Household food insecurity and coping strategies in a poor rural community in Malaysia

Experiences of Food Insecurity Among Pregnant Adolescents and Adolescent Mothers in Ghana: A Photovoice Method

Objectives: Food insecurity (FI) remains a major public health problem globally. However, there is limited information about adolescents' experiences. The current study explored FI experiences of pregnant adolescents and adolescent mothers in Cape Coast, Ghana using a Photovoice method. Methods: This study recruited 34 pregnant adolescents and adolescent mothers from communities in Cape Coast, Ghana. Each participated in a training session then was provided prompts to take photos that portrayed food access barriers, facilitators and coping strategies. In a debrief session, each participant selected two pictures they took and explained the image, followed by a group discussion of the selected photos. Debrief sessions were audio recorded and transcribed verbatim to develop themes using a theory-driven approach. Results: Most participants reported several or many experiences with FI (64.7%) in the previous month. Participants discussed money, unwanted pregnancy, and unstable work as barriers to obtaining food and working, selling goods, and family support as facilitators to obtaining food. Coping strategies mentioned include providing services to others, borrowing food and goods, meal stretching, pawning personal items and trading. Conclusion: The FI experience of this population is complex; interventions, including trade training or school retention, should be multifaceted.

Understanding the association between unmet dental care needs and household food security status among older people in Ghana

The literature recognizes food insecurity as a barrier to access to health care services. However, we know very little about the association between food insecurity and unmet dental care needs among older people in Ghana. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether older people who experienced household food insecurity differently report unmet dental care needs in comparison to their counterparts without any food insecurity. We find that 40% of older adults reported unmet dental care needs. Results from logistic regression analysis show that older people who experienced severe household food insecurity were more likely to report unmet dental care needs, compared to those who did not experience any type of food insecurity, even after accounting for theoretically relevant variables (OR = 1.94, p < 0.05). Based on these findings, we discuss several implications for policymakers and directions for future research.

Intrahousehold Food Intake Inequality by Family Roles and Age Groups

Food intake inequality at the individual level is rarely analyzed in intrahousehold settings. We examine dietary diversity scores of household members with a focus on their family roles (fathers, mothers, sons, daughters and grandparents) and age groups (children, adults and elderly). Whereas theory suggests that members in a household should have equal dietary diversity by receiving a certain share of available foods, this research hypothesizes that they do not do so by their roles and/or age groups. We conduct questionnaire surveys, collecting sociodemographic information and dietary data by using a 24 h recall method of 3248 subjects in 811 households from 1 urban and 2 rural areas in Bangladesh. The statistical analysis demonstrates three findings. First, poor and rural people have lower dietary diversity than nonpoor and urban people, respectively. Second, grandparents (children) have lower dietary diversity than do fathers (adults), confirming the existence of intrahousehold food intake inequality by the roles and/or age groups, irrespective of poverty level and areas of residence. Third, father and mother educations are crucial determinants that raise the dietary diversity of household members; however, they do not resolve the inequality. Overall, it is suggested that awareness programs of dietary diversity shall be necessary with a target group of fathers and mothers for the betterment of intrahousehold inequality and health at the household level, contributing to sustainable development goals.

Coping Strategies to Mitigate Food Insecurity at Household Level: Evidence From Urban Setting in Addis Ababa, Ethiopia

Food insecurity is the limited or uncertain ability of households to acquire nutritionally adequate and safe foods in socially acceptable ways. There is paucity of empirical evidence on household food insecurity, level of expenditure, and coping strategies in urban setting of Ethiopia. The objective of this paper is to examine the coping strategies of food insecure households in an urban area setting of Addis Ababa, Ethiopia. This study is based on data collected from 632 mothers interviewed in 2017. Multi-stage sampling techniques were carried out to identify the study unit from selected sub-cites. From each sub-city, proportion to population sampling was applied to obtain the sample size. Simple random sampling method was used to select districts in each sub-city. Multivariable logistic regression model was used to identify factors associated with food security status. The most common coping strategies households used in response to food insecurity were: rely on less preferred and less expensive foods, borrow food, or borrow money to buy food and purchase of food on credit. Food insecure households were 3 times more likely to rely on help from a relative or friend outside the household [AOR = 2.37; 95% CI: (1.01, 5.53); P < .047] compared to food secure households. Similarly, food insecure households were approximately 4 times more likely to limit portions at mealtimes [AOR = 3.55; 95% CI: (1.36, 9.30); P < .010] compared to food secure households. Furthermore, households with no access to a bank or microfinance savings account were 3 times [AOR = 2.62; 95%: (1.21, 5.66); P < .014] more likely to become food insecure compared to those with access to financial services. Households rely on less preferred cheap foods or lending to cope with food insecurity in urban settings of Ethiopia. Encouraging households to practice urban gardening, social protection through integrated national safety net programs, and improving access to microfinance services would be vital to address food insecurity among urban households of the country to bring successful social and economic development.

Development and Validation of a Direct Food Insecurity Measurement Instrument: A Study Protocol (Preprint).. [DOI: 10.2196/preprints.40945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

The Sustainable Development Goals (SDGs) aim to achieve sustainable food security with a focus on eradicating hunger and poverty. Although some progress has been made, conflicts and food insecurity issues are still inevitable worldwide. In Malaysia, food insecurity is still evident in 2021 as food-insecure groups were present in the surveyed population. The problem leads to negative impacts on the health and development of individuals. To tackle this problem, an appropriate measurement tool is needed to assess the experience of food insecurity among Malaysians. A valid, reliable and culturally specific food insecurity measurement tool is needed for further planning and implementation.

