Are household food security, nutrient adequacy, and childhood nutrition clustered together? A cross-sectional study in Bankura, West Bengal.

BACKGROUND

Research on different measures of food security and their interrelation in order to identify vulnerable households are scarce in India.

OBJECTIVES

The objective was to assess household food security (HHFS), nutrient adequacy, dietary diversity, and nutritional status of under-five children along with their interrelation in the slums of Bankura Municipality, West Bengal.

METHODS

A cross-sectional study was conducted during 2016-2017 among 240 households using two-stage 30-cluster random sampling. Information regarding socioeconomic characteristics, availability, and utilization of different poverty alleviation schemes was collected. HHFS was assessed by a validated HHFS scale-short form in Bengali and nutrient adequacy with 24-h recall method. The eldest under-five child in the family was measured for anthropometry using standard procedure and for dietary diversity with the Individual Dietary Diversity Score.

RESULTS

Overall, 74 (29.1%) households had "food security," whereas 102 (44.3%) and 64 (26.6%) had, respectively, low and very low food security. Among 190 under-five children, 63 (35.3%) had single and 50 (25.5%) had multiple anthropometric failures. Overall, 89 (36.1%) households were deficient for both energy and protein and 111 (47.6%) had deficiency of either of these two. Indicators on the utilization of different poverty alleviation schemes were associated with low/very low food security. A "Composite Index of Food Scarcity" comprising of HHFS, nutrient adequacy, and dietary diversity was proposed which was found to have dose-response relationship with grades of anthropometric failure of under-five children.

CONCLUSIONS

An index comprising of three indicators might help identify the vulnerable households in relation to food security more effectively than a single indicator.