Prevalence and determinants of adult consumer use and comprehension of food labels in sub-Saharan Africa: a systematic review and meta-analysis

Context: Food labelling is a global strategy recommended to reduce noncommunicable diseases. Few reviews, however, have focused on food label use in sub-Saharan Africa (SSA). Objective: To determine the prevalence of food label use and describe determinants of food label use and purchasing decisions of adult consumers in SSA. Data source: PubMed (Medline), Web of Science, Cochrane Central, and Google Scholar databases. Data extraction: Search criteria included adults (aged =18 years), conducted in SSA, focusing on food label use or understanding and their determinants or determinants of food-purchasing decisions, and articles published in English. Study quality and data analysis: Risk-of-bias assessment of included studies was done using the Joann Briggs Institute checklist for prevalence studies. Publication bias was assessed using funnel plots and Egger's test. Analysis included narrative synthesis and moderator and meta-analyses of food label use. Results: A total of 124 articles were found, of which 21 were included in the review. Of participants in the selected studies, 58% were female. About 80% reported food label use (either used sometimes or always) (70%-88%) (I-2 = 97%; n = 6223), and regular use was estimated at 36% (28%-45%) (I-2 = 97%; n = 5147). Food label use was influenced by level of income, education, employment status, and household size. Food-purchasing decisions were influenced by attributes such as expiry dates, price, and taste. Major recommendations reported were tailored education campaigns and reducing barriers to food label use. Conclusion: Most (80%) of adults in SSA reported using food labels; however, only about one-third used them consistently. Demographic and situation factors determined patterns in food label use, whereas product attributes influenced food purchasing decisions. Complexity of these determinants requires adopting tailored, multisectoral, theory-driven programs to improve food label use.