Ali D 1 , Saha KK 2 , Nguyen PH 3 , Diressie MT 1 , Ruel MT 4, Menon P 5 , Rawat R 4 1 International Food Policy Research Institute (IFPRI), Addis Ababa, Ethiopia; 2 IFPRI, Dhaka, Bangladesh; 3 IFPRI, Hanoi, Vietnam; 4 IFPRI, Washington DC, USA; 5 IFPRI, New Delhi, India. . Bangladesh.
Ali D1, Saha KK2, Nguyen PH3, Diressie MT1, Ruel MT4, Menon P5, Rawat R4
1International Food Policy Research Institute (IFPRI), Addis Ababa, Ethiopia; 2IFPRI, Dhaka, Bangladesh; 3IFPRI, Hanoi, Vietnam;
4IFPRI, Washington DC, USA; 5IFPRI, New Delhi, India.
Background and Objectives
Household food insecurity (HFI) is a recognized underlying determinant of child undernutrition, but evidence of associations between HFI and child undernutrition is mixed.
This study examines the association between household food insecurity (HFI) and child undernutrition in Bangladesh, Ethiopia and Vietnam using Household Food Insecurity Access Scale (HFIAS) Food as a measure of HFI. We hypothesized that children in food-insecure households would be more undernourished than their counterparts in food-secure households, independent of household wealth.
Data and Methods
Data from the Alive & Thrive (A&T) baseline surveys conducted in Bangladesh, Ethiopia and Vietnam in 2010 were used in this study. Analyses were conducted in children 6-59.9 months of age in Ethiopia (N=2,356) and Vietnam (N=3,075), and 6-47.9 months of age in Bangladesh (N=3,422).
The association between four categories of HFI (food-secure, mild food-insecurity, moderate food-insecurity and severe food-insecurity) and undernutrition was assessed using logistic regression models that controlled for potential confounders including child, maternal and household factors, including the wealth index (WI). All regression models adjusted for sample clustering using the cluster command in Stata 11 and separate analyses were conducted for each country.
Figure 1: Prevalence of undernutrition across three countries
Approximately one quarter of households in Bangladesh and Vietnam and nearly half of households in Ethiopia were moderately to severely food-insecure.
The prevalence of stunting, underweight and wasting were higher in Bangladesh and Ethiopia than in Vietnam .
Figure 3: Associations of HFI with underweight in children 6-59 months of age in Bangladesh, Ethiopia and Vietnam1
Figure 2: Associations of HFI with stunting in children 6-59 months of age in Bangladesh, Ethiopia and Vietnam1
1adjusted for household size, maternal age, maternal education, maternal height (only for stunting), child age, child sex, ARI and diarrhea, wealth index.
Household food insecurity were significantly associated with stunting and underweight in all three countries in multivariate models without WI. The associations remained statistically significant with WI in the model, but magnitude of the associations and levels of statistical significance, decreased in Bangladesh and Vietnam (figure s2&3).
These results show that HFI is associated with a higher odds of stunting and underweight in these geographically varied countries. Programs to improve HFI along with other nutrition interventions may enable greater synergy and sustainable impacts in addressing childhood undernutrition than just nutrition-specific interventions.
Food insecurity, child undernutrition, Bangladesh, Ethiopia, Vietnam
Poster ReferenceNumber: PO1427