Abstract
Background Despite mixed reports, food insecurity emerges as a predictor of nutritional status, assumably limiting the quantity and quality of dietary intake. In Ethiopia, the prevalence of childhood undernutrition and food insecurity is highly pronounced. However, whether household food insecurity predicts undernutrition in children was not yet well established. Thus, the aim of the present study was to identify the link between household food access and undernutrition in children aged 6–23 months in West Oromia zones, Ethiopia. Methods A cross-sectional study was conducted on a sample of 525 households during June–October 2016. Food access was measured as Household Food Insecurity Access Scale. Semistructured interviewer-administered questionnaires were employed to collect data on sociodemographics, child health, child dietary practices, household food security, and anthropometrics. The height and weight of children aged 6–23 months in each household were measured. Multivariate logistic regression models were constructed to assess the association between household food insecurity and child nutritional status measured from undernutrition indicators. Results Overall, more than two-thirds (69%) of households were classified as food insecure (had insufficient access to adequate food), with a mean (SD) household food access score of 7.9 (7.7). The respective prevalence of mild and moderate food-insecure households was 56.6% and 12.4%. Higher proportions of children in food-insecure households were stunted (41.8% vs. 15.5%), underweight (22.0% vs. 6.1%), and wasted (14.9% vs. 6.1%). Overall, the prevalence of child undernutrition was 21.3% in the target population, with 16.2% stunted, 6.9% underweight, and 6.3% wasted. The present finding shows food-secure households were 54% protective (OR: 0.46, 95% CI: 0.25–0.84) for child undernutrition. Compared to children in food-secure households, children who were reportedly living in moderately food-insecure households were over twice more likely stunted (OR: 2.09, 95% CI: 1.02–4.28) and over 4 times more likely underweight (OR: 4.73, 95% CI: 1.81–12.35). However, household food insecurity was not a correlate for acute malnutrition (wasting) in children. Conclusions The prevalence of household's food insecurity situation is very common and more pronounced among households with undernourished children aged 6–23 months in Ethiopia. The analysis of this work shows that moderately food-insecure households are a salient predictor for composite undernutrition, stunting, and underweight, but not for wasting. Thus, this finding informs the need for multisectoral strategies and policies to combat household's food insecurity and multiple forms of child undernutrition, beyond the socioeconomic wellbeing.
Highlights
Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and other foods and liquids are needed, along with breast milk
WHO recommends [2] complementary feeding should be timely; adequate; safe; and appropriate and applying responsive feeding following the principles of psychosocial care
In Ethiopia, inappropriate child feeding practices are mostly attributed to poor dietary quality or poor feeding practice, if not both [3], and are often the main determinants of inadequate intakes than the availability of foods in the households [1, 2]
Summary
Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and other foods and liquids are needed, along with breast milk. Such transition from breastfeeding to family foods (complementary feeding) typically covers the period from 6 to 24 months of age and is often considered as a critical period of growth during which nutrient deficiencies and illnesses contribute globally to higher rates of undernutrition among children [1, 2]. The prevalence of child undernutrition was 21.3% in the target population, with 16.2% stunted, 6.9% underweight, and 6.3% wasted
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