OBJECTIVE

Our objective is to develop a direct food insecurity measurement instrument that will assist practitioners in assessing food security status in communities.

METHODS

This paper describes a mixed-methods sequential study to develop and validate a direct food insecurity measurement tool that is culturally specific for use in Malaysia. It begins with a qualitative study to understand the experience of food insecurity among food bank beneficiaries through interpretive phenomenological analysis (IPA). Validation procedures will then be conducted to validate the instrument under study, assessing content validity, construct validity and reliability. Finally, a pilot study will be conducted to evaluate the instrument in order to increase the credibility of this measurement tool in directly assessing the experience of food insecurity.

RESULTS

In-depth interviews for qualitative data will be carried out after ethics approval and expected to be completed by 2022 November 30. For validation procedures, it is estimated to be completed by 2023 June 31.

CONCLUSIONS

This study will enable the development and validation of a direct food insecurity measurement tool to be used nationwide in Malaysia, and will go part of the way in assessing the relationship between the determinants and consequences of food insecurity status.

Factors Associated with Food Insecurity among Pregnant Women and Caregivers of Children Aged 0-6 Years: A Scoping Review

With a global focus on improving maternal and child nutrition through the 2030 Sustainable Development Goals, it is important to understand food insecurity in pregnant women and families with young children, as food insecurity at these life stages can have ongoing negative health consequences. However, factors that influence food insecurity among this population group are not well understood. This scoping review investigates the factors that influence food insecurity among pregnant women and households with young children aged 0–6 years living in high-income countries. A scoping literature review was conducted using four electronic databases. The search combined terms relevant to: food security, determinants, pregnancy and family and high-income countries. Only full text and English language articles were included. The search identified 657 titles and abstracts; 29 articles were included in the review. A majority (70%) of the studies were conducted in the United States and were mostly either cross-sectional or secondary data analysis of existing population data. Factors associated with food insecurity were identified and grouped into 13 constructs. These included social, economic and health risk factors, food access and utilization factors and health and dietary outcomes. This scoping review identifies the factors associated with food insecurity among pregnant women and families with young children that could be used to better measure and understand food insecurity, which could assist in developing program and policy responses. This review also highlights the lack of literature from high-income countries outside the US.

The Evolution of Food Security: Where Are We Now, Where Should We Go Next?

Food security is one of the most challenging topics globally; however, the concept of food security has taken on additional dimensions that are general and are less detailed. This study aims to identify the intellectual structure of food security research and the changes in this structure. This paper analyzed 3169 documents from the Web of Science database through a bibliometric review. A review of the published documents shows an increasing trend over the past 46 years. In accordance with co-occurrence analysis, 125 keywords were grouped into five clusters: food security and sustainable development; food security and socioeconomic factors; food security policy and governance; coping strategies for poverty, inequality, and hunger; and modern food security management. This study identifies four streams within food security research: sustainability and environmental, socioeconomic, cultural, and political factors. The paper concludes that even though food security might investigate many significant areas, other new dimensions should still be considered. Further gaps in the literature emerge that present avenues for future research directions. Reviewing indicators and techniques of food security assessment and identifying high-risk groups should be a priority.

Prevalence of food insecurity and related factors among slum households in Kerman, south of Iran

INTRODUCTION

Household food insecurity (FI) is defined as limited or uncertain access to nutritionally adequate and safe food or limited ability to obtain foods in socially acceptable ways has become a global issue in recent decades.

METHODS

This cross-sectional study was conducted in Kerman, southeast of Iran in 2019, covering 559 marginalised households. United States Department of Agriculture food security measure was used for data collection. Finally, data were analysed using t-test, χ ² , Mann-Whitney tests and logistic regression.

RESULTS

The prevalence of FI was 82% among slums households. The most important experience of FI in households was reliance on low-cost foods. There was a significant relationship between slums FI and gender of head of household, household size, household income, household education level and marital status (p ˂ 0.05). According to the results of the multivariate regression the variables of education, household income level and household size significantly determined FI (p ˂ 0.05).

CONCLUSION

The most important determinant of FI was low socioeconomic status (income, education, household size). Hence, public policies targeting socioeconomic factors should be made to improve the socioeconomic status of slum dwellers.

A Food Insecurity Systematic Review: Experience from Malaysia

Living free from hunger is a basic human right. However, some communities still experience household food insecurity. This systematic literature review explored different aspects of household food insecurity in Malaysia including vulnerable groups, prevalence, risk factors, coping strategies, and the consequences of food insecurity. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Thirty-three relevant articles were selected from scientific databases such as CINAHL, Pubmed and Google Scholar, scrutiny of reference lists, and personal communication with experts in the field. The prevalence of household food insecurity in Malaysia was unexpectedly reported as high, with affected groups including Orang Asli, low-income household/welfare-recipient households, university students, and the elderly. Demographic risk factors and socioeconomic characteristics included larger household, living in poverty, and low education. Coping strategies were practices to increase the accessibility of food in their households. Consequences of household food insecurity included psychological, dietary (macro- and micronutrient intakes), nutritional status, and health impacts. In conclusion, this review confirmed that household food insecurity in Malaysia continues to exist. Nevertheless, extensive and active investigations are encouraged to obtain a more holistic and comprehensive picture pertaining to household food security in Malaysia.

Is food insecurity a problem among the elderly in Sharpeville, South Africa?

