Abstract
About 2 billion people worldwide suffer moderate or severe forms of food insecurity, calling for correctional measures involving economic strengthening interventions. This study assessed the impact of household economic strengthening (HES) intervention on food security among caregivers of orphans and vulnerable children (OVC) in Tanzania. The study was longitudinal in design, based on OVC caregivers' baseline (2017-2018) and midline (2019) data from the USAID Kizazi Kipya project. Food security, the outcome, was measured using the Household Hunger Scale (HHS) in three categories: little to no hunger (food secure), moderate hunger, and severe hunger. Membership in the USAID Kizazi Kipya-supported economic strengthening intervention (i.e. WORTH Yetu) was the main independent variable. Data analysis involved generalized estimating equation (GEE) for multivariate analysis. With mean age of 50.3 years at baseline, the study analyzed 132,583 caregivers, 72.2% of whom were female. At midline, 7.6% of all caregivers enrolled at baseline were members in WORTH Yetu. Membership in WORTH Yetu was significantly effective in reducing household hunger among the caregivers: severe hunger dropped from 9.4% at baseline to 4.1% at midline; moderate hunger dropped from 65.9% at baseline to 62.8% at midline; and food security (i.e., little to no hunger households) increased from 25.2% at baseline to 33.1% at midline. In the multivariate analysis, membership in WORTH Yetu reduced the likelihood of severe hunger by 47% (OR = 0.53, 95% CI 0.48-0.59), and moderate hunger by 21% (OR = 0.79, 95% CI 0.76-0.83), but increased the likelihood of food security by 45% (OR = 1.45, 95% CI 1.39-1.51). The USAID Kizazi Kipya's model of household economic strengthening for OVC caregivers was effective in improving food security and reducing household hunger in Tanzania. This underscores the need to expand WORTH Yetu coverage. Meanwhile, these results indicate a potential of applying the intervention in similar settings to address household hunger.
Highlights
The Food and Agriculture Organization (FAO) estimates that 2 billion people of the world’s population are experiencing moderate or severe food insecurity [1]
Results are interpreted considering that the effect of WORTH Yetu on household hunger is adjusted for caregiver sex, age, marital status, education, place of residence, mental or physical disability, health insurance, and HIV status
The caregivers who were members in WORTH Yetu were 45% more likely to be in little to no hunger households than non-members (OR = 1.45, 95% confidence intervals (CIs) 1.39– 1.51) (Model 1)
Summary
The Food and Agriculture Organization (FAO) estimates that 2 billion people of the world’s population are experiencing moderate or severe food insecurity [1]. Concentrated in low- and middle-income countries (LMICs), these people are facing irregular access to nutritious and sufficient food. Because of this, they are exposed to a greater risk of malnutrition and poor health in general [1]. The UN believes that the SDGs are not possible to achieve without ending hunger and malnutrition, and without having sustainable and resilient agriculture and food systems [3]. Food insecurity has been associated with several adverse outcomes, including among others, an increased HIV transmission risk [4, 5] through transactional sex and inability to negotiate safer sex [4], poor clinic attendance [6], poor antiretroviral therapy (ART) uptake and adherence [4, 6, 7], lower likelihood of achieving complete viral suppression [8], poor immunological and virological responses, lower efficacy of ART, and high mortality [6, 8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
