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Afr. J. Biomed. Res. Vol. 24 (January, 2021); 41- 46

Research Article
Household Food Insecurity and Nutrient Adequacy of Under-
Five Children in Selected Urban Areas of Ibadan, Southwestern,
Nigeria.
Yahaya S.P., Sanusi R.A., *Eyinla T.E., Samuel F.O.
Department of Human Nutrition, College of Medicine, University of Ibadan, Ibadan, Nigeria

ABSTRACT
In Nigeria, the impact of household food insecurity on nutritional status, especially the nutrient intake adequacy of under-5
children has not been fully explored. This study was aimed at evaluating household food security and nutritional status of under-
5 children in Ibadan, southwestern Nigeria. A multi-stage sampling approach was used to select households with mothers who
have at least one child under the age of five years. Information was elicited through an interviewer administered questionnaire
and a multi-pass 24hr dietary recall method. The results reflect low food security status of households with more than half of
households being food insecure (63%) and experiencing some form of hunger within the study period. Low socioeconomic status
was observed in most of the sampled households which may have reduced purchasing power for food expenditure. While
anthropometric indices showed no major problem with the children’s nutritional status, the quality of their diet as deduced from
nutrient adequacy analysis revealed high micronutrient inadequacy in Vitamin A (82%), Vitamin C (80%), Folate (44%),
Potassium (91%), Zinc (91%), and Iron (74%). This study shows that even though households may be above the severe hunger
status, the quality of the diet may be insufficient to provide needed nutrition for health security of household members especially
under-5 children.

Keywords: Food security, nutrient adequacy, children, micronutrients, Diet quality

*Author for correspondence: [email protected]; Tel: +2348068467771

Received: March, 2020; Revised version Accepted: October, 2020
Abstracted by:
Bioline International, African Journals online (AJOL), Index Copernicus, African Index Medicus (WHO), Excerpta medica
(EMBASE), CAB Abstracts, SCOPUS, Global Health Abstracts, Asian Science Index, Index Veterinarius

INTRODUCTION undernourishment in most (and -surprisingly obesity in some)

contexts of the world (FAO, 2019). In Nigeria, estimates show
Food still remains a basic necessity of life. It is important at
that food insecurity is a persistent problem (FAO, 2019).
household level since it is a basic means of sustenance and is
Despite being blessed with numerous natural and human
a critical human need (Olayemi, 1996). The presence or
resources, Nigeria is still having a high incidence of socially
absence of food for consumption usually predicts human
deprived and food insecure households (Akinyele, 2009;
capacity development of a whole population. This shows why
Sanusi et al., 2019).
at national levels, food supply is of economic and political
Lack of food or insufficient access to food can have
significance especially in issues relating to peace and stability
various impact by disrupting eating pattern which in turn
among the populace. Food security exists when a household
reduces diet quality and compromises adequate nutritional
can reliably gain access to food in sufficient quantity and
status and well-being on the long term. Good nutrition is
quality for all household members to enjoy a healthy and
necessary to achieve a healthy and active lives, optimize
active life (FAO, 2019). Globally, the occurrence of moderate
education performance and enhance productivity. The
and severe food insecurity is still a challenge and is currently
nutritional status of under-5 children at household level has
affecting a little over a quarter of the world’s population which
been widely used to gauge well-being of the whole population
equals about 2 billion people (FAO, 2010; 2019). Regional
mainly because of their vulnerability to environmental and
prevalence for Africa shows that about 277 million people are
dietary changes. Moreover, food security at the national and
experiencing severe forms of food insecurity. The impact of
household levels, good care practice and access to adequate
this challenge is reflected also in the high levels of
basic health services have been established as essential
 Food Insecurity and Nutrient Adequacy of under-five

