Seasonal variations in household food insecurity and dietary diversity and their association with maternal and child nutritional status in rural Ethiopia

Abstract

Food availability and access are strongly affected by seasonality in rural households in Ethiopia. However, relationships between household food insecurity indicators and dietary diversity and nutritional status of reproductive age mothers and their young children are unclear. A longitudinal study was conducted among 800 farming households in lowland and midland agro-ecological zones of rural Ethiopia in pre and post-harvest seasons. A structured interview, which included measures of three food access indicators − household food insecurity access scale (HFIAS), household dietary diversity score (HDDS) and household food consumption score (HFCS) − was conducted. Additionally, a subset of 183 households was selected for assessment of indicators of nutritional status including maternal and child dietary diversity and anthropometric measurements for children 6–23 months of age. Magnitudes of household food insecurity indices were high by international standards, particularly during the lean season (pre-harvest). Using correlation, Chi square and multivariable regression models, HFCS in both seasons was related to maternal body mass index and haemoglobin, and weight-for-length of their children. HDDS was associated in the post-harvest season with haemoglobin level of the mothers, and weight-for-length of their children. HFCS was a better predictor of nutritional status of mothers and children in both the food surplus and lean seasons, while HDDS was a better predictor of maternal and child nutritional status post-harvest. It is recommended that nutritional interventions should therefore focus on household food insecurity as well as targeting the individual nutritional status of mothers and children.

This is a preview of subscription content, access via your institution.

References

  1. Abay, K., & Hirvonen, K. (2017). Does market access mitigate the impact of seasonality on child growth? Panel data evidence from northern Ethiopia. The Journal of Development Studies, 53(9), 1414–1429.

    Article  Google Scholar 

  2. Adams, A. (1995). Seasonal variations in energy balance among agriculturalists in Central Mali: Compromise or adaptation? European Journal of Clinical Nutrition, 49, 809–823.

    CAS  PubMed  Google Scholar 

  3. Alaimo, K., Olson, C. M., Frongillo, E. A., Jr., & Briefel, R. R. (2001). Food insufficiency, family income, and health in US preschool and school-aged children. American Journal of Public Health, 91(5), 781–786.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ali, D., Saha, K. K., Nguyen, P. H., Diressie, M. T., Ruel, M. T., Menon, P., & Rawat, R. (2013). Household food insecurity is associated with higher child undernutrition in Bangladesh, Ethiopia, and Vietnam, but the effect is not mediated by child dietary diversity. The Journal of Nutrition, 143(12), 2015–2021.

    Article  CAS  PubMed  Google Scholar 

  5. Arimond, M., & Ruel, M. T. (2004). Dietary diversity is associated with child nutritional status: Evidence from 11 demographic and health surveys. The Journal of Nutrition, 134(10), 2579–2585.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Arimond, M., Wiesmann, D., Becquey, E., Carriquiry, A., Daniels, M. C., Deitchler, M., Fanou-Fogny, N., Joseph, M. L., Kennedy, G., & Martin-Prevel, Y. (2010). Simple food group diversity indicators predict micronutrient adequacy of women’s diets in 5 diverse, resource-poor settings. The Journal of Nutrition, 140(11), 2059S–2069S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Arsenault, J. E., Nikiema, L., Allemand, P., Ayassou, K. A., Lanou, H., Moursi, M., De Moura, F. F., & Martin-Prevel, Y. (2014). Seasonal differences in food and nutrient intakes among young children and their mothers in rural Burkina Faso. Journal of Nutritional Science, 3, e55.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bates, C. J., Prentice, A. M., & Paul, A. A. (1994). Seasonal variations in vitamins a, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: Some possible implications. European Journal of Clinical Nutrition, 48(9), 660–668.

    CAS  PubMed  Google Scholar 

  9. Becquey, E., Delpeuch, F., Konaté, A. M., Delsol, H., Lange, M., Zoungrana, M., & Martin-Prevel, Y. (2012). Seasonality of the dietary dimension of household food security in urban Burkina Faso. British Journal of Nutrition, 107(12), 1860–1870.

    Article  CAS  PubMed  Google Scholar 

  10. Berhane, G., Gilligan, D. O., Hoddinott, J., Kumar, N., & Taffesse, A. S. (2014). Can social protection work in Africa? The impact of Ethiopia’s productive safety net programme. Economic Development and Cultural Change, 63(1), 1–26.

