Journal of Public Health and Nutrition

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Research Article - Journal of Public Health and Nutrition (2019) Volume 2, Issue 3

Household characteristics and food insecurity and their association with nutritional outcome of under-five children of a rural farming community of Sokoto State, Nigeria.

Kaoje AU1*, Raji MO1, Aliyu A1, Mainasara A1, Aghedo MO1, Raji IA2

1Department of Community Health, Usmanu Danfodiyo University, Sokoto, Nigeria

2Department of Community Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

*Corresponding Author:
Kaoje AU
Department of Community Health
Usmanu Danfodiyo University Sokoto
Nigeria
Tel: +2348037003110
E-mail: [email protected]

Accepted date: June 13, 2019

Citation: Kaoje AU, Raji MO, Aliyu A, Mainasara A, Aghedo MO, Raji IA. Household characteristics and food insecurity and their association with nutritional outcome of under-five children of a rural farming community of Sokoto State, Nigeria. J Pub Heath Catalog 2019;2(3):173-181.

Visit for more related articles at Journal of Public Health and Nutrition

Abstract

Background: Malnutrition is a global problem and continues to be one of the major health problems among children particularly for the poor and underprivileged as poverty remain a fundamental cause of household food insecurity and consequently malnutrition.
 
Objective: To determine household characteristics, food Security status and their association with nutritional status of under five children of a rural community.
 
Methodology: A community-based descriptive cross-sectional study was conducted among 200 households’ in a rural community. Sampled households with eligible children were selected using multistage sampling technique. Interviewer-administered questionnaires were used to collect data through face-to-face interview. Data was analyzed using SPSS version 23.0. Both univariate and bivariate analyses were carried out. Statistically significant level was set at p<0.05.
 
Results: Respondents average age was 42; IQR: 33-51 years. Nearly two-thirds (62.8%) had only Qur’anic education. More than three quarters (86.8%) of respondents experienced food shortage in the recent past, 47.9% are food insecure and 24.5% of the under-five children were acutely malnourished. Respondents ’ age (p=0.001); households head educational level (p=0.001); family composition (p=0.001); type of household food insecurity suffered (p=0.001) showed statistically significant association with children nutritional status.
 
Conclusion: A significant proportion of the households head are of low-social status and food insecure. Majority of households in the recent past experienced food shortage and a quarter of under-five children were acutely malnourished.

Keywords

Households characteristics, Food security, Nutritional status, Rural community

Introduction

Freedom from hunger and malnutrition is a basic human right and their alleviation is a fundamental prerequisite for human and national development [1]. Sustainable development goals 1 and 2 focus on the eradication of extreme poverty and hunger, achieving food and nutrition security and making agriculture sustainable [2]. Malnutrition is one of the major public health challenges in developing countries. Usually referred to as a silent emergency, it has devastating effects on children, women, society and future humankind [3]. Low socio-economic status is highly related to household nutritional status. Characteristics of low socio-economic status are reflected in low monthly household income, low income per capita, low educational level, unemployment among adult members and large households [4]. Malnutrition is typically associated with lowincome, poverty, food insecurity, limited access to health care and lack of sanitary conditions [5]. These associations are particularly salient in Africa where malnutrition continues to be a major public health issue [6,7]. Studies have identified poverty as the chief determinant of malnutrition in the developing country that perpetuate into inter-generational transfer of poor nutritional status among children and prevent social improvement and equity [8,9].

Food insecurity is a worldwide problem. A household is considered food insecure if it has limited or uncertain physical and economic access to secure sufficient quantities of nutritionally adequate and safe foods in socially acceptable ways to allow household members to sustain active and healthy living [10].

It is common for low-income households to experience food insecurity, as poverty is the principal cause of food insecurity and consequently malnutrition [11]. The food security problem in Nigeria is pathetic as more than 70 percent of the populace lives in households too poor to have regular access to the food that they need for healthy and productive living [12]. Studies done in Nigeria revealed that between 37.8 and 63% of households are food insecure and therefore unable to meet the recommended daily per capital calorie requirement [13,14]. A study from Bangladesh revealed that 33.3% of the surveyed households were found to be food insecure and could not get the minimum and above recommended calorie level per capita per day [15]. Children from food insecure households have higher probability of being underweight and stunted than those from food-secure households [16]. A study done in Kelantan showed that prevalence of underweight, stunting, and wasting among children from food insecure homes in Kelantan were 61.0%, 61.4% and 30.6%, respectively [17]. Nepal study reported greater number of malnourished children in food insecure households, with slightly higher prevalence rates of stunting and underweight, though the prevalence of wasting was almost similar in food secure and insecure households [18].