prerequisites for reduced under-five mortality. Although

current trends reveal a co-existence of undernourishment and Sampling Approach: A multi-stage sampling approach was
obesity in developing countries, the most common nutritional used to select respondents from Ibadan-the most populous city
problems are those of macro- and micro- deficiencies (de in southwestern Nigeria. The respondents were chosen from
Onis, 2010; Popkin, 2012; FAO, 2019). Anthropometric different local government areas in a four-stage sampling
indices of children, mainly derived from weight and height, procedure:
are common indicators of malnutrition (WFP, 2005). Chronic 1. Selection of the three local government areas in Ibadan was
protein energy malnutrition (PEM) is measured as stunting. the first stage. One local government area was selected
This index reveals a long-term deprivation of adequate from each of the three senatorial districts in the state by a
nutrition and is also affected by recurrent or chronic illness. balloting system.
Wasting which results from a more recent acute shortage of 2. The second stage was the selection of the wards from each
food and/or severe disease is used as a measure of acute local government area. Simple random sampling was used
undernutrition. Underweight which is defined as a low weight to pick the wards. One third of the wards from each local
for age is a metric that combines the presence of stunting and government area were chosen.
wasting in children and by extension in the overall population. 3. The third stage was the selection of communities were
These indices have often reflected poor health status in chosen randomly from the wards.
Nigerian children especially those within the cluster of 4. The fourth stage was the selection of households. The
insufficient access to food. An assessment of nutrient intake households were systematically selected in the streets of
and adequacy is a further step of understanding the impact of different communities.
food insecurity on nutritional status of under-5 children within
the household. From literature, it is an already established fact Study Population: The primary respondents were mothers in
that the insufficient access to food restricts dietary diversity selected households who had at least one under-5 child.
which impacts diet quality negatively (Cristofar and Basiotis,
1992; Rose and Oliveira, 1997; Dixon et al., 2001; Kirkpatrick Sampling Size determination
et al., 2015). In a study of Sri Lankan children, household food The following assumptions were made;
insecurity was strongly associated with the occurrence of child Food insecurity prevalence in the households = 74.1% (Sanusi
undernutrition and anemia (Kandeepan et al., 2016). et al., 2006)
Currently, there is paucity of information on links between p = 0.741, q= 1-p
household food insecurity and the nutritional status of under- Confidence interval (CI) = 95%, which means 𝛼 is set at 0.05
5 children in Nigeria especially their dietary and nutrient and 𝑍= 1.96 (value of 𝑍 at 𝛼0.05 or critical value for normal
intake. A study conducted by Ajao et al., (2010) in a distribution at 95% CI).
southwestern town of Nigeria revealed an inverse influence of The formula used for calculation of the minimum sample size:
family size, household food security status, and childcare
practices on the nutritional status of under – five children in
Ile-Ife, southwestern Nigeria. A recent study also established The obtained minimum sample size from calculation was 294.
that children from food insecure households were more likely
to be consuming very low dietary diversity (Samuel et al., Data collection Instrument: A semi-structured interviewer
2020). The existing gap in knowledge is the unreported link administered questionnaire was designed to elicit information
between food insecurity on not only anthropometric indices and it contained the following sections:
but also nutrient adequacy status of under-5 children in a. Socio-demographic and Socio-economic questions
households. This study aimed at identifying the level of food b. Household Food Insecurity Access Scale (HFIAS)
insecurity among selected households and the nutritional Measurement Tool which consists of 9 items developed
status (the anthropometric indices and nutrient adequacy by the Food and Nutrition Technical Assistance
status) of under-5 children living in those households. The (FANTA) project (Coates et al., 2007).
study location was chosen since it is the largest city in the c. Anthropometric measurements of the under-five children
Southwestern part of Nigeria and hosts a wide range of (Height of the children under-2 years was measured using
ethnicities. Three Local Government Areas (Akinyele, Ibadan measuring board while those older were measured
South East and Oluyole) were randomly selected among the standing. Weight was measured using an electronic
eleven urban and peri urban local governments in Oyo State, weighing scale).
Nigeria. d. Dietary intake assessment section which contained a form
for a 24-hour dietary recall of the children.
MATERIALS AND METHODS
Ethical Consideration: Ethical clearance was obtained from
Study Design: This study was a descriptive cross-sectional the University of Ibadan/University College Hospital ethical
study in which a semi-structured questionnaire was used to review committee of the College of Medicine, University of
elicit information about households. Measurements of weight Ibadan, Ibadan, Nigeria. Informed consent was obtained from
and height were taken to determine the nutritional status of each study participant (mother of under-5 child). All the
under-five children aged 6–59 months in the selected interviews were conducted with sufficient privacy after
households. A multi-pass 24-hr recall method was also used getting informed consent from the respondents.
to assess dietary intake among a proportion of the children.

