Determinants of Household Food Insecurity and Its Association with Child Malnutrition in Sub-Saharan Africa: A Review of the Literature

Food insecurity is a global public health challenge. Household food insecurity is the leading risk factor of malnutrition, claiming approximately 300,000 deaths each year. Whether directly or indirectly, due to inadequate food consumption and poor diet quality, it is also accountable for over half of all deaths among children in Sub-Saharan Africa. It is estimated that the prevalence of food-insecure individuals in the area will reach 17 million by the year 2021. Inadequate nutrition may result in low immunity, impaired physical and mental development and reduced productivity among children under five years and throughout the life course. This review article attempts to discuss the various household food insecurity determinants and their association with child malnutrition in a Sub-Saharan Africa context. The purposes of this article are to inform governments, policymakers and service providers regarding the importance of household food security and its determinants on child malnutrition, and to plan strategies to improve the household food security status in Sub-Saharan Africa.

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Comparing measures of urban food security in Accra, Ghana

Food Security ◽

10.1007/s12571-020-01011-4 ◽

2020 ◽

Vol 12 (2) ◽

pp. 417-431 ◽

Cited By ~ 3

Author(s):

Cascade Tuholske ◽

Kwaw Andam ◽

Jordan Blekking ◽

Tom Evans ◽

Kelly Caylor

Keyword(s):

Food Security ◽

Food Insecurity ◽

Sub Saharan Africa ◽

Poor Correlation ◽

Household Food Insecurity ◽

Urban Food Security ◽

Household Level ◽

Household Food ◽

Sub Saharan ◽

Food Insecurity Access

AbstractThe urban population in Sub-Saharan Africa is projected to expand by nearly 800 million people in the next 30 years. How this rapid urban transition is affecting household-level urban food security, and reverberating into broader food systems, is poorly understood. To fill this gap, we use data from a 2017 survey (n = 668) of low- and middle-income residents of Accra, Ghana, to characterize and compare the predictors of household-level food security using three established metrics: the Household Food Insecurity Access Scale (HFIAS); the Household Food Insecurity Access Prevalence (HFIAP); and the Food Consumption Score (FCS). According to HFIAP, 70% of sampled households are food insecure, but only 2% fall below acceptable thresholds measured by FCS. Only one household reported sourcing food from modern supermarkets and fewer than 3% produce food for consumption through gardening, farming, or fishing. Instead, households rely on purchased food from traditional markets, local stalls and kiosks, and street hawkers. Results from a suite of general linear models show that household assets, education, and demographic characteristics are significantly associated with food security outcomes according to HFIAS and HFIAP. The poor correlation and weak model agreement between dietary recall such as FCS, and experience-based food security metrics, like HFIAS and HFIAP, highlight limitations of employing historically rural-centric food security measurement approaches within the urban context. Given that Sub-Saharan Africa’s future is urban, our results add empirical evidence in support of the growing chorus of scholars advocating for comprehensive urban-oriented food security research and policy agendas across Sub-Saharan Africa.

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Household Food Insecurity and Psychosocial Dysfunction in Ecuadorian Elementary Schoolchildren

International Journal of Pediatrics ◽

10.1155/2018/6067283 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

M. Margaret Weigel ◽

Rodrigo X. Armijos

Keyword(s):

