Household Food Insecurity Status Research Articles

Prevalence and risk factors of food insecurity among Syrian refugees in Türkiye

BackgroundAlthough Türkiye (Turkey) hosts the largest number of Syrian refugees, studies on food insecurity are limited. This study examined the prevalence and risk factors of food insecurity among Syrian refugees living in Istanbul, which has the highest number of refugees in Türkiye.MethodsA cross-sectional survey was conducted among Syrian refugees in Istanbul between September 2021 and March 2022. The main income earners of 103 households were interviewed by a research dietitian, with the assistance of an Arabic speaking interpreter through hour-long face-to-face. Data on sociodemographic characteristics (age, gender, nationality, marital status, educational status, the family income, the major source of family income, and the number of family members living in the household etc.) and household food insecurity status were collected. Household food insecurity status was assessed with the eighteen-item Household Food Security Survey Module.ResultsThe household food insecurity rate was 90.3%, and those of adults and children were 88.4% and 84.8%, respectively. It was observed that family income level was significantly associated with food insecurity. A one-unit increase in monthly income increased food security by 0.02 times (p < 0.001). The number of employed refugees in the food security group was higher than that in the food insecurity group (p = 0.018). A significant difference was found in the rate of occupation type of the major income earner between the groups (p = 0.046).ConclusionsHigh rates of food insecurity, particularly severe food insecurity, were found among Syrian refugees living in Istanbul. While more research is warranted to explore the root causes and efficacy of the current support system, it requires the immediate attention of policymakers at the national and international levels to implement effective policies and interventions.

Does COVID-19 Influence the Urban Household’s Food Security in Horo Guduru Wollega Zone, Ethiopia?

Household food insecurity is an important variable for understanding the nutritional status of children and women in low-income countries. This study was therefore initiated to determine household food insecurity status and to analyse the impact of COVID-19 on household food security in a selected number of households in the Horo Guduru Wollega Region of Ethiopia. Multistage sampling methods were used in this study. First, 4 were randomly selected from 12 found in the Horo Guduru Wollega area. The population/size ratio is then used to select households in each city. Finally, the eligible households for the study were randomly selected. Accordingly, 360 sample data were collected from 5,710 poor households in four urbans in the Horo Guduru Wollega zone. Both qualitative (in-depth interview) and quantitative data (structured questionnaires) were included in this study. The data collected were analysed using the propensity score matching model. The result of the concordant estimation of the propensity score showed supportive indications for improving the food security standard of living. All consistent test methods used for analysis showed that there was a statistically significant difference in the assessment of dietary diversity between safe and unsafe foods. This study concludes that the COVID-19 pandemic is affecting household food security in the study area. Therefore, all concerned bodies are responsible to overcome the problem of food insecurity that occurred due to the COVID-19 in the region and nationally. The data analysed to know impact COVID-19 on food security in the study area. The propensity score matching estimation result has shown supportive evidence about the improvements of the living standard of food security. All of the matching test methods employed for the analysis showed that there was statistically significant dietary diversity scores difference between food secure and insecure. In general, this study revealed that COVID-19 pandemic affects household food insecurity status in study area.

A Comparative Analysis of Household Food Insecurity Status among Rice Farmers in Savanna and the Rainforest Agro-ecological Zones in Southwest States, Nigeria

The study presents findings on comparative analysis of household food insecurity status among rice farmers in the Savanna and the Rainforest agro-ecological zones in Southwest States, Nigeria. Primary data were used and obtained through the administration of a well structured questionnaire. A multistage random sampling was used to select 577 rice farmers in the study area. Data were analyzed using descriptive statistics, household food insecurity access (HFIA) scale, household food insecurity access prevalence (HFIAP) scale, likert scale and linear regression model. The results revealed that majority of the rice farmer’s fall within 31-50 years of age bracket, with household size of 5-8 persons, married, with farming experiences and have small farm size. The findings from average household food insecurity access scale scores in the Savanna and the Rainforest agro-ecological zones were 4.0 (mildly food insecure) and 5.2 (moderately food insecure) respectively. The results of HFIAP indicator revealed that about 39.1% and 33.5% of respondents were classified as food secure, 8% and 13.9% were mildly food insecure, 15.1% and 22.2% were moderately food insecure and 37.8% and 30.4% were severely food insecure in the Savanna and the Rainforest agro-ecological zones respectively. The major coping strategies adopted by the respondents against food insecurity include reduce the quantity of food consumed and eating but not satisfied. The linear regression model revealed that age, sex, years in school, farm size, household size, farming experience, rice farming experience and tenure system significantly affect household’s food insecurity status. To transport from food insecure to food secure, age, sex, years in school, farm size, household size, farming experience, rice farming experience and tenure system alleviation policies are imperative.

