Food insecurity during COVID-19 pandemic: A genuine concern for people from disadvantaged community and low-income families in Province 2 of Nepal

Food insecurity and sociodemographic factors in Latin America during the COVID-19 pandemic

Objective

To understand the association of food insecurity with sociodemographic factors in a sample population in Latin America during the COVID-19 pandemic.

Methods

This was a multicenter cross-sectional study conducted in 10 countries in Latin America using an online survey through various digital platforms from October 14, 2020 to February 15, 2021. Statistical analysis of data was performed by applying descriptive statistics, chi-square test, and logistic regression analysis.

Results

Of a total of 6 357 surveys, 58.2% of respondents experienced food security, 29.3% were slightly food insecure, 9.2% were moderately food insecure, and 3.3% were severely food insecure. Concerning the association food insecurity and sociodemographic variables, there is a significant association in the variables studied, including area of residence, education level, occupation, number of persons in the household, household with children younger than 10 years of age, and socioeconomic level.

Conclusions

These findings indicate that sociodemographic factors associated with food insecurity during the COVID-19 pandemic in Latin America were rural residence; complete and incomplete basic and secondary schooling; occupation (homemaker, unemployed, and self-employed); low, medium-low, and medium socioeconomic level; household with more than four persons; and household with children younger than 10 years of age.

The socioeconomic impact of the COVID-19 lockdown on families affected by childhood respiratory illnesses in Cape Town, South Africa

The COVID-19 pandemic impacted families globally, directly and indirectly. Children presenting with respiratory illnesses are affected by emerging health systems and socioeconomic changes in the COVID-19 era. We explored the socioeconomic impacts of the COVID-19 lockdown on families with a respiratory illness diagnosed in their child in Cape Town, South Africa. This study was nested in a prospective observational cohort of children presenting with respiratory symptoms presumptive of COVID-19. We conducted 21 semi-structured interviews to explore the socioeconomic impact of the COVID-19 pandemic on families with a child affected by respiratory illnesses. We used case descriptive analysis and thematically organised common and divergent experiences. We found that socioeconomic challenges in low-income communities were exacerbated: 1) loss of pre-COVID sources of income (loss of income, employment and working hours), 2) shrinking employment opportunities due to business closures and strict preventative measures, 3) family network dependence to cope with financial pressures, 4) impact on education, implicating additional pressures due to lack of resources for adequate home schooling and 5) caregivers' mental health and wellbeing being impacted, causing stress and anxiety due to loss of income. This study shows that the COVID-19 lockdown impacted the socioeconomic aspects of families caring for a child with a respiratory illness. Care became more complicated and adversely impacted the family's emotional well-being and health-seeking behaviour. These impacts should be more carefully considered in order to strengthen health services and global health messaging in future pandemics.

A systematic review of the direct and indirect COVID-19's impact on food security and its dimensions: pre-and post-comparative analysis

BACKGROUND

Since its emergence, the COVID-19 pandemic has compromised the food security both directly by impacting food supply chain and indirectly by overwhelming the individual health and/or personal financial situation. The overarching aim of the current study is to assess aspects of the food security crisis that have arisen due to COVID-19 and to identify which, if any, food security dimensions were specifically compromised.

METHODS

Primary research articles were initially identified through four online databases (Scopus, PubMed, Google Scholar, and Web of Science), with the references of each paper then also reviewed for additional article. The food security status of individuals and the wider community, both before and after the emergence of COVID-19, were examined.

RESULTS

Of the 2,057 studies initially identified, a total of ten were included in the final review. The included studies confirmed that COVID-19 had substantially impacted food security, with individuals, households and the wider community experiencing food insecurity. Nine of the included studies aruged that the food accessibility dimension was the most compromised.

CONCLUSION

To address the identified direct and indirect food security issues associated with COVID-19, it is proposed that a combination of prevention practices and proactive food security activities is required. Integrating food security interventions, supporting and facilitating food security resilience, and conducting further studies on the food security of COVID-19 are also recommended.

