Household food insecurity among refugees: examining variations across different climatic contexts in Ugandan refugee settlements

Background Over a quarter of Uganda’s population is food-insecure. Agrarian refugee populations are disproportionately affected; however, evidence on how food insecurity varies across refugee settlements by climatic region remains limited.Objective We assessed refugee household food insecurity across three settlements located in different climatic regions of Uganda.Methods A cross-sectional study was conducted among 600 refugees from Kiryandongo, Nakivale, and Rhino Camp (200 per settlement). The Household Food Insecurity Access Scale was used to assess food insecurity and to compare it across and within settlements, using the adjusted chi-square test and post hoc survey-weighted tests. Modified Poisson regression identified factors associated with food insecurity, with 95% confidence intervals.Results Household food insecurity was high (84.7%, 508/600) and varied significantly by settlement and background characteristics. Prevalence was highest among households in Rhino Camp settlement (100%, p < 0.001), situated within the unimodal rainfall region, among female-headed households (p = 0.009) and among households with heads aged 18–30 years (p = 0.02). Households with 7–12 members had a 10% higher prevalence compared with those with 1–6 members (APR = 1.10; 95% CI: 1.02–1.19). Conversely, food insecurity was 9% lower among households with married heads (APR = 0.91; 95% CI: 0.85–0.97), and 12% lower among households whose heads had secondary education or higher (APR = 0.88; 95% CI: 0.79–0.99).Conclusions Food insecurity was more prevalent in unimodal rainfall regions, larger families, female-headed households, and those with older heads. In contrast, households with higher education levels were more food secure. Implementing gender-sensitive interventions and educational initiatives would be essential for improving food security.