Background. The magnitude of food insecurity in Ethiopia ranges from 38.7% to 82.3% among the general population. Children under the age of five years were more prone to food insecurity and its serious consequences like anemia, low bone density, frequent episodes of common cold, stomachache, poor educational performance, and dental carries in developing countries like Ethiopia. However, there is no any research finding that documented the magnitude of child food insecurity, coping strategies, and associated factors in the study area. Therefore, the aim of this study was estimating the magnitude of child food insecurity, major coping strategies, and factors associated with child food insecurity in the study area. Methods. A community-based cross-sectional survey has been conducted in Dabat demographic and health surveillance site among 7152 mothers/caretakers of children under the age of five years. Data were collected by experienced data collectors working for the demographic and health surveillance site, and the collected data were entered into EpiData template and then transported to Stata 14 software for data cleaning and analysis. The ordinal logistic regression model was fitted to identify predictors for child food insecurity. Results. About 21.42% of children under the age of five years were food insecure in Dabat district of whom 57.8%, 38.6%, and 3.6% had experienced mild, moderate, and severe levels of child food insecurity, respectively. All most all 1391 (92%) of the mothers/caretakers of food insecure children had practiced food insecurity coping strategies. More than half (57%) of mothers/caretakers reduces the size of child meal as insecurity coping strategy. Child food insecurity was associated with household wealth status, parent’s education status, and maternal and child health service utilization and child feeding practices. Conclusion. A large segment of under-five children had experienced food insecurity in Dabat district, and the major coping strategy for child food insecurity was reducing meal size. Therefore, working on household wealth improvement and expansion of basic health services would improve child food security.
The study was conducted at Dabat Demographic and Health Surveillance System (HDSS) site. The HDSS covers 13 kebeles divided into 83 clusters. The altitude of the district ranges from 1000 meters to 2500 meters above sea level, and the weather condition is divided into highland, midland, and lowland climatic conditions. Dabat town, the capital of the district, is located 821 km from Addis Ababa and 75 km from Gondar town to the north. Dabat district has six health centers, three health stations, and thirty-one health posts that provide health services to the community. The total population of the district was estimated to be 158,250 of whom about 70,611 were the population of the HDSS with the sex ratio of nearly 1 : 1. In the HDSS, there are 7,918 children under the age of five years [20]. The community-based cross-sectional study design was carried out among rural and urban households with under-five children from April to December 2016. Mothers/caretakers of under-five children available during the study period were participants for this study. In the absence of mothers/caretakers of under-five children during visit day, other senior household members beyond 18 years were interviewed after consenting. A pretested interviewer-administered structured questionnaire was used to collect data on sociodemographic, and maternal and child health service utilization. To assess the level of child food security, we use FANTA III food insecurity access measurement scale version 3. A five-day training was provided for data collectors and supervisors. A pretest was conducted in the rural and urban kebeles of Dabat district which are not included in the HDSS, and necessary modification of the tool was made according to the inputs of the pretest. Data were collected by 15 experienced data collectors and supervised by supervisors working for Dabat HDSS. To avoid data entry errors related to the translation of the responses, collected data were entered into EpiData template prepared in Amharic language that have similar content with the data collection tool. Five experienced data entry clerks were recruited for the data entry, and the overall data entry process was supervised by a data manager working at the HDSS site. Entered data were transported to STATA version 14.1 for data cleaning and analysis. The correlation of a dependent variable with each independent variable was assessed by Pearson’s chi-square test before fitting univariate and multivariate ordinal logistic regression models. All variables with significant Pearson’s chi-square test were considered for univariate ordinal logistic regression model, and variables significant at the univariate ordinal logistic regression model were fitted into the multivariate ordinal logistic regression model to identify predictors for child food insecurity. Proportional cumulative odds ratio assumption was checked by significant Pearson’s chi-square before the attempt to interpret the final model. The level of child food insecurity is the dependent variable. The following are the independent variables:
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