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Yasmin S, Bhattacharya A, Sinha N, Baur B, Gupta A, Sau M. Determinants of Household Food Insecurity among Tribal Population: An Experience from Rural West Bengal, India. JNFS. 2018; 3 (3) :149-156
URL: http://jnfs.ssu.ac.ir/article-1-196-en.html
Department of Community Medicine, Midnapore Medical College, Midnapore, India
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Determinants of Household Food Insecurity among Tribal Population: An Experience from Rural West Bengal, India
 

Shamima Yasmin; MD1, Abantika Bhattacharya; MD1, Nirmalya Sinha; MD*1, Baijayanti Baur; MD1, Avisek Gupta; MD1 & Manabendra Sau; MD1

1 Department of Community Medicine, Midnapore Medical College, Midnapore, India.

ARTICLE INFO   ABSTRACT
ORIGINAL ARTICLE  
Background: Knowledge regarding distribution and determinants of household food insecurity focusing on vulnerable groups is utmost important for ensuring food security, which is every nation prime agenda. This study was conducted to determine the prevalence and determinants of household food insecurity among the tribal population of Purulia, West Bengal. Methods: A cross-sectional study was carried out among 134 tribal households covering a total 632 population selected from 3 administrative divisions of Purulia district by two-stage random sampling. Information collected on selected demographic and socio-economic profile of the households including utilization of public distribution system (PDS) by house-to-house interview. A Bengali version of validated household food security scale-short form was used as a tool for data collection. Furthermore, the anthropometry was carried out among the children aged 6-59 months. Results: The results showed that the prevalence of household food insecurity was 35.8% in the study area. Households with lower socio-economic status, kutcha houses, low income related to the family members, holding of below poverty line (BPL), and ration card were significantly associated with the household food insecurity. Prevalence of under-weight and stunting among 6-59 months children were found significantly more among food insecure households. Conclusions: In-spite of several efforts, household food insecurity was quite prevalent especially among vulnerable poor households. Therefore, it shows that food security along with poverty reduction activities are required to be increased at the household level.
 
Keywords: Determinants; Household food insecurity; India; Tribal population
Article history:
Received: 20 Mar 2018
Revised: 14  May 2018
Accepted: 28 May 2018
*Corresponding author:
drnirmalya.sinha@rediffmail.com
Department of Community Medicine Midnapore, Medical College, Midnapore, Pin-72101, W.B, India.
 