Nigerian government through its economic diversification efforts invested heavily on agriculture to boost food production for self-sufficiency and improvement in nutritional wellbeing of households. Therefore, it is with this background that the study was conducted to assess the household characteristics and food insecurity status and their association with nutritional status of under-five children in a rural farming community of Sokoto state. The study objectives are: 1) To assess the food insecurity status in the community; 2) To measure the nutritional status of the children and 3) To determine the association between the household characteristics, food insecurity status and nutritional status of under five children.

Methods

The study was conducted in a rural community in Wamakko Local Government Area (LGA) of Sokoto State from January to March 2018. A community-based descriptive cross-sectional study was conducted among households ’ head whose predominant occupation is farming. The criteria selection in the study was being household head, farmer, resident of the study community and willingness to participate in the study. The required sample size for the study was determined using the formula, n=Z2pq/d2, Where; n=minimum sample size desired; Z=standard normal deviate corresponding to Z value at alpha level of 0.05=1.96; p=prevalence or proportion of factor under study in the previous similar study; q=complimentary probability of p=1-p; d=level of precision=5%=0.05 [19].

A multistage sampling technique was used to select the study respondents. Interviewer-administered questionnaire with closed ended questions were used to collect field data through face-to-face interview. The questionnaires were pretested in a farming community in another LGA.

All the household heads gave verbal consent prior to data collection. The questionnaire consisted of three sections: Socio-demographic characteristics; assessment of food security using a validated Radimer/Cornell Hunger scale [11]. The anthropometric measures such as weight, height and mid-upper arm circumference (MUAC) were taken. Weight and height of the children were measured using a weighing scale and a stadiometer while MUAC using Shakir ’ s strip. The measurement procedures for MUAC were adopted from the National Guidelines for Community Management of Acute Malnutrition [20]: the left arm of the child was bent at right angle; located the tip of shoulder (acromion) and elbow (olecranon); measured the distance between the two points and located the midpoint; with the left arm relaxed, wrapped the tape around the midpoint and measure the circumference in centimeter and also noted the color coding. Data collected ensured that the measuring tape was snugged against the skin without pinching or leaving gaps. A MUAC of less than 11.5 cm (red) was adjudged severe acute malnutrition, MUAC of greater than 11.5 cm and less than 12.5 cm (yellow) as moderate acute malnutrition and MUAC of 12.5 cm and above (green) as being normal. For the purpose of this study, the dependent variable, nutritional status, was categorized into Normal MUAC of 12.5 cm and above (green) and malnourished as MUAC of less than 12.5 cm.

Statistics

Data was entered and analyzed using SPSS Version 23.0. Respondents ’ age was summarized using median and interquartile range. Categorical data were expressed in frequencies and percentage. Chi square test of association was performed to identify the respondents ’ socio-demographic characteristics, household characteristics and food insecurity status that were associated with under-five nutritional status in the community. The level of statistical significance (alpha error) for the test was set at p<0.05. Ethical permission to conduct the study was sought and obtained from the Sokoto State Research Ethics Committee. Permission for community entry was obtained from the LGA and village head while consent was obtained from individual household heads before questionnaires was administered.

Results

Respondents’ average age was 42; IQR:33-51 years. Those aged between 40-64 years were more represented, while age group 25 to 39 years accounted for 42.0%. All respondents are Muslims and most (96.5%) of them are Hausas. Nearly two thirds (62.8%) had only Qur’anic school education, 16.6% had secondary education while only 6.5% had tertiary level of education. Almost (88.2%) all the respondents have off-farm activities like trading and artisan (Table 1).

Variables Number Percentage
Age group (years)
22-24 1 0.5
25-39 84 42
40-64 102 51
≥ 65 13 6.5
Religion
Islam 200 100
Tribe
Hausa 192 96.5
Fulani 5 2.5
Others 2 1
Educational level of Household head
Qur’anic school only 125 62.8
Primary school 28 14.1
Secondary school 38 16.6
Tertiary school 13 6.5
Off-farm Activity
Trading 76 39.4
Artisan 60 31.1
Civil servant 26 13.5
Nothing 22 11.8
Others 9 4.2

Table 1. Socio-demographic characteristics of the respondents.

Almost all the households (99.5%) are male headed and 39.9% of the families are polygamous. Households’ young and adult dependents population was 679, with a population dependent ratio of 1.4. Millet is the commonest staple food produced in the area and more than half of the respondents (57.4%) felt the quantities of food produced were inadequate. Almost half (47.5%) of the households were food insecure and 24.5% of children below five years in the households were malnourished as 55.1% of this figure had severe acute malnutrition (Table 2).

