The association between household food security and mortality in children under-five years of age in Agincourt, Limpopo Province, in 2004
Year: 2008
Type: dissertation
Abstract: Background: When children experience food insecurity, in addition to poverty, their \nresultant inadequate food intake and disease often leads to the development of proteinenergy \nmalnutrition and ultimately to death. In South Africa, where three out of every four \nchildren live in poverty, food insecurity and its multiple negative effects are consequently \namong the most urgent social issues affecting households and their children. Since \nhousehold food insecurity is thought to be associated with increased child mortality, it is \nimportant to study any such associations amongst South African children to determine \nadditional risk factors for child mortality. \nObjectives: The main objective of this study was to establish the relationship between \nhousehold food security and mortality in children under the age of five years in the \nAgincourt field site, Limpopo Province, in 2004. \nMethods: An analytical cross-sectional study of secondary data obtained from the 2004 \ncensus questionnaire and food security module of the Agincourt Health and Demographic \nSurveillance System in rural Limpopo Province was conducted, involving a total of 7,790 \nblack children under the age of five years. Certain exposure variables were selected for use \nas indicators of food security and these were analysed with respect to child mortality using univariate and multivariate logistic regression. \nResults: Based on the outcome indicators of food consumption, 37% of the study \npopulation were found to have experienced household food insecurity in 2004, reporting \ninsufficient food for the entire household in the previous month and year. The limited \ndietary diversity and insufficient quantities of food experienced by the majority of the \npopulation were supplemented by the local growth of food crops and the gathering of food \nfrom the bush. Of the 79 children (1%) under the age of five years who died in 2004, the majority (24%) died of HIV-related diseases, in addition to deaths caused by diarrhoea, \nrespiratory infections, and malnutrition. Child mortality was found to be associated with \nthe reporting of “unknown” for several indicators of food security. Additionally, expecting \nthe food availability of the household in the coming year to be less than that of the current \nyear (that is, the prediction of future household food insecurity) was significantly \nassociated with an increased risk of under-five child mortality compared to the expectation \nof the same amount of food the following year (adjusted odds ratio (OR) 2.0), and with a \ngreatly increased risk of mortality compared to the prediction of more food (future \nhousehold food security) (adjusted OR 4.4). The latter association was age-specific to \ninfants under the age of one year (adjusted OR 5.6) and cause-specific to HIV deaths \n(adjusted OR 5.9). \nConclusions: Following a significant trend in this study in the rural north-east of South \nAfrica, future household food security was inversely related to, and hence protective over, \nchildhood mortality in 2004, even after controlling for confounding factors. Further \nresearch on the associations between household food security and under-five child \nmortality, conducted following the development of a standard nation-wide food security \nmeasurement tool specific to South African household conditions, would confirm \nhousehold food insecurity as a significant risk factor for under-five child mortality and, \nconsequently, as a target for future policies in the reduction of child mortality in this country.
Author: Penny Crowther
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W160126468