Food Security ◽

Food Insecurity ◽

Low Income ◽

Maternal Mental Health ◽

Household Food Security ◽

Household Food Insecurity ◽

Global Public Health ◽

School Aged Children ◽

Psychosocial Dysfunction ◽

Household Food

Household food insecurity (HFI) is a major global public health and pediatric concern due to its reported association with adverse child nutrition, growth, and health outcomes. Psychosocial dysfunction is a major cause of childhood disability. US and Canadian studies have linked HFI to poorer overall psychosocial dysfunction and specific dysfunction types in school-aged children, i.e., internalizing, externalizing, and attention behaviors. However, it is uncertain whether prior findings are generalizable to low- and middle-income country (LMIC) settings. We conducted a cross-sectional study to explore the association of HFI with psychosocial dysfunction in 6-12-year-old public elementary schoolchildren (n=279) residing in low-income neighborhoods in Quito, Ecuador. Maternal caregivers were interviewed to obtain data on child psychosocial dysfunction (Pediatric Symptom Checklist, PSC), food security (Household Food Security Survey Module), and maternal mental health (SF-36 Mental Composite Summary). Capillary blood samples were obtained from child participants to measure hemoglobin levels. The data were analyzed using general linear models with adjustment for covariates. The results revealed that HFI was associated with significantly higher overall average PSC scores (p=0.002) and with internalizing (p=0.001) and externalizing (p=0.03) but not attention subscale scores. However, anemia was independently associated with PSC attention subscale scores (p=0.015). This is the first study to report on the relationship between HFI and psychosocial dysfunction in school-aged children in a LMIC setting. It highlights the importance of improving policies and programs protecting vulnerable households from HFI. In addition to improving health and nutrition, such improvements could potentially reduce the burden of child psychosocial dysfunction.

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Preparing for COVID-19: Household food insecurity and vulnerability to shocks in Nairobi, Kenya

PLoS ONE ◽

10.1371/journal.pone.0259139 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259139

Author(s):

Elizabeth Opiyo Onyango ◽

Jonathan Crush ◽

Samuel Owuor

Keyword(s):

Food Security ◽

Food Insecurity ◽

Emergency Preparedness ◽

Multilevel Modelling ◽

Household Food Security ◽

Household Food Insecurity ◽

Preparedness Plan ◽

Household Food ◽

New Policies ◽

Social Safety Nets

An understanding of the types of shocks that disrupt and negatively impact urban household food security is of critical importance to develop relevant and targeted food security emergency preparedness policies and responses, a fact magnified by the current COVID-19 pandemic. This gap is addressed by the current study which draws from the Hungry Cities Partnership (HCP) city-wide household food insecurity survey of Nairobi city in Kenya. It uses both descriptive statistics and multilevel modelling using General Linear Mixed Models (GLMM) to examine the relationship between household food security and 16 different shocks experienced in the six months prior to the administration of the survey. The findings showed that only 29% of surveyed households were completely food secure. Of those experiencing some level of food insecurity, more experienced economic (55%) than sociopolitical (16%) and biophysical (10%) shocks. Economic shocks such as food price increases, loss of employment, and reduced income were all associated with increased food insecurity. Coupled with the lack of functioning social safety nets in Nairobi, households experiencing shocks and emergencies experience serious food insecurity and related health effects. In this context, the COVID-19 pandemic is likely to have a major negative economic impact on many vulnerable urban households. As such, there is need for new policies on urban food emergencies with a clear emergency preparedness plan for responding to major economic and other shocks that target the most vulnerable.

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Association between Household Food Insecurity and Asthma in Korean Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122115 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2115 ◽

Cited By ~ 2

Author(s):

Seo-Hee Park ◽

Byung-Jin Park ◽

Dong-Hyuk Jung ◽

Yu-Jin Kwon

Keyword(s):

Food Security ◽

Food Insecurity ◽

Confidence Intervals ◽

Household Food Security ◽

Asthma Prevalence ◽

Household Food Insecurity ◽

Confounding Factors ◽

Odds Ratios ◽

Korean Adults ◽

Household Food

Household food insecurity has been associated with noncommunicable diseases. The aim of this study was to investigate the association between household food insecurity and asthma in Korean adults. Household food security statuses were classified into three groups: Food-secure household, food-insecure household without hunger, and food-insecure household with hunger. The odds ratios and 95% confidence intervals for the presence of asthma according to household food security status were calculated using multiple logistic regression analyses after adjusting for confounding factors. A total of 14,770 participants were included in the analysis. The prevalence of asthma was 2.6% in those with a secure food status, 3.2% in those with an insecure food status without hunger, and 7.6% in those with an insecure food status with hunger (p < 0.001). Compared with that in participants with a household food secure status, the odds ratios (95% confidence intervals) for asthma were 1.12 (0.73–1.73) in those with a food-insecure household without hunger status and 2.44 (1.33–4.46) in those with a food-insecure household with hunger status after additionally adjusting for confounding factors. We found that household food insecurity with hunger was significantly associated with asthma prevalence in Korean adults. Implementation of household food security screening and public health intervention could be helpful to prevent and reduce asthma in adults.