Postal code: 72101
Tel: +91 9933887740
 
Introduction
Despite rapid economic growth, remarkable progress in food production as well as sufficiency and technological innovations, India is lagging behind the commitment for achieving ‘Millennium Development Goals’. The regional inequality associated with ignorance and poverty especially among vulnerable population make the situation worse even seventy years after independence. More than 217 million undernourished people are living in India (Food and Agriculture Organization, 2002).
About 40.4% and 44.9% of the children below the age of 3 years were underweight and stunted, respectively, in India (National Family Health Survey (NFHS-3) 2007). According to the ‘Global Hunger Index’, India placed in the ‘alarming category (Grebmer KV, 2010). The ‘World Food Summit’ at Rome in 1996 adopted the definition: ‘Food security exists when all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life’ (Food and Agriculture Organization, 1996).  However, it is a challenging job for a vast and populous country like India where 25.7% of the population is below the poverty line in rural areas (Planning Commission, 2013).
Scheduled tribes are considered as socially and economically one of the most vulnerable populations comprised 8.6% of the India population (Registrar General and Census Commissioner of India under the Ministry of Home Affairs, 2011).  Poverty, ignorance and under nutrition are prevalent among the tribal population (National Family Health Survey (NFHS-3) 2007).  Valid and reliable information are necessary for formulating strategies to confront the situation. Several methods are commonly used for assessing food insecurity at the household level. The qualitative measures based on the ‘Household Food Security Scale’ (HFSS) are rapid and cheap methods to assess the perception of the people regarding household food insecurity (Bickel G, 2000). Considering these facts in mind, the present study aimed to investigate the prevalence and determinants of household food insecurity among the tribal population of Purulia district, West Bengal.
Materials and Methods
Study design and setting: A community based cross-sectional study was conducted among the tribal population of Purulia district of West Bengal during October 2015 to March 2016. Purulia is a borderline drought prone district situated at West Bengal with a population of 2, 92, 7965; nearly 20% of which belonged to scheduled tribes (Registrar General and Census Commissioner of India under the Ministry of Home Affairs, 2011).
Study units and participants: The present study considered household as the study unit and all the family members of the studied households were included for assessing the food security status at the household level. Anthropometric indictors of the children aged 6-59 months used as proxy outcome indicators of the household food security.
Sample size and sampling technique: Considering the prevalence of household food insecurity as 44% (Chakraborty, 2005); 5% alpha error, 20% relative precision and 10% non-response rate, the desired sample size was 134. The district of Purulia has three administrative divisions namely; Purulia Sadar East, Purulia Sadar West and Raghunathpur. Villages with at least 25% tribal population were eligible for inclusion in the present study. Two-stage random sampling technique was used for selection of the villages (one from each administrative division). The required number of the studied households from randomly selected villages out of the administrative divisions was calculated by using probability proportional to size (PPS) sampling to ensure representation of all divisions. In each village, required numbers of tribal households were selected randomly and incase of non-availability, households from the nearby tribal village were investigated. 
Ethical issues and necessary approval: The study obeyed the ethical standards for an observational study and approved by the Institutional Ethics Committee, Midnapore Medical College, Paschim Medinipur, and West Bengal. The informed written consent was obtained from each of the study participant.
Data collection and measurements:The head of the household or any responsible adult family member, preferably a woman was interviewed with means of a predesigned, pretested, semi-structured questionnaire. The demographic, socio-economic as well as food security status information at household level were collected.
A slightly modified and validated bengali version of ‘Six-item HFSS-Short Form’ was used to assess the household food security status after pretesting (Bickel G, 2000). The households responding affirmatively to four or more items of the scale were considered as very low food secure and those responded to two to three affirmative answers were considered as low food secure households. Households which responded negatively to all six items and those which gave only one affirmative answer were coded as households with high food security and marginal food security, respectively (Blumberg SJ, 1999). High and marginal food secure households were considered as food secure; whereas low and very low food secure households were categorized as food insecure households. Socio-economic status of the households was assessed by the ‘modified Prasad classification’ (Mangal A, 2015). The utilization of the public distribution
system (PDS) through fair price shops was
also enquired and expressed as regular (on an average ≥ 3 weeks/month), irregular (< 3 weeks /month), and not used PDS at all as stated by the respondents. Anthropometric assessments such as weight and height were measured among
the youngest children aged 6-59 months presented in the surveyed households by
using standard techniques (World Health Organization, 1995) and expressed in terms of weight-for-age and weight-for height/length indicators as the new WHO standards (World Health Organizatio, 2007).
Data analysis: After verification, the data were entered in Microsoft Excel worksheet (2010 version). The statistical analysis was done using the Epi-InfoTM [Version 7.2] software package. The continuous variables were expressed in terms of mean and standard deviation. Proportions were used for calculating the prevalence of different grades of household food security. Associations between risk factors and the household food insecurity were evaluated by calculating the chi-square test. For all statistical tests, P-value < 0.05 was considered as statistically significant.
Results
Among 134 surveyed households, the majority (58.2%) lived in kutcha houses and 23.1% and 18.7% lived in semi-pucca and pucca houses, respectively. The average family size was 5.7 ± 0.37 and the majority (97%) belonged to Hindu caste. Illiteracy was evident among 35.8% of the housekeepers and more than half of them (56%) engaged in unskilled works. Under-five children were among 47% (63 out of 134) of the households.
According to the ‘modified B.G. Prasad scale’ (Mangal A, 2015), 91% of the households belonged to poor socio-economic (class V and class IV) and the remaining (only 9%) belonged to lower middle, upper middle and upper class (class I to class III) together. The average total income related to members was 4.04 ± 0.15. The majority (85.9%) of the households had Below Poverty Line (BPL) ration card and 70.1% households utilized the public distribution system for ration on regular (≥ 3 weeks/month) basis.
The prevalence of food security (considering both high as well as marginal food security) was 64.2% among the studied households and the rest (35.8%) of the households had food insecurity (32.8% belonged to very low food secure category and 3% were low food secure category). Intake of the balanced diet represented a proxy measure of dietary quality in the study. Only 44% of the households took balanced meal on regular basis. (Table 1
The overall household food insecurity was 35.8%. All (100%) the food insecure households were Hindu. (Household Food insecurity was not significantly different according to education and occupation of the housekeeper and presence of under-five children in the family (Table 2).
Food insecurity was significantly more prevalent (P < 0.05) among families who lived in kutcha houses (79.2%) and where members' income to the total income was 1 : > 4 (62.5%) as compared to the ratio of 1 ≤ 4. It was also evident that food insecurity increased with increasing socio-economic classes (Class I to Class V) as in the B.G. Prasad scale with the highest prevalence (77.1%) in Class V. Though majority (95.8%) of the food insecure households had BPL ration card, only 66.7% of the families utilized the PDS regularly. One-third of the food insecure households (16.7% in each category) did not utilize the PDS at all or regularly due to financial constraints (Table 3).
Table 4 indicates that the prevalence of underweight (72.7%) as well as stunting (54.5%) among the children aged 6-59 months were significantly higher among the food insecure households (P < 0.05).  
 
