The urban population in Sub-Saharan Africa is projected to expand by nearly 800 million people in the next 30 years. How this rapid urban transition is affecting household-level urban food security, and reverberating into broader food systems, is poorly understood. To fill this gap, we use data from a 2017 survey (n = 668) of low- and middle-income residents of Accra, Ghana, to characterize and compare the predictors of household-level food security using three established metrics: the Household Food Insecurity Access Scale (HFIAS); the Household Food Insecurity Access Prevalence (HFIAP); and the Food Consumption Score (FCS). According to HFIAP, 70% of sampled households are food insecure, but only 2% fall below acceptable thresholds measured by FCS. Only one household reported sourcing food from modern supermarkets and fewer than 3% produce food for consumption through gardening, farming, or fishing. Instead, households rely on purchased food from traditional markets, local stalls and kiosks, and street hawkers. Results from a suite of general linear models show that household assets, education, and demographic characteristics are significantly associated with food security outcomes according to HFIAS and HFIAP. The poor correlation and weak model agreement between dietary recall such as FCS, and experience-based food security metrics, like HFIAS and HFIAP, highlight limitations of employing historically rural-centric food security measurement approaches within the urban context. Given that Sub-Saharan Africa’s future is urban, our results add empirical evidence in support of the growing chorus of scholars advocating for comprehensive urban-oriented food security research and policy agendas across Sub-Saharan Africa.

African cities face immense challenges over the coming decades. As countries urbanize, African cities must maintain service provision for rapidly increasing populations, yet with limited resources. In particular, urban food systems must be able to cope with regional food shortages and catalyze (or at least enable) the distribution of food from diverse sources in order to ensure that the cost of food remains affordable for all of the segments of a city’s population. Food systems in most African cities are composed of wholesale sellers, formal markets, street vendors, shops, and increasingly large-scale international stores, creating an evolving landscape of food sources. At the same time, urban population growth can result in rapid changes in urban structure with new peri-urban development and transitions in socioeconomic status within existing areas. Governance plays an important role in the creation and coordination of formal and informal actors across different types of food providers. At the municipal level, new markets must be approved to keep pace with urban expansion. Within residential areas, market management committees must work to maintain traditional markets in the context of increasing competition from large-scale grocers and small-scale street vendors. We use household and market-level data that was collected in Lusaka, Zambia, to conduct an institutional analysis of residential areas to examine the interplay between households, public markets, and street vendors. Analysis of the city’s food system identifies a complex network of relationships featuring formal and informal governance arrangements, which may affect food system functionality.