Food Insecurity among In-school Adolescents in Ghana: What are the Determinants?

Child-report food insecurity assessment measures: A scoping review

BACKGROUND

Experiences of household food insecurity are associated with a wide range of deleterious nutritional, developmental, psychological and social consequences for children. Children's distinct experiences of food insecurity, compared to adults, have been identified in diverse economic and cultural contexts. Yet historically, measurement of food insecurity in children has been predominantly reported by adult respondents on behalf of children, potentially underestimating prevalence and neglecting their unique perspectives. In response to this, child-report measures have been developed to assess food security status at both the individual and household level.

OBJECTIVES

To identify and characterise child self-report food insecurity assessment tools used globally, with particular interest in how children's perspectives have been included in measure development processes.

METHODS

A scoping systematic literature review was conducted using PRISMA-ScR. Searches were conducted in four databases in January 2024 using keywords and MeSH terms. Data were extracted and synthesised relating to population and measure characteristics, validity and reliability metrics, and child involvement in measure development.

RESULTS

A total of 169 papers employing child-report measures were included after screening. Most papers originated in North America, used a single-item and included children aged >12 years. Of the child-report measures identified (n = 33), most were not specifically validated in the population of use. Only a small number of included papers (n = 13) had the aim to specifically evaluate measure validity. The Child Food Insecurity Experiences Scale and Child Food Assessment Scale emerged as child-centred measures with comprehensive validity evidence.

CONCLUSIONS

Further child-centred validity testing, particularly with younger children (<12 years) is necessary to ensure validity of measures across age-groups and contexts. Ethical considerations when employing child-report measures, including how to best use tools across different child settings also warrant further exploration.

Suicidal Ideation among Adolescents: A Case of Bullying Victimization and Emotional Intelligence

This paper attempted to examine suicidal ideation among adolescents in terms of bullying victimization and emotional intelligence. It had been observed that adolescents have to face the challenge of suicidal ideation through bullying and reduce it through emotional intelligence. A sample of 1017 adolescents was sampled from public sector primary schools in the district of Gujrat, Punjab, Pakistan to conduct the cross-sectional survey. For this study, the scale of bullying victimization (Illinois Bullying Scale by Espelage & Holt, 2001), emotional intelligence (Emotional Intelligence Scale for Children & Adolescents by Batool & Hayat, 2018) and suicidal ideation (Suicidal Ideation Attribution Scale by Van Spijker, 2014) had been used to measure the responses of the students. The study findings pointed out that emotional intelligence was a significant negative predictor of suicidal ideation. Similarly, the analysis showed that bullying victimization was a significant predictor of suicidal ideation among adolescents.

Food insufficiency and its associated factors: Experiences of in-school adolescents in Sagamu Township, southwest Nigeria

Background: The burden of hunger, food insecurity and malnutrition in sub-Saharan Africa is enormous. A higher proportion of the population suffer the consequences of food insecurity, hunger and undernourishment than previously assumed. Food insecurity among adolescents has been documented to be associated with malnutrition, poor health outcomes, low educational attainment and other negative consequences. Aim: This study therefore assessed food insecurity and its associated factors among adolescents in Sagamu, Ogun State, Nigeria. Methods: A cross-sectional study was conducted among 1300 in-school adolescents in Sagamu Township, Ogun State in southwestern Nigeria, selected via multi-stage sampling. A semi-structured, self-administered questionnaire was used for data collection. Data were analyzed with the aid of SPSS 20.0. Relevant descriptive and inferential statistics were calculated, with p < 0.05. Result: The prevalence of food insecurity was 45%, of which 34.6% had mild food insecurity, 34.7% had moderate food insecurity, while others experienced the severe form of food insecurity. Gender, age; maternal occupation, maternal education, living arrangement, low sense of self-worth, alcohol intake and cigarette smoking were associated (p < 0.05) with food insecurity. Predictors of food insecurity were: age; maternal education, living arrangement and some behavioral factors. Conclusion: The prevalence of food insecurity among adolescents in Sagamu was high. Multi-sectorial action is essential in tackling the challenges of food insecurity and its numerous consequences among adolescents, at all levels of governance.

Food insecurity and its impact on substance use and suicidal behaviours among school-going adolescents in Africa: evidence from the Global School-Based Student Health Survey

The study sought to assess the prevalence and factors associated with Food Insecurity (FI) and further quantify its impact on substance use and suicidal behaviours (ideation, planning, and repeated attempted suicide) among school-going adolescents in Africa. The study involved a secondary analysis of cross-sectional data from the Global School-Based Student Health Survey (GSHS) conducted in Africa. Substance use and suicidal behaviours were the main outcomes. We employed the Double Selection Least Absolute Shrinkage and Selection Operator Poisson regression (DSLASSOPM) model to assess risk factors associated with FI and further employed Coarsened Exact Matching involving DSLASSOPM to assess the influence of FI on the study outcomes. Meta-analysis was conducted to obtain between-country heterogeneity in the prevalence of FI and the prevalence ratio of substance use and suicidal behaviours. The study involved 34,912 school-going adolescents. The pooled 30-day prevalence estimate of FI was 11.1% (95% CI  9.1-18.6), ranging from 6.7% (95% CI 5.0-8.3) in Tanzania to 18.4% (95% CI 14.4-22.4) in Benin. The most common associated factors included the experience of insomnia and the number of times injured. The pooled prevalence ratio of substance use, suicidal ideation, suicidal planning, and repeated attempted suicide among adolescents experiencing food insecurity were 1.92(95% CI 1.69-2.16), 1.56(95% CI 1.46-1.66), 1.50 (95% CI 1.41-1.58), and 1.90 (95% CI 1.73-2.07) respectively. A considerable heterogeneity between the sub-regions prevalence ratio for suicidal ideation and planning was also observed (I2 = 0, p value > 0.05). The study observed a high prevalence of food insecurity in West Africa with negligible heterogeneity between the countries. A significant positive association between FI and the study outcomes (substance use and suicidal behaviours) was observed. The study recommends country-specific social and school-based health interventions to screen risk factors associated with food insecurity for early identification. Measures to achieve Sustainable Development Goal 2 (Zero Hunger) by 2030 are key in these African countries and is likely to yield demographic dividends through improvement in mental health among school-going adolescents.

Examining mediators of associations of food insecurity and being bullied with suicide among in-school adolescents in Eswatini: a cross-sectional study

We examined the potential mediating roles of anxiety and loneliness on the association of concurrent food insecurity (FI) and being bullied (BB) with suicidal behavior (SB) in Eswatini, a lower-middle-income country. We used data from the Global School-based Student Health Survey (GSHS; N = 3264), which employed a two-stage cluster sampling: first, 25 schools were selected based on the proportionate probability of enrollment; second, classes were randomly selected. A self-reported 84-item GSHS questionnaire was used to collect data for students aged 13-17 years. FI was measured by requesting students to recall how often they went hungry because of a lack of food at home in the 30 days before the study. Multiple logistic regressions and binary mediation function was applied to examine mediating factors of SB. The prevalence of SB, FI, and BB among adolescents was 27.5%, 7.7%, and 30.2%, respectively. Moreover, the relationship between FI and BB with SB was partly (approximately 24%) mediated by anxiety and loneliness. Our results highlight the mediating roles of anxiety and loneliness in suicidal adolescents who experience FI and BB. In conclusion, interventions for alleviating SB in high-risk adolescents experiencing FI and BB should also be aimed at ameliorating anxiety and loneliness.