The objective of this study was to determine the prevalence of food and nutrition insecurity and assess the socio-demographic factors associated with food and nutrition insecurity among 146 free-living elderly persons attending a care centre in Sharpeville, South Africa. Measurement instruments included socio-demographic-, 24-hour-recall and dietary diversity questionnaires and the validated household food insecurity access scale/score (HFIAS). Data were analysed with IBM SPSS Software, version 25.0. The prevalence of food insecurity from HFIAS was 60% (n = 87), with a variety of balanced responses being employed. Significant relationships were observed between HFIAS and age (r = 0.301; p = 0.000) and with household income (r = −0.258; p = 0.007). An association was observed between HFIAS and marital status (p = 0.005). Regression analysis showed that age and being single were predictors of food and nutrition insecurity. This study indicated a problem of household food insecurity with poor dietary intakes among these elderly people, mostly due to poverty and being single. More research on associations between food security and socio-economic variables is needed to plan and implement appropriate strategies to address food and nutrition insecurity in South Africa.

Acute food insecurity and short-term coping strategies of urban and rural households of Bangladesh during the lockdown period of COVID-19 pandemic of 2020: report of a cross-sectional survey

INTRODUCTION

We conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.

SETTING

Selected urban and rural areas of Bangladesh.

PARTICIPANTS

106 urban and 106 rural households.

OUTCOME VARIABLES AND METHOD

Household food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.

RESULTS

We found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).

CONCLUSION

Both urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.

Presence of Older Adolescents in the Household is Associated with Depressive Symptoms Among Women Living with HIV in Kenya

The objective of this study was to determine the association between the number of adolescents in a household and depressive symptoms among adult caregivers living with HIV. We examined cross-sectional baseline data among adults enrolled in the Shamba Maisha multisectoral agricultural intervention (n = 705) in the Nyanza region of Kenya (NCT02815579). Each additional adolescent 15-19 years in a household was associated with a 1.35 (95% CI 1.06-1.71) higher odds of depressive symptoms among women, but not men, adjusting for potential confounders. Interventions to support the mental health of adults living with HIV may target women caring for dependent adolescents 15-19 years.

Dietary Diversity and Food Coping Strategies in Zimbabwe: Do Resilience and Food Insecurity Status Matter?

This study assessed how dietary diversity and food coping strategies differ by resilience and food insecurity status. Proportionate sampling technique was used to interview 3440 households in 18 districts of Zimbabwe. Results show that resilient and food secure households had good diet diversification and were less likely to adopt food coping strategies when compared to less resilient and food insecure ones. Adaptive and absorptive resilience capacities and income reduced the use of food coping strategies. Interventions that improve household resilience capacities and income should be promoted to reduce the use of food coping strategies.

Food insecurity is associated with compromised dietary intake and quality among Lebanese mothers: findings from a national cross-sectional study

OBJECTIVE

Examine the associations between household food insecurity (HFI) with sociodemographic, anthropometric and dietary intakes of mothers.

DESIGN

Cross-sectional survey (2014-2015). In addition to a sociodemographic questionnaire, data collection included the validated Arabic version of the Household Food Insecurity Access Scale, which was used to evaluate HFI. Dietary intake was assessed using 24-h dietary recall of a single habitual day, and maternal BMI was calculated based on weight and height measurements. Associations between HFI and maternal dietary intake (food groups, energy and macronutrients' intake) were examined. Simple and multiple logistic regression analyses were conducted to explore the associations between HFI status with odds of maternal overweight and measures of diet quality and diversity (Healthy Eating Index (HEI) and Minimum Dietary Diversity for Women of Reproductive Age (MDD-W)).

SETTING

Lebanon.

PARTICIPANTS

Mothers, nationally representative sample of Lebanese households with children (n 1204).

RESULTS

HFI was experienced among almost half of the study sample. Correlates of HFI were low educational attainment, unemployment and crowding. Significant inverse associations were observed between HFI and dietary HEI (OR 0·64, 95 % CI 0·46, 0·90, P = 0·011) and MDD-W (OR 0·6, 95 % CI 0·42, 0·85, P = 0·004), even after adjusting for socioeconomic correlates. No significant association was observed between HFI and odds of maternal overweight status.

CONCLUSIONS

HFI was associated with compromised maternal dietary quality and diversity. Findings highlight the need for social welfare programmes and public health interventions to alleviate HFI and promote overall health and wellbeing of mothers.

Dietary intake of Aboriginal Australian children aged 6-36 months in a remote community: a cross-sectional study

BACKGROUND

Scarce literature comprehensively captures the transition to solid foods for children in remote Aboriginal Australian communities, a population expected to be especially vulnerable to nutritional inadequacy for largely socio-economic reasons. This study describes the dietary intake of children aged 6-36 months in a remote Aboriginal community during the years of solids introduction and establishment. Specifically, we aimed to explore milk feeding practices, major sources of nutrition and traditional food consumption, dietary patterns and nutrient and food group intakes, and compare these to national and international recommendations.

METHODS

This dietary assessment was conducted as part of an observational, cross-sectional Child Health and Nutrition study. Three 24-h dietary recalls were completed with the parent/care-giver of each participant over 2-4 weeks, capturing a pay-week, non-pay-week and weekend day from October 2017-February 2018. Additional information collected included sociodemographic data, food security status, usual cooking practices, and attendance at playgroup.

