Risk Factors for Severe Household Food Insecurity
in Rural South Haiti
1 1 2 1 3 1
Rafael Pérez-Escamilla , Michael Dessalines , Mousson Finnigan , Amber Hromi-Fiedler , Helena Pachón , Nishang Gupta
1
University of Connecticut, Storrs, CT, USA, 2Organization for the Rehabilitation of the Environment, Camp-Perrin, Haiti, 3Centro Internacional de Agricultura Tropical, Cali, Colombia
Abstract Results
Haiti, the poorest country in the Western Hemisphere, is ravished by Table 1. Latin American and Caribbean Household Food Security Table 2. Household socio-economic and demographic Table 3. Maternal and child demographic and biomedical Table 4. Factors associated with severe household
food insecurity (FI). A convenience sample of 153 households were Scale (ELCSA) characteristics. characteristics. FI1 in Camp Perrin, South Haiti. Multivariate logistic
studied to find out what the most significant independent factors (N=153) Camp Perrin, South Haiti (N=153) Camp Perrin, South Haiti (N=153) regression analyses (N=149)
associated with food insecurity in Haiti are. Household FI was assessed Item % Yes N % N % or mean ± SD Variable Odds Ratio 95% CI
with the 16-item ELCSA scale previously validated in the target Monthly household income: Mother’s age (y) 153 30.8 ±7.1 Land Ownership
Questions referring to Respondent and/or Other Adults in the Household
communities. ELCSA’s reference time period was the three months During the last 3 months… US$1 to US$30 100 65.3 Marital status Yes 0.18 0.05-0.68
preceding the survey and it was answered by the mother. Households
US$31 to US$60 33 21.6 Common law 97 63.4
were categorized as either food secure (2%, ELCSA score=0), FI/very FI Were you worried about running out of food? 72.5 No 1.00
(42%, ELCSA score range:1-10) or severely FI (56%, ELCSA score range:11- US$61 to US$120 20 13.1 Married 40 26.1 Occupation head of household
16). Multivariate logistic regression results indicated that land ownership Did your home run out of food at any time? 88.9
Savings in bank 23 15.0
Single/never married 11 7.2 Trader 0.09 0.01-0.58
(OR: 0.18; 95% CI: 0.05-0.68), trader-headed household (vs. farmer) Employment status of head of the household
Separated/divorced/widowed 5 3.3 Farmer 1.00
(0.09; 0.01-0.58), and lower frequency of rice consumption (0.17; 0.05- Were people in your home unable to eat, at any time, the kind of foods Working full-time 66 43.1
71.9 Mother’s parity
0.52) were associated with lower risk of severe FI. Lunch (6.9, 1.8-27.0) that make you healthy? Rice consumption frequency
Working part-time 58 37.9
and dinner skipping (16.5, 2.4-114.5), female index child (3.2, 1.1-9.4) 1 to 3 children 75 49.0 < median 0.17 0.05-0.52
Did you or anybody in your home usually have to eat the same foods Unemployed 29 19.0
and larger household size (3.4, 1.0-11.5) increased the risk of severe FI. 64.7
almost every day? 4 to 6 children 56 36.6 > median 1.00
These findings suggest that policies that increase landownership and Occupation of head of household
Was there any day that you or any other adult in your home skipped a 7 to 13 children 22 14.3 Lunch skipping
occupation status are likely to reduce household food insecurity. meal because of lack of food?
60.1 Farming 91 59.5
Respondent’s educational status Yes 6.90 1.80-27.00
Trading 30 19.6
Did any adult in your home eat less food than what they needed because No formal schooling 41 26.8 No 1.00
70.6 Other1 32 20.9
there wasn’t enough food?
Métayage (sharecropping system) 58 37.9 Elementary not completed 68 44.4 Dinner skipping
Introduction Was there any day when you or any other adult in your home felt hungry
58.8 Land ownership 106 69.3 Elementary completed 18 11.8 Yes 16.50 2.40-114.50
but did not eat because there wasn’t enough food?
Haiti’s modern history has been Land size (hectare (ha)) (n=106) High school not completed 1 0.7 No 1.00
Was there any day when you or any other adult in your home didn’t eat for
characterized by major civil a whole day or just ate once during the day because there wasn’t enough 63.4 High school completed 25 16.3
None to < 1/4 ha 92 86.8 Study child sex
unrest, political instability, and food?
