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Global Health Econ Sustain Household food insecurity and Under-five Mortality

ranged from 13% to 66%, with at least three-quarters urban household food insecurity and under-five mortality
of this arising from mild-to-moderate malnutrition in in the sub-city. The findings are expected to provide
each case (Pelletier et al., 1995). In addition, a study policymakers and development stakeholders with valuable
conducted by the Pan American Health Organization’s insights to guide well-informed decision-making and
Inter-American Investigation of Mortality in Childhood effective interventions.
identified malnutrition as the primary cause of death in
15% of severe cases and an associated cause in 85% of less 2. Methods
severe cases among children aged 1 – 4 years (Puffer & 2.1. Study design and area
Serrano, 1973).
A cross-sectional study design was used, and data
A study conducted by Campbell et al. (2009) in rural collection was conducted from February to March 2023
Indonesia has demonstrated that food insecurity is related in Lideta Sub-City, located in the central-western area
to mortality among neonates and children under five of Addis Ababa. The sub-city shares borders with Addis
after adjusting for potential confounders such as the age Ketema, Arada, Kirkos, Nifas Silk-Lafto, and Kolfe Keranio
of the mother, maternal education, household kitchen sub-cities and is divided into ten Woredas. Three Woredas
sharing, maternal body mass index, and household food (districts) were randomly selected for data collection,
expenditure. Similarly, a study conducted by Cassidy conducted at respondents’ residences in the sub-city. Lideta
et al. (2022) in North Carolina, America, has confirmed Sub-City covers an area of 9.18 square kilometers and
a positive correlation between household food insecurity has a population of 284,208, consisting of 134,372 males
and infant mortality after controlling for other variables and 149,836 females. The study focuses on this densely
such as diabetes. According to their findings, a 1% increase populated and economically disadvantaged district in
in country food insecurity results in 1.2 additional infant Addis Ababa, with a population density of 30,960 people
deaths per 1000 live births. per square kilometer (CSA, 2022b).
Inadequate access to food among young children 2.2. Sampling design and procedure
significantly contributes to mortality rates, and increases
in the average dietary energy supply for infants have The sample size was determined using the single
notably reduced these mortality rates. A study conducted population proportion formula proposed by Bartlett
by Beyene (2023), based on evidence from sub-Saharan et al. (2001) with the assumption that a single population
Africa, confirms that an increase in the prevalence of proportion experiencing food insecurity is often estimated
undernourishment has a significant positive effect on infant to be 50%, with a margin of error of 5% and a 95%
mortality. The study findings revealed that a 1% increase in confidence interval (CI) (z = 1.96). In addition, a design
1/2
the prevalence of undernourishment leads to a reduction of effect of 1.5 was applied for cluster sampling and some
0.00348% in life expectancy while simultaneously causing allowances were also added, considering the variability
infant mortality rates to increase by 0.0119%. Furthermore, in the study population and controlling for non-response
a study by Walker et al. (2019) used a Cox regression model rates and outliers, respectively. The sampling strategy of this
to demonstrate that food insecurity is linked not only to study was operationally predicated on the pre-established
enumeration areas of the sub-city delineated by the
under-five mortality but also to adult mortality. According Central Statistical Service of Ethiopia. Samples were drawn
to the study, individuals reporting very low food security
have twice the risk of mortality compared to those with full using a multi-stage random sampling technique. Initially,
food security after adjustment for demographics. three Woredas were randomly selected in the first stage.
Second, from each of these three Woredas (each Woreda
Although various studies have explored the effects comprises different Ketenas [villages]), two Ketenas were
of food insecurity on child health and development selected using the random sampling method. In the last
(Kimbro & Denney, 2015; Quyen et al., 2014), educational step, a final sample of 605 respondents was selected from
performance, intellectual development (Belachew et al., the six Ketenas. The total sample was divided among all the
2011), and external and internal behaviors (Murphy et al., Woredas and then among Ketenas proportionally to their
1998), as well as stunting, wasting, and underweight (Abdu population size. Households from the respective Woreda
et al., 2018; Abdurahman et al., 2016; Berra, 2020; Betebo were selected using a systematic random sampling method
et al., 2017; DiClemente et al., 2021), insufficient emphasis based on a sampling frame of house numbers developed
has been placed on investigating the association between from Ketenas records. Individual women within the age
urban household food insecurity and demographic range of 15 – 49 years, either household heads or spouses,
outcomes within scholarly discourse. This study aims who had given birth within the last 10 years preceding the
to fill this gap by investigating the relationship between survey, were sampled. If the selected household was found

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/ghes.1682