RESULTS

Diet histories for 40 children were included in the analysis (~ 40% of the population). Breast feeding rates were high (85%), with mothers exclusively feeding on demand. Very few participants met recommended intakes for wholegrains (n = 4, 10%), vegetables (n = 7, 18%), dairy (n = 5, 18%) and fruit (n = 13, 33%), while more children met the guidelines for meat (n = 19, 48%) and discretionary food intake (n = 28, 70%). Traditional foods were always nutritionally dense and consumed frequently (n = 22, 55% of children). Statistically significant pay-cycle differences in intakes of all macro-, and numerous micro-nutrients were observed.

CONCLUSIONS

Many positive early feeding practices are currently enacted in remote Aboriginal communities including responsive and long duration breastfeeding, and nutrient-dense traditional food consumption from earliest solids introduction. However, the non-pay-week/pay-week cycle is impacting the quality and quantity of children's diets at a time of rapid growth and development.

Determinants of Food Insecurity in Rural Households: The Case of the Paute River Basin of Azuay Province, Ecuador

Eliminating food insecurity is one of humanity’s greatest global challenges. Thus, the purpose of this research was to analyze the factors that determine food insecurity in households in the rural area of the Paute River Basin, Azuay Province, Ecuador. Stratified sampling was used as the sampling method, with proportional affixation. Moreover, we employed the Latin American and Caribbean Household Food Security Measurement Scale (ELCSA). We estimated the main determinants of household food insecurity using two binomial logit models and one ordered logit model. For the analysis of the data, the respective statistical and econometric tests were employed. The results show that housing size and access to food security information are the most important determinants of food insecurity in the three predictive models applied in this research. This research contributes to the existing literature on food insecurity and provides important information for policymakers, especially regarding food insecurity in rural areas, which has profound economic and social implications.

Pengembangan Indeks Ketahanan Pangan Rumah Tangga dan Kaitannya dengan Tingkat Kecukupan Zat Gizi dan Status Gizi Anak Balita

 Background: Household food insecurity is a underlaying causes on undernutrition problems in children under five years. Household food security especially from food acces dimention is reflected from many indicators that are complex and easier to understand in a composite index. Objectives: The purpose of this study was to develop a index of household food security and its relationship to nutrient intake level and nutritional status in children under five years. Method: This cross-sectional study was conducted in four villages in West Bangka Regency in December 2018 until April 2019. The study involved 219 subjects consisting of mothers and children aged 12-59 months. Data were analyzed using Rank Spearman relationship test. Results: The validation results showed that the index score has a negatively correlation (p<0.01) with the proportion of food expenditure and it has a significant correlation with dietary diversity (HDDS Score). In addition, the index score was a significant correlation (p<0.01) with the level of adequacy of energy, protein, fat, calcium, iron, zinc and dietary diversity in children. The index score was a significant associated (p<0.01) with the nutritional status of children based on height for age, weight gor age, and height for wight. Conclusions: The index was developed from this study can be an alternative to evaluate the status of household food security level and stronger marker of food consumption and nutritional status of under five children.ABSTRAKLatar Belakang: Kondisi rawan pangan pada rumah tangga merupakan salah satu penyebab masalah kekurangan gizi pada anak berusia di bawah lima tahun. Ketahanan pangan rumah tangga tercermin dari banyak indikator yang kompleks dan lebih mudah dipahami dalam indeks komposit.Tujuan: Penelitian ini bertujuan mengembangkan indeks ketahanan pangan rumah tangga serta hubungannya dengan tingkat asupan gizi dan status gizi pada anak balita.Metode: Penelitian cross-sectional ini dilakukan di empat desa di Kabupaten Bangka Barat. Penelitian ini melibatkan 219 subjek yang terdiri dari anak berusia 12-59 bulan dan ibu dari anak. Data dianalis menggunakan uji beda Kruskal Wallis dan uji hubungan Rank Spearman.Hasil: Hasil validasi menunjukkan bahwa skor indeks memiliki perbedaan yang nyata (p<0,05) berdasarkan tingkat kerentanan pangan wilayah dan terdapat hubungan negatif yang kuat (p<0,05) dengan proporsi pengeluaran pangan. Selain itu, skor indeks memiliki keterkaitan yang kuat (p<0,05) dengan tingkat kecukupan energi, protein, lemak, kalsium, besi, seng serta keragaman diet pada balita. Skor indeks juga memiliki hubungan yang nyata (p<0,05) dengan nilai z-score status gizi balita berdasarkan indeks antropometri tinggi badan menurut usia, berat badan menurut umur, dan tinggi badan menurut berat badan.Kesimpulan: Indeks yang dikembangkan dari penelitian ini dapat menjadi alternatif dalam menilai status ketahanan pangan rumah tangga serta prediktor yang kuat dalam melihat gambaran konsumsi pangan dan status gizi balita. 

Assessment of Food Safety Knowledge and Behaviors of Cancer Patients Receiving Treatment

Cancer patients receiving treatment are at a higher risk for the acquisition of foodborne illness than the general population. Despite this, few studies have assessed the food safety behaviors, attitudes, risk perceptions, and food acquisition behaviors of this population. Further, no studies have, yet, quantified the food safety knowledge of these patients. This study aims to fill these gaps in the literature by administering a thorough questionnaire to cancer patients seeking treatment in three hospitals in a Midwest, metropolitan area. Demographic, treatment, food security, and food safety knowledge, behaviors, attitudes, risk perceptions, and acquisition information was assessed for 288 patients. Specific unsafe attitudes, behaviors, and acquisition practices were identified. Most notable is that 49.4% (n = 139) of participants were not aware that they were at increased risk of foodborne infection, due to their disease and treatment. Additionally, though patients exhibited a general understanding of food safety, the participant average for correctly answering the food safety questions was 74.77% ± 12.24%. The section concerning food storage showed lowest participant knowledge, with an average score of 69.53% ± 17.47%. Finally, patients reporting low food security also reported a higher incidence of unsafe food acquisition practices (P < 0.05). These findings will help healthcare providers to better educate patients in the food safety practices necessary to decrease risk of foodborne infection, and to provide targeted food safety education to low-food-security patients.

