Household food insecurity is associated with both body mass index and middle upper-arm circumference of mothers in northwest Ethiopia: a comparative study.

Background: Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia.

Methods: This was a community-based comparative cross-sectional study conducted May 24-July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia's Productive Safety Net Programme was used for grouping the study areas. A food-security access scale developed by the Food and Nutrition Technical Assistant project was used to measure food security. Sociodemographic data were collected using a structured questionnaire. A binary logistic regression model was used to assess the association of food insecurity and maternal undernutrition.

Results: From the total participants, 12.6% (95% confidence interval [CI] 11.6%-13.6%) had a body mass index (BMI) <18.5 kg/m2. Comparison of maternal undernutrition in the two study areas revealed 8.8% (95% CI 7.6%-10.2%) in the program area and 16.4% (95% CI 14.8%-18.1%) in nonprogram areas were undernourished. Severe food insecurity was significantly associated with BMI of mothers (adjusted odds ratios [AORs] 3.6 and 2.31, 95% CI 2.32-5.57 and 1.52-3.5, respectively) in both program and nonprogram areas. Mild (AOR 1.77, 95% CI 1.21-2.6) and moderate (AOR 1.6, 95% CI 1.18-2.16) food insecurity significantly associated with maternal undernutrition in nonprogram areas. In the same way, all forms of food insecurity significantly associated with maternal middle upper-arm circumference in both program and nonprogram areas. The odds of mothers who did not exercise decision-making practice on the household income was also 4.13 times higher than those who did (AOR 4.13, 95% CI 2.2-7.77) in the program area.

Conclusions: Food insecurity significantly associated with both maternal BMI and middle upper-arm circumference in both study areas. Female authority also significantly associated with BMI of the mothers in the program area. Maternal nutrition-intervention programs should focus on women-empowerment strategies that enable them to decide on the income for household-nutrition provision.