Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine.

Abdel Hamid El Bilbeisi,Samer Abuzerr,Ibrahim Elmadfa,Ayoub Al-Jawaldeh,Ali Albelbeisi,Lara Nasreddine

doi:10.3389/fpubh.2022.808700

Abstract

The present study aimed to determine the households' food insecurity and their association with dietary intakes, nutrition-related knowledge, attitudes and practices (KAP) among under-five children in the Gaza Strip, Palestine. This cross-sectional study was conducted in 2021 among a representative sample of under-five children. A total of 350 children and their proxy were selected from all Gaza strip governorates, using a cluster random sampling method. The Radimer/Cornell food-security scale was used. A 24-h dietary recall was employed for dietary intakes assessment. Nutrition-related KAP for feeding under-five children, anthropometric measurements, and demographic-socioeconomic characteristics were obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. The children from food-insecure households had a high prevalence of moderate underweight (30.4%), stunting (32.8%), wasting (9.6%), and acute undernutrition (30.4%). Between food-insecure and food-secure groups there were significant differences in weight, height/length, mid-upper arm circumference, weight-for-age and mid-upper arm circumference z-scores, underweight, acute undernutrition, intakes of protein, fat, vitamin D, zinc, continued breastfeeding, having nutrition-related adequate knowledge, having nutrition-related positive attitudes, and achieved minimum dietary diversity score (P < 0.05 for all). Additionally, about (56.0%) food-insecure households have inadequate nutrition-related knowledge, (77.6%) have nutrition-related negative attitudes, and (95.2%) did not achieve a minimum dietary diversity score. In conclusion, the children from food-insecure households had a high prevalence of moderate underweight, stunting, wasting, and acute undernutrition. Moreover, low economic status, poor dietary intakes, low levels of nutrition-related KAP, and lack of dietary diversity could contribute to the high levels of food insecurity among under-five children.

Highlights

Food insecurity is a significant nutritional issue worldwide and is commonly found in low- and middle-income countries [1, 2]
The characteristics of under-five children were compared by household food insecurity status (Table 1)
The results revealed that children in food-insecure households had a higher proportion (71.4%) than those in food-secure households (28.6%)

Summary

Introduction

Food insecurity is a significant nutritional issue worldwide and is commonly found in low- and middle-income countries [1, 2]. Since 2014, the global incidence of moderate or severe food insecurity has steadily increased, with the projected increase in 2020 equaling the preceding 5 years combined [3]. It was projected that 119 million children under five would be stunted in 2030 in the 135 lowand middle-income countries [5]. A nutrition needs assessment was conducted in the most vulnerable areas in the Gaza strip, indicating that only 14% of children under 5 years of age had a minimum acceptable diet [8]

Methods

Results

Conclusion