Household food insecurity and its association with nutritional status of under five children in Sekela District, Western Ethiopia: a comparative cross-sectional study

BACKGROUND: Food insecurity influences children nutritional status by limiting the quantity and quality of dietary intake. Studies conducted across different parts of the world revealed controversial evidences about the relationship between household food insecurity and child nutritional status. Although child malnutrition and food insecurity are the main problems in Ethiopia, to what extent food insecurity contributes to children nutritional status is not yet well studied. Therefore, this study was conducted to compare children nutritional status in food secure and insecure housholds. METHOD: A community based comparative cross sectional study was conducted in Sekela District,Western Ethiopia from February 5-27, 2014. The total sample size was 576 households having at least one children less than 5 year's old. Two stage cluster stratified sampling technique was used to select study participants. Data were collected using a pre tested structured questionnaire and anthropometric measurements. Household food insecurity was measured using household food insecurity access scale. Anthropometry indices were calculated using WHO Anthro 3.1.0 and interpreted according to WHO 2006 cutoff points. Data were entered using Epi.Data 3.2. and exported to SPSS 21.0 for analysis. Logistic regression analysis was employed to identify independent predictors of children under nutrition. RESULT: The mean of household food insecurity score was 8.16 ± 6.01 and the prevalence of food insecurity was 74.1%. Of children in food insecure households 38.9% were stunted, 22.6% were underweighted and 12.9% were wasted while the respective prevalence of stunting, underweight and wasting were 31.3%, 11.8% and 7.6% among children in food secure households. Food insecurity had association with children underweight (AOR = 2.25; 95% CI = 1.29, 3.94), but not with stunting and wasting. Children under nutrition had independent association with sex and age of the child, colostrum feeding, upper respiratory infection, fever, and maternal literacy. CONCLUSION: Household food insecurity and child under nutrition were critical problems in the study setting. Socio demographic factors, poor child caring practices, infection and food insecurity had positive association with children under nutrition. Thus, due emphasis should be given for the designing and implementation of multi sectorial community based nutrition interventions and initiation of income generating livelihood to the community to curtail under nutrition and household food insecurity in the locality.