DOI: 10.4103/sijm.sijm_17_26 ISSN: 3050-838X

Bridging Household Food and Nutrition Insecurity through Primary Health Care and System Responses: Evidence from Household Food and Nutrition Security Metrics in Low-resource Urban Settlements

Manisha Kabra, Arindam Das

Abstract

Background:

Rapid urbanization has expanded low resource urban settlements, in the form of informal settlements of “slums,” intensifying the household food and nutrition insecurity and sustaining the burden of malnutrition among vulnerable populations.

Aims and objectives:

This study aims to examine the Household Food and Nutrition Security (HFNS) and its association with the intra-household nutritional behaviours, water, sanitation and hygiene (WASH) practices and primary healthcare (PHC) responses in 397 households across 22 Jaipur slums using a validated 25 point HFNS Scale.

Methodology:

Using a validated 25 point HFNS scale (Cronbach’s alpha = 0.80), and semi structured tools, the scale covered experiences felt by the mothers of children of 0–5 years of age for dietary inadequacy integrated with accessibility to the safe drinking water, soap and sanitary facilities of toilets, maternal and child health services and financial security related to health and foods for past 12 months preceding the study.

Results:

The study found only 5.3% ( n = 21) households secure, 84.1% ( n = 334) moderately secure, and 10.6% ( n = 42) severely insecure for food and nutrition. HFNS scale demonstrated a strong, significant association ( P < 0.05) with intra-household maternal and child healthcare behaviours, Infant and young child feeding behaviours, WASH behaviours and women’s autonomy, whereas weak primary health care engagement increased sub optimal practices and risks of reinforcing the infection–malnutrition cycle and nutrition insecurity for women and children.

Conclusions:

The Household Food and Nutrition Security scale helps to identify vulnerable households for equitable Primary Health Care interventions in urban slums to reduce undernutrition.

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