Abstract
Food insecurity (FI) is a major public health problem in Lebanon, a small middle-income country with the highest refugee per capita concentration worldwide and prolonged political and economic challenges. The present study aimed to measure the prevalence and sociodemographic correlates of household FI and to explore the association of household FI with anthropometric measures of children and their mothers. Cross-sectional survey (2014-2015). Lebanon.ParticipantsNationally representative sample of Lebanese households with 4-18-year-old-children and their mothers (n 1204). FI prevalence (95 % CI), measured using the Arabic-translated, validated Household Food Insecurity Access Scale, was found to be 49·3 (44·0, 54·6) % in the study sample. Mild, moderate and severe FI were found in 7·0 (5·5, 9·2) %, 23·3 (20·1, 26·8) % and 18·9 (14·9, 23·5) % of households, respectively. Multiple regression analysis showed that low maternal and paternal education, unemployment and crowding were significant correlates of household FI (P<0·05). No significant associations were observed between FI and anthropometric measures of children and their mothers, after adjusting for other socio-economic correlates. Food-insecure households reported various mechanisms to cope with food shortage, such as reducing the number of meals/d (49·6 %), borrowing food (54·4 %), spending savings (34·5 %) and withdrawing children from schools (8·0 %). FI exists among a remarkable proportion of Lebanese households with children. Correlates of household FI should be considered when designing social welfare policies and public health programmes to promote more sustainable, resilient and healthier livelihoods among vulnerable individuals.
Highlights
Food insecurity (FI) prevalence in our study sample remained higher than those reported in other middle-income countries in the Middle East and North Africa (MENA) region, including Jordan, Turkey and Egypt (17–32 %)(39–41); and it was much higher than prevalence rates reported in highincome countries, such as the USA, Canada and France, with only 5–15 % of their respective populations experiencing FI[12,42,43]
When exploring correlates of FI, findings from the present study showed that household FI was associated with several sociodemographic characteristics, including lower parental educational attainment and unemployment
Findings from the present study show that the prevalence of FI was notably high among Lebanese households with children
Summary
Study population Data for the present study were drawn from a crosssectional survey, the Lebanese Food and Nutrition Security Survey (L-FANUS), conducted on a nationally representative sample of Lebanese households with children aged 4– 18 years. A stratified cluster sampling strategy was followed, whereby the strata were the six Lebanese governorates and the clusters were drawn from the twenty-six districts (Caza) in Lebanon. Households were selected based on a probability-proportional-to-size approach. A higher number of participating households was drawn from districts with higher population density using data from the Lebanese Central Administration of Statistics[28] and after consulting with a local statistics agency. Households were selected using a systematic sampling approach. The estimate of 51·7 % used in the sample size calculation was based on the FI estimate reported among a small sample of households in Lebanon[29]
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