Table 1. Prevalence of different categories of household food insecurity
 
Categories of household food security N %
Food Secure High food secure 39 29.1
Marginal food secure 47 35.1
Food Insecure Low food secure 04 3.0
Very low food secure 44 32.8
Balanced Dieta Regular 59 44.0
Not regular 75 56.0
Total   134 100
a: taking rational mix of essential nutrients
 
 
Table 2. Household food insecurity by selected socio-demographic factors
 
Variables Total households Food Insecure P-valuea
N % N %    
Religion
 
Hindu 130 97.0 48 100 --
Islam / Others 04 3.0 0 0
Education of the housekeeper
 
 
 
Illiterate 48 35.8 20 41.8 0.05
 
 
 
1-4 13 9.7 03 6.2
5-12 51 38.1 22 45.8
> 12 22 16.4 03 6.2
Occupation of the housekeeper
 
 
 
 
Service/Business 25 18.7 06 12.5   0.19
 
 
 
 
Skilled worker 14 10.4 3 6.2  
Unskilled Worker 75 56.0 29 60.4  
Home maker 20 14.9 10 20.8  
Under-five children?
 
Yes 63 47.0 23 47.9   0.87
 
 
No 71 53.0 25 52.1  
a: chi square test

 
Table 3. Household food insecurity by selected socio-economic factors
 
Variables Total households Food Insecure P-valuea
N % N %
Socio-economic status (as per B.G. Prasad’s classification)
    Class I to III 
 
12
 
9.0
 
01
 
02.1
0.08
 
 
 
    Class IV 31 23.1 10 20.8
    Class V 91 67.9 37 77.1
Earning to total family members ratio
     ≤ 4
      >4
 
84
 
62.7
 
18
 
37.5
< 0.001
 
 
50 37.3 30 62.5
Possession of BPL ration card
    Yes
    No
 
115
 
85.9
 
46
 
95.8
0.02
 
19 14.2 02 4.2
Utilization of the PDS
    Not utilized at all
    Regularly utilized
    Not regularly utilized
 
28
 
20.9
 
08
 
16.7
0.07
 
 
94 70.1 32 66.7
12 9.0 08 16.7
Type of house
    Kutcha
    Pucca
    Semi Pucca
 
78
 
58.2
 
38
 
79.2
< 0.001
 
 
 
25 18.7 04 8.3
31 23.1 06 12.5
a: chi square test
 
Table 4. Household food insecurity by under-nutrition status of the children 6-59 months
 
Nutrition status Total households Food insecure P-valuea
N % N %    
Underweight
    Yes
    No
 
