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Background: Household food insecurity and lack of education are two of the most remarkable deprivations which developing countries are currently experiencing. Evidences from different studies showed that health and nutrition problems are major barriers to educational access and achievement in low-income countries which poses a serious challenge on effort towards the achieving Sustainable Development Goals. Evidence on the link between food security and school attendance is very important to address this challenge. This study aimed to assess to what extent food insecurity affects school absenteeism among primary school adolescents. Methods: A school based cross-sectional study was conducted among primary school adolescents in Jimma zone from October-November, 2013. Structured questionnaire was used to collect data on the household food security and socio-demographic variables. Data were analyzed using SPSS for windows version 16.0 after checking for missing values and outliers. Multivariable logistic regression analyses were used to determine the association of school absenteeism and food insecurity with independent variables using odds ratio and 95 % of confidence intervals. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression analysis to control for associations among the independent variables. Results: The frequency of adolescent school absenteeism was significantly high (50.20 %) among food insecure households (P < 0.001) compared to their peers whose households were food secure (37.89 %). Findings of multivariable logistic regression analysis also showed that household food insecurity [AOR = 2.81 (1.70, 4.76)] was positively associated with poor school attendance while female-headed household [AOR = 0.23 (0.07, 0.72)], urban residence [AOR = 0.52 (0.36, 0.81)] and male-gender [AOR = 0.64 (0.54, 0.74)] were inversely associated with school absenteeism. Household food insecurity was positively associated with lack of maternal education [AOR = 2.26 (0.57, 8.93)] and poor household economic status [AOR = 1.39 (1.18, 2.83)]. However, livestock ownership [AOR = 0.17 (0.06, 0.51)] was negatively associated with household food insecurity. Conclusions: Findings of this study showed that household food insecurity has strong linkage with adolescent school absenteeism. Maternal education and household economic status were significantly associated with household food security status. Therefore, national policies and programs need to stress on how to improve family income earning capacity and socioeconomic status to handle household food insecurity which is a key contributor of adolescent school absenteeism.
A school based cross-sectional study was conducted in the Jimma from October-November, 2013. Jimma Zone is one of the 20 administrative zones of Oromia Regional State with its capital Jimma town located at 350 km from Addis Ababa, Ethiopia, in the southwest direction. Jimma Zone has 18 administrative districts containing a total population of 2.5 million with the majority (94 %) living in the rural settings. The study area was stratified into urban schools and rural schools to represent a range of ecological and developmental settings. Four primary schools were selected from both urban and rural schools. Then, from each school, sections (classes) were identified and eligible study participants were randomly selected. A total of 1000 students who were permanent residents attending the school of the study area were randomly selected using their rosters as a frame. The sample was calculated using Gpower 3.0 with the following assumptions: 90.4 % an expected prevalence of poor dietary practices among food insecure school adolescents, 0.42 odds ratio of poor dietary practices among food insecure adolescents (29), margin of error of 5 % and power of 88 %. This gives a total sample size 434 and multiplied with a design effect of two. Finally, 15 % non-response was added to a final sample. Structured questionnaire was used to collect data on food security, socio-demographic and economic variables. Questionnaires were prepared in English and translated to Amharic and Afan Oromo by language experts. Finally, questionnaires were retranslated back to English by a person who can speak both languages. After the recruitment of data collectors, questionnaire was pre-tested for its clarity and time required. Based on a pretest, additional adjustment was made on terminologies and the formats of the questionnaire. Data were collected by trained data collectors who were selected depending on their abilities of speaking the local language. Supervisors kept track of the field procedures and daily checked the completed questionnaires to ensure accuracy of the collected data. To avoid the possibility of measurement bias, data collectors were blinded of the study objective. Household food insecurity was measured in the last three months using household food insecurity scales that were validated for use in developing countries [6, 7, 11] which included questions (I) the respondent worried about food (II) the household run out of food (III) reduced food variety and enforced to eat similar food (IV) reduced the amount of food intake and skipped meal (V), the respondent or another adult did not have enough to eat (VI) and felt hungry due to lack of food and stayed without food for 24 h. All “Yes” responses were coded as one and “No” responses were coded as zero. Finally, all responses were summed and dichotomized to food secure and food insecure to create an index of household food insecurity. School absenteeism was defined as any illegitimate absence from school for at least a day within the last semester, which do not include formal school closure days (national holidays or religious days). Data analyses were done using SPSS for windows version 16.0 (Chicago, Illinois) after checking for missing values and outliers. Descriptive statistics were presented using standard statistical parameters such as percentages, means and standard deviations. Multivariable logistic regression analyses were used to determine the association of school absenteeism and food insecurity with independent variables using odds ratio and 95 % of confidence intervals. Multicollinearity among independent variables was assessed using the standard errors. The standard errors for regression coefficients <2.0, as a familiar cutoff value, showed that there was no multicollinearity among independent variables. Variables that have p values ≤0.25 with dependent variables in the bivariate analyses were selected as a candidate variable for multivariable logistic regression analyses to control for associations among the independent variables.
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