Urban Household Food Insecurity and Demographic Outcomes: Implications for Fertility, Contraceptive Use and Under-Five Mortality in Lideta Sub-City, Addis Ababa, Ethiopia
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Date
2024-06
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Addis Ababa University
Abstract
Food security and vulnerability assessments in Ethiopia have traditionally focused on rural regions. However, in contemporary policy discussions, the topic of urban food security has garnered significant attention. Household food insecurity increases the risk of morbidity and mortality in children. The current investigation endeavors to ascertain the covariates associated with household food insecurity and to analyze the interrelationship amongst demographic indicators, fertility, and childhood mortality in the Lideta sub-city, Addis Ababa, Ethiopia. A community-based cross-sectional study was conducted from February to March 2023 in the subcity. A total of 692 households were selected using a multistage sampling technique. The Pearson chi-square test ( 2 ) and regression models were used to assess the association between food insecurity and demographic outcomes. As the results show, the overall prevalence of household food insecurity in the study area was 66.5%. Regression results indicate that seven of the hypothesized nine demographic and socio-economic determinants of household food insecurity have a significant influence on the probability of being food-insecure (P < 0.05). Household food expenditure, dependency ratio, age, sex, educational status of the household head, access to savings and credit, and the urban productive safety net program were significant determinants of urban household food insecurity. Food insecurity status was also a significant predictor of the number of children ever born. Holding the other variables constant, the number of children ever born into food-secure households is 0.655 times lower compared to households with food insecurity. Similarly, the age of the mother, contraceptive use, women's income, and childhood mortality were significant in predicting the effect of the mean number of children ever born at P< 0.05. The findings further reveal a prevailing usage percentage of modern contraception of 50.5%. The utilization of contemporary contraceptive modalities was found to be markedly lower among food-insecure households (32.0%) in comparison to those who were food-secure (68.0%). It was found that households that experience food insecurity had a significantly reduced likelihood, by 76.5%, of contraception. Similarly, a positive attitude towards contraceptive use, utilizing family planning information services, discussion on contraceptive techniques with partners, women's income, and childhood mortality have a significant association with contraceptive use at p 0.05. Likewise, food insecurity status was a significant predictor of under-five mortality. Food-insecure households were 3.89 times more likely to experience under-five mortality as compared to food-secure households. Similarly, xi women's education, age at first birth, initiation of breast feeding, age and sex of the child, birth order, and children ever born were significant predictors of under-five mortality at p < 0.05. The reduction of household size, amelioration of the dependency ratio, and improvement of other socio-economic factors collectively serve the purpose of empowering households to enhance their resilience in the context of food insecurity, which in turn improves fertility and child survival. Accordingly, policymakers ought to adopt measures aimed at enhancing stability in the food market and generating prospects that can enhance the living standards and economic capabilities of urban households.
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Household food insecurity, Fertility, Children ever born, Modern contraceptive use, Under-five mortality, Lideta sub-city, Ethiopia