Household food insecurity during the COVID-19 pandemic and associated socioeconomic demographic factors in Papua New Guinea: evidence from the Comprehensive Health and Epidemiological Surveillance System

INTRODUCTION

The COVID-19 pandemic had an unprecedented impact on global food security, but little is known about the impact on food security at the household level. We examined the prevalence and socioeconomic demographic factors for household food insecurity during the COVID-19 pandemic in Papua New Guinea.

METHODS

Household socioeconomic demographic data from the Comprehensive Health and Epidemiological Surveillance System were collected from six main provinces in 2020 (37880 participants) and compared with the 2018 data (5749 participants). The prevalence of household food insecurity was estimated and stratified by household socioeconomic demographic characteristics. Multinomial logistic regression was conducted to estimate adjusted OR (aOR) and 95% CI of risk factors.

RESULTS

The overall prevalence of household food insecurity increased from 11% in 2018 to 20% in 2020, but varied across provinces, with the highest level reported in Central Province (35%) and the lowest level in East New Britain Province (5%).Food shortages were 72% less likely among urban residents than those living in rural areas (aOR 0.28 (95% CI 0.21 to 0.36)). The risk of food insecurity was 53% higher among adults aged 25+ years with primary education (grades 3-8) than those with university education (aOR 1.53 (95% CI 1.09 to 2.13)). People from households in the poorest wealth quintiles were 80% more likely to report food shortage than those from the richest wealth quintile (aOR 1.78 (95% CI 1.29 to 2.45).

CONCLUSION

The study provides evidence to develop policy and intervention to deal with food insecurity in emergency situations in the future.

Household food security access and dietary diversity amidst COVID-19 pandemic in rural Nepal; an evidence from rapid assessment

BACKGROUND

The COVID-19 pandemic led to surging concerns about food insecurity status throughout the world. In response to global and national concerns on food and nutrition security, this study aimed to examine the prevalence and determining factors of household food insecurity and dietary diversity among people from selected rural municipalities of Lalitpur district, Nepal.

METHODS

A community-based cross-sectional study was conducted among 432 households. Pretested structured questionnaires were used to collect socio-demographic characteristics of the participants, household income; influence of COVID-19 on their income and livelihood, household's access to food and dietary diversity. Food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS) and the Household Dietary Diversity Score (HDDS). A multivariable analysis was done using binary logistic regression model following a bivariate analysis to assess the association between the dependent and independent variables.

RESULTS

More than one-third (36%) of the households reported some form of food insecurity. The overall mean score for Household Dietary Diversity Score (HDDS) was 6.0 (±1.1). Multivariable logistic regression analysis showed that participants aged 41-64 years (aOR = 0.35, 95% CI: 0.21-0.59), those over 64 years (aOR = 0.22, 95% CI: 0.07-0.66), as well as those in service occupation (aOR = 0.22, 95% CI: 0.06-0.77) were associated with lower odds of HFIAS. Conversely, Participants belonging to a disadvantaged ethnic group (aOR = 2.73, 95% CI: 1.23-6.07), having no education (aOR = 3.70, 95% CI: 1.16-11.71) or primary education (aOR = 3.67, 95% CI: 1.23-9.89), and those suffering from chronic illness (aOR = 3.12, 95% CI: 1.53-6.35) were associated with higher odds of HFIAS. As for HDDS, participants aged 41-64 years (aOR = 0.48, 95% CI: 0.28-0.83) were associated with lower odds of HDDS, while participants having no education (aOR = 10.05, 95% CI: 4.05-24.01) were associated with significantly higher odds of HDDS.

CONCLUSION

Owing to the pandemic, our study showed a substantial prevalence of food insecurity among diverse community residing in rural outskirts of Kathmandu Valley, particularly among disadvantaged ethnic group and people with lower level of education. Interventions targeting these particular groups may help in improving HFIAS and HDDS among them during emergencies.