    Article  Google Scholar 

  11. Bhattacharya, J., Currie, J., & Haider, S. (2004). Poverty, food insecurity, and nutritional outcomes in children and adults. Journal of Health Economics, 23, 839–862.

    Article  PubMed  Google Scholar 

  12. Bickel, G., Nord, M., Price, C., Hamilton, W., & Cook, J. (2000). Guide to measuring household food security. Food and Nutrition Service, Alexandria VA: US Department of Agriculture.

    Google Scholar 

  13. Biederlack, L., & Rivers, J. (2009). Comprehensive Food Security and Vulnerability Analysis (CFSVA). United Nations World Food Programme: Ghana.

    Google Scholar 

  14. Bogale, A., & Shimelis, A. (2009). Household level determinants of food insecurity in rural areas of Dire Dawa, eastern Ethiopia. African Journal of Food, Agriculture, Nutrition and Development, 9(9), 1914–1926.

    Google Scholar 

  15. Coates, J., Swindale, A., & Bilinsky, P. (2007). Household food insecurity access scale (HFIAS) for measurement of food access: Indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.

    Google Scholar 

  16. Darapheak, C., Takano, T., Kizuki, M., Nakamura, K., & Seino, K. (2013). Consumption of animal source foods and dietary diversity reduce stunting in children in Cambodia. International Archives of Medicine, 6(1), 29.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Das, M., Sharma, A., & Babu, S. C. (2018). Pathways from agriculture to nutrition in India: Implications for sustainable development goals. Food Security, 10(6), 1561–1576.

    Article  Google Scholar 

  18. Egata, G., Berhane, Y., & Worku, A. (2013). Seasonal variation in the prevalence of acute undernutrition among children under five years of age in east rural Ethiopia: A longitudinal study. BMC Public Health, 13, 864.

    Article  PubMed  PubMed Central  Google Scholar 

  19. FAO. (1996). Rome Declaration on World Food Security and World Food Summit Plan of Action. Rome: FAO http://www.fao.org/docrep/003/w3548e/w3548e00.htm. Accessed 23 Jan 2017.

    Google Scholar 

  20. FAO. (2010). Guidelines for measuring household and individual dietary diversity. Rome: Food and Agriculture Organization of the United Nations.

    Google Scholar 

  21. FMOH. (2011). Federal Ministry of Health, Nutrition Module: Ethiopian Federal Ministry of Health: Federal Democratic Republic of Ethiopia Ministry of Health; The Open University, www.open.ac.uk/africa/heat. Accessed on 25 December 2017.

  22. Furness, B. W., Simon, P. A., Wold, C. M., & Asarian-Anderson, J. (2004). Prevalence and predictors of food insecurity among low-income households in Los Angeles County. Public Health Nutrition, 7(6), 791–794.

    Article  PubMed  Google Scholar 

  23. Gilligan, D. O., Hoddinott, J., & Taffesse, A. S. (2009). The impact of Ethiopia's productive safety net Programme and its linkages. The Journal of Development Studies, 45(10), 1684–1706.

    Article  Google Scholar 

  24. Gittelsohn, J., Mookherji, S., & Pelto, G. (1998). Operationalizing household food security in rural Nepal. Food and Nutrition Bulletin, 19(3), 210–222.

    Article  Google Scholar 

  25. Gooding, H.C., Walls, C.E. &, Richmond, T.K. (2012). Food insecurity and increased BMI in young adult women. Obesity, 20(9), 1896–1901.

  26. Guja, M. (2012). Household food security status and coping strategies in Humbo Wereda, Snnprs, Ethiopia. International Journal of Sciences: Basic and Applied Research, 6, 64–77.

    Google Scholar 

  27. Hackett, M., Melgar-Quiñonez, H., & Álvarez, M. C. (2009). Household food insecurity associated with stunting and underweight among preschool children in Antioquia, Colombia. Revista Panamericana de Salud Pública, 25(6), 506–510.

    Article  PubMed  Google Scholar 

  28. Hadley, C., Lindstrom, D., Tessema, F., & Belachew, T. (2008). Gender bias in the food insecurity experience of Ethiopian adolescents. Social Science and Medicine, 66(2), 427–438.

