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      Reducing amount and frequency of meal as a major coping strategy for food insecurity

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          Abstract

          Background

          Food insecurity is a global problem affecting many people worldwide, including approximately 220 million people in sub-Saharan Africa. Ethiopia is among the countries severely affected by hunger. However, evidence on how populations within Ethiopia cope with hunger and food insecurity is limited. This study aimed to identify household coping mechanisms in response to food insecurity at a Dabat Health and Demographic Surveillance System site.

          Methods

          This study used data from a re-census collected between October 2014 and December 2014.15,159 household members in thirteen kebeles of the Dabat Health and Demographic surveillance system were included. The outcome variables of the study were food insecurity and coping strategies. Household Food Insecurity Access Scale (HFIAS) was used to assess food insecurity. If food insecurity was found, families were asked about coping mechanisms used. Binary logistic regression analysis was applied to identify socio-demographic determinants of reducing amount and frequency of meal as a coping mechanism in response to food insecurity.

          Result

          Of the 15,159 households surveyed, 6671 (44.01%) reported the presence of a food insecurity in their household. Decreasing meal frequency and portions (3733 (55.96%)), borrowing money and food (2542 (38.11%)), and receiving food and money aid (1779 (26.67%)) were among the major coping strategies used by the households. Urban dwellers (AOR 2.07: 95% CI 1.74, 2.46), mid-altitude (weyina-dega) and high-land (dega) dwellers (AOR 2.46: 95% CI 2.08, 2.92 and AOR 1.22 95% CI 1.08, 1.38 respectively), and not married persons (AOR 1.60: 95% CI 1.07, 2.39) were more likely to consume less when faced with a food insecurity (using reducing amount and frequency of meal as a coping strategy).

          Conclusion

          Households in the study area experienced a very high rate of food insecurity . Decreasing meal frequency and portions was the primary coping mechanism used by the households. Due to the severe insecurity of food in their household, many people chose to reduce the amount and frequency of their meal in order to prolong the small amount of food in their house. This finding indicates a high risk for undernourishment which can exacerbate the burden of malnutrition and related diseases in the region.

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          Most cited references28

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          Malnutrition as an enteric infectious disease with long-term effects on child development.

          Malnutrition is a major contributor to mortality and is increasingly recognized as a cause of potentially lifelong functional disability. Yet, a rate-limiting step in achieving normal nutrition may be impaired absorptive function due to multiple repeated enteric infections. This is especially problematic in children whose diets are marginal. In malnourished individuals, the infections are even more devastating. This review documents the evidence that intestinal infections lead to malnutrition and that malnutrition worsens intestinal infections. The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies. Also reviewed are the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens enteric infections, with implications for potential novel interventions. Further intervention studies are needed to document the relevance of these mechanisms and, most importantly, to interrupt the vicious diarrhea-malnutrition cycle so children may develop their full potential.
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            Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002.

            Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes. To evaluate whether there is an independent association between food insecurity and diabetes. Cross-sectional analysis of the nationally representative, population-based National Health and Nutrition Examination Survey (1999-2002 waves). Four thousand four hundred twenty-three adults > 20 years of age with household incomes or = 126 mg/dl. Diabetes prevalence in the food secure, mildly food insecure, and severely food insecure categories was 11.7%, 10.0%, and 16.1%. After adjusting for sociodemographic factors and physical activity level, participants with severe food insecurity were more likely to have diabetes than those without food insecurity (adjusted odds ratio [AOR] 2.1, 95% CI 1.1-4.0, p = .02). This association persisted after further adjusting for body mass index (AOR 2.2, 95% CI 1.2-3.9, p = .01). Food insecurity may act as a risk factor for diabetes. Among adults with food insecurity, increased consumption of inexpensive food alternatives, which are often calorically dense and nutritionally poor, may play a role in this relationship. Future work should address how primary care clinicians can most effectively assist patients with food insecurity to make healthy dietary changes.
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              Malnutrition in Sub – Saharan Africa: burden, causes and prospects

              Malnutrition is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause. Contributing to more than half of deaths in children worldwide; child malnutrition was associated with 54% of deaths in children in developing countries in 2001. Poverty remains the major contributor to this ill. The vicious cycle of poverty, disease and illness aggravates this situation. Grooming undernourished children causes children to start life at mentally sub optimal levels. This becomes a serious developmental threat. Lack of education especially amongst women disadvantages children, especially as far as healthy practices like breastfeeding and child healthy foods are concerned. Adverse climatic conditions have also played significant roles like droughts, poor soils and deforestation. Sociocultural barriers are major hindrances in some communities, with female children usually being the most affected. Corruption and lack of government interest and investment are key players that must be addressed to solve this problem. A multisectorial approach is vital in tackling this problem. Improvement in government policy, fight against corruption, adopting a horizontal approach in implementing programmes at community level must be recognized. Genetically modified foods to increase food production and to survive adverse climatic conditions could be gateways in solving these problems. Socio cultural peculiarities of each community are an essential base line consideration for the implementation of any nutrition health promotion programs.
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                Author and article information

                Contributors
                atesfahun1@gmail.com
                amaretariku15@yahoo.com
                gabebaw2worku@gmail.com
                solomekonnen@yahoo.com
                mezgebuy@gmail.com
                tawoke7@gmail.com
                kassalemu@gmail.com
                gashawab@gmail.com
                Journal
                Arch Public Health
                Arch Public Health
                Archives of Public Health
                BioMed Central (London )
                0778-7367
                2049-3258
                4 October 2018
                4 October 2018
                2018
                : 76
                : 56
                Affiliations
                [1 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                [2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                [3 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Health Service Management and Economics, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                [4 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                [5 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                Author information
                http://orcid.org/0000-0001-9210-172X
                Article
                303
                10.1186/s13690-018-0303-3
                6171242
                30305899
                3ed0a377-e33c-4a5e-9996-4b19a6af48bd
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 December 2017
                : 7 August 2018
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Public health
                food insecurity,coping,reducing amount and frequency of meal,food aid,borrowing,ethiopia
                Public health
                food insecurity, coping, reducing amount and frequency of meal, food aid, borrowing, ethiopia

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