Is household food insecurity a predictor of under-five malnutrition in rural and urban communities of Ondo State, Nigeria ?

INTRODUCTION :  Household is said to be food insecure when they lack regular access to sufficient, safe and nutritious food needed for healthy living. About 53% of under-5 deaths in Nigeria in 2010 were related to malnutrition. This study compared household food insecurity and nutritional status of under-five children.

METHODS:  A comparative cross-sectional study was conducted between July and August, 2012 using a four stage sampling method to select 826 primary care givers- index child (aged 6-59months) pair in Ondo East (rural) and Ondo West (urban) Local Government Areas. Household food insecurity was measured using an adapted United States Department of Agriculture Household Food Insecurity Access Scale, while anthropometric measurement was used to assess nutritional status of the under-5 children. Data was analysed using SPSS 20 statistical packages. Chi-square and t-test were used to test association between variables and predictors were determined by binary logistic regression. Statistical significance was set at 5%. Ethical approval was obtained from the Ondo State Ministry of Health Ethical Review Committee. Limitation of this study was recall bias.

RESULTS:  The prevalence of all forms of stunting and under-weight were higher in the rural areas. The predictor of stunting in the rural areas was food insecure households (95% CI 1.112-6.196; P=0.028), while in urban areas, the predictors were household heads lack of formal education (95%CI 0.5-1.0; p=0.048), food insecure households (95% CI 3.5-15.0; p<0.001) and lower wealth quintiles (95% CI 8.0-44.5; p<0.001). In the rural areas, being in food insecure households (95% CI 1.2-8.9; p=0.020) and lower wealth quintiles (95% CI 0.4-0.8; p<0.00) were the predictors of under-weight, while in urban area, the predictors were food insecure households (95% CI 1.1-6.6; p=0.032) and lower wealth quintiles (95% CI 0.3-0.7; p<0.001). 

CONCLUSIONS:   Household food insecurity was the most recurrent predictor of under-five malnutrition in both the rural and urban areas.