    Article  PubMed  Google Scholar 

  29. Hartikainen, H., Maleta, K., Kulmala, T., & Ashorn, P. (2005). Seasonality of gestational weight gain and foetal growth in rural Malawi. East African Medical Journal, 82(6), 294–299.

    Article  CAS  PubMed  Google Scholar 

  30. Hassan, N., Huda, N., & Ahmad, K. (1985). Seasonal patterns of food intake in rural Bangladesh: Its impact on nutritional status. Ecology of Food and Nutrition, 17(2), 175–186.

    Article  Google Scholar 

  31. HEA (2007), HEA LZ Profile - Tana Zuria Livelihood Zone (TZA) Amhara Region, Ethiopia 2007. Household economy approach and cost of the diet (HEA), tools for food security and nutrition analysis. Available http://www.heawebsite.org/countries/ethiopia/reports/hea-lz-profile-tana-zuria-livelihood-zone-tza-amhara-region-ethiopia-2007 Accessed 01 November 2015.

  32. Hirvonen, K., Taffesse, A. S., & Hassen, I. W. (2016). Seasonality and household diets in Ethiopia. Public Health Nutrition, 19(10), 1723–1730.

    Article  PubMed  Google Scholar 

  33. International Zinc Nutrition Consultative Group (IZiNCG) (2004). Assessment of the risk of zinc deficiency in populations and options for its control. International Zinc Nutrition Consultative Group (IZiNCG) Technical Document #1. Food and Nutrition Bulletin, 25(1) (supplement 2) S94–S204.

  34. Kahsay, Z.A. (2017). Smallholder Agriculture and Household Food and Nutrition Security: A Study from South-eastern Tigray, Ethiopia. Unpublished PhD thesis submitted to University College Cork, Cork, Ireland.

  35. Kaiser, L. L., Melgar-Quiñonez, H. R., Lamp, C. L., Johns, M. C., Sutherlin, J. M., & Harwood, J. O. (2002). Food security and nutritional outcomes of preschool-age Mexican-American children. Journal of the American Dietetic Association, 102(7), 924–929.

    Article  PubMed  Google Scholar 

  36. Kennedy, G., Ballard, T., & Dop, M. C. (2011). Guidelines for measuring household and individual dietary diversity (p. 2011). Rome: Food and Agriculture Organization of the United Nations.

    Google Scholar 

  37. Kidane, H., Alemu, Z. G., & Kundhlande, G. (2005). Causes of household food insecurity in Koredegaga peasant association, Oromiya zone, Ethiopia. Agrekon, 44(4), 543–560.

    Article  Google Scholar 

  38. Kramer, M. S. (1987). Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663–737.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Kumar, N., Harris, J., & Rawat, R. (2015). If they grow it, will they eat and grow? Evidence from Zambia on agricultural diversity and child undernutrition. Journal of Development Studies, 51(8), 1060–1077.

    Article  Google Scholar 

  40. Mallard, S. R., Houghton, L. A., Filteau, S., Mullen, A., Nieuwelink, J., Chisenga, M., Siame, J., & Gibson, R. S. (2014). Dietary diversity at 6 months of age is associated with subsequent growth and mediates the effect of maternal education on infant growth in urban Zambia. The Journal of Nutrition, 144(11), 1818–1825.

    Article  CAS  PubMed  Google Scholar 

  41. Manlosa, A. O., Hanspach, J., Schultner, J., Dorresteijn, I., & Fischer, J. (2019). Livelihood strategies, capital assets, and food security in rural Southwest Ethiopia. Food Security, 11(1), 167–181.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Maxwell, D., Coates, J., & Vaitla, B. (2014). How do indicators of household food insecurity measure up? An empirical comparison from Ethiopia. Food Policy, 47, 107–116.

    Article  Google Scholar 

  43. McKinney, P. (2009). Comprehensive Food Security & Vulnerability Analysis (CFSVA). Rome: United Nations World Food Programme.

    Google Scholar 

  44. Mekonnen, D. A., & Gerber, N. (2017). Aspirations and food security in rural Ethiopia. Food Security, 9(2), 371–385.

    Article  Google Scholar 

  45. Nord, M., Andrews, M. & Carlson, S. (2005). Household food security in the United States, 2004. USDA-ERS Economic Research Report.

  46. Passarelli, S., Mekonnen, D., Bryan, E., & Ringler, C. (2018). Evaluating the pathways from small-scale irrigation to dietary diversity: Evidence from Ethiopia and Tanzania. Food Security, 10(4), 981–997.

