Food security and associated factors among urban refugee households: A case study of refugees in Makindye Division, Kampala-Uganda

Abstract

Food security is one of the most important foundations of not only health but sustainable development in its entirety. However, currently, the world has about 828 million people who are not certain of whether they will eat the next day and almost a million people are chronically food insecure at any one time. Among those affected are refugees, who currently number at over 43.7 million globally, with their number of expected to escalate over the years. Of concern, refugees are among the most food insecure persons in the world, and in Uganda out of the 1.8 million, the United Nations High Commissioner for Refugees noted that 44% of them had borderline food consumption. In addition, refugees in Uganda, including urban ones post more cases of child acute malnutrition than host communities, despite the reception of food and cash aid. The purpose of this study was to assess the factors associated with food security among refugee households in Makindye division, in Kampala, Uganda and its influence on the nutritional status of children under five years. An explanatory sequential mixed method design was used to study refugee household heads in Makindye division. Parishes were purposively sampled, and systematic random sampling used to conduct a household survey, following which the household head were purposively sampled and engaged in structured and in-depth interviews. Data was captured using structured questionnaires and in-depth interview guides, with quantitative data analyzed using a log-binomial model, and qualitative data, thematically. The proportion of selected refugee households in Makindye division that are food secure is 90% (n = 334), with 74.5% of those being highly food secure. Female-headed household, and those with three to four members, were more likely to be food secure. Household head education to primary level, household head being employed, inability to speak the local language, local integration, being in a host community that can speak the local language as refugees reduced odds of food security. However, easy access to transport means in the community, increased food security odds. Children in food secure households had 86% less odds of being malnourished. The prevalence of food security among urban refugees in Makindye division is high; 9 in every 10 of them have high availability and access to food, which leaves only 1 in every 10 that are food insecure. However, while that level of food security is laudable, about three quarters of those that are food secure are truly secure (high security), which implies that 25% of the secure households are at a risk of slumping in to insecurity. Both intrahousehold and societal characteristics influence food security among those urban refugee households, almost in equal measure, and food security is significantly associated with child malnutrition in those households.