Evidences of Widespread Hunger in Gbeo Community, North East Region, Ghana; the Determinants of Malnutrition and Susceptibility to Extreme Hunger

Background: The global community aspires towards zero hunger and minimized prevalence of various metrics of malnutrition by 2030 and beyond. Despite mainstream routine nutrition/food surveillance interventions carried out by provincial, national and civil society bodies, the markers of global hunger are rife. This study sought to investigate with the aid of household food insecurity experience scale (HFIES) and nutrition indices, the evidence of hunger, child malnutrition and other forms of extreme household deprivation in Gbeo; a rural hard-to-reach community in the Mamprugu East Municipality, North East Region. Methods: This study was a case analysis of Gbeo community using cross-sectional modalities. Mother – child dyads from 235 systematically selected households were recruited for one-on-one interviews including anthropometric/dietary assessments. Data were obtained on household hunger (using HFIES as proxy), child (6 – 59 months) malnutrition and their potential predictors (SE characteristics, IYCF, WASH, etc.). Child anthropometric growth indices were computed in accordance with WHO (2017) revised standard protocols. Findings: Out of 235 children 34.4% were stunted, 18.8% underweight and 37.9% wasted; these are elevated above Ghana Demographic and Health Survey (GDHS) data for Northern Region, Ghana as a whole and WHO/UNICEF/World Bank (2021) latest global estimates. Four (1.8%) children had all growth failure and in 5.6% of cases, underweight co-occur with stunting and wasting. The proportion of HHs in the 3rd tertile [T3], 2nd tertile [T2] and 1st tertile [T1] of food insecurity were 33%, 29% and 38% respectively. Multiple logistic regression models showed that mean HFIES scores were higher among households that; has a female food-based decision maker [t (degrees of freedom=1, n=235) = 1.93, significance level p =.000], have not received any form of remittances within the past 12 months [t (1, 235) = 2.65, p = .016], source their food stuffs from predominantly purchasing [t (1, 235) = 2.65, p = .009] and has a caregiver or household head that is an alcoholic [t (1, 235) = 4.01, p = .000]. Conclusion: Food insecurity predicts acute child malnutrition. Social protection and economic empowerment interventions should be integrated with nutrition-based initiatives for holistic household improvement.