20
 
35.1
 
16
 
72.7
< 0.001
 
37 64.9 6 27.3
Stunting
    Yes
    NO
 
16
 
28.1
 
12
 
54.5
< 0.001
 
41 71.9 10 45.5
a: chi square test
 
Discussion
The present study revealed that 35.8% of the households were food insecure in the study areas. The majority (32.8%) of which belonged to very low food secure category and the remaining (3%) were in low food secure category. A similar study from rural West Bengal among tribal population reported higher prevalence (52.8% of overall prevalence; 29.6% and 23.2% were low and very low food secure, respectively) (Mukhopadhyay DK, 2010). Another study also reported higher prevalence (51%) of household food insecurity as compared to the present study (Agarwal S, 2009). The difference in the prevalence may be due to different study settings as well as up-scaling of food security interventions. The present study revealed that though nearly two third (64.2%) of the studied households were food secure, only in 44% of the households where family members with balanced diet (rational mix of essential nutrients) which reflected the quality of consumed food as well as the nutritional security.
Food security depends on several factors, such as availability and accessibility of food, food safety, economic access, social acceptance. Furthermore, not only food security, but also nutritional security can’t be ignored. A study from North India among population of an urban slum reported only 34.2% of the households consumed balanced diet (Agarwal S, 2009). The present study showed a significant association between parameters of lower socio-economic status such as kutcha houses, high earning to total family members ratio (> 4) and lower class (Class V)  of modified B.G Prasad scale. Several studies also reported similar association between lower socio-economic status and high unemployment to employment ratio with household food insecurity (Agarwal S, 2009, Mukhopadhyay DK, 2010, Ray SK, 1997).
The majority of the studied households possessed BPL card (85.9%) and regularly utilized the PDS (70.1%) which could be justified as rational inclusion (inclusion as below poverty line); since the study was conducted among the most socio-economical vulnerabletribal population in the driest district of West Bengal. However, surprisingly, even one third (33.4%) of the food insecure households those had BPL ration card did not utilize the PDS regularly, probably due to monetary constraints. Poverty was intractably related to household food security, since there was a positive association between lower socio-economic status and food insecurity (Table 3). A similar study among tribal population of rural West Bengal reported less prevalence of possession of BPL card (69.3%) as well as regular utilization of PDS (56.9%) than the results of the present study (Mukhopadhyay DK, 2010). Another study also reported less availed services of PDS in-spite of owning a ration card on regular basis in an urban colony of North India (Chinnakali, 2014). A study from urban area of Tamil Nadu, India reported overall 58.5% households and 82.9% households in the lower socioeconomic strata used the PDS mainly for buying rice-the main food, respectively (Gopichandran V, 2010).
Therefore, mere availability and accessibility of food is not enough for household food security without improving the purchasing power. The community awareness program along with association of the marginalized rural community with the existing poverty reduction activities and income generation programs should be promoted.
The present study revealed higher prevalence of under-nutrition among tribal with children under the age of 5; similar to the findings of other studies (Agarwal S, 2009, Mukhopadhyay DK, 2009, Yadav RJ, 1999). The proportions of under-weight and stunting among children aged 6-59 months were found 35.1% and 28.1%, respectively; while it increased drastically in food insecure households (72.7% under-weight and 54.5% stunting). A greater prevalence was found than the national as well as the state prevalence (National Family Health Survey (NFHS-3) 2007). Several other studies reported less prevalence findings. The findings differed due to the different references used in anthropometric interpretation, different study settings and study population (Chinnakali, 2014, Mukhopadhyay DK, 2009, Ray SK, 1997).
Conclusions
It was concluded that food as well as nutritional insecurity were prevalent among the study population. Food insecurity was significantly associated with lower socio-economic status. The study findings showed that better accessibility of balanced food and improvement of socio-economic status are required. The community awareness program along with association of the vulnerable and marginalized community with the existing poverty alleviation activities and income generation programs should be strongly promoted. Not only the quantity, but also the quality of the ration should be requested to ensure about both food and nutritional security at the household level.
The present study tried to assess both quantities as well as quality aspects of household food security among the marginalized community of rural West Bengal. Nutritional status of the under-five children was considered as one of the most important proxy indicators of severe consequences of household food insecurity. However the study had some limitations, which suggest cautious interpretation of its findings. The study mainly relied on self-reported data which had some subjective components related to social expectations. The study was carried out only among a small tribal population of a single district of West Bengal; therefore, the study findings could not be generalized. The diet survey was not considered for assessing nutritional security. The knowledge regarding low cost locally available food, food diversity, social acceptance etc. was not assessed. A further large scale study with refined tools must be conducted to ascertain the exact situations of household food security and its predictors especially among vulnerable population in India for better program management and policy construction towards achieving the ‘Millennium Development Goals’.
Authors’ Contributions
Yasmin S, Sinha N and Baur B designed and conceptualize the study. Yasmin S, Bhattacharjya A and Sinha N analyzed the data. All the authors collected the data, took part in drafting of the manuscript and finally approved the same. Yasmin S, Sinha N and Baur B critically reviewed and edited and manuscript.
Acknowledgements
Thanks are owed to all participants and their family members for their sustained co-operation throughout this study. The authors also would like to thank the heath authority team of Purulia District for their endless support.
Source(s) of Support
Technical and logistics supported by the Department of Community Medicine, Midnapore Medical College,Midnapore, Paschim Medinipur, West Bengal, India. No financial  support reveived from any where for the present study. 
Conflict of Interest
None of the authors declared any conflict of interest.
 
