Key messages:

• Stunting in children under five years of age has declined since 2008 but remains significant, affecting one in five in rural areas and one in ten in urban areas.
• Obesity is twice as prevalent in women as men, affecting half of urban women and onethird of rural women, and it is rising faster in urban areas. Overweight, obesity, and unhealthy diets are driving an increase in noncommunicable diseases (NCDs).
• Urban diets are slightly more diverse than rural ones but remain poor due to unhealthy foods and low micronutrient intake, leading to nutrient deficiencies, especially among children, adolescents, and women.
• Half of urban Kenyans live in informal settlements and have low dietary diversity, relying mostly on cereals with minimal intake of fruits and vegetables. This contributes to child stunting, underweight, and a double burden of malnutrition (DBM), or concurrent underand overnutrition at the population, household, and individual levels.
• The cost of a healthy diet increased from $2.79 to $3.54 per person per day, from 2017– 2022 and the percentage of the population unable to afford a healthy diet fell from 72 to 79 percent. Currently, 43 million people are unable to afford a healthy diet.
• Updated data on micronutrient deficiencies are needed, as current information indicates insufficient micronutrient intake among both children and adults.
• Household-level DBM, in which child stunting coexists with maternal overweight, is prevalent in rural areas and low-income informal urban settlements.
• Urban programs, such as home-visit counseling, have reduced stunting, low birth weight, and improved breastfeeding, while facility or video-based models show mixed results.
• Kenya's nutrition policies focus on rural areas with limited urban actions. These policies are hindered by outdated plans, poor coordination, insufficient data, and low coverage.
• Policies for urban nutrition, such as the NCD Strategic Plan, Nutrition Action Plan and a soda tax aim to reduce obesity and NCDs through health promotion and fiscal measures.
• Evidence on urban food environments, primarily focused on Nairobi, is growing and includes evaluations of policies, regulations, and programs.
• Kenya needs to tackle the multiple burdens of malnutrition through integrated doubleduty actions and policies that address both undernutrition and overnutrition.