Household food insecurity and its determinants in urban health and demographic surveillance system sites of Northwest Ethiopia, 2022

Urban food insecurity is rooted in a number of causes, including high living costs, economic inequality, food deserts, limited access to fresh food, transportation hurdles that may limit access to grocery stores, and unemployment. Thus, this study aimed to assess household food insecurity and its contributing factors across urban Health and Demographic Surveillance Systems sites in Northwest Ethiopia. A community-based cross-sectional survey with 12,400 urban permanent resident homes was carried out between March and October 2022. The DRC database was used for data entry, and clean data was transferred to STATA version 17 for analysis. Variables with a P-value less than 0.2 were analyzed using multivariable logistic regression, and those with a P-value under 0.05 were deemed significantly associated with the dependent variables. In the baseline survey, the results indicated that 32.1% (95% CI: 31.3–33.0) of households were food insecure. Being a female-headed household (AOR = 1.4; 95% CI: 1.2–1.6), unable to read and write (AOR = 2.0; 95% CI: 1.7–2.4), aged 50 years and above (AOR = 1.5; 95% CI: 1.3–1.7), unable to work (AOR = 1.6; 95% CI: 1.3–2.1), retired (AOR = 1.5; 95% CI: 1.2–1.8), working as a daily laborer (AOR = 1.3; 95% CI: 1.2–1.5), and being in the poorest wealth category (AOR = 7.2; 95% CI: 6.1–8.5) were significantly positively associated with food insecurity. In contrast, being a student (AOR = 0.5; 95% CI: 0.4–0.7), a farmer (AOR = 0.6; 95% CI: 0.5–0.8), and having a chronic illness (AOR = 0.5; 95% CI: 0.4–0.5) were significantly negatively associated with food insecurity. A substantial proportion of households in northwest Ethiopia faced food insecurity, significantly linked to the sex, occupation, age, educational attainment, illness, and wealth status of household heads. To reduce food insecurity among the most vulnerable populations, targeted actions are required. Social safety and livelihood programs for these populations need to be improved. Hence, the emphasis will be on educating elderly folks and those with less education about nutrition. Improve women’s work prospects and advance food security; there will also be a focus on growing income-generating actions, with a focus on retirees, which will also be prioritized.