References
Agarwal S SV, Gupta P, Jha M, Agnihotri A, Nord M 2009. Experiential Household Food Security in an Urban Underserved Slum of North India. Food security. 1 (3): 239-250.
Bickel G NM, Price C, Hamilton W, Cook J 2000. Guide to Measuring Household Food Security: Revised 2000. (ed. F. a. N. S. U.S. Department of Agriculture): Alexandria VA.
Blumberg SJ BK, Hamilton WL, Briefed
RR
1999. The effectiveness of a short form of the household food security scale. American journal of publichHealth. 89: 1231-1234.
Chakraborty D 2005. Food Security in India: Policy Challenges and Responses. In Brief Paper, Asia Programme, pp. 1-13. Chatham House: New Delhi, India.
Chinnakali P 2014. Prevalence of Household-level Food Insecurity and Its Determinants in an Urban Resettlement Colony in North India. Journal health Population nutrition. 32 (02): 227-236.
Food and Agriculture Organization 1996.
Rome Declaration on World Food Security
and World Food Summit Plan of Action, Rome, Italy.
Food and Agriculture Organization 2002. Food Security: Concepts and Measurement. FAO Rome, Italy.
Gopichandran V CP, Baby LS, Felinda A, Mohan VR 2010. Household Food Security in Urban Tamil Nadu: A Survey in Vellore. National medical journal of India. 23 (05): 278-280.
Grebmer KV RM, Menon P, Nestorova B, Olofinbiyi T, Fritschel H et al. 2010. Global Hunger Index.  The Challenge of Hunger: Focus on The Crisis of Child Under-Nutrition. p. 17. International Food Policy Research Institute: Washington DC, USA.
Mangal A KV, Panesar S, Talwar R, Raut D, Singh S 2015. Updated BG Prasad socioeconomic classification, 2014: A commentary. Indian journal of public health. 59 (01): 42-46.
Mukhopadhyay DK BR, SadhukhanS, Chakraborty M, Banik KK 2009. Anthropometric Failure, A New Approach to Measure Under-Nutrition: An Experience From A Rural Community of West Bengal, India. Journal of Indian medical association. 107 (04): 211-214.
Mukhopadhyay DK MS, Biswas AB 2010. Enduring Starvation in Silent Population: A Study on Prevalence and Factors Contributing to Household Food Security in the Tribal Population in Bankura, West Bengal. Indian journal of public health. 54 (02): 92-97.
National Family Health Survey (NFHS-3) 2007. 2005-06: India. Key Findings.  (ed. M. International Institute for Population Sciences, India.): Mumbai.
Planning Commission 2013. Press Note on Poverty Estimates 2011-12.  (ed. G. o. India). Government of India. Press Information Bureau: New Delhi, India.
Ray SK BA, Kumar S 1997. A Comparative Study of Household Food Security and Nutritional Profile of Under-five Children in A Rural and An Urban Community of West Bengal. Indian of journal public health. 42: 136-147.
Registrar General and Census Commissioner of India under the Ministry of Home Affairs GoI 2011. Census of India. India.
World Health Organizatio 2007. WHO Child Growth Standards. Methods and Development. World Health Organization: Geneva, Switzerland.
World Health Organization 1995. Physical Status: The Use and Interpretation of Anthropometry: Report of WHO Expert Committee. In WHO Technical Report Series-854. World Health Organization: Geneva, Switzerland.
Yadav RJ SP 1999. Nutritional status and dietary intake in tribal children in Bihar. Indian pediatrics. 36: 37-42.