1/4 to < 1/2 ha 6 5.6 Maternal BMI (kg/m2)
major ecological destruction, Did you do things that you would have preferred not to do, such as
Female 3.20 1.10-9.40
in part as a result of the local 13.1 1/2 to < 1 ha 3 2.8 Underweight (< 20) 44 28.8
begging or sending children to work, to get food? Male 1.00
production of charcoal from > 1 ha 5 4.6 Normal weight (20-< 25) 85 55.6 Household size
Questions referring to Children in the Household
trees and uncontrolled grazing During the last 3 months… Household size Overweight (25-< 30) 20 13.1 > median 3.40 1.00-11.50
of livestock (1). Thus, it is not 2 to 4 people 29 19.0
Were you unable to provide the children in your home with the kinds of Obese (>= 30) 4 2.6
surprising that Haiti ranks 56.2 < median 1.00
foods they need to be healthy? 5 to 7 people 86 56.2 Household Food Insecurity
amongst the most food insecure 1
Severely food insecure was defined as having an ELCSA score of 11 or
countries in the world (2). 8 to 14 people 38 24.9
Did any children in your home usually have to eat the same foods almost Food Secure 3 2.0 more (out of 16). Food insecure was defined as an ELCSA score between
61.4
every day? # of bedrooms
Food Insecure 26 17.0 1 and 10. The 3 food secure households were dropped from analyses.
Did any child in your home eat less food than what s/he needed because 1 bedroom 45 29.4
77.8 Very Food Insecure 38 25.0
there wasn’t enough food? 2 bedrooms 72 47.1
Severely Food Insecure 86 56.0
Did you have to serve less food to any child because there wasn’t enough >2 bedrooms 36 23.5
Objective food?
77.8
Sewage at home 4 2.6
Child age (y) 153 2.3±1.1
To identify independent risk factors for severe household food insecurity Was there any day when any child in your home felt hungry but could
56.2
Head of household
Study child gender
Summary of Findings
in rural south Haiti. not be fed because there wasn’t enough food? Male 82 53.6
Mother 36 23.5 Independent protective factors for severe FI were:
Did any child in your home go to bed hungry on any day because of lack Grandmother 27 17.6 Female 71 46.4
of food?
49.0 • Landownership
Father 72 47.1 Child health rating (maternal report)
• Higher occupation status
Was there any day when any child in your home didn’t eat for a whole Other 18 11.8 Good/Very Good 45 29.4 • Lower rice consumption
Methods day or just ate once during the day because there wasn’t enough food?
54.9
1
daily worker, wood charcoal maker, tailor, custodian Average 99 64.7 • Not skipping meals
• Convenience sample of 153 mothers were recruited in the three Poor/Very Poor 9 5.9 • Being a male child
districts of Camp Perrin in approximately equal numbers (district 1 • Smaller household size
Child diarrhea in previous 2 weeks 45 29.4
(n=53), district 2 (n=57), and district 3 (n=43))
• Convenience sampling snowball approach Child malaria in previous 2 months 51 33.3
• Women were interviewed in Haitian Creole by three fieldworkers Child fed colostrum 124 81.0
Conclusion
• Household food insecurity was assessed with the previously validated Child stunting (<-2 height-for-age Z-score) 61 42.7 Findings suggest that policies that increase
‘Latin American and Caribbean Household Food Security Scale’ (Escala Child underweight (<-2 weight-for-age Z-score) 28 18.3
landownership and occupation status are likely to
Latinoamericana y Caribeña de Seguridad Alimentaría (ELCSA) (3)) 3 reduce household food insecurity in Haiti.
Child wasted (<-2 weight-for-height Z-score) 7 4.8
months as reference period (Table 1)
Child BMI (kg/m2)
<15.22 50 32.7
Acknowledgement
15.22-16.88 51 33.3 Funded by the AgroSalud Project (CIDA # 7034161).
Inclusion Criteria
>16.88 52 34.0
References
Women were included in the study if they were: 1. Baro M. Food insecurity and livelihood systems in northwest Haiti. Journal
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• Living in the target community for at least the past 12 months in developing countries. Agricultural Economics 2000:22:199-215.
• The biological mother of at least one healthy child between the ages Hospital 22 14.4 3. Perez-Escamilla R, Dessalines M, Finnigan M, Hromi-Fiedler A, Pachón Validity
of the Latin American and Caribbean Household Food Security Scale (ELCSA) in
of 1 and 5 years South Haiti. The FASEB Journal. 2008;22:871.3.