Qualitative exploration of the impact of COVID-19 on the food environment of urban informal settlements of Dhaka, Bangladesh

OBJECTIVE

Our study explored the impact of the COVID-19 pandemic on the food environment from the perspective of the urban poor and food vendors.

DESIGN

This was a qualitative study conducted during September 2020 and February 2021.

SETTING

The study was carried out in two purposively selected informal settlements of Dhaka City, Bangladesh.

PARTICIPANTS

We conducted 21 in-depth interviews with residents of informal settlements and 10 key informant interviews with food vendors and food aid workers.

RESULT

The availability of staple foods was not disrupted during the pandemic but some perishables foods became more expensive due to supply chain disruptions and increased transportation costs. Limited market hours affected market access and mobility restrictions adversely affected local vendors. Cart vendors selling perishables incurred business losses they could ill afford. Demand for food reduced as employment disruption lead to reduced purchasing power and, therefore, reduction of quantity, quality and desirability of foods purchased. Respondents reported skipping meals and going hungry. The aid received was considered inadequate to meet needs.

CONCLUSION

The food environment of the urban poor was disrupted from both supply and demand sides and the organisational response (both government and non-government) was severely inadequate. The social safety net needs to be extended and redesigned to ensure food security and health for the urban working poor in the future.

COVID-19 and food security risk in Nkambe Cameroon: perceptions, drivers and household response measures

This study focuses on COVID-19 and food security risk, capturing perceptions, drivers and household response measures. Using a mixed research design, the researchers investigated food security risk in Nkambe Cameroon during peak periods of COVID-19. Data were collected through a structured questionnaire distributed to 400 respondents and key informant interviews, and it was analysed using both descriptive and inferential statistics. Results showed significant differences in the food security dynamics among COVID-19-infected and non-infected households (19% and 33%, respectively, p = 0.002), with non-infected households being more food secure than COVID-19-infected ones. Significant positive effects between variables, like age of respondent, household size, level of education and food security of affected households were identified. The regression model explains 82.8% of the food security determinants in the midst of COVID-19's peak period. Both COVID-19-infected and non-infected households responded to food insecurity through food rationing and consumption frequency rationing, instead of reducing food consumption frequency. The researchers recommend increasing the efficacy of safety nets and other social assistance programmes in the face of shocks by targeting households most vulnerable to COVID-19-induced food insecurity. Expanding this research agenda to other study sites with a gender lense can provide insights for food security policies post COVID-19.

Food insecurity and health outcome nexus: empirical evidence from the informal sector enterprises in Bangladesh

BACKGROUND

Food insecurity indicates the difficulty of constantly obtaining adequate food because of limited economic resources. Food insecurity challenges the desired health outcomes. Although extensive literature has examined the associations between food security and health, low-wage informal sector workers have been less frequently addressed in this topic. The present study has focused on food insecurity among the workers working in the informal sector enterprises who experienced entrenched disadvantage during COVID-19 and examines the relationship between food insecurity and health status as measured by self-reported physical and mental health conditions.

METHODS

This study has utilized cross-sectional data collected from workers working in informal manufacturing and business enterprises in Dhaka city of Bangladesh. The Food Insecurity Experience Scale (FIES) with eight items is used to screen for food insecurity, and the Short Form 12v2 (SF12v2) scale with 12 questions, and validated for use with Bengali respondents, is used to measure the health status of the informal workers. A health production function has been constructed where the health status (both physical and mental) of workers is associated with food insecurity and other socio-economic and health care factors. Empirical analyses of the study have included descriptive statistics, mean score comparisons, and multivariate regression analyses to identify the predictive factors of the physical and mental health status of the workers.

RESULTS

A moderate to severe food insecurity is found to be responsible for the poor health status (both physical and mental) of the selected working group population. Moreover, age over 40 years, having a large family, dissatisfaction with the work place, and the prevalence of occupational health risks are linked to lower physical health, while dissatisfaction with the work place and the incidence of severe diseases contribute to poor mental health status along with food insecurity.