    Article  Google Scholar 

  47. Psaki, S., Bhutta, Z. A., Ahmed, T., Ahmed, S., Bessong, P., Islam, M., John, S., Kosek, M., Lima, A., & Nesamvuni, C. (2012). Household food access and child malnutrition: Results from the eight-country MAL-ED study. Population Health Metrics, 10, 24.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Regassa, N., & Stoecker, B. J. (2012). Household food insecurity and hunger among households in Sidama district, southern Ethiopia. Public Health Nutrition, 15(7), 1276–1283.

    Article  Google Scholar 

  49. Roba, K. T., O'Connor, T. P., Belachew, T., & O'Brien, N. M. (2015). Seasonal variation in nutritional status and anemia among lactating mothers in two agro-ecological zones of rural Ethiopia: A longitudinal study. Nutrition, 31, 1213–1218.

    Article  PubMed  Google Scholar 

  50. Roba, K. T., O’Connor, T. P., Belachew, T., & O’Brien, N. M. (2016a). Infant and young child feeding (IYCF) practices among mothers of children aged 6–23 months in two agro-ecological zones of rural Ethiopia. International Journal of Nutrition and Food Sciences, 5(3), 185–194.

    Article  Google Scholar 

  51. Roba, K. T., O’Connor, T. P., Belachew, T., & O’Brien, N. M. (2016b). Serum zinc, iron and urinary iodine levels and their relationship to other indices of malnutrition among lactating mothers in two agro-ecological zones of rural Ethiopia. Journal of Nutrition and Health Sciences, 3(2), 202.

    Google Scholar 

  52. Roba, K. T., O’Connor, T. P., Belachew, T., & O’Brien, N. M. (2016c). Variations between post- and pre-harvest seasons in stunting, wasting, infant and young child feeding (IYCF) practices among children 6-23 months of age in lowland and midland agro-ecological zones of rural Ethiopia. Pan African Medical Journal, 24, 163.

    Article  PubMed  Google Scholar 

  53. Ruel, M. (2002). Is dietary diversity an indicator of food security or dietary quality? A review of measurement issues and research needs. Food consumption and nutrition division discussion paper 140. Washington, D.C International Food Policy Research Institute.

  54. Ruel, M.T., Minot, N. & Smith, L. (2004). Patterns and determinants of fruit and vegetable demand in sub-Saharan Africa: a multicountry comparison. Prepared for the Joint FAO/WHO Workshop on Fruit and Vegetables for Health, 1–3 September 2004, Kobe, Japan. http://www.who.int/dietphysicalactivity/publications/f%26v_africa_economics.pdf. Accessed 23 Jan 2017.

  55. Saaka, M. & Osman, S.M. (2013). Does Household Food Insecurity Affect the Nutritional Status of Preschool Children Aged 6–36 Months? International Journal of Population Research, Article ID 304169. https://doi.org/10.1155/2013/304169

  56. Savy, M., Martin-Prével, Y., Traissac, P., Eymard-Duvernay, S., & Delpeuch, F. (2006). Dietary diversity scores and nutritional status of women change during the seasonal food shortage in rural Burkina Faso. The Journal of Nutrition, 136(10), 2625–2632.

    Article  CAS  PubMed  Google Scholar 

  57. Sewnet, Y. (2015). Causes and coping mechanisms of food insecurity in rural Ethiopia. Agriculture and Biology Journal of North America, 6(5), 123–133.

    Google Scholar 

  58. Swindale, A., & Bilinsky, P. (2006). Household dietary diversity score (HDDS) for measurement of household food access: Indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.

    Google Scholar 

  59. Tefera, T., & Tefera, F. (2014). Determinants of households food security and coping strategies for food shortfall in Mareko District, Guraghe zone southern Ethiopia. Journal of Food Security, 2(3), 92–99.

    Google Scholar 

  60. Tetens, I., Hels, O., Khan, N. I., Thilsted, S. H., & Hassan, N. (2003). Rice-based diets in rural Bangladesh: How do different age and sex groups adapt to seasonal changes in energy intake? The American Journal of Clinical Nutrition, 78(3), 406–413.

