Food insecurity and its associated factors among lactating mothers in Ankesha Guagusa Woreda, Northwest Ethiopia: a community-based cross-sectional study

Food insecurity is defined as the limited or uncertain availability of nutritious, adequate, and safe food, as well as a constrained potential to obtain suitable foods in socially acceptable manners. Food insecurity leads to both macro/micronutrient deficiency, making lactating women more vulnerable to inadequate human milk production and malnutrition during their optimal lactation period. However, data on the prevalence and associated factors that contribute to food insecurity are sparse within this specific population, where food insecurity might also be worsened in relatively highland areas. Thus, this study aimed to assess the prevalence of food insecurity and its associated factors among lactating mothers in Ankesha Guagusa Woreda, Awi Zone, Northwest Ethiopia. A community-based cross-sectional study was conducted from July 1 to August 30, 2025, in Ankesha Guagusa Woreda. The data were collected by a pretested structured questionnaire. The single-population proportion formula was used to estimate sample size. The final sample size was 464. To assess the food insecurity status of mothers, an eight-item Food Insecurity Experience Scale (FIES) was considered. Data were cleaned, coded and entered into EpiData version 4.6 and then exported to SPSS Version 25 for analysis. Both bivariable and multivariable logistic regression analyses were used to identify associated factors of food insecurity. The prevalence of food insecurity among lactating mothers was 70.9%. Mothers residing in rural areas (AOR = 1.97; 95% CI 1.2, 3.2), mothers experiencing an illness (AOR = 1.72; 95% CI 1.11, 2.68) and mothers who did not consume Vitamin A-rich vegetables, roots, or tubers (AOR = 1.99; 95% CI 1.06, 3.73) had higher odds of food insecurity. Conversely, meal frequency (> 3 meals) (AOR = 0.34, 95% CI 0.14, 0.76) and consuming milk and milk products (AOR = 0.5, 95% CI 0.3, 0.9) were inversely associated with food insecurity. The prevalence of food insecurity among lactating mothers was high in the study area. Therefore, to optimize food security, resources must prioritize remote rural kebeles during lean cycles while health extension workers screen for maternal illnesses during postnatal visits. Additionally, establishing community-based dairy cooperatives and supporting Vitamin A-rich home gardens will directly enhance nutrition and lower food access barriers for vulnerable, lactating households.