Food insecurity among low-income households in Addis Ababa, Ethiopia

With the rapid urbanization in developing countries, poverty and food insecurity are becoming increasing prevalent, posing a major challenge to urban areas. The COVID-19 pandemic induced job losses and reduced income combined with inflation have further exacerbated the household food insecurity situation, particularly in cities of low-income countries. Our study aims to assess the extent of food insecurity and its determinants among low-income household in Addis Ababa, Ethiopia. We conducted a community-based cross-sectional study among a sample of 578 households in Addis Ababa. We estimated the household food insecurity status using the Household Food Insecurity Access Scale (HFIAS). An ordinal logistic regression model was used to assess the relationship between household food insecurity status and the socioeconomic and demographic covariates. The STATA 14 software package was used for data analysis. We found that household food insecurity was prevalent among low-income households in Addis Ababa, with a prevalence rate of 92.4 % (95 % CI: 90.2–94.6 %). Of these households, 33.6 % (95 % CI: 29.7–37.4 %) were severely food insecure. To cope with the food shortage, households were forced to reduce their food quantity and quality. We also found that respondent's education, engagement in income generating activities, and household wealth were independently associated with household food insecurity. We conclude that although supporting people living below the poverty line (pro-poor) remains the top priority for social protection programs, adapting the program to accommodate the working poor (informal sector employees and casual workers) is crucial, especially during shocks.

Peri-urban food insecurity and coping strategies among farm households in the face of rapid urbanization in Sub-Saharan Africa: Evidence from Ethiopia

A growing body of literature discusses food insecurity in rural and urban contexts in Sub-Saharan Africa (SSA). Peri-urban food insecurity and coping strategies remain an understudied topic. To fill this gap, household cross-sectional survey data was collected from randomly selected 300 farm households in the peri-urban area of Jimma City and complemented with key informant interviews (KIIs) and focus group discussions (FGDs) to assess their food insecurity status and coping strategies in the face of rapid urbanization. A structured questionnaire was used to collect quantitative data from farm households while an unstructured questionnaire was used to gather qualitative data from key informants. Twelve indicators involving the four food insecurity dimensions were identified to develop a food insecurity index and categorize households into four food insecurity levels. The Principal Component Analysis (PCA) is employed to determine the most important indicators of household food insecurity. The ordered probit regression model was employed to ascertain significant factors affecting farming household food insecurity. The results revealed that 46% of peri-urban farm households were food-insecure at various levels. The household food insecurity status varied with their level of human capital, physical endowments, risk aversion behaviour, and institutional barriers. The expansion of built-up areas and marketable crops, particularly eucalyptus trees have greatly affected the food security status of peri-urban farm households. Income diversification, farming diversification, social ties, and farming specialization were the main food insecurity coping strategies of peri-urban farm households. The findings of this study highlighted insights into the urban expansion of medium-sized cities and agricultural land loss, marginalization of staple food crops, and market food prices increase, which resulted in increased vulnerability to food insecurity and poverty among farm households in peri-urban areas. The recommendations drawn from these findings are formulating strategies that preserve agricultural land-use and promoting food insecurity mitigation programs that capitalize on the coping strategies of households in peri-urban areas in the face of rapid urbanization.

Household food insecurity is negatively associated with achievement of prenatal intentions to feed only breast milk in the first six months postpartum.

