Understanding Food Insecurity in Kinshasa During the COVID-19 Pandemic

Introduction Food insecurity is a vital issue, especially in places like Kinshasa. Additionally, food insecurity has been worsened by the COVID-19 pandemic, particularly in low- and middle-income countries. Thus, this study examined food insecurity in Kinshasa after the peak of the pandemic to understand food insecurity in post-pandemic recovery efforts and the possible implications for public health policies for future pandemics similar to COVID-19. Methods This study was conducted in Kinshasa with a representative sample of 2,160 households selected from 36 enumeration areas. We interviewed participants from different areas and used a questionnaire to ask them about their food situation. Interviews were conducted with the head of each household or their designated representative by 150 master’s students using tablets powered by the SurveyCTO application. Household food security status was evaluated through the Household Food Insecurity Access Scale. A logistic regression model was developed to assess household risk factors associated with food insecurity. Results Most people we talked to were over 40 years old, and many lived in households with fewer than six people. About a third of the households were overcrowded. Factors associated with food insecurity included being a household head aged over 50 years, insufficient living space, lower socioeconomic status, and residing in slum areas (AOR: 1.38; 95% CI: 1.06–1.79). In 2022, 12,627,424 individuals faced food insecurity in Kinshasa, including 8,829,820 individuals who experienced severe food insecurity. Conclusion Living conditions play a significant role in food insecurity. Governments need to do more to help people, especially those living in crowded areas. To combat economic restrictions that lead to food insecurity during crises, policymakers and implementing partners should enhance food assistance programs, such as cash transfers and food supply initiatives, focusing on overcrowded households and the informal job sector. What is already known on this topic This study emphasizes the multifaceted nature of food security, defined as the continuous access to sufficient, safe, and nutritious food, comprising availability, accessibility, utilization, and stability. Food insecurity, resulting from unmet needs in any of these dimensions, correlates with poor health outcomes and increased mortality. The global COVID-19 pandemic exacerbated food insecurity, particularly in low- and middle-income countries, with rates exceeding 50%. Factors such as poverty, living conditions, low income, lack of livestock, large household size, and psychological factors contribute significantly. While prior studies in the Democratic Republic of the Congo exist, they are limited, often focusing on specific groups. This study aims to comprehensively assess household food security in Kinshasa during the post-COVID-19 period, identifying associated factors for a more nuanced understanding. What this study adds This study adds to the existing literature by investigating the prevalence and determinants of food insecurity during a global health crisis, employing the Household Food Insecurity Access Scale for assessment. It contributes novel insights by examining the prevalence and severity of food insecurity in Kinshasa, the Democratic Republic of the Congo, offering a unique context for understanding the impact of a global health crisis on household food security. How this study might affect research, practice, or policy The study recommends implementing cash transfer strategies for vulnerable households, particularly those with informal jobs and young children, based on significant associations between lower socioeconomic status and food insecurity during the COVID-19 pandemic. Another recommendation is to expand food assistance programs for overcrowded households and the informal job sector, addressing the high prevalence of food insecurity in slum areas. Other social and structural determinants of food security, such as women’s empowerment and access to water and electricity, should be further researched. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement https://osf.io/h4jt2/?view_only=ad40b39d0f584bf480fb04571ed86b70 ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical clearance was obtained from the ethical committee/IRB of the Kinshasa School of Public health (no. ESP/CE/71B/2022). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All the relevant data for this study are available from KSPH. The materials will be made available by the leading author upon request. Dataset can be found also in osf: https://osf.io/h4jt2/?view_only=ad40b39d0f584bf480fb04571ed86b70