Household food insecurity and its associated factors, dietary diversity and nutritional status of children 6 to 59 months in Central River Region South, Gambia
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Date
2020-05
Authors
Drammeh, Wuyeh
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
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, including The Gambia. Food insecurity is a major challenge in The Gambia,
especially in the Central River Region South. However, little is known about its
determinant factors. The objective of this study was to assess the household food
insecurity (food access) and its associated factors, household dietary diversity, and
nutritional status of children aged 6 to 59 months in Central River Region South, The
Gambia. A cross-sectional study was conducted among the households (n= 334)
consisted of children aged 6 to 59 months. Women, as a proxy to the selected
households, were interviewed as they were responsible for food acquisition and
preparation of meals for their family members. The households were selected through
a random sampling technique. Household Food Insecurity Access Scale (HFIAS) and
Household Dietary Diversity Score (HDDS) questionnaire were used to measure
household food security and dietary diversity status, respectively. The children's
nutritional status was assessed through anthropometric measurements. Weight,
height/length, and mid-upper arm circumference were recorded. Weight andheight/length were calculated using the WHO Anthro Calculator, and nutritional status
was determined based on WHO (2006) reference. Multiple logistic regression analysis
was conducted to identify factors associated with household food insecurity (food
access). The finding showed that the prevalence of household food insecurity was
80.5% in the study area. Whereas 65.0% of children were stunted, 32.7% underweight,
and 17.1% were wasting. Moderate and severe acute malnutrition was 1.8% and 6.3%,
respectively. In terms of dietary diversity status, 60.2% were at low diversified, 25.4%
of them were medium diversified, and 14.4% were highly diversified. Wasting was
associated with household food insecurity (X2, p=0.030), but not for stunting and
underweight. Household dietary diversity was also significantly associated with
household food insecurity (X2, p=0.003). Based on multiple logistic regression analysis,
women employment status (AOR = 4.23, 95% CI: 1.21, 14.86, p= 0.024), husband’s
employment status (AOR = 4.60, 95% CI: 2.00, 10.57, p= 0.001) and lack of market
access (AOR = 2.09, 95% CI: 1.09, 3.99, p = 0.025) were the factors associated with
household food insecurity (food access) in the study area. In conclusion, household food
insecurity was prevalent, and employment status regardless of either the women or their
husbands and market access were the predictors of household food insecurity.
Household food insecurity was associated with poor dietary diversity and malnutrition,
in particular, wasting among children aged below five. Therefore, programmes to
improve job opportunities should be strengthened, in particular among women to
improve household food insecurity, therefore, would reduce child malnutrition in this
region.
Description
Keywords
Food insecurity