Household food insecurity (HFI) has been associated with suboptimal breastfeeding practices. Postpartum factors reported by caregivers include stressful life circumstances and maternal diet quality concerns. It is unknown whether prenatal breast milk feeding intentions, a well-established predictor of breastfeeding outcomes, differ by HFI status. We explored associations between HFI and prenatal intentions to feed any and only breast milk in the first 6 months postpartum, and achievement of these intentions. We utilized data from self-identified biological mothers with children 6-12 months of age who responded to a retrospective, cross-sectional online infant feeding survey conducted in Nova Scotia, Canada. HFI (yes/no) was assessed using the Household Food Security Survey Module. Prenatal intentions to feed any and only breast milk were assessed based on responses to five options for infant milk feeding plans. Achievement of intentions was assessed by breast milk and formula feeding practices in the first 6 months. Multivariable logistic regressions were conducted, adjusting for maternal socio-demographics. Among 459 respondents, 28% reported HFI; 88% intended to feed any breast milk and 77% intended to feed only breast milk, with no difference by HFI status. Of those intending to feed any breast milk, 99% succeeded, precluding further analysis. Among mothers who intended to provide only breast milk, only 51% achieved their intention, with lower odds among those with HFI (aOR 0.54, 95% CI 0.29-0.98). HFI was not associated with intentions for feeding breast milk in the first 6 months postpartum, but mothers with HFI were less likely to achieve their intention to provide only breast milk. Further research is needed to understand the underlying reasons for this and to guide intervention designs to address HFI and help mothers reach their breastfeeding goals.

Rotation Double Random Forest Algorithm to Predict The Food Insecurity Status of Households

Rotation Double Random Forest Algorithm to Predict The Food Insecurity Status of Households

Outcomes of a homestead food production program on nutritional knowledge, dietary diversity, food security and empowerment of rural women in Tehran province, Iran

BackgroundFood and nutrition insecurity is a major health issue in developing countries. Homestead food production (HFP) programs are strategies for improving food and nutrition security of a country. Iran implemented a HFP program entitled “Nutrition Improvement of Rural and Nomadic Women” in its villages for a five-year period from 2017. The current study assessed the outcomes of this mentioned program and its determinants among rural women in Tehran province.MethodsThe population of this cross-sectional study comprised a group covered by the program (n = 143) and a non-covered group (n = 160). The participants were selected randomly from 32 villages of five counties in Tehran province. Data was collected using five questionnaires: (1) General information, (2) Women’s empowerment, (3) Nutritional knowledge, (4) Dietary diversity, and (5) Household Food Insecurity Access Scale (HFIAS). Data was analyzed using the IBM SPSS version 21 and the IBM Amos SPSS version 22 software.ResultsThe results of the study showed no significant improvement in the expected indicators, such as frequency of home gardening, nutritional knowledge, dietary diversity, women’s empowerment, and household food insecurity status among women covered by the program (p > 0.05). The structural equation modelling (SEM) results indicated that women’s empowerment from the dimension of decision-making power (r = 0.151) and nutritional knowledge (r = 0.135) were the significant positive predictors of dietary diversity (p < 0.05), while household food insecurity predicted it negatively (r=-0.138) (p < 0.05).ConclusionBecause the current evaluated program has not been able to improve the expected indicators, modification of the program implementation may be needed, such as: addressing the probable barriers and challenges and strengthening the facilities in the covered villages. The current study presents a model of the dietary diversity predictors for consideration in redesigning or enhancing the program.

Food Insecurity Transition Among Agricultural Households In Nigeria

ABSTRACT: Hunger continues to be on the increase and food crises remain a developmental challenge. The incidence of food insecurity in the country has heightened in recent years due to unprecedented natural hazards, economic shocks and climate change, which have eroded livelihoods and worsened the country’s performance in food security-related indices. We therefore used the panel data from Nigeria to examine the food insecurity transition among agricultural households. The data covered four rounds. The food insecurity status of agricultural households was estimated using the Foster-Greer-Thorbecke measure. We explained the interaction among the states of food security of agricultural households across different periods using the food insecurity transition matrix. The determinants of food insecurity were explored using the dynamic probit model. The model addressed unobserved heterogeneity, state dependency, and serial correlation arising from the data and model. Findings revealed that the mean food expenditure increased across the period. Similarly, mean per capita food expenditure also increased across periods except for the 2012/2013 period where it dropped slightly. We observed a rising incidence of food insecurity across the period from 44.1% in 2010/2011 to 53.4% in 2018/2019 representing a 21.1% increase in food insecurity incidence. Widening inequality exists even among the food insecure. Our findings revealed that 87.6% of households are transitorily food insecure, 5.5% are chronically food insecure and 7% are food secured. The significant factors driving food insecurity across the period were the area of land under cultivation, the fall in the price of outputs, and the increase in the price of major food items. Coping strategies employed were eating less preferred foods, restriction in diversity of foods eaten, limiting food portions, and minimizing the frequency of meal consumption. It is therefore important that the government encourage the adoption of yield-enhancing technologies to ensure household food security. Rising prices of major food items and fall in output price gives a cause for concern over the macroeconomic environment in the country, which fuels rising food prices. Policymakers should exercise caution when implementing exchange rate policies that may affect food and output prices, given the impact they have on the livelihood and household security of smallholders.