Household food insecurity but not dietary diversity is associated with children's mean micronutrient density adequacy in rural communities across Ghana

OBJECTIVE

The aim of this study was to examine predictors of household food insecurity, dietary diversity, and children's mean micronutrient density adequacy and the relationship among these dietary measures.

METHOD

Baseline analysis of a quasi-experimental 16-mo intervention study conducted in 12 rural communities in the three main agroecological zones in Ghana. The study included 608 caregivers with their 2- to 5-y-old children. Nutrient density adequacy was estimated for a subsample of 120 children.

RESULTS

Food insecurity was more severe among farming households than their non-farming counterparts (P = 0.032). Dietary diversity score was significantly higher among non-farming households than farming households (P < 0.001). Food insecurity was negatively correlated with both household dietary diversity (r = -0.385; P < 0.001) and child mean micronutrient adequacy (r = -0.305; P < 0.001). There was no significant correlation between dietary diversity and children's mean micronutrient density adequacy. Belonging to a household that is severely food insecure and household size were significant predictors of children's mean micronutrient density adequacy (ß = -0.124, P = 0.006; ß = 0.011, P = 0.006, respectively).

CONCLUSION

Household food insecurity continues to be a good indicator of lower nutrient intake in children.

Household food insecurity and coping strategies among pensioners in Jimma Town, South West Ethiopia

Background

Ethiopia is currently facing new challenges related to food insecurity among the urban poor. Pensioners are segments of the population with reduced income and working capacity because of advancement of age and other related problems. There is no empirical evidence on Jimma Town pensioner’s household food insecurity and coping strategies.

Methods

A cross-sectional study was conducted among households in Jimma Town living on an income obtained from a pension from March 01–28, 2017. Data were collected from 399 randomly selected participants. Data were entered into EPi-Data version 3.1 and analyzed using SPSS Version 20.0. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression model to control for confounding variables.

Results

Nearly, 83.5% of households were food insecure. The odds of food insecurity among households with heads attending secondary school and above was 78% lower when compared to that of households with uneducated household heads (AOR = 0.22, 95% CI: 0.97 to 0.49). The odds of food insecurity among households headed by merchants was 91% lower when compared to that of households headed by guards (AOR = 0.09, 95% CI: 0.03, 0.29). Food insecure households were using coping strategies such as changing consumption patterns (44%), eating inexpensive foods (72.4%), reducing meal frequency (62.4%) and selling household assets, such as household food utensils (30.8%). The odds of food insecurity among households having large family size (≥ 7) was 3.74 times higher when compared to that of households with family size less than three (AOR = 3.74(1.27_, 10.99).

Conclusions

Household food insecurity was associated with having households headed by uneducated, widowed and guard household heads and having large family size. Food insecure households used both consumption and asset-based coping strategies such as eating less preferred, lower quality or less expensive foods and receiving donation from relatives or friends. Government policies should consider revising the current social protection scheme for pensioners. Special attention should be given to widow pensioners and pensioners with low educational status and with large family sizes.

Prevalence and correlates of food insecurity among Lebanese households with children aged 4-18 years: findings from a national cross-sectional study

Objective

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.

Design

Cross-sectional survey (2014–2015).

Setting

Lebanon.

Participants

Nationally representative sample of Lebanese households with 4–18-year-old-children and their mothers (n 1204).

Results

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 %).

Conclusions

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.

Emerging themes in food security: environmental justice, extended families and the multiple roles of grandmothers

BACKGROUND

Pre- and perinatal nutritional status defines the development of adult metabolism and energy balance in humans. Young children in poor households are disproportionately more vulnerable to food insecurity given the cumulative impact of chronic stress on susceptibility to chronic diseases as an adult. Qualitative studies focusing on the experience of food insecurity in Latin America are scarce. In Argentina, although socioeconomic indicators improved in the aftermath of the 2001ecomomic crisis, the disadvantaged provinces in the north continue to bear the burden of historical inequities. The study was conducted among Primary Health Care patients in the city of San Salvador de Jujuy, Argentina. It analyzes environmental and household level stressors through the narratives of mothers with young children living with food insecurity, from the perspectives of eco-developmental conceptual frameworks.

METHODS

We conducted 11 semi-structured interviews with mothers of children < 1 to 6 years of age who participated in maternal-child health programs in Primary Health Care clinics and lived in food insecure households. Interviews focused on the environmental context and the resources and processes for obtaining and preparing daily meals.

RESULTS

The Eco-bio-developmental (EBD) framework and the vulnerability-assets approach, provided a basis for conceptualizing the significance of findings. Our results indicated the need to understand pathways in the association of stressors, vulnerability and ill health, as well as the mitigating role of social relationships. For example, understanding the link between the stress of being exposed to environmental contaminants and the capacity to overcome food insecurity, or developing strategies to integrate the support provided by kinship networks like extended families into food security programs. The results also indicate the importance of developing support mechanisms for vulnerable family members like grandmothers in food insecure households who play instrumental roles as providers and caretakers of younger relatives.

CONCLUSION

The empirical evidence generated by this study may inform community based strategies and public health policies to address food insecurity in vulnerable population groups who face health effects from multiple stressors.

