Barcelona 2013
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| Abstract #497 - Well Being and Life Expectancy | ||||
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Session: 25.5: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li, Carlos Mur Authors: Presenting Author: Miss Natasha Croome - UCL, United Kingdom |
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| Additional Authors: | ||||
| Aim: The prevalence of food insecurity in families affected by HIV/AIDS is high. Food insecurity is associated with poor health and developmental outcomes in children. Previous research, mainly in high income countries, has revealed an increased risk of hyperactivity/ inattention, anxiety, depression, and aggression in children living in food insecure households. The objective of this study was to measure the prevalence of food insecurity of children affected by HIV attending community-based organisation (CBO) programmes in South Africa and Malawi and assess its relationship to mental health outcomes. We also determined what nutrition and food-related programming these children were receiving, in order to provide evidence for policy and planning for CBO programmes to meet the needs of children and families affected by HIV/AIDS. | ||||
| Method / Issue: We interviewed 979 children and their carers attending 28 randomly-selected CBOs in South Africa and Malawi. Food security was measured using child and carer report measures from the Child Status Index Domain on Food Security. Mental health outcomes were measured using UNICEF's Psychosocial Vulnerability and Resilience Measures For Monitoring of OVCs, including items from the carer report Strengths and Difficulties Questionnaire (SDQ). These measured emotional, peer, conduct, and hyperactivity problems. Depressive symptoms were assessed using an adaptation of the child report Child Depression Inventory. A range of organisational measures that were developed for the study were administered to carers, including questions about the type of provision that carers were receiving from their CBOs. | ||||
| Results / Comments: The sample was made up of 476 boys (48.62%) and 503 girls (51.38%) girls, with a mean age of 8.97 years. The mean number of people living in the children's households was 7.5. On the carer report item, most carers (73.14%) reported that their child is well-fed and eats regularly. However, 13.38% carers reported that the child only sometimes has enough to eat depending on the season or food supply, 11.44% reported that their child frequently has less food to eat than needed and often complains of hunger, and 1.94% of carers reported that their child rarely has food to eat and goes to bed hungry most nights. Of the children, 12.97% reported having gone to bed hungry the previous night. Carers reporting food insecurity had children who were more likely to have emotional problems (p=0.012) and conduct problems (p=0.001). Children reporting acute hunger were at greater risk of poor depression scores (p=0.018), and were more likely to present with conduct problems (p=0.017) and hyperactivity problems (p=0.002). Over half of the carers (54.44%) reported receiving some kind of food or nutrition service from their CBO. Of the children reporting acute hunger, 55.9% were receiving food and nutrition services from their CBO, compared to 44.0% of those who did not report it. Of the carers reporting poor food security, 48.1% were receiving food and nutrition services from their CBO, compared to 55.4% of those who were food secure. | ||||
| Discussion: In our sample, children living in food insecure households were at risk for poor mental health outcomes. While CBO programmes may be making some impact on food security, there are food-insecure children who are not accessing programmatic support for improving food and nutrition outcomes. Food insecurity has been identified as a contributing factor to increased HIV-morbidity and mortality in people with HIV. Targeting food security may improve mental health outcomes for both the child and their family members, and potentially improve HIV-related outcomes. Expanding the reach of current community-based food and nutrition programmes may contribute to better child mental and physical health outcomes. | ||||
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