Hidden Hunger in Sahelian Cities: Nutrient Adequacy and Food Security in Urban Mali

Background: In Mali, rapid urbanization has led to increasing food security challenges, but research on urban dietary patterns is limited. The objective of this analysis is to assess food security, dietary diversity and the associated socio-demographic determinants of Bamako households, between 2018 and 2022. Methods: We analyzed 5,792 households based on data from the National Food Security and Nutrition Survey (ENSAN) in Mali with descriptive statistics, bivariate, and multivariable logistic regression. Primary predictors were Household Dietary Diversity Scores (HDDS), Food Consumption Scores (FCS), and wealth quintiles. Results: The household diet was cereal-based (99.3%) and largely devoid of protein-rich foods such as eggs (20.1%) and legumes (36.7%). We found a significant decrease in the prevalence of food security between 2018 (64.5%) and 2022 (59.2%) (p<0.01). Several important predictors of HHFS status were found in the multivariable regression. Urban and higher education were identified as strong positive predictors (AOR 1.8, CI:1.4-2.3 and AOR=2.1, CI:1.7–2.6, respectively), indicating associations between urban and being well-educated with better access to and use of food. On the other hand, households with the least wealth quintile (AOR=0.4, 95% CI:0.3-0.6) and polygamous family structures (AOR=0.7, 95% CI:0.5-0.9) witnessed a significant decrease in food security, thus pinpointing the combined burden of economic and complex household-based adversities. The findings emphasize the importance of targeted interventions directed to the socioeconomic and cultural dimensions of food insecurity. Conclusion: The food insecurity of Bamako, however, was resultant of economic instability and educational imbalances even though there is fair dietary diversity. Policy responses must incorporate urban farming, nutrition-sensitive social protection and gender-sensitive instruction programs.