Impact of Farm Size and Sociodemographic Characteristics on Agricultural Households’ Food Security

Most agricultural households in Indonesia are small-scale farmers making them prone to food insecurity. Until recently, no study has assessed the impact of farm size and sociodemographic characteristics on the food insecurity status of agricultural households using a nationwide agricultural household survey in Indonesia. Our study aims to address this gap by utilizing the results of the first Indonesian Agricultural Integrated Survey conducted by BPS in 2021. Applying the Rasch Model and Multinomial Logistic Regression, we found that the farm size has a positive impact in lowering the probability of agricultural households experiencing moderate or severe levels of food insecurity. Our study also found that agricultural households with a higher probability of being food insecure are characterized by having higher members of households, relying only on agriculturalactivities for their livelihood, lower education attainment of household heads, and being led by female farmers. Our study recommends improving the farmers’ agricultural scale by focusing on the improvement of the yield. It can be done through the adoption of mechanization and digital technology. Moreover, we also recommend a social assistance programme for food security targeting agricultural households with characteristics identifiedin our findings.

Does Farm Size Matter for Food Security Among Agricultural Households? Analysis of Indonesia’s Agricultural Integrated Survey Results

Most agricultural households in Indonesia are small-scale farmers making them prone to food insecurity. Until recently, no study has assessed the impact of farm size and sociodemographic characteristics on the food insecurity status of agricultural households using a nationwide agricultural household survey in Indonesia. Our study aims to address this gap by utilizing the results of the first Indonesian Agricultural Integrated Survey conducted by BPS in 2021. Applying the Rasch Model, Multinomial Logistic Regression, and Ordinary Least Squares Regression, we found that the farm size has a positive impact in lowering the likelihood of experiencing moderate or severe levels of food insecurity among agricultural households. Our study also found that agricultural households with a higher probability of being food insecure are characterized by having higher members of households, relying only on agricultural activities for their livelihood, lower education attainment of household heads, and being led by female farmers.

Prevalence of the metabolic syndrome by household food insecurity status in the United States adolescent population, 2001–2020: a cross-sectional study

BackgroundHousehold food insecurity (FI) is a modifiable social determinant of health linked to chronic health outcomes. Little is known, however, about the prevalence of metabolic syndrome (MetS) in pediatric population-based studies by household FI status. ObjectivesThe objective of the study was to estimate the prevalence of the MetS by household FI status over the past 2 decades. MethodsThis cross-sectional study used data from the 2001–2020 National Health and Nutrition Examination Survey (NHANES). Participants were nonpregnant adolescents ages 12– 18 y in United States. The prevalence of MetS [elevated waist circumference and >2 of the following risk factors: elevated blood pressure, and fasting glucose, triglyceride, and/or low high-density lipoprotein (HDL) cholesterol concentrations] by FI status was evaluated using chi-square and logistic regression analyses. ResultsThe estimated prevalence of MetS was 2.66% [95% confidence interval (CI): 2.28%, 3.09%] in the final analytical sample (unweighted N = 12,932). A total of 3.39% (95% CI: 2.53%, 4.53%) of adolescents from FI households had MetS compared to 2.48% (95% CI: 2.11%, 2.9%) among adolescents with no household FI. Hispanic adolescents had the highest prevalence of MetS (3.73%, 95% CI: 3.05, 4.56) compared with adolescents who identified as non-Hispanic White (2.78%, 95% CI: 2.25, 3.43), non-Hispanic Black (1.58%, 95% CI: 1.19, 2.10). Adolescents with household FI (23.20%) were more likely to have MetS [odds ratio (OR): 1.38; 95% CI: 1.02, 1.88; I=0.039) compared with adolescents with no household FI, but in fully adjusted models this was not significant (OR: 1.13; 95% CI: 0.75, 1.72). ConclusionsUsing the most current NHANES data, the estimated prevalence of MetS in adolescents in United States was slightly higher among those from FI households. However, after adjusting for potential confounders, the relationship between household FI and MetS was nonsignificant, highlighting the complexity of factors contributing to MetS in this population. Hispanic adolescents share a disproportionate burden of MetS compared with their non-Hispanic counterparts.

