Prevalence and risk factors for severe food insecurity and poor food consumption during a drought emergency in Ethiopia

Abstract Frequent drought emergencies have heightened nutritional concerns in Ethiopia. This cross-sectional secondary data analysis assesses prevalence and risk factors of severe food insecurity and poor food consumption in Productive Safety Net Programme (PSNP) households in drought-prone Ethiopia. Data was from the USAID-funded Resilience Food Security Activity baseline survey. Severe food insecurity (n=4628; multivariate n=4335) was defined as Food Insecurity Experience Scale (≥7) and poor food consumption (n=4554; multivariate n=4268) was defined as Food Consumption Score (≤22). Logistic regression identified risk and protective factors from sociodemographic, economic, crops/livestock, and water/sanitation/hygiene variables. Severe food insecurity prevalence was 77.79% and poor food consumption prevalence was 69.74%. Risk factors for severe food insecurity included women/girls aged 15-19 years (Adjusted OR=1.79; 95% CI: 1.36-2.34), currently pregnant (1.52; 1.17-1.96), history of pregnancy (3.46; 2.76-4.33), cash-earning work (1.35; 1.12-1.61), daily-per-capita food consumption <1.61USD (2.98; 1.91-4.66), crop-planting (1.67; 1.31-2.13), and handwashing materials (3.83; 1.92-7.63); protective factors included raising livestock/crops (0.50; 0.42-0.60) and oxen (0.34; 0.26-0.45). Risk factors for poor food consumption included female household-head (1.44; 1.15-1.81) and household-head with no education (1.46; 1.18-1.79), daily-per-capita food consumption <1.61USD (4.00; 2.58-6.21), and financial service use (2.10; 1.69-2.59); protective factors included women aged 15-19 (0.59; 0.46-0.76) and 30-49 (0.76; 0.63-0.91), currently pregnant (0.57; 0.47-0.70), history of pregnancy (0.70; 0.55-0.89), crop-planting (0.57; 0.44-0.75), raising livestock/crops (0.40; 0.34-0.48) and oxen (0.68; 0.52-0.90). This study found vulnerable PSNP groups to be households with women that are/have previously been pregnant, no education, low economic status, and lack of livestock. PSNP should tailor education towards local climate-resistant crops and prioritize the livestock market, breeding, and survivability (specifically oxen), as crop production appears insufficient to maintain food security. The dual burden of food insecurity and low food consumption threatens current and future generations, and data-driven action can help progress towards the goal of zero hunger in Ethiopia. Competing Interest Statement The authors have declared no competing interest. Funding Statement The United States Agency for International Development (USAID) Bureau of Humanitarian Assistance (BHA) provided funding for Ifaa Resilience Food Security Activity (Ifaa/RFSA) to a consortium led by Catholic Relief Services in Ethiopia (720BHA21CA00035). Causal Design was contracted for data collection of the baseline survey for the Ifaa/RFSA project, and to develop an Impact Evaluation under the Implementer-Led Evaluation and Learning (IMPEL) Associate Award funded by USAID BHA, which provided the dataset for this study. The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Causal Design attained Institutional Review Board (IRB) approval for Ifaa baseline data collection from the Ethiopian Society of Sociologists, Social Workers, and Anthropologists (ESSSWA). The study authors received an exempt determination for a secondary data analysis from the Johns Hopkins Bloomberg School of Public Health IRB (FWA: #00000287). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable DATA AVAILABILITY The dataset used in this study is not publicly available, as it is subject to third-party ownership by Catholic Relief Services. Access may be shared upon reasonable request, pending approval from the authors and Catholic Relief Services. Access to analytic code may also be shared upon reasonable request. The dataset for this study was the baseline survey of the USAID-funded Ifaa (RFSA) Resilience Food Security Activity implemented by a consortium led by Catholic Relief Services. (“Causal Design, IMPEL. Baseline study of the Ifaa Resilience Food Security Activity in Ethiopia. Vol. 1. Washington, DC: The Implementer-Led Evaluation & Learning Associate Award; 2022.”) Further information regarding the dataset is included in the Materials and Methods section. With any questions please reach out to the corresponding author Yunhee Kang (ykang12{at}jhu.edu) or Noah Baker (nbaker17{at}alumni.jh.edu).