CONCLUSIONS

Extending social and economic protection towards health coverage and basic consumption is suggested as an immediate action to save lives and ensure productivity of the informal workers. Besides, an increase in income and ensuring decent working conditions are also recommended for the health, safety and satisfaction of workers working in informal sector enterprises.

Socioeconomic and sociodemographic factors associated with food expense insufficiency during the COVID-19 pandemic in Japan

OBJECTIVE

To examine the status of food expense insufficiency in Japan during the coronavirus disease 2019 (COVID-19) pandemic and the socioeconomic and sociodemographic factors associated with food expense insufficiency.

DESIGN

Food expense insufficiency before and after the pandemic was assessed. The multivariable-adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated for the association between food expense insufficiency and socioeconomic and sociodemographic factors.

SETTING

A large-scale, cross-sectional online questionnaire survey.

PARTICIPANTS

From August to September 2020, 25,482 participants aged 15-79 years completed the questionnaire (JACSIS 2020 study; Group 1). In October 2020, 917 single parents were surveyed for oversampling purposes. There were 179 single parents in Group 1 and a total of 1096 single parents in Group 2.

RESULTS

Group 1 and Group 2 had 747 (2.9%) and 55 (5.0%) participants, respectively, who experienced food expense insufficiency for the first time after April 2020. Young age, part-time employment, being a single parent (in Group 1), and the number of people in the household (five or more in Group 1 and child/children alone in Group 2) were significantly associated with food expense insufficiency. As being a single parent was significantly associated with food expense insufficiency in Group 1 (AOR [95% CI] = 7.23 [5.40-9.68]), we further examined it in Group 2. Single parents who exhibited multiple factors (young age, part-time employment, living only with child/children) were likely to experience food expense insufficiency (15.3-15.8%).

CONCLUSIONS

Triggered by the pandemic, a small percentage of individuals experienced food expense insufficiency. We identified that factors such as young age, part-time employment, and being a single parent were significantly associated with food expense insufficiency, and discovered that a multiplicity of these factors further increased the risk. Our findings suggest an urgent need to support individuals with a potentially high risk of food expense insufficiency.

Impacts of COVID-19 pandemic on the livelihoods of rural households in the community forestry landscape in the Middle Hills of Nepal

The novel coronavirus disease (COVID-19) has severely affected all sectors of the economy, and the impacts are expected to last-long. One major impact is that migrants return to their original households in rural communities due to loss of jobs. Since rural communities are highly dependent on forest and agriculture for livelihoods, an influx of return migrants likely increases the consumption of forest products and intensifies the agriculture practices, increasing the pressure on forest resources. Based on in-person interview of 215 in 2018 before the pandemic and a phone interview of the same 215 rural households in 2021 at the peak of the pandemic in Kavrepalanchowk district in Nepal, this study addresses the following research questions: (1) Does COVID-19 exert differential impacts among the socio-economic groups? (2) How do return migrants affect the rural land use? (3) Do return migrants put additional pressure on forests resources? The rare before-and-after dataset provide a precious opportunity to assess the COVID-19 impacts on the livelihoods of rural households in the community forestry landscape in the Middle Hills of Nepal. We found that the impacts of COVID-19 were severe on the households with larger family size, those belonging to the marginalized caste groups, having lower number of livestock, low wellbeing index, those who rely on daily wage-based occupation, with low level of education, and the households with return migrants. A significant number of migrants were found to return to their village of origin. As a result, there was a decrease in abandoned land and an increase in the livestock number and forest product use. These findings provide timely insights for the post-pandemic recovery efforts in better targeting needy household with limited resource in the community forestry landscape in the Middle Hills of Nepal.

The Global Burden of Food Insecurity Due to COVID-19

The insurgence of the COVID-19 pandemic has demonstrated that no country or region was prepared to face such a devastating emergency, nor have researchers uncovered permanent solutions to solve this everlasting crisis thus far [...]

Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006-2016)

Anemia among under-five children is the major health problem in Nepal. The lack of nutritional supplementation and lack of healthcare facilities are influential factors of anemia. Thus, the main objective of this study is to explore spatial variations and determinants of anemia among under-five children in Nepal. Nepal Demographic and Health Survey (NDHS) data from 2006 to 2016 were used in this study, which includes: household and individual-level data of 8555 under-five children, whose anemia was measured. In addition, a total of 260 (2006), 281 (2011), and 383 DHS clusters (2016) were taken in consideration for spatial analysis. The overall prevalence of anemia was 48.9%, 46.4%, and 52.2% in 2006, 2011, and 2016 respectively. The spatial analysis revealed a nonrandom spatial distribution, where statistically significant hotspots and coldspots were detected in different parts of the country. The results also identified mother’s age, mother’s educational level, socioeconomic status of household, number of under-5 children, household size, birth weight, underweight, stunting, diarrhea, and fever as associated factors of anemia among under-5 children. These findings may provide assistance to concerned health officials in adopting anemia-related programs and policies to address the anemia problems that plague Nepalese children under the age of five.

Subjective socioeconomic disadvantage is indirectly associated with food portion selection through perceived disruption of personal resources during a nationwide COVID-19 stay-at-home order

In addition to its public health implications, the global COVID-19 pandemic has also produced significant disruptions to individuals' socioeconomic resources and opportunities. Prior research has suggested that low subjective socioeconomic status (SSES) may stimulate appetite and motivate increased energy intake. Here, we tested whether individuals experiencing lower levels of SSES (SSES disadvantage) during a nationwide stay-at-home order for COVID-19 exhibited preferences for larger food portion sizes through perceived disruptions to personal financial and material resources. Data was collected near the conclusion of a nationwide partial lockdown (Singapore's “Circuit-Breaker” from April to June 2020). Participants (N = 295) completed an online survey involving a measure of SSES, the Coronavirus Impacts Questionnaire, and a food portion selection task where participants estimated the portion size they prefer to consume for a range of common foods. SSES disadvantage was associated with selection of smaller average portion sizes. Yet, a significant indirect effect of coronavirus impact was observed in this relationship, such that participants experiencing greater SSES disadvantage selected larger portion sizes through the effect of greater perceived impacts of COVID-19 to one's financial/material resources (controlling for one's actual level of income). These findings further support the idea that perceived deprivation and insecurity of important resources (financial, social, material) may influence intentions to consume greater amounts of energy. Consequently, systematic societal disruptions to such resources may reinforce and perpetuate potentially obesogenic eating behaviors of populations that are especially vulnerable to such shocks (i.e., people experiencing SSES disadvantage).

Role of cash transfers in mitigating food insecurity in India during the COVID-19 pandemic: a longitudinal study in the Bihar state

OBJECTIVE

There are scant empirical data on the impacts of the COVID-19 pandemic on food security across the globe. India is no exception, with insights into the impacts of lockdown on food insecurity now emerging. We contribute to the empirical evidence on the prevalence of food insecurity in Bihar state before and after lockdown, and whether the government's policy of cash transfer moderated negative effects of food insecurity or not.

DESIGN

This was a longitudinal study.

SETTINGS

The study was conducted in Gaya and Nalanda district of Bihar state in India from December 2019 to September 2020.

PARTICIPANTS

A total of 1797 households were surveyed in survey 1, and about 52% (n=939) were followed up in survey 2. Valid data for 859 households were considered for the analysis.

MAIN OUTCOME MEASURES

Using the Food Insecurity Experience Scale, we found that household conditions were compared before and after lockdown. The effect of cash transfers was examined in a quasi-experimental method using a longitudinal study design. Logistic regression and propensity score adjusted analyses were used to identify factors associated with food insecurity.