Variables Frequency Percent
Head of household (n=199)
Men 198 99.5
Women 1 0.5
Family composition (n=198)
Monogamous 119 60.1
Polygamous 79 39.9
Household dependents
0-14 years 185 92.5
65 and above years 67 33.5
Type of farm produce annually
Cereals (maize, Millet, guinea corn, rice) 193 96.5
Legumes (beans, g/nut etc.) 155 77.5
Vegetables/fruits 18 9
Perception of Quantity produced
Marginal amount 60 30.5
Inadequate amounts of food 113 57.4
Adequate amount 24 12.2
Average Household Monthly income (n=172)
Below poverty index 20 11.6
Above poverty index 152 88.4
Sources of the household income
Farming 177 89.8
Livestock keeping 59 29.9
Household labour 28 14.2
Small businesses 96 48.7
Children support 3 1.5
Pension payment 1 0.5
Others (specify) 1 1
Food security status (n=200)
Food secured 105 52.5
Food insecure 95 47.5
Under 5 nutritional status (n=190)
Malnourished 49 24.5
Normal 141 75.5
MUAC values (n=49)
Red 27 55.1
Yellow 22 44.9

Table 2. Household characteristics and under five nutritional status.

Nearly all the respondents (92.9%) own a farmland, of which more than three quarters (88.3%) obtained the lands by inheritance. More than three quarters (86.8%) of the respondents experienced food shortage in the recent past. Inadequacy of farmland and lack of other resources to facilitate farming activities were largely identified as a key contributing factor by 47.9% and 38.2% of the respondents respectively (Table 3).

Variables Frequency Percentage
Ownership of a farm land
Yes 183 92.9
No 14 7.1
Source of the land
Inheritance 143 88.3
Purchase 17 10.5
Gifts from relatives or friends 2 1.2
Non-owners source of land
Hire 11 78.6
Borrow 3 21.4
Availability of stores/ local silos for farm produce
Yes 183 92.9
No 14 7.1
Experienced food shortage
Yes 165 86.8
No 25 13.2
How often did you experience the shortage (n=165)
Most time of the year 25 20
Some times 72 41.1
Occasionally 68 38.9
Contributing factors to occurrence of food shortage (n=165)
Lack of adequate land 79 47.9
Lack of other resources to facilitate farming activities 63 38.2
Low harvest due insect infestation 13 7.9
Limited access to land ownership 9 5.5
Female headed household 1 0.5
Coping method adopted during food shortage (n=165)
Purchased food to supplement own production 137 83
Sold assets especially land and livestock to buy food 14 8.5
Rationed household consumption 5 3.1
Dietary changes (meal skipping) 3 1.8
Altered household food distribution (considered vulnerable) 3 1.8
Migrated to neighbouring area for paid labour 3 1.8
Allocation of household expenditure
Food purchase 182 94.8
Other home expenses 113 58.9
School payment 25 13
Health care 24 12.5
Purchase of agricultural inputs like fertilizers, seeds 14 7.3

Table 3. Availability and adequacy of land.

Slightly above half (52.0%) of the households produce their own food. Less than two-third (59.8%) of the households’ current food stock can only last between four and six months. Reasons were: little or no alternative sources of income, small farm size, shortage of labour due to few members of the household and large number of dependents (Table 4).

Variables Frequency Percentage
Household methods of access to adequate food
Direct access method (produce own food) 103 52
Produce and purchase food stuff 93 46.9
Transfer from relatives/friends 2 1.1
Accessible resources for direct food production
Sufficient and fertile land 76 38.2
Labour 98 49.2
Tools (improved technology) 41 20.6
Seeds 20 10.1
Credit 6 3
Knowledge to grow crops and raise animals 18 9
Means of procuring food
Bartering 69 35.2
Purchase 179 91.8
Food-for-work 3 1.5
Sell assets such as small livestock 20 10.3
Engage in wage labour 4 2.1
Receive food as gifts 8 4.1
Transfers from relatives/friends 3 1.5
Women involved in farming activities
Yes 3 1.5
No 193 98.5
Form of farming activities engaged
Subsistence farming activities, 3 100
Available food adequate till next harvest
Yes 14 7.1
No 184 92.9
Time foodstuff can last the household (months)
2-3 31 15.6
4-6 119 59.8
7-11 49 24.6
Reasons foods cannot last household till next harvest
I have a small farms 41 31.1
Shortage of labour due to few number the household 15 11.4
Many dependents within the household 31 23.5
Have little or no alternative sources of income 45 34.1
Conduct of land clearing and preparation including planting, weeding and harvesting
Myself 86 43.4
My children 29 14.6
Myself and my children 77 38.9
Engage labourers 111 56.1

Table 4. Household access to food.