What Influences Urban Mothers' Decisions on What to Feed Their Children Aged Under Five-The Case of Addis Ababa, Ethiopia

Mothers carry the prime responsibility for childcare and feeding in low-income countries. Understanding their experiences in providing food for their children is paramount to informing efforts to improve the nutritional status of children. Such information is lacking in Sub-Saharan Africa. To understand what influences urban mothers' food acquisition and their motivations for selecting food for their children, 36 in-depth interviews were carried out with mothers having children under five years of age. Interviews were conducted in the local language, audio-recorded, transcribed, and translated into English. Data were analyzed using thematic analysis which led to the identification of four major themes: mothers give-in to a child-driven diet; quick-fix versus the privilege of planning; keen awareness on food safety, nutrition, and diet diversity; and social, familial, and cultural influences. The findings indicate that child feeding practices are influenced by interlinked social and environmental factors. Hence, nutrition education campaigns should focus on targeting not only families but also their children. Attention should also be given to food safety regulations, as well as to the much-needed support of mothers who are struggling to ensure their children's survival in low-income countries.

Qualitative study on identification of common coping strategies practised by Indigenous Peoples (Orang Asli) in Peninsular Malaysia during periods of food insecurity

OBJECTIVE

To examine the types of coping strategies practised by Indigenous women or Orang Asli (OA) in Peninsular Malaysia during times of food shortage and to determine the level of severity for food insecurity that will trigger each specific coping strategy.

DESIGN

A qualitative case study was conducted. Pertinent information about each type of coping strategy was gathered by in-depth interviews. To gauge the level of severity for each of the coping strategies, focus group discussions (FGD) were held. Thematic analysis was used for data analysis.

SETTING

OA villages in the states of Kelantan, Pahang, Perak and Selangor, Malaysia.

SUBJECTS

Sixty-one OA women from three ethnic groups (Senoi, Proto-Malay and Negrito) for in-depth interviews and nineteen OA women from the Proto-Malay ethnic group for three FGD.

RESULTS

The findings identified twenty-nine different coping strategies and these were divided into two main themes: food consumption (sub-themes of food consumption included dietary changes, diversification of food sources, decreasing the number of people and rationing) and financial management (sub-themes of financial management included increasing household income, reducing expenses for schooling children and reducing expenses on daily necessities). Three levels of severity were derived: less severe, severe and very severe.

CONCLUSIONS

This information would enable local authorities or non-governmental organisations to more precisely target and plan interventions to better aid the OA communities needing assistance in the areas of food sources and financial management.

Socio-demographic Determinants of Household Food Insecurity among Iranian: A Population-based Study from Northwest of Iran

BACKGROUND

We aimed to evaluate the household food security status and associated factors in East-Azerbaijan, Iran (urban and regional areas).

METHODS

Data (n=1385) as a part of the major lifestyle promotion project conducted in northwest of Iran were collected in 2015, by short form of the Household Food Security Scale consisting six questions. The Chi-square and Logistic regression were used to for statistical analysis.

RESULTS

The prevalence of food insecurity was 58.4%. The rate of food insecurity in the residents of capital city (59.7%) was higher than those of residents of regional cities (57.18%), however, this difference was not statistically significant (P=0.36). The respondents with family size more than 3 (P=0.01), unemployed (0.001) and married (0.01) respondents and the ones with lower education levels (P<0.001) were significantly more food insecure than other respondents. After adjusting for depending factors, the marital status, household size, educational level and the employment status of the head of the family had significant association with food security.

CONCLUSION

Family size, employment status and educational level of the head of the family were significant predictors of food insecurity. Policymakers should focus on increasing minimum education levels and employment situations to decrease food insecurity.

Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia

BACKGROUND/OBJECTIVES

This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia.

SUBJECTS/METHODS

The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women.

RESULTS

Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025).

CONCLUSIONS

The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.

Coping strategies related to food insecurity at the household level in Bangladesh

Introduction

In connection to food insecurity, adaptation of new techniques or alteration of regular behavior is executed that translates to coping strategies. This paper has used data from food security and nutrition surveillance project (FSNSP), which collects information from a nationally representative sample in Bangladesh on coping behaviors associated with household food insecurity. To complement the current understanding of different coping strategies implemented by the Bangladeshi households, the objective of this paper has been set to examine the demographic and socio-economic characteristics of the food insecure households which define their propensity towards adaptation of different types of coping strategies.

Methodology

FSNSP follows a repeated cross-sectional survey design. Information of 23,374 food insecure households available from February 2011 to November 2013 was selected for the analyses. Coping strategies were categorized as financial, food compromised and both. Multinomial logistic regression was employed to draw inference.

Results

Majority of the households were significantly more inclined to adopt both multiple financial and food compromisation coping strategies. Post-aman season, educational status of the household head and household women, occupation of the household’s main earner, household income, food insecurity status, asset, size and possession of agricultural land were found to be independently and significantly associated with adaptation of both financial and food compromisation coping strategies relative to only financial coping strategies. The relative risk ratio of adopting food compromisation coping relative to financial coping strategies when compared to mildly food insecure households, was 4.54 times higher for households with moderate food insecurity but 0.3 times lower when the households were severely food insecure. Whereas, households were 8.04 times and 4.98 times more likely to adopt both food compromisation and financial relative to only financial coping strategies if moderately and severely food insecure respectively when compared to being mildly food insecure.

Conclusion

Households suffering from moderate and severe food insecurity, are more likely to adopt both financial and food compromisation coping strategies.

