Combined with wasting, micronutrient deficiencies and suboptimal breastfeeding, undernutrition as a whole is estimated to be the cause of 3.1 million child deaths annually (45% deaths in 2011 Liu et al., 2015). Maternal undernutrition restricts foetal growth increasing the risk of neonatal death or stunting in infants who survive. Undernutrition continues to be a widespread issue in low‐income countries globally, impacting infant and child survival (Black et al., 2013). Ground eggshell could be a highly equitable method of increasing calcium intakes across rural sub‐Saharan Africa where calcium intake is low and village poultry ownership common. Development of suitable communication methods are required to convey benefits and safe preparation methods. However, there was an indication of general acceptance of the approach and a willingness to consider the incorporation of ground eggshells into their diets. Five focus groups ( n = 46) indicated eggshells were perceived as waste. Experts agreed that eggshells boiled for 10 min when preparing hard‐boiled eggs with a further 20 min cooking of crushed eggshell in staple foods would eliminate identified egg‐associated pathogens. Salmonella was indicated as the most likely threat to human health through eggshell consumption. Chicken eggshell has high calcium content (380 mg of calcium/gram) and bioavailability comparable to calcium carbonate (~39%) with 1 g sufficient to provide one half of a sub‐Saharan African adult female's dietary calcium needs. A mixed methods approach of literature review, Delphi expert survey and focus group discussions with women of childbearing age in rural Tanzania, were used to assess the practicality, safety, and acceptability of consumption of ground eggshell. This study investigated the potential of increasing dietary calcium intake by the addition of heat‐treated ground eggshell to locally prepared food. Inadequate dietary intake leads to a deficiency in nutrients including calcium, required for growth and physiological functioning. Undernutrition resulting from inadequate access to high‐quality, nutritious food is a widespread issue in sub‐Saharan Africa impacting the health and survival of mothers and their children.
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