Crop failure resulting from low rain or pest infestation (62.0%), lack of other source of income (36.0%) and market fluctuations (32.5%) were the commonest problems that affect household food supplies. Majority (55.5%) of the households experienced transitory food insecurity while 44.5% suffered seasonal food insecurity. More than three quarters (83.5%) of households were able to regain food supply quickly after food shortage (Table 5).

Variables Frequency Percentage
Common problems encountered
Crop failure resulting from low rain or pest infestation 124 62
Lack of other source of income 72 36
Market fluctuations such as sudden price rise 65 32.5
Loss of productive capacity because of sudden illness 1 0.5
Regain adequate food supply after shortage
Yes 167 83.5
No 33 16.5
Risk faced with the farming activities
Lack of fertilizer 139 69.5
Pest infestation 60 30
Lack of improved seeds 48 24
Poor access to irrigation 48 24
Large, sudden price rises 14 7
Lack of market 13 6.5
Lack of storage facilities for the harvested farm product 12 6
Illness that affect my work 5 2.5
Type of food insecurity suffered by the household
Transitory food insecurity 111 55.5
Seasonal food insecurity 87 43.5
Chronic food insecurity 2 1

Table 5. Household food supplies stability.

Chi square test of association revealed that respondents’ age group (p=0.001); household head educational level (p=0.001); family composition (p=0.001); perception of quantity produced (p=0.02); type of household food insecurity suffered (p=0.001) showed statistically significant association with under five nutritional status (Table 6).

Variables Under 5 Nutritional status
Normal, n (%) Malnourished, n (%) Test statistic and p value
Household head
Man 151 (100) 48 (98.0) X2LR=0.55
df=1; p=0.46
Woman 0 1 (2.0)
Age group (years)
≤ 24 0 1 (2.0) Fisher Exact=115.17
p=0.001
25-39 37 (24.2) 28 (57.2)
40-64 99 (65.3) 19 (38.8)
≥ 65 16 (10.5) 1 (2.0)
Educational level of household head
Qur’anic school only 108 (71.6) 27 (54.8) Fisher Exact=71.29
p=0.001
Primary school 19 (12.6) 8 (15.4)
Secondary school 14 (9.5) 11 (23.1)
Tertiary 10 (6.3) 3 (6.7)
Other activities other than farming
Civil servant 20 (13.2) 8 (13.7) Fisher Exact=4.40
p=0.35
Trading 51 (40.7) 19 (38.2)
Artisan 40 (26.4) 17 (35.3)
Nothing 25 (16.5) 3 (6.9)
Others 5 (3.3) 2 (4.7)
Family composition
Monogamous 65 (43.2) 37 (75.7) X2=15.60
df=1; p<0.001
Polygamous 86 (56.8) 12 (24.3)
Farmland ownership
Yes 145 (95.7) 44 (90.4) X2LR= 2.43
df=1; p>0.14
No 6 (4.3) 5 (9.6)
Perception of Quantity produced
Marginal amount 50 (33.1) 10 (20.4) X2 =7.92
df=2; p<0.02
Inadequate amounts of food 77 (51.0) 36 (73.5)
Adequate amount 24 (15.9) 3 (6.1)
Food security status
Food Secured 49 (32.6) 16 (32.4) X2= 0.001
df=1; p>0.14
Food Unsecured 102 (67.4) 33 (67.6)
Type of food insecurity suffered
Transitory food insecurity 98 (64.9) 11 (22.4) Fisher Exact =27.85
p=0.001
Seasonal food insecurity 51 (33.7) 36 (73.5)
Chronic food insecurity 2 (1.4) 2 (4.1)

Table 6. Relationship between under-5 nutritional status and household characteristics.

Discussion

Child malnutrition has been a long-standing public health problem and serious socioeconomic challenges in the many developing countries. Nutritional status is an element of household food security and lack of access to food influences intake of food and this will consequently impact on health and nutritional status of household [21].

