Factors Affecting Food Security in Women Enrolled in a Program for Vulnerable Group Development

Abstract
Background: Food security is defined as physical and economic access to sufficient food to meet the dietary requirements for a productive and healthy life. Evidence from the literature suggests that >800 million people worldwide are food insecure. Vulnerable Group Development (VGD) is the largest social safety net of the Government of Bangladesh targeting ultra-poor women to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture. Objectives: The objective of this study is to explore the factors associated with food security among VGD women in Bangladesh. Methods: A total of 870 women (435/group) participated in the baseline survey and another 800 women (400/group) participated in the endline survey. Participants in the intervention group received monthly rations of 30 kg fortified rice (FFR) and the control group received 30 kg of non-FFR for 12 mo. Multiple logistic regression analysis was used to establish both crude and confounder-adjusted relations between the primary outcome and response variables. Written consent was proved by study participants. This study (PR-14091) was approved by the Research Review Committee and Ethical Review Committee. Results: Severe food insecurity in the endline survey decreased from similar to 50% to 6.3% in both groups. The hunger scale also improved between the baseline and endline survey. More than 97% of respondents at endline reported no hunger compared with 80% at baseline; only 3% of women in both groups reported moderate hunger at endline. Multivariable regression model showed that