Household Food Insecurity and Women's Dietary Diversity in Seqota Declaration Pilot Woredas Across the Tekeze River Basin of Amhara and Tigray Regions.

Food insecurity and inadequate dietary diversity worsen undernutrition in Ethiopia, hindering progress toward the Sustainable Development Goals and the Seqota Declaration's objective to eliminate hunger and chronic undernutrition by 2030. This study investigates the prevalence and causes of household food insecurity and dietary diversity among pregnant and lactating women (PLW) in the Seqota Declaration pilot woredas of the Tekeze River basin, situated in the Amhara and Tigray regions. A cross-sectional survey conducted from March to April 2018 sampled 2036 households across 13 Seqota Declaration woredas. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS) and the Months of Adequate Household Food Provisioning (MAHFP) scale. Women's Dietary Diversity Score (WDDS) was evaluated for 642 PLW. Logistic and Poisson regression models identified predictors of food insecurity and dietary diversity, respectively. More than half of households in Tigray (55.0%) and Amhara (59.5%) experienced moderate to severe food insecurity. Only 7% of pregnant and lactating women (PLW) in Tigray and 10% in Amhara met the minimum dietary diversity requirements. Older household heads and those with lower wealth status faced a higher risk of food insecurity. Increased livestock ownership, improved land and water management practices, and greater production diversity were linked to lower odds of food insecurity. A larger land size (adjusted incidence rate ratio (AIRR) 1.04 per hectare,  = 0.017) and higher wealth status (AIRR 1.19 for the wealthiest quintile (Q5),  = 0.043; AIRR 1.17 for Q4,  = 0.044) improved Women's Dietary Diversity Score (WDDS). Seqota Declaration interventions should prioritize asset building, crop diversification, and improved land and water management to increase food security and dietary diversity. More research is needed to determine how market food availability, affordability, and recent events, such as conflicts and droughts, impact these predictors.