Reliability and validity of an individually-focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

Authors: Barnabas K. Natamba; Angela Arbach; Hillary Kilama; Jane Achah; Jeffrey Griffiths; Sera Young Journal: Cambridge University Press

Food security occurs “when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.” Food insecurity (FI) exists when these conditions are not met and is a major underlying cause of undernutrition enshrined in the UNICEF conceptual framework.

FI is a major risk factor for adverse health outcomes among specific vulnerable populations including persons infected with HIV, women and children. Women’s responsibilities in managing family feeding, gender bias in the experience of FI , and unequal control over household resources make them particularly vulnerable to FI and its consequences. Data from the US indicates that, when faced with FI, women suffer negative nutritional and psychosocial consequences.

Pregnant women are more likely to experience greater food insecurity than non-pregnant women because they have higher nutrient demands, less physical ability to obtain and prepare food (especially later in pregnancy and early postpartum), and less ability to engage in income-generating labor. The three studies to date about food insecurity among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women’s health. However, all of these studies were done in the US, and contextual differences between resource-rich and resource-poor settings make the generalizability of these findings questionable. For instance, a higher burden of infectious diseases and poverty in resource-poor settings may exacerbate women’s experiences of FI. Thus, it is important to document the burden and impacts of FI among pregnant women living in resource poor settings.