Food Insecurity and Its Association With School Absenteeism Among Rural School Adolescents in Jimma Zone, Ethiopia

Studies showed that poor health and nutrition among school adolescents are major barriers to educational access and achievements in low-income countries. This school-based study was aimed to assess the association of school absenteeism and food insecurity among rural school adolescents from grades 5 to 8 in Jimma zone, Ethiopia. Regression analyses were used to see the strength of association between dependent and independent variables using odds ratio and 95% confidence intervals. Multivariable logistic regression analysis was used to identify the predictor of school absenteeism. Validated tools are used to collect household food insecurity data. Results showed that school absenteeism is significantly high among adolescents from food insecure households when compared to adolescents from food secure households ( P <.001). School absenteeism was negatively associated with male sex (adjusted odds ratio [AOR] = -0.91, 95% CI -1.85 to -0.03), household food security (adjusted odds ratio = -1.85, 95% CI -3.11 to -0.59), being an elder sibling (AOR = -0.37, 95% CI, -0.62 to -0.12), and mother involvement in decision making (AOR = -0.68, 95% CI, -1.33 to -0.03) while male-headed household was positively associated (AOR = 2.46, 95% CI, 1.37 to 4.56). Generally, this study showed that household food insecurity has significant contribution to school absenteeism among rural adolescents. Therefore, efforts should be made to improve household income earning capacity to reduce the prevalence of school absenteeism among rural school adolescents.

Household food insecurity and its association with school absenteeism among primary school adolescents in Jimma zone, Ethiopia

Background

Household food insecurity and lack of education are two of the most remarkable deprivations which developing countries are currently experiencing. Evidences from different studies showed that health and nutrition problems are major barriers to educational access and achievement in low-income countries which poses a serious challenge on effort towards the achieving Sustainable Development Goals. Evidence on the link between food security and school attendance is very important to address this challenge. This study aimed to assess to what extent food insecurity affects school absenteeism among primary school adolescents.

Methods

A school based cross-sectional study was conducted among primary school adolescents in Jimma zone from October-November, 2013. Structured questionnaire was used to collect data on the household food security and socio-demographic variables. Data were analyzed using SPSS for windows version 16.0 after checking for missing values and outliers. Multivariable logistic regression analyses were used to determine the association of school absenteeism and food insecurity with independent variables using odds ratio and 95 % of confidence intervals. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression analysis to control for associations among the independent variables.

Results

The frequency of adolescent school absenteeism was significantly high (50.20 %) among food insecure households (P < 0.001) compared to their peers whose households were food secure (37.89 %). Findings of multivariable logistic regression analysis also showed that household food insecurity [AOR = 2.81 (1.70, 4.76)] was positively associated with poor school attendance while female-headed household [AOR = 0.23 (0.07, 0.72)], urban residence [AOR = 0.52 (0.36, 0.81)] and male-gender [AOR = 0.64 (0.54, 0.74)] were inversely associated with school absenteeism. Household food insecurity was positively associated with lack of maternal education [AOR = 2.26 (0.57, 8.93)] and poor household economic status [AOR = 1.39 (1.18, 2.83)]. However, livestock ownership [AOR = 0.17 (0.06, 0.51)] was negatively associated with household food insecurity.

Conclusions

Findings of this study showed that household food insecurity has strong linkage with adolescent school absenteeism. Maternal education and household economic status were significantly associated with household food security status. Therefore, national policies and programs need to stress on how to improve family income earning capacity and socioeconomic status to handle household food insecurity which is a key contributor of adolescent school absenteeism.

Food variety consumption and household food insecurity coping strategies after the 2010 landslide disaster - the case of Uganda

Objective

To evaluate the nutritional situation of the victims of the 2010 landslide disaster in Uganda, food varieties consumed and coping strategies were assessed.

Design

Cross-sectional. Food variety scores (FVS) were obtained as the total of food items eaten over the last week while an index was based on severity weighting of household food insecurity coping strategies. We included 545 affected and 533 control households.

Setting

Victims in the affected Bududa district in Eastern Uganda and those victims resettled in the Kiryandongo district, Western Uganda.

Results

Adjusted for covariates, in Bududa significantly higher mean FVS were observed among: affected than controls; farmers than others; and relief food recipients. Control households scored higher means (se) on severity of coping: 28·6 (1·3) v. 19·2 (1·2; P<0·01). In Kiryandongo, significantly higher FVS were observed among: control households; household heads educated above primary school; those with assets that complement food source; and recipients of relief food. Severity of coping was significantly higher among affected households and non-recipients of relief food. Affected households had a higher likelihood to skip a day without eating a household meal in Bududa (OR=2·31; 95 % CI 1·62, 3·29; P<0·01) and Kiryandongo (OR=1·77; 95 % CI 1·23, 2·57; P<0·01).

Conclusions

Whereas FVS and severity of coping showed opposite trends in the two districts, resettlement into Kiryandongo led to severe coping experiences. Administrative measures that provide a combination of relief food, social protection and resettlement integration may offset undesirable coping strategies affecting diet.

Association between household food insecurity and nutritional outcomes among children in Northeastern of Peninsular Malaysia

BACKGROUND/OBJECTIVES

The purpose of the study was to investigate the relationship between household food insecurity and nutritional status of children in low-income households. A cross sectional study involved a survey of households (n = 223) receiving the financial assistance.

SUBJECTS/METHODS

Eligible mothers that fulfilled the inclusion criteria such as non-pregnant, non-lactating mothers, aged 18 to 55 years with their youngest children aged 2 to 12 years, were purposively selected. The Radimer/Cornell hunger and food-insecurity instrument was administered and children's height and weight were measured.