 
Type of article: orginal article | Subject: public specific
Received: 2018/03/20 | Accepted: 2018/05/28 | Published: 2018/08/1

References
1. Agarwal S SV, Gupta P, Jha M, Agnihotri A, Nord M 2009. Experiential Household Food Security in an Urban Underserved Slum of North India. Food security. 1 (3): 239-250.
2. Bickel G NM, Price C, Hamilton W, Cook J 2000. Guide to Measuring Household Food Security: Revised 2000. (ed. F. a. N. S. U.S. Department of Agriculture): Alexandria VA.
3. Blumberg SJ BK, Hamilton WL, Briefed
4. RR 1999. The effectiveness of a short form of the household food security scale. American journal of publichHealth. 89: 1231-1234.
5. Chakraborty D 2005. Food Security in India: Policy Challenges and Responses. In Brief Paper, Asia Programme, pp. 1-13. Chatham House: New Delhi, India.
6. Chinnakali P 2014. Prevalence of Household-level Food Insecurity and Its Determinants in an Urban Resettlement Colony in North India. Journal health Population nutrition. 32 (02): 227-236.
7. Food and Agriculture Organization 1996. Rome Declaration on World Food Security and World Food Summit Plan of Action, Rome, Italy.
8. Food and Agriculture Organization 2002. Food Security: Concepts and Measurement. FAO Rome, Italy.
9. Gopichandran V CP, Baby LS, Felinda A, Mohan VR 2010. Household Food Security in Urban Tamil Nadu: A Survey in Vellore. National medical journal of India. 23 (05): 278-280.
10. Grebmer KV RM, Menon P, Nestorova B, Olofinbiyi T, Fritschel H et al. 2010. Global Hunger Index. The Challenge of Hunger: Focus on The Crisis of Child Under-Nutrition. p. 17. International Food Policy Research Institute: Washington DC, USA.
11. Mangal A KV, Panesar S, Talwar R, Raut D, Singh S 2015. Updated BG Prasad socioeconomic classification, 2014: A commentary. Indian journal of public health. 59 (01): 42-46.
12. Mukhopadhyay DK BR, SadhukhanS, Chakraborty M, Banik KK 2009. Anthropometric Failure, A New Approach to Measure Under-Nutrition: An Experience From A Rural Community of West Bengal, India. Journal of Indian medical association. 107 (04): 211-214.
13. Mukhopadhyay DK MS, Biswas AB 2010. Enduring Starvation in Silent Population: A Study on Prevalence and Factors Contributing to Household Food Security in the Tribal Population in Bankura, West Bengal. Indian journal of public health. 54 (02): 92-97.
14. National Family Health Survey (NFHS-3) 2007. 2005-06: India. Key Findings. (ed. M. International Institute for Population Sciences, India.): Mumbai. Planning Commission 2013. Press Note on Poverty Estimates 2011-12. (ed. G. o. India).
15. Government of India. Press Information Bureau: New Delhi, India.
16. Ray SK BA, Kumar S 1997. A Comparative Study of Household Food Security and Nutritional Profile of Under-five Children in A Rural and An Urban Community of West Bengal. Indian of journal public health. 42: 136-147.
17. Registrar General and Census Commissioner of India under the Ministry of Home Affairs GoI 2011. Census of India. India.
18. World Health Organizatio 2007. WHO Child Growth Standards. Methods and Development. World Health Organization: Geneva, Switzerland.
19. World Health Organization 1995. Physical Status: The Use and Interpretation of Anthropometry: Report of WHO Expert Committee. In WHO Technical Report Series-854. World Health Organization: Geneva, Switzerland.
20. Yadav RJ SP 1999. Nutritional status and dietary intake in tribal children in Bihar. Indian pediatrics. 36: 37-42.

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