Food insecurity and dietary diversity among women of reproductive age in an informal settlement in Tshwane, South Africa

Abstract

Objectives: Household food insecurity (HFI) is a public health concern, particularly in informal settlements, where women of reproductive age (WRA) are vulnerable to malnutrition. This study aimed to determine the HFI, dietary diversity and anthropometric status of WRA (18–49 years) residing in an informal settlement in Tshwane, South Africa. Additionally, differences between moderately food-insecure (MFI) and severely food-insecure (SFI) women were determined.
Design: Descriptive, cross-sectional study.
Setting: An informal settlement in Tshwane, South Africa.
Subjects: A convenience sample of WRA (n = 103).
Outcome measures: HFI and dietary diversity were assessed using the Household Food Insecurity Access Scale (HFIAS) and the Minimum Dietary Diversity for Women (MDD-W) tool, respectively. Anthropometric measurements were recorded, including mid-upper-arm circumference, height and weight.
Results: The median age of the participants was 30 (23.0–37.0) years, with a mean HFIAS of 14.0 (10.0–18.0). Most women were either moderately (17.5%) or severely (75.7%) food insecure. The median MDD score was 3.0 (2.0–4.0), and only 20.4% of study participants met the minimum dietary diversity criterion. A significant difference between MFI and SFI women was observed only in the consumption of the pulse food group (33.3% vs. 14.1%; p = 0.002). High rates of overweight (36.9%) and obesity (30.1%) were recorded in the study population, with no significant differences between MFI and SFI groups.
Conclusion: Most WRA in this informal settlement were SFI, overweight or obese and exhibited low dietary diversity, underscoring the importance of further research to identify strategies that improve access to affordable, diverse diets for households living in poverty. 

Keywords: dietary diversity, food insecurity, informal settlements, overweight and obesity, women of reproductive age