Household dietary diversity and associated factors in rural and peri-urban areas of Mbale District, Eastern Uganda.

BACKGROUND

Globally, the importance of dietary diversity in addressing malnutrition and promoting overall health is increasingly being recognized. However, increasing urbanization has led to shifts in dietary preferences, food consumption patterns, and a greater reliance on less nutritious processed foods. Efforts to address these challenges have been futile, as nutrition in peri-urban areas often receives less attention, with food and nutrition insecurity typically seen as a rural issue. This study, therefore, examined dietary diversity (DD) and its socio-economic and demographic predictors in rural and peri-urban households.

METHODS

A cross-sectional study of 221 households in rural and peri-urban Eastern Uganda collected data on DD, socio-economic and demographic factors using the Household Dietary Diversity Score (HDDS) and structured questionnaires, respectively. The data were analyzed in SPSS using descriptive statistics, and independent sample t-tests compared mean DD scores between rural and peri-urban areas. Pearson Chi-square tested differences in food group consumption, while binary logistic regression in STATA identified socio-economic and demographic predictors of household dietary diversity.

RESULTS

There was no significant difference in dietary diversity (DD) between rural and peri-urban households, with mean DD scores of 6.64 ± 1.60 and 6.55 ± 1.30, respectively, indicating a medium level in both areas. However, significant differences were observed in the consumption of cereals and roots/tubers/plantains (p < 0.05), while intake of animal-source foods and fruits remained generally low across both settings. In rural areas, household DD was significantly influenced by the education levels of the household head (β: -1.276) and spouse (β: -1.123), as well as access to credit (β: 1.136), while in peri-urban areas, average monthly income (β: -0.801) was a significant predictor of household DD.

CONCLUSION

The study showed that dietary diversity was similar and at a medium level in both rural and peri-urban households, and mainly consisted of plant-based foods, with limited consumption of fruits and animal-sourced foods. Socio-economic factors, including level of education, access to credit, and income, significantly influenced DD. These results highlight the role of socio-economic and demographic factors in shaping household diets and underscores the need for targeted interventions to improve dietary diversity and address nutritional gaps in the study area.