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Household Food Insecurity and the Association with Cumulative Biological Risk among Lower-Income Adults: Results from the National Health and Nutrition Examination Surveys 2007–2010

Nutrients ◽

10.3390/nu12051517 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1517 ◽

Cited By ~ 2

Author(s):

Cindy W. Leung ◽

Megan S. Zhou

Keyword(s):

Food Security ◽

Health Outcomes ◽

Food Insecurity ◽

Risk Score ◽

Risk Scores ◽

Household Food Security ◽

Household Food Insecurity ◽

Biological Risk ◽

Health And Nutrition ◽

Household Food

Household food insecurity has been associated with adverse health outcomes; however, the mechanisms underlying these associations are not well-defined. Using data from 5005 adults from the 2007–2010 National Health and Nutrition Examination Surveys (NHANES), we examined associations between household food insecurity and cumulative biological risk, a measure of the body’s physiological response to chronic stress. Household food security was assessed using the 18-item Household Food Security Survey Module. Marginal food security refers to 1–2 positive responses, and food insecurity refers to ≥3 positive responses. The cumulative biological risk scores were calculated based on the distributions of ten biomarkers from the cardiovascular, metabolic, and immune systems. Elevated biological risk was defined as a risk score of ≥3. Multivariable regression models were used to examine associations between food security and cumulative biological risk scores, adjusting for sociodemographic characteristics. After multivariable adjustment, food insecurity was associated with a 0.14-unit higher cumulative biological risk score (95% CI 0.05–0.22, p-trend = 0.003) and higher odds of elevated biological risk (OR 1.20, 95% CI 1.05–1.37, p-trend = 0.003). These associations differed by gender. Among women, food insecurity was associated with 0.30-unit higher cumulative biological risk score (95% CI 0.14–0.45, p-trend = 0.0004) and higher odds of elevated biological risk (OR 1.61, 95% CI 1.29–2.00, p-trend < 0.0001). These associations were not observed in men. Women experiencing food insecurity demonstrated elevated levels of biological risk. These findings support the hypothesis that food insecurity may be associated with women’s chronic health outcomes through the pathway of chronic stress. Further research is needed to understand why these associations were not observed in men.

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Linking Household Food Security and Food Value Chains in North West Mt. Kenya

Sustainability ◽

10.3390/su12124999 ◽

2020 ◽

Vol 12 (12) ◽

pp. 4999

Author(s):

Veronica Mwangi ◽

Samuel Owuor ◽

Boniface Kiteme ◽

Markus Giger ◽

Johanna Jacobi ◽

...

Keyword(s):

Food Security ◽

Food Insecurity ◽

Value Chain ◽

Smallholder Farmers ◽

Sub Saharan Africa ◽

Household Food Security ◽

Value Chains ◽

North West ◽

Household Food ◽

Food Value

Smallholder farmers and pastoralists produce the largest proportion of food consumed in sub-Saharan Africa. However, they remain among the food insecure populations. This paper explores the food (in)security among smallholder farmers and pastoralists using a sample of 175 households in three agro-food value chains of wheat, dairy, and beef in the north-west Mt. Kenya region. The study seeks to answer if a farmer’s participation in a particular agro-food value chain determines his/her food security situation. We use the Household Food Insecurity Access Scale (HFIAS) and two Poisson regression models, parsimonious and full, to assess the household food security status and determinants of food security among the smallholder farmers and pastoralists. The results show that 61% of the households were either mildly, moderately, or severely food insecure. Households in the beef value chain experienced relatively higher incidences of food insecurity compared to households in the wheat and dairy value chains. The HFIAS scores revealed a wide gap between households with minimum and maximum score. Household size, income and income-related variables (ability to save and borrow to meet family needs), transport assets, membership in farmers’ associations, and household energy were significant in determining household food security, while access to credit and to extension services was not. Strategies that focus on boosting smallholder farmers’ incomes, building strong and resilient farmers associations to improve inclusive and equitable value chains have the potential to get smallholder farmers out of recurrent food insecurity.