Risk factors for household food insecurity in the Eastern Caribbean Health Outcomes Research Network cohort study.

Globally, 1.3 billion people were considered food insecure as of 2022. In the Caribbean region, the prevalence of moderate or severe food insecurity was 71.3% as of 2020, the highest of all subregions in Latin America. Experienced based measurement scales, like the Latin American and Caribbean Food Security Scale, are efficient measurement tools of food insecurity used globally. The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study is a population-based longitudinal cohort study in the two Caribbean U.S. territories of Puerto Rico and the U.S. Virgin Islands, as well as in Barbados and Trinidad & Tobago. The purpose of this research was to examine the demographic, psychosocial, behavioral, and environmental risk factors associated with household food insecurity (HFI) among adults ≥40 years of age in the ECHORN cohort. A cross-sectional analysis of baseline ECHORN cohort study data was conducted. The primary outcome was household food insecurity (none, mild, moderate/severe). A total of 16 known and potential risk factors were examined for their association with HFI. The ANOVA and chi-square statistics were used in bivariate analysis. Ordinal logistic regression was used for the multivariable and sex stratified analyses. More than one-quarter of the sample (27.3%) experienced HFI. In bivariate analyses, all risk factors examined except for sex, were significantly associated with HFI status. In the multivariable analysis, all variables except sex, education, marital status, smoking status, and residing in Puerto Rico were significant predictors of HFI in the adjusted model. In sex stratified analysis, depression, food availability, self-rated physical health, and island site were significantly associated with increased odds of worsening HFI for women, but not for men. Source of potable water was an important risk factor for both men and women. The prevalence of HFI in the ECHORN cohort study is comparable to other studies conducted in the region. While women did not have an increased risk of HFI compared to men, a different set of risk factors affected their vulnerability to HFI. More research is needed to understand how water and food security are interrelated in the ECHORN cohort.

An examination of willingness to participate and willingness to pay for a universal school food program in the Canadian context.

To examine parents'/caregivers' willingness to participate and willingness to pay (WTP) for a cost-shared school food program (SFP) and its associated factors. A quantitative survey design was used where WTP for a hypothetical SFP was elicited using a double-bounded dichotomous choice elicitation method. We used a double hurdle (logistic and truncated regression) model to examine WTP and positively or negatively associated factors. Saskatoon Public School Division elementary schools situated in high-, mid- or low-median-income neighbourhoods. Parents or caregivers of children attending grades 1 to grade 8 in the Saskatoon Public School Division elementary schools. 94 % respondents were willing to participate in a SFP while less than two-thirds of participants were willing to pay for such a program. Over 90 % respondents from all the socio-economic groups were willing to participate. Multiple household income earners, higher household income, higher number of children, household food security status and higher academic attainment of parents'/caregivers predicted greater willingness to pay. Mean willingness to pay was $4·68 (CAN), and households reporting moderate or severe food insecurity were likely to be willing to pay significantly less for a SFP. A cost-shared program might be financially sustainable in Canada if community characteristics such as household food insecurity status, economic participation of women and average household size are kept in mind while determining the price of the program.

Is household food insecurity related to mothers' stress, anxiety and depression in Iran?