RESULTS

Household food insecurity worsened considerably during lockdown, rising from 20% (95% CI 17.4 to 22.8) to 47% (95% CI 43.8 to 50.4) at the sample mean. Households experiencing negative income shocks were more likely to have been food insecure before the lockdown (adjusted OR 6.4, 95% CI 4.9 to 8.3). However, households that received cash transfers had lower odds of being food insecure once the lockdown was lifted (adjusted OR 0.75, 95% CI 0.56 to 0.99).

CONCLUSION

These findings provide evidence on how the swift economic response to the pandemic crises using targeted income transfers was relatively successful in mitigating potentially deep impacts of food insecurity.

Loss of Livelihood, Wages, and Employment During the COVID-19 Pandemic in Selected Districts of Chhattisgarh in India, and Its Impact on Food Insecurity and Hunger

The COVID-19 pandemic has exacerbated the existing food insecurity in developing nations. The cumulative effect of restricted mobility to curtail the spread of the infection, loss of livelihood and income, worst affected the economically weaker sections. Our work examined the availability, accessibility, and affordability of food during the first wave of the pandemic using the FAO, HFIAS questionnaire, in a random sample (N = 401) from Kanker and Narayanpur districts in Chattisgarh, an Empowered Action Group state, in India. Total food security scores were derived by summing the individual scores. Percentages above and below the median scores were used to assess food insecurity. Proportion Z test was used to compare settings and a generalized linear model was used to determine the association between dependent and independent variables. Of the 63% non-tribal population, a greater percent experienced income loss (13.4%) and worried about not having sufficient food (40%). A significantly higher proportion from the non-tribal regions reported food scarcity in the household (34%) and experienced hunger (15%). Non-tribal participants (77%) scored ≤ median (score 8) demonstrating high food insecurity. The odds of poor food access increased in the non-tribal settings (B: 0.024, 95% CI: 0.011–0.051, P < 0.001), income between Rs. 10,000–29,000/- per month (B: 0.385, 95% CI: 0.146–1.014, P < 0.05) and among those experiencing total or partial income loss (B: 0.505, 95% CI: 0.252–1.011, P < 0.05). Urban residence increased the odds of poor food availability (B: 15.933, 95% CI: 3.473–73.096, P < 0.001). Being male (B: 0.450, 95% CI: 0.208–0.972, P < 0.05), and not experiencing income loss (B: 0.367, 95% CI: 0.139–0.969, P < 0.05) decreased the odds of poor availability and affordability (B: 0.153, 95% CI: 0.067–0.349, P < 0.001). Non-tribal setting increased the odds of poor affordability (B: 11.512, 95% CI: 5.577–23.765, P < 0.001) and hunger (B: 19.532, 95% CI: 7.705–49.515, P < 0.001). Being male (B: 0.445, 95% CI: 0.277–0.715, P < 0.05) and higher age (B: 0.936, 95% CI: 0.936–0.906, P < 0.001) decreased the odds of food insecurity as per the total food security score. While India is likely to experience multiple waves, actions urgent and targeted toward the needs of the vulnerable sections be prioritized to endure and overcome the impact of the pandemic.

Can Informal Savings Groups Promote Food Security and Social, Economic and Health Transformations, Especially among Women in Urban Sub-Saharan Africa: A Narrative Systematic Review

This narrative review aimed to identify if roles of common informal savings groups known as Accumulating Savings and Credit Associations (ASCAs) or Rotating Savings and Credit Associations (ROSCAs) can play a significant role in mitigating food insecurity, socioeconomic inequality, promoting health, and/or increasing agency in women in urban sub-Saharan Africa (SSA). These organizations exist in most low- and middle-income countries (LMICs) worldwide under various names. A comprehensive search of scholarly outputs across six electronic databases (Pub-Med, Google Scholar, EBSCOhost, Scopus, Sabinet, and Cochrane) from 2000 to 2021 was completed. Twenty-eight (28) records met our inclusion criteria, and their quality was appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. We identified through thematic analysis that ROSCAs/ASCAs play a crucial role in advancing social, economic, and health transformations, especially among women in urban SSA. However, while ROSCAs/ACSAs played important roles in food security, it was often not the primary motivation for participation. None of the selected studies identified the importance of dietary quality or access to healthy food in relation to food security. This review suggests a window of opportunity to promote partnerships and collaborations of ROSCAs/ASCAs with relevant stakeholders to leverage the functionalities of ROSCAs/ASCAs as vehicles for re-alignment of priorities, increased knowledge, and opportunities to encourage affordable healthy diets in urban SSA.