42 Afr. J. Biomed. Res. Vol. 24, No.1 (January) 2021 Yahaya et al

 Food Insecurity and Nutrient Adequacy of under-five

Data Analysis: The collected data was entered into SPSS Micronutrient intake adequacy was low for all nutrients
version 17 for analysis. The World Health Organization considered in this study. The study revealed inadequacies in
Anthro software version 3.2.2, 2007, was used to convert the Vitamin A (82%), Vitamin C (80%), Folate (44%), Potassium
anthropometric data into 𝑍-scores for HAZ, WHZ, and WAZ (91%), Zinc (91%), and Iron (74%). Of all micronutrients,
indices. Dietary data was processed using an adapted Total folate adequacy was highest of all (24%) while vitamin A
Dietary Assessment Software to generate nutrient intake intake was lowest with only 2% of the under-five children
results which were then exported to SPSS. Nutrient adequacy having adequate intake.
was calculated by comparing nutrient intake results with
recommended references (IOM, 2001). The HFIAS responses Table 1:
were used to classify the households into four categories: Food Sociodemographic/Socioeconomic characteristics of respondents
secure, Food insecure without mild hunger, Food insecure (n=707)
with moderate hunger and Food insecure with severe hunger. Characteristics Frequency Percentage
Descriptive statistical techniques were used to describe the Ethnicity
data on socio-economic and demographic information, Yoruba 582 82.3
anthropometric indicators, nutrient intake by generating Igbo 81 11.5
Hausa 44 6.2
frequencies and percentages.
Educational Level of Household head
RESULTS No formal 16 2.3
education
Sociodemographic/Socioeconomic Characteristics of Primary 88 12.5
Respondents: The demographic distribution of the Secondary 496 70.4
respondents presented in Table 1 shows that most of the Tertiary 105 14.9
respondents were Yoruba and they accounted for 82.3% of all
respondents, 1.5% were of the Igbo ethnic group while 5.9% Primary source of water for domestic use
were Hausa. The educational level of household heads was Well 453 64.1
observed as follows; 54.2% had secondary education, primary Borehole 239 33.8
education (27.3%), Tertiary education (11.3%), few have no River 11 1.6
formal education (7.2%). Majority of the household heads Rain 4 0.6
were traders (38.6%) and artisans (37.2%) while others were
either engaged in farming or were employed in civil service. Occupation of Household head
The estimated monthly income of the sampled households Farming 38 5.4
mainly ranged from N5,000 to N 50,000. The study revealed Trading 273 38.6
majority of the households (64.1%) relied on a well as their Civil Servant 133 18.8
primary source of water for domestic use in the household, Artisan 263 37.2
about 34% used bore-holes as their primary source of water
Main type of Toilet
while 0.6% used rain water. The predominant type of toilet
Bush 46 6.5
was the pit latrine
Pit Latrine 610 86.5
Water Closet 49 7.0
Household Food Security: The frequency distribution of System
household food security is presented in Table 2. Only 36% of
the households were food secure and 55 (7.8%) of the Estimated Household Monthly Income (in naira)
households were severely food insecure in terms of access to <5000 113 16.0
food and experiencing hunger. About a third of respondents 5000 – 20000 386 54.8
(31.4%) were experiencing mild hunger while 24.8% 20000 – 50000 166 23.5
experienced a moderate form of hunger. 50000 - 100000 40 5.7

Anthropometry Results of Under-five Children: About Table 2:

15.5% of the children were moderately stunted and 11.9% Frequency distribution of household food security (n=707)
severely stunted (Table 3). Weight-for-height results show Categories Frequency Percentage
that 50 (8.8%) of the respondents were wasted while 3.5% Food secure 255 36.0
were moderately underweight. Food insecure without mild 222 31.4
hunger
Nutrient Adequacy of the Under-Five Children: Adequacy Food insecure with moderate 175 24.8
and inadequacy of nutrient intake among under-5 children hunger
Food insecure with severe 55 7.8
sampled in the selected households is presented in Table 4.
hunger
The carbohydrate intake adequacy was attained by 46% and
24% of the respondents were found to have excess intake,
however, inadequacy of protein and fat intake was found in
about half and in almost all (92%) of the children respectively.

