵

RESULTS:
Across the four countries, 36 policies and plans were identified. Most policies emphasised nutrition-specific interventions (e.g., supplementation, growth monitoring) while food system–wide domains such as processing, retail governance, and market regulation were less frequently addressed. Policies in decentralised systems (Kenya, Philippines) showed greater diversity and local adaptation, while more centralised systems (Bangladesh, Rwanda) demonstrated stronger vertical coherence but narrower food system scope. Weaknesses were identified in research, monitoring systems, and climate/environmental integration. Uneven coverage of the food value chain reveals gaps in systemic readiness for urban food system transformation.

CONCLUSIONS:
Secondary cities are critical yet under-supported arenas for public health, climate-resilient governance, and food system transformation. Strengthening multisectoral, and evidence-informed policy frameworks is essential to healthier, equitable, and sustainable urban food environments in LMICs.
eISSN:2654-1459
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