Determinants of Household Food Insecurity among Tribal Population: An Experience from Rural West Bengal, India
 

 

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-Info^TM [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).  

 

 
 

^a: chi square test

 

^a: chi square test