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Household food insecurity: a systematic review of the measuring instruments used in epidemiological studies

Public Health Nutrition ◽

10.1017/s1368980014001050 ◽

2014 ◽

Vol 18 (5) ◽

pp. 877-892 ◽

Cited By ~ 41

Author(s):

Emanuele S Marques ◽

Michael E Reichenheim ◽

Claudia L de Moraes ◽

Marina ML Antunes ◽

Rosana Salles-Costa

Keyword(s):

Systematic Review ◽

Food Security ◽

Food Insecurity ◽

Standard Form ◽

Reliability And Validity ◽

Household Food Security ◽

Measuring Instruments ◽

Household Food Insecurity ◽

Household Food ◽

Psychometric Studies

AbstractObjectiveTo conduct a systematic review aimed at identifying and characterizing the experience-based household food security scales and to synthesize their psychometric properties.DesignSearch in the MEDLINE, LILACS and SciELO databases, using the descriptors (‘food insecurity’ OR ‘food security’) AND (‘questionnaires’ OR ‘scales’ OR ‘validity’ OR ‘reliability’). There was no limitation on the period of publication. All articles had their titles and abstracts analysed by two reviewers. The studies of interest were read in their entirety and the relevant information extracted using a standard form.ResultsThe initial bibliographic search identified 299 articles. Of these, the 159 that seemed to meet the criteria for inclusion were read fully. After consultation of the bibliographic references of these articles, twenty articles and five documents were added, as they satisfied the previously determined criteria for inclusion. Twenty-four different instruments were identified; all were brief and of easy application. The majority were devised in the USA. Forty-seven references reported results of psychometric studies. The instruments that presented the highest number of psychometric studies were the Core Food Security Measurement/Household Food Security Survey Module (CFSM/HFSSM) and the Self-Perceived Household Food Security Scale.ConclusionsThere are a number of structured scales available in the literature for characterization of household food insecurity. However, despite some psychometric studies already existing about the majority of the instruments, it is observed that, except for the studies of the CFSM/HFSSM, these are still restricted to appraisal of a few aspects of reliability and validity.

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Rural and Urban Differences in Household Food Insecurity and Diet Diversity of Preschool Children (PSC) in Occidental Mindoro

Acta Medica Philippina ◽

10.47895/amp.v54i5.2254 ◽

2020 ◽

Vol 54 (5) ◽

Author(s):

Kim Leonard G. Dela Luna ◽

Ernani R. Bullecer

Keyword(s):

Food Security ◽

Preschool Children ◽

Rural Communities ◽

Food Insecurity ◽

Urban Communities ◽

Dietary Diversity ◽

Household Food Security ◽

Household Food Insecurity ◽

Household Food ◽

Rural And Urban

Objective. Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a greatimpact on household food security and dietary diversity. The relationship between the human environment andother factors threatens different domains of food systems resulting in food security. The objective of this study isto determine significant differences between the prevalence of household food security and diet diversity betweenurban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake ofpreschool children between rural and urban communities Methods. This study utilized a comparative, cross-sectional, analytic study design in order to determine theprevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the foodsecurity status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversityof diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participatein this study. Ratio and proportion using the point and interval estimate were used to determine the prevalencein different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the twoareas under study. Results. Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while theprevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant differencein the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile,the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97%to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant differencein prevalence of low dietary diversity score among preschool children between rural and urban communities(p=0.0107). Conclusion. There were significant differences in terms of household food insecurity and less diverse dietbetween two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize thesevulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fishwas observed in the diet of preschool children for both communities however, higher prevalence of less dietarydiversity was detected among rural communities.