Food insecurity is a public health concern with pervasive effects on numerous human biological factors. In addition to physical problems, food insecurity may have adverse social and psychological impacts. The present study aimed to determine the correlations between household food insecurity and stress, anxiety, and depression in mothers living in Mashhad, Iran. In this cross-sectional study we recruited 312 mothers. We collected data on the food insecurity status of households using the Household Food Insecurity Access Scale (HFIAS) and used the Depression Anxiety Stress Scale (DASS) to assess the levels of stress, anxiety, and depression in the subjects. The prevalence rate of food insecurity was 51.9%, and the prevalence rate of stress, anxiety, and depression was 70.2%, 70.2%, and 55.1%, respectively. In the food-insecure group, 94.3% of the mothers had stress, 91.4% had anxiety, and 87.1% had depression. While in the food-secure group, 60.7%, 61.3%, and 37.3% of the mothers had stressed, anxiety, and depression, respectively. In all the analytical models, food insecurity was significantly and positively associated with stress, anxiety, and depression (P < 0.001). Our results suggested that a higher level of food insecurity correlates with extreme degrees of stress, anxiety, and depression. Therefore, the improvement of mothers' mental health in terms of stress, anxiety, and depression depends on the improvement of household food insecurity.

Food insecurity status of rural microfinance households in Ekiti State, Nigeria

Food insecurity status of rural microfinance households in Ekiti State, Nigeria

498-P: Prevalence and Impact on Quality of Life of Diabetic Retinopathy in African Americans with End-Stage Kidney Disease on Hemodialysis

Background: The prevalence, severity, and quality of life (QoL) impact of diabetic retinopathy (DR) among African Americans (AA) with end-stage-kidney disease (ESKD) receiving dialysis are unknown. Methods: We conducted a prospective cross-sectional study in 93 AA adults with type 1 (n=9) and type 2 (n=84) diabetes with ESKD on hemodialysis. The diagnosis of DR was based on a review of medical records and/or having a positive photograph with a portable hand-held device (Optomed Aurora retinal camera) reviewed by both artificial intelligence software (AEYE Health’s retinal screening system) and a retinal specialist. Visual acuity was assessed with the Snellen Chart. Associations with QoL (ascertained using kidney disease QoL and depression questionnaires), physical disability (ascertained using visual impairment questionnaire), and social determinants of health (SDoH) including personal and household income, marital status, health insurance, education, food insecurity, or employment status assessed by standardized questionnaires. Results: The overall prevalence of DR was 75%, with 33% of patients having mild, 9.6% moderate and 57.4% severe DR. A total of 43% had normal visual acuity, 45% had moderate and 12% severe visual impairment. We found high burden of disease, multiple SDoH challenges, and low QoL among all patients, with most unemployed or disabled, living below poverty line, mainly receiving public health insurance, reporting poor general health, and substantial time spent dealing with kidney disease interfered with daily and family activities. However, the presence of DR had no significant impact on physical health and QoL compared to subjects without DR. Conclusion: DR is present in 75% of AA patients with diabetes and ESKD on hemodialysis. ESKD has a significant burden on general health and QoL; however, DR has a minor additional impact on the overall physical health and QoL in people with ESKD and diabetes. Disclosure Z.E.Zabala: None. B.Moazzami: None. M.Egeolu: None. R.L.Caleon: None. A.Y.G.Gerges: None. R.J.Galindo: Consultant; Novo Nordisk, Eli Lilly and Company, Sanofi, Pfizer Inc., Bayer Inc., WW (Weight Watchers), Research Support; Novo Nordisk, Eli Lilly and Company, Dexcom, Inc. R.G.Mccoy: Consultant; Emmi. L.Peng: None. G.Umpierrez: Research Support; Abbott, Dexcom, Inc., Baxter.

Contribution of Fruits and Vegetables to the Household Food Security Situation of Rural Households in Limpopo.

Food insecurity continues to be a burden for many South Africans. The production and consumption of fruits and vegetables have a potential role in improving household food security and are considered one of the critical pathways for reducing food insecurity and malnutrition levels in the country. This paper set out to determine the effect of fruits and vegetables on the food security status of rural households in the Limpopo province. Data (secondary) for this study were collected from 2043 respondents who were selected through stratified random selection based on the population size of the district municipalities in Limpopo. This study used a quantitative research approach, and data were analyzed using a descriptive analysis, the household food insecurity access scale (HFIAS), and a Poisson regression model with an endogenous treatment model. The findings revealed that gender and involvement in agricultural production had a positive significant relationship with the consumption of fruits and vegetables, while disability grants had a negative impact. Age, household size, and receiving a disability grant had a positive significant impact on determining the household food insecurity status; however, gender had a negative significant relationship. This study concluded that the consumption of fruits and vegetables considerably influenced the food security status of the household. There is a need for government officials and local leaders to provide food security interventions that prioritize women and elders. These may include promoting household production and consumption of diversified fruits and vegetables.