43 Afr. J. Biomed. Res. Vol. 24, No.1 (January) 2021 Yahaya et al

 Food Insecurity and Nutrient Adequacy of under-five

Table 3:
Frequency of Stunting, Underweight and Wasting of the under-five children
Variable Category Frequency Percentage
Height-for-Age Severely stunted 81 11.9
(Stunting n=679)

Moderately stunted 105 15.5

Weight-for-Age Moderately underweight 24 3.5
(Underweight n=687)
Weight-for-Height Severe Wasting 16 2.4
(Wasting n=681)
Moderate Wasting 44 6.4

Table 4:
Nutrient Adequacy of the Under Five Children (n=242)
*Recommended Inadequate Adequate Excessive
Nutrient Intake (<80% RNI) N (%) (80-120% RNI) N (%) (>120% RNI) N (%)
Energy (Kcal) 570 – 1742 Kcal 78(34) 115(48) 43(18)
Carbohydrate (g) 60-130g 68(30) 110(46) 58(24)
Protein (g) 9.1 – 19g 110(46) 88(30) 58(24)
Fat (g) 30-31g 214(92) 20(9) -
Vitamin A (RAE) 300-500mg 193(82) 5(2) 38(16)
Vitamin C (mg) 15-50mg 188(80) 15(6) 33(14)
Folate (mcg) 65-150mcg 104(44) 57(24) 75(32)
Potassium (mg) 400-2000mg 214(91) 10(4) 12(5)
Zinc (Zn) 2-5mg 214(91) 20(9) -
Iron (mg) 0.27-11mg 174(74) 40(17) 21(9)
*RNI was adjusted for Age

DISCUSSION not having additional years of education beyond secondary

school may be a limiting factor to wealth creation which
This study assessed the sociodemographic and socioeconomic impacts on household food expenditure. The levels of stunted
status, household food security and under-five children children were higher (27.4 %) than those in the wasting
nutritional status in selected local Government areas of category (1.8 %). This is in accordance with the report from
Ibadan, southwestern area of Nigeria. The ethnic composition NDHS (2018) in which the level of stunted under-five children
of respondents in the study expectedly show a predominantly was higher than that of children that were wasted. The
Yoruba populace but also reflects the urbanization effect prevalence in this study was however lower than the reported
which has attracted households from the other two major prevalence for Oyo state which may imply that most of the
ethnic groups in the country. The socioeconomic indices of the children sampled in this study are not suffering from protein
respondents indicate that most of the households were within energy malnutrition. This is may be as a result of the study
the low to middle income class of wealth strata earning less location which focused more on households in urban areas
than N50000 naira (≈$140 @360 naira per dollar) in a month. since evidence shows that child undernourishment is usually
Evidence from literature have established an association higher in rural areas compared to urban areas (Betebo et al.,
between low wealth status and household food insecurity 2017). Results from this study show that household food
(Uko-Auimoh, 2005; Sanusi et al., 2006; 2019; Hannum et al., security status is higher in comparison with a previous study
2012; Saaka et al., 2013; Chinnakali et al., 2014). While the of households within the same region by Sanusi et al. (2006)
household income presented in this study are estimates of the but similar to a more recent study of households in the same
reality, they serve as a determinant factor of the occurrence of region carried out by Roberts et al. (2019). The pattern of food
mild to moderate forms of hunger and poor access to food. The insecurity is however similar as found in previous studies
Food Agriculture Organization (FAO, 2010) advocates that which establishes that food insecure households with mild
households must have sufficient income to purchase the food hunger usually have highest counts. The results presented in
they are unable to grow since insufficient money and poverty this study reflect a slight improvement in the food security
could reduce access to foods of adequate nutrient quality. status of households over a period of time but the implications
Another observable factor associated with the low economic for dietary intake and by extension nutrient adequacy still
status of the sampled households is the educational status of remain unexplained. The relationship between food insecurity
the household heads. Muhammad and Sidique (2019) and inadequate dietary intake was predicted by Sanusi et al.
examined determinants of food insecurity and discovered the (2006) (but not explored) in a previous study of households
impact of increased years of education on the chances of within the region. This present study specifically considered
securing higher income generating activities and having the nutrient adequacy of key nutrients of public importance in
higher social capital for better quality of life. The impact of the foods consumed by the most vulnerable members of the

44 Afr. J. Biomed. Res. Vol. 24, No.1 (January) 2021 Yahaya et al

 Food Insecurity and Nutrient Adequacy of under-five

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