RESULTS

About 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity. Out of food insecure category, 29.6% households were food insecure, 19.3% women were individual food insecure and 35.0% fell into the child hunger category. Education of the mother (P = 0.047), household size (P = 0.024), number of children (P = 0.024), number of children going to school (P = 0.048), total monthly income (P < 0.001), income per capital (P < 0.001), number of household members contributing to the income (P = 0.018) and food expenditure (P = 0.006) were significant risk factors for household food insecurity. The prevalence of underweight, stunting and wasting in children were 61.0%, 61.4% and 30.6% respectively. Based on multinomial logistic regression, children in food-insecure households were 2.15 times more likely to be underweight and three times to be stunted than children in the food-secure households.

CONCLUSIONS

The findings suggest that household food insecurity is associated with the nutritional status of the children in the rural area of Northeastern Peninsular Malaysia.

Food insecurity among Iraqi refugees living in Lebanon, 10 years after the invasion of Iraq: data from a household survey

Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1% (95% CI 17·3, 23·2) were found to be food secure, 35·5% (95% CI 32·0, 39·2) moderately food insecure and 44·4% (95% CI 40·8, 48·1) severely food insecure. Severe food insecurity was associated with the respondent's good self-reported health (OR 0·3, 95% CI 0·2, 0·5), length of stay as a refugee (OR 1·1, 95% CI 1·0, 1·2), very poor housing quality (OR 3·3, 95% CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95% CI 1·0, 1·4), and resulted in poor dietary diversity (P< 0·0001). Anaemia was found in 41% (95% CI 30·6, 51·9) of children below 5 years of age, but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.

Nutritional outcomes related to household food insecurity among mothers in rural Malaysia

During the past two decades, the rates of food insecurity and obesity have risen. Although a relationship between these two seemingly-paradoxical states has not been repeatedly seen in men, research suggests that a correlation between them exists in women. This study examines nutritional outcomes of household food insecurity among mothers in rural Malaysia. A cross-sectional survey of low-income households was conducted, and 223 households with mothers aged 18-55 years, who were non-lactating, non-pregnant, and had at least one child aged 2-12 years, were purposively selected. A questionnaire was administered that included the Radimer/Cornell Scale, items about sociodemographic characteristics, and anthropometric measurements. Of the households, 16.1% were food-secure whereas 83.9% experienced some kind of food insecurity: 29.6% of households were food-insecure, 19.3% contained individuals who were food-insecure, and 35.0% fell into the 'child hunger' category. The result reported that household-size, total monthly income, income per capita, and food expenditure were significant risk factors of household food insecurity. Although there was a high prevalence of overweight and obese mothers (52%) and 47.1% had at-risk waist-circumference (> or = 80 cm), no significant association was found between food insecurity, body mass index, and waist-circumference. In conclusion, the rates of household food insecurity and overweight and obesity were high in the study population, although they are looking paradoxical. Longitudinal studies with larger sample-sizes are recommended to further examine the relationship between food insecurity and obesity.

Giving voice to food insecurity in a remote indigenous community in subarctic Ontario, Canada: traditional ways, ways to cope, ways forward

BACKGROUND

Food insecurity is a serious public health issue for Aboriginal people (First Nations [FN], Métis, and Inuit) living in Canada. Food security challenges faced by FN people are unique, especially for those living in remote and isolated communities. Conceptualizations of food insecurity by FN people are poorly understood. The purpose of this study was to explore the perceptions of food insecurity by FN adults living in a remote, on-reserve community in northern Ontario known to have a high prevalence of moderate to severe food insecurity.

METHODS

A trained community research assistant conducted semi-directed interviews, and one adult from each household in the community was invited to participate. Questions addressed traditional food, coping strategies, and suggestions to improve community food security and were informed by the literature and a community advisory committee. Thematic data analyses were carried out and followed an inductive, data-driven approach.

RESULTS

Fifty-one individuals participated, representing 67% of eligible households. The thematic analysis revealed that food sharing, especially with family, was regarded as one of the most significant ways to adapt to food shortages. The majority of participants reported consuming traditional food (wild meats) and suggested that hunting, preserving and storing traditional food has remained very important. However, numerous barriers to traditional food acquisition were mentioned. Other coping strategies included dietary change, rationing and changing food purchasing patterns. In order to improve access to healthy foods, improving income and food affordability, building community capacity and engagement, and community-level initiatives were suggested.

CONCLUSIONS

Findings point to the continued importance of traditional food acquisition and food sharing, as well as community solutions for food systems change. These data highlight that traditional and store-bought food are both part of the strategies and solutions participants suggested for coping with food insecurity. Public health policies to improve food security for FN populations are urgently needed.

Gender disadvantage and common mental disorders in women

Research in the area of gender and mental health indicates that women are disproportionately affected by common mental disorders (CMDs) as well as co-morbid mental disorders. However, the concept of gender disadvantage, its correlates, and mental health outcomes has received relatively less research attention. In addition, there are no known systematic reviews in the area of gender disadvantage and common mental disorders in recent years. In this review we have therefore attempted to deconstruct the concept of gender disadvantage, identify important correlates of gender disadvantage and illustrate their influence on common mental disorders. Since gender is a social construct and is greatly influenced by one's culture and ethnicity, we have made an attempt to integrate international literature on the subject and highlight cultural and ethnic relevance of topics as they emerge. Finally, we have provided take home messages from existing literature, identified gaps in literature, and formulated directions for future research in this area.