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Association of Household Food Security with Anaemia among Children of a Selected Rural Area of Bangladesh

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v14i2.45892 ◽

2020 ◽

Vol 14 (2) ◽

pp. 130-133

Author(s):

Md Nazrul Islam Khan ◽

Nasim Jahan ◽

Md Abdul Wahab ◽

Farzana Zafreen

Keyword(s):

Food Security ◽

Iron Deficiency ◽

Food Insecurity ◽

Rural Area ◽

Family Income ◽

Household Food Security ◽

Household Food Insecurity ◽

Age And Gender ◽

Household Food ◽

And Gender

Introduction: Food insecurity refers to a household’s having “limited or uncertain availability of food, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”. Iron deficiency and iron deficiency anaemia, are the most prevalent nutritional deficiencies worldwide and related to household food insecurity. Objectives: To find out the association between household food security and anaemia in children of a selected rural area of Bangladesh. Materials and Methods: This descriptive cross-sectional study was conducted among children ranging age from 12 to 60 months during the period ofJanuary 2009 to June 2009in Chandpur district. Mothers of the children were the respondents. A total of 192 children selected by simple random sampling were included in the study. Data were collected by face-to-face interview of the respondents and by estimation of haemoglobin of the children. Results: The mean age of the children was 34.5 ± 16.8 months. Male children were more than the female children with male to female ratio being 3:2. The average monthly family income was taka 7500. More than 60% of the mother had secondary level education. Farming was the prime occupation (36.4 %) of the father followed by business (25.5%) and service (22.4%). About 36% of the household did not have food security and nearly 45% of the children wereanaemic (Hb<11 g/dl). About two-thirds (65.2%) children with household food insecurity was anaemic (Hb 11g/dl). Estimation of odds ratio demonstrates that food insecured children were nearly 3 times as likely to develop anaemia as the children having household food security. The present study revealed a significant association (P<0.001) between household food security and anaemia in children. Household food security was not influenced by age and gender of the children. Low family income and mother’ illiteracy was significantly associated with household food insecurity. Conclusion: The present study revealed a significant association between household food insecurity and anaemia in children. Household food security was not influenced by age and gender of the children. However, low family income and mothers’ illiteracy play significant role in household food security. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 130-133

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Socio-demographic, household food security and nutritional status of older (> 50 Y) women from rural Zambian communities: A descriptive study

African Journal of Food, Agriculture, Nutrition and Development ◽

10.18697/ajfand.105.20490 ◽

2021 ◽

Vol 21 (105) ◽

pp. 18912-18931

Author(s):

U Mukherjee ◽

◽

JM Chalwe ◽

S Mbambara ◽

WH Oldewage-Theron ◽

...

Keyword(s):

Food Security ◽

Nutritional Status ◽

Food Insecurity ◽

Older Women ◽

Demographic Characteristics ◽

Household Food Security ◽

Household Food Insecurity ◽

Dietary Intakes ◽

Household Food ◽

Socio Demographic Factors

Socio-demographic factors and household food insecurity are considered to influence the nutritional status of older women. The rapidly growing elderly population in Africa is a concern particularly in sustaining their health and nutritional status. In spite of this, there is a scarcity of information in older Zambian women and this study aimed to assess the socio-demographic factors, nutritional status and household food insecurity status of older women in rural Zambian communities. This cross-sectional study was conducted in Twatasha compound of Kitwe and Ndeke community of Ndola. The socio-demographic characteristics, anthropometric measurements, dietary intakes and household food security were evaluated in a convenience sample of 153 older women (≥ 50 years) through the Household Food Insecurity Access Scale (HFIAS). IBM SPSS version 26 was used for descriptive (frequencies, means and standard deviations, and medians with interquartile frequencies) and inferential (bivariate and Spearman correlations) statistical analyses. The socio-demographic characteristics showed that almost all (98.7%) of the participants had other members of the family residing with them. Most participants (57%) had attained primary school education, 19% had secondary education and 5% had college education. Almost half (49%) of the participants did not report their employment status and 36% reported to be unemployed. Over-nutrition was most prevalent (37.3% overweight and 39.8% obese) while 20.9 % and 2.0% of the respondents were normal weight and underweight respectively. The median (25th percentile; 75th percentile) dietary intakes showed inadequate intakes for most nutrients, except for carbohydrates (170 g [133;225]). The total fat intake represented 14% of total energy intake. The majority (86.0%) of the participants were identified as severely food insecure while only 6.0% were food secure. The majority of the participants (80-90%) used at least seven out of the nine behavioural responses to food insecurity. The findings show resource-poor and severely food insecure communities. We recommended urgent interventions to improve access to healthy foods (such as home gardening projects) and promote healthy dietary habits (including nutrition education).

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