A significant proportion of the households were found to be food insecure even though only about a quarter of under five children in the surveyed households were found to be acutely malnourished. As long as the households continue to experience food shortage and insecurity, malnutrition will remain an endemic problem. But for the deep rooted northern culture that encourage sharing of resources with less privileged and vulnerable, food transfers from friends and relatives could explain the disparity between insecurity and number of malnourished in the community. Respondents’ were largely farmers and their predominant means of land ownership is through inheritance, which implies that average size of each household landholdings continue to steadily decline over the successive family generation. Non-members of the community are not likely to have access to farmland at all or must pay heavily to obtain it. Also because of the prevailing economic hardship and fluctuating prices of foodstuff, many of hitherto non-farming working populations engage in agriculture as a marginal economic activity further depriving the poor farmers. The farmers are left with insufficient farmland, coupled with pest infestation and large dependents to cater for will continue to be a trigger of observed pattern of food shortage and insecurity. Land continues to be a critical determinant of the socioeconomic position of rural families and thus a critical determinant of food security and nutritional status of the households. An earlier study in Sokoto among farming communities along Rima basins, revealed more serious insecurity status of 59% among households. The study was conducted following flood disaster which resulted in mass destruction of farm lands, stored food items and livestock [22]. Similar study in North central Nigeria revealed more serious level where nearly two thirds (64%) of households were food insecure [23]. The large gap between the two zones is due to the fact that in Sokoto state many farmers engage in both wet and dry season farming whereas in the central region most of the farmers predominantly farm during the raining season. Food availability, accessibility and supplies stability are key elements of food security. Availability and adequacy of farmland among other factors will influence food availability at household level. Others are land acquisition pattern and decreasing soil yield, as there is no opportunity for land fallowing to regain lost mineral content coupled with poor access to farm input such as fertilizer to boost their yield. This study revealed that inadequacy of farmland, lack of resources to facilitate farming activities and insect infestations were contributing factors to the food shortage which have potential to lead to malnutrition.

Most of the households have very poor due low average monthly income, which is shared with other competing needs within the household. Similarly, lack of other income generating activities forced the farmers to sell nearly half of their harvest to meet up with other household expenditures. All these factors interplayed and resulted to food shortage. Although majority of household heads produce are subsistent, some are able to achieve commercial production while few receive gifts from families and friends. Therefore vast majority of household do not have access to adequate amount of food due to poor alternative sources of income, small farm size, large number of dependents resulting from polygamous nature of family system and lack of inputs to facilitate farming. The low purchasing power of the household heads and populated household with largely young dependent age group contributed negatively to food availability and access. Similarly, a multiagency study done on food consumption pattern in rural area of northern Nigeria showed that 65.7% of the respondents purchase food while few get their food from farming [24]. Entrenched irrigation farming system in Sokoto provide opportunity for many farming families to access food from their farms whereas some other northern communities focus more on wet season farming, as such many of resident have rely on market purchase.

Household heads ’ age, household heads ’ educational level, family composition and type of household food insecurity suffered were associated with under five nutritional status. And composition of the household family being the key determining factor of household under five nutritional status. Islamic religion has a great influence on cultural values and beliefs including marriage and family norms of the respondents. All the respondents are Muslim and Islam encourages polygamy, which result to large family size. Although the large family size is supposed to be an advantage with respect to contribution to family income but many are young dependents. Findings from a similar study from North Western Nigeria showed that household size was a major determinant of food security [25]. This is in contrast to findings in another study in Ondo State, South West Nigeria where household income was the only determinant of food security [26]. Households in Ondo are predominantly civil servant and largely rely on market purchase from family income unlike Sokoto where farming is the predominant occupation. Another study in Pakistan identified family income level as the most decisive variable for food security [26]. Findings from another study showed that household characteristics are strong predictors of both acute and chronic indicators of nutritional status and those households with poor socio-economic characteristics such as those with less access to adequate food for all members, or resident in low-income neighborhoods are likely to have children with poor growth [27].

Sokoto state is one of the states with high under five malnutrition and currently being supported by development partners in community management of acute malnutrition. Improving household nutrition through intersectorial collaboration is one of the cardinal principles of primary health care. Therefore to combat malnutrition means that every household must have access to food in quantity and quality and ensure the food supply is stable.

Conclusion

There is high level of food insecurity and malnutrition in the rural communities especially from food insecure household. Households were characterized by low educational status and level, large family size and large young dependents and low average monthly income. In view of study findings, it is recommended that government should support the farmers with basic inputs including credit facilities to facilitate farming activities while farmers are also sensitized to engage in other profitable off-farming activities to complement their income generation.

Conflict of Interest

The author declares no competing interests.

Acknowledgements

The researchers acknowledge the support of district head of the community for cooperation and also the respondents for their valuable time and information.

References