Impacts of the COVID-19 pandemic on food prices: Evidence from storable and perishable commodities in India

The supply chain disruptions caused by the COVID-19 outbreak have led to changes in food prices globally. The impact of COVID-19 on the price of essential and perishable food items in developing and emerging economies has been lacking. Using a recent phone survey by the World Bank, this study examines the impact of the COVID-19 pandemic on the prices of the three essential food items in India. The results indicate that price of basic food items such as atta (wheat flour) and rice increased significantly during the pandemic compared to the pre-pandemic period. In contrast, during the same period, the price of onions declined significantly. The findings may suggest panic-buying, hoarding, and storability of food items. The results further reveal that remittance income and cash transfers from the government negatively affected commodity prices. Thus, this study's findings suggest that families may have shifted the demand away from essential foods during the pandemic.

Social inequalities and their impact on children's health: a current and global perspective

OBJECTIVE

To describe the consequences of social inequalities on children's health as a global and persistent problem, demonstrating its historical and structural roots in different societies.

DATA SOURCES

Relevant articles in the PubMed/MEDLINE database, in addition to those found in a manual search and in the bibliographic references of selected studies and consultation to the websites of international organizations to obtain relevant data and documents.

DATA SYNTHESIS

To understand how inequities affect health, it is necessary to know the unequal distribution of their social determinants among population groups. In the case of children, the parental pathway of determinants is central. The non-equitable way in which many families or social groups live, determined by social and economic inequalities, produces unequal health outcomes, particularly for children. This is observed between and within countries. Children from the most vulnerable population groups consistently have worse health conditions. Interventions aimed at children's health must go beyond care and act in an integrated manner on poverty and on social and economic inequalities, aiming to end systematic and unfair differences.

CONCLUSIONS

Despite the considerable advances observed in children's health in recent decades at a global level, the inequalities measured by different indicators show that they persist. This scenario deserves attention from researchers and decision-makers, especially in the context of the global health crisis caused by the COVID-19 pandemic, which has further intensified the situation of vulnerability and social inequalities in health around the world.

Effects of COVID-19 Pandemic on Nutritional Status, Feeding Practices, and Access to Food Among Infants and Children in Lower and Middle-Income Countries: a Narrative Review

Purpose of Review

The COVID-19 pandemic has affected children across the planet and the consequences on their health, nutritional status, and social structure have been more pronounced in low- and middle-income countries (LMICs). This review will focus on the effects of the COVID-19 pandemic on infant growth and feeding practices and access to food and obesity prevalence among children in LMICs. An electronic search was performed on MEDLINE and Embase to identify relevant articles in the English language.

Recent Findings

A higher prevalence of infections by the SARS-CoV-2 virus and a lower mortality rate were found in children in LMICs compared to western countries. In 2020, 22% and 52% of the wasting and deaths in children under 5 years of age in LMICS came from the sub-Saharan Africa region, respectively. Despite the decrease in stunting from 40% in 1990 to 24.2% in 2019, the prevalence remains above 30% in LMICs. Regarding breastfeeding practices in LMICs, many organizations recommend breastfeeding for infants and children born to infected mothers with SARS-CoV-2. This pandemic has resulted in higher food insecurity and disruption to access to health care and nutrition-related programs from schools; this situation has been more detrimental for younger children from LMICs.

Summary

Given the devastating effects of the COVID-19 pandemic on the nutritional status, higher food insecurity, and lack of access to health care for infants and children in LMICs, efforts from government, world organizations, and non-for-profit institutions should be implemented to ameliorate the effects of this pandemic.