Food Insecurity and Water Insecurity in Rural Zimbabwe: Development of Multidimensional Household Measures.

Nadia Koyratty,Andrew Jones,Laura Smith,Robert Ntozini,Jean Humphrey,Mduduzi Mbuya,Chin-Shang Li,Roseanne Schuster,Katarzyna Kordas,Godfred Boateng,Bernard Chasekwa

doi:10.3390/ijerph18116020

Abstract

Background: With millions of people experiencing malnutrition and inadequate water access, FI and WI remain topics of vital importance to global health. Existing unidimensional FI and WI metrics do not all capture similar multidimensional aspects, thus restricting our ability to assess and address food- and water-related issues. Methods: Using the Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) trial data, our study conceptualizes household FI (N = 3551) and WI (N = 3311) separately in a way that captures their key dimensions. We developed measures of FI and WI for rural Zimbabwean households based on multiple correspondence analysis (MCA) for categorical data. Results: Three FI dimensions were retained: ‘poor food access’, ‘household shocks’ and ‘low food quality and availability’, as were three WI dimensions: ‘poor water access’, ‘poor water quality’, and ‘low water reliability’. Internal validity of the multidimensional models was assessed using confirmatory factor analysis (CFA) with test samples at baseline and 18 months. The dimension scores were associated with a group of exogenous variables (SES, HIV-status, season, depression, perceived health, food aid, water collection), additionally indicating predictive, convergent and discriminant validities. Conclusions: FI and WI dimensions are sufficiently distinct to be characterized via separate indicators. These indicators are critical for identifying specific problematic insecurity aspects and for finding new targets to improve health and nutrition interventions.

Highlights

Over two billion people do not have regular access to safe, nutritious and sufficient food [1], while about four billion are exposed to water stress at least once a month [2]
The two samples used to generate food insecurity (FI) and water insecurity (WI) measures were similar for all variables
The same proportion of participants were randomized in the four SHINE trial arms, 15% were living with HIV, 44% were interviewed during the rainy season and 28% during the hungry season, more than 40% of the participants had completed secondary school, more than half had children, and 45% were of Apostolic faith

Summary

Introduction

Over two billion people do not have regular access to safe, nutritious and sufficient food [1], while about four billion are exposed to water stress at least once a month [2]. With millions of people experiencing malnutrition and inadequate water access, FI and WI remain topics of vital importance to global health. The dimension scores were associated with a group of exogenous variables (SES, HIV-status, season, depression, perceived health, food aid, water collection), indicating predictive, convergent and discriminant validities. Conclusions: FI and WI dimensions are sufficiently distinct to be characterized via separate indicators. These indicators are critical for identifying specific problematic insecurity aspects and for finding new targets to improve health and nutrition interventions

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Conclusion