Food Consumption Surveys and Nutrition Policy in Africa: A Narrative Review with Policy Lessons for Zimbabwe

Malnutrition and micronutrient deficiencies remain major public health challenges, with an estimated 2.3 billion people unable to access adequate diets globally and vitamin A deficiency affecting approximately 29% of children under five worldwide, contributing to 250,000 to 500,000 cases of preventable childhood blindness annually. This narrative review examines national food consumption survey methodologies and dietary evidence from selected African countries (Zimbabwe, Nigeria, Kenya, Ethiopia and South Africa) in comparison with global benchmark contexts (United States of America, United Kingdom and Japan), to assess their implications for nutrition policy. In contrast to most African settings, long-running individual dietary surveillance systems in the United States, United Kingdom, - and Japan enable routine monitoring of nutrient adequacy and early detection of diet-related non-communicable disease risks, demonstrating how sustained investment in dietary data systems strengthens policy responsiveness. Evidence from African surveys indicates that cereal-based staples contribute 65–85% of total dietary energy intake in rural populations across Zimbabwe, Nigeria and Ethiopia, while fruit and vegetable consumption remain below the World Health Organization (WHO) recommended minimum of 400 g per person per day in most settings. Vitamin A deficiency exceeds 40% among children under five in several low- and middle-income countries, iron deficiency anaemia affects 29–38% of women of reproductive age in sub-Saharan Africa, and zinc inadequacy remains widespread due to low dietary diversity and poor bioavailability from cereal-based diets. Countries implementing nationally representative individual dietary recall surveys, such as Nigeria, generate population-level nutrient intake distributions that inform fortification design and coverage. However, reliance on household-level surveys in Zimbabwe and Kenya constrains estimation of individual nutrient adequacy and masks age- and sex-specific vulnerabilities. The review further documents nutrition transition dynamics, with ultra-processed foods contributing approximately 39% of total energy intake among urban adults in South Africa and expanding rapidly in Kenya and Nigeria, signaling a growing dual burden of persistent undernutrition alongside rising diet-related non-communicable disease risks. Biofortified crops, including provitamin A maize, can contribute 30–50% of daily vitamin A requirement under typical consumption patterns; however, their population-level impact cannot be reliably quantified without intake data. Strengthening national dietary surveillance through integration of standardised individual dietary assessment modules into existing household survey platforms, including Zimbabwe Livelihoods Assessment Committee/ Poverty, Income, Consumption and Expenditure Surveys (Zimbabwe), (ZIMLAC/PICES), is essential to support evidence-based fortification, improve targeting of nutrition interventions, and better align agriculture, food systems and public health policies in Zimbabwe and comparable African settings. Key words: Food, Consumption, Dietary, Micronutrients, Africa, Zimbabwe, Global, Comparisons, Policy