    Article  CAS  PubMed  Google Scholar 

  61. Tiwari, S., Skoufias, E. & Sherpa, M. (2013). Shorter, cheaper, quicker, better: Linking measures of household food security to nutritional outcomes in Bangladesh, Nepal, Pakistan, Uganda, and Tanzania. World Bank Policy Research Working Paper.

  62. Torheim, L. E., Ouattara, F., Diarra, M. M., Thiam, F. D., Barikmo, I., Hatloy, A., & Oshaug, A. (2004). Nutrient adequacy and dietary diversity in rural Mali: Association and determinants. European Journal of Clinical Nutrition, 58(4), 594–604.

    Article  CAS  PubMed  Google Scholar 

  63. United Nations. (2008). The millennium development goals report 2008. New York: United Nations.

    Google Scholar 

  64. Vaitla, B., Tesfay, G., Rounseville, M., & Maxwell, D. (2012). Resilience and livelihoods change in Tigray, Ethiopia. Somerville: Tufts University, Feinstein International Center.

    Google Scholar 

  65. Webb, P., Coates, J., Frongillo, E. A., Rogers, B. L., Swindale, A., & Bilinsky, P. (2006). Measuring household food insecurity: Why it's so important and yet so difficult to do. The Journal of Nutrition, 136(5), 1404S–1408S.

    Article  CAS  PubMed  Google Scholar 

  66. WHO, UNICEF, USAID, FANTA, AED, UC DAVIS & IFPRI. (2010). Indicators for assessing infant and young child feeding practices part 2: Measurement. Geneva: The World Health Organization Dept of Child and Adolescent Health and Development.

    Google Scholar 

  67. Wiesmann, D., Bassett, L., Benson, T., & Hoddinott, J. (2009). Validation of the world food Programme’s food consumption score and alternative indicators of household food security. International Food Policy Research Institute: Washington D.C.

    Google Scholar 

  68. Working Group on Infant and Young Child Feeding Indicators. (2006). Developing and validating simple indicators of dietary quality and energy intake of infants and young children in developing countries. Washington, D.C: Food and Nutrition Technical Assistance Project (FANTA).

    Google Scholar 

  69. World Health Organization. (2009). Child growth standards: Growth velocity based on weight, length and head circumference: Methods and development. Geneva: World Health Organization.

    Google Scholar 

  70. Yigrem, S., Markemann, A., Abebe, G., & Ogutu, J. O. (2015). Assessing the relative importance of dairy products to family nutrition in mixed crop-livestock production systems of Ethiopia. Food Security, 7(5), 1003–1015.

    Article  Google Scholar 

Download references

Acknowledgements

The authors acknowledge Irish Aid for sponsoring this study as part of the Agridiet project. The study was funded by Irish Aid and the Higher Education Authority of Ireland through the Programme of Strategic Cooperation. We would like to thank Haramaya University and Mekelle for assisting us in transport facilities during the data collection. We also thank the Ethiopian Public Health Institute for analysing the micronutrients and Hiwot Fana Specialized University Hospital for separating serum from whole blood and storing the serum at the required temperature. We would like to express our sincere gratitude to all participants of the study and data collectors.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Edward Lahiff.

Ethics declarations

Ethical consideration and informed consent

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were registered and approved by University College Cork, Ireland and Haramaya University College of Health and Medical Sciences Institution, Ethiopia, Research Ethics Review Committees. Subsequently, the final registration and approval of the protocol were granted by the Ethiopian National Ministry of Science and Technology Ethical Review Committee with registration nos. of 310/592/06 dated 08/05/06 Ethiopian calendar. Informed consent was obtained from the mothers, and verbal informed consent was obtained from the caregivers of the children; they were informed that they had the right to refuse or exit from the study at any time and refusing to participate in the study would not have any negative implications for them. Verbal consent was witnessed and formally recorded. Children and women who were found to be undernourished during assessment were referred to the nearest health institution for health care services.

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

ESM 1

(DOCX 19 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Roba, K.T., O’Connor, T.P., O’Brien, N.M. et al. Seasonal variations in household food insecurity and dietary diversity and their association with maternal and child nutritional status in rural Ethiopia. Food Sec. 11, 651–664 (2019). https://doi.org/10.1007/s12571-019-00920-3

Download citation

Keywords

  • HFIAS
  • HFCS
  • HDDS
  • Malnutrition
  • Seasonality
  • Maternal and children
  • Ethiopia