Factors Influencing Undernutrition among Female Adolescent Students in Darchula District, Nepal

Failure to understand and address the problem of malnutrition and its associated factors among female adolescents could lead to a vicious cycle of intergenerational malnutrition. A cross-sectional study was conducted in six secondary schools of four rural municipalities in Darchula District, Nepal. Data collection for the study was conducted from November 2021 to February 2022. Four hundred female adolescent students aged 15 to 19 years old were selected using quota sampling. The study aims to examine the prevalence of malnutrition by assessing different levels of body mass index (BMI) that is thinness (BMI less than 18.5 kg/m2), normal (18.5 kg/m2 to 24.9 kg/m2), overweight (25 kg/m2 to 29.9 kg/m2) and obese (BMI more than or equal to 30 kg/m2). Along with BMI, factors associated with undernutrition, here identified as thinness, are assessed using a structured questionnaire. Additionally, key informant interviews and review of interventions was performed to understand the gaps in nutrition-related policies and programs of school going adolescents in the study district. Quantitative data analysis included a prevalence study and chi-square test along with simple and multiple logistic regression to obtain crude and adjusted odds ratio at 95% confidence interval for the significant factors with p < 0.05 identified in the chi-square test. Thematic analysis and reviews were used for the synthesis of qualitative data. The results show a 24.7% prevalence of thinness in the study participants. Pre-mensuration status (OR = 5.015, CI = 1.257-20.011, p < 0.022), father having a monthly paying job (OR = 4.384, CI = 1.135-16.928, p < 0.032), father's foreign employment (OR = 6.96, CI = 1.649-29.377, p < 0.008), household (HH) food insecurity status (OR = 2.079, CI = 1.182-3.658, p < 0.011) and grain/roots/tuber as most commonly bought food (OR = 9.487, CI = 1.182-76.138, p < 0.034) were found to be significantly associated with thinness. Information from the qualitative part identified gaps in existing interventions for an improved nutritional outcome among school going adolescent females. Further studies to understand the nutritional practices and its contributory factors in relation to thinness is encouraged. Stakeholders are urged to effectively address the shortcomings in existing interventions and adopt a more adolescent-centered approach to enhance the nutritional status of female adolescents.

Household food insecurity and hunger status in Debre Berhan town, Central Ethiopia: Community-based cross-sectional study.

Food security occurs when all people have physical, social, and economic access to sufficient, safe, and nutritious food that fits their dietary needs and food preferences for an active and healthy life at all times. There is limited evidence on this topic and not well studied in Ethiopia. This study aimed to investigate food insecurity and hunger status among households (HHs) in Debre Berhan town, Ethiopia. A community-based cross-sectional study was undertaken from 1 January 2017 to 30 January 2017. A simple random sampling technique was used to enroll 395 HHs for the study. An interviewer-administered, structured, and pretested questionnaire was used to collect data through a face-to-face interview. The household food security and hunger status were assessed by using the Household Food Insecurity Access Scale and the Household Hunger Scale, respectively. Data were entered and cleaned using Epiata 3.1 and exported to SPSS software version 20 for statistical analysis. Logistic regression was fitted, and an odds ratio with a 95% confidence interval (CI) and a value of p of less than 0.05 were used to identify factors associated with food insecurity. A total of 377 HHs participated in the study with a response rate of 95.4%. The proportion of households with food insecurity was 32.4%, among which mild, moderate, and severe food insecurity accounted for 10.3, 18.8, and 3.2%, respectively. The mean score of the Household Food Insecurity Access Scale was 1.88 ± 3.5. Hunger occurred among 3.2% of households. The mean score of the Household Hunger Scale was 2.17 ± 1.03. Husband or male cohabitant's occupation (AOR = 2.68; 95% CI: 1.31-5.48) and wife or female cohabitant's literacy (AOR = 3.10; 95% CI: 1.01- 9.55) were the only factors associated with HH food insecurity. HH food insecurity and hunger in Debre Berhan town were unacceptably high, which can hamper achieving national targets for food security, nutrition, and health. Intensified efforts are further needed to accelerate the decline in food insecurity and hunger prevalence. Therefore, interventions need to target self-employed merchants in small businesses and women who are uneducated.