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SUMMARY: Food security is a world-wide concern and it is of more concern in low and middle income countries. Food security issue and its associated factors have not been sufficiently explored and studied in Nepal although this issue has been considered as a public health and social concern. Demographic and Health Survey 2011, for the first time, included the issue of food security in its survey however it has not been explored in detail. The study entitled "Intra-household food security and its associated factors in selected districts of Nepal" was carried out in selected four districts (Dolkha, Jumla, Syangja and Kapilvastu) of Nepal to explore the intra-household food security status and the associated factors existing in different ecological regions of the country with different socio-economic characteristics of the households. The study was approved by Child Health Division of Ministry of Health and Population and supported by WHO Country Office for Nepal. The study used a cross-sectional descriptive design with the mix of both qualitative and quantitative methods of data collection. Altogether, there were 1200 households in the study sample (300 household from each district). The sample VDC from each Illaka of each district was selected randomly and a randomly selected ward was fixed for all the sample VDCs. The households in the sample ward were identified using spin-a-pen random walk method. The number of sample households from each ward ranges from 20-33 depending upon the number of Illaka in each district. The study unit was household head with women of three generation (as available). Altogether, 1200 household head and 2078 women of three generation were interviewed about intra-household food security issues in their home setting. Similarly, 78 and 24 key informant interviews were conducted at community level and district level respectively. Two focus group discussions were conducted in every district. Majority of the households (94%) have owned some piece of land and the food produced from their own farmland was sufficient throughout the year for about one-fourth of them (27%). Different food crops were produced in different districts depending upon the climatic conditions. Barley, millet, wheat, maize were more common in hilly and mountain districts whereas rice and wheat were the major crops in terai district. About two thirds of the household heads, in average, were found worried about the food for their family, in the last 12 months. Percentage of those who worried for food in Jumla was very high (93%) in comparison to other districts. Percentage of households which had limited variety of food items to eat, due to lack of resources, was also very high Jumla (93%) but was relatively lower in Syangja district (25%). Altogether, 9% of the households experienced inadequacy of food to meet their satiety and the similar percentage of them had to sleep hungry, which is indicative of a chronic stage of food insecurity. It was higher in Jumla (15%) followed by Kapilvastu (13%). Regarding the reasons of worry about food insecure conditions, most of the respondents (48.7%) replied poverty (economic difficulty) or the lack of purchasing power of the family. Low production and lack of sufficient cultivable land were the other reasons explained by the respondents of food shortage. Very few of them (2%) replied that there was no stock of food in the market when required. Majority of the respondents replied that they took loan (43.3%) and those involved in labor works to cope with the situation of food insecurity in the family were 22.9%. Regarding market access, except in Jumla, most of the respondents of other districts had access to the local markets to buy required food for their families. More than 80% of the respondents in three study districts reached local markets within two hour but in Jumla those who had to walk for more than two hours was 51. Most of the household head replied that food was available at the local market when required. Although food was available at the local market, about 30% of the households reported that they were unable to afford it. Difference in food security experience was found among household head and women of three generation of the same study households. Women of first generation were found more worried nearly in equal percentage as the household head but the women of second and third generation were found less worried in comparison which might be due to less role or involvement in such family matters. Within the household, in case of lack of food in the family, women of first generation followed by second generation were found to cut their meals or sleep hungry than the household head and the third generation which signals the male dominance. Practice of eating together in the family was more common in mountain and hilly districts. Findings from qualitative data analysis also implied similar results. Discrimination in food consumption although persisting in some ethnic groups was reported to be in decreasing trend. Gender discrimination in food distribution was found comparatively more in terai district, Kapilvastu. Decision making at household level was dominated by males in most (57%) of the households. However, about one-fourth of them practiced joint decision making. In the families whether nuclear or joint, women have main roles in cooking and serving the food to all the family members. Regarding frequency of food consumption per day, eating food for four or more times was lower in Jumla and Kapilvastu districts where more than 50 % consumed food only twice or thrice a day. Practice of eating breakfast was less common in those two districts. The major staple food in all the study districts was rice. Key informants at district and community level in districts like Jumla and Dolkha also replied that people preferred rice most of the times and bought from the market as it was not sufficiently produced in the district. The preference of staple food of ethnic groups like Magar and Gurung also shifted to rice from millet and maize. Consumption of fruits was seasonal and was consumed if available from their own production. Similarly, fish or meat was found consumed mostly during feasts and major festivals, otherwise it was very occasional. Concept of hot and cold food and food taboos still prevailed in rural households in regard to consumption during pregnancy and lactation. Papaya, lemon, green vegetables, bottle gourd and colocassia roots including spicy foods were prohibited during pregnancy while pumpkin, fish, curd, fruits and spicy food were discouraged during lactation. In Jumla, lactating women were not given salt, beans and green vegetables as these were assumed to cause swelling to mother and newborn. Women during menstruation, in all the districts mostly in Brahmin/Chhetri communities, were not given cow's milk, not to impure the milk and the holy cow. Food taboos were found to be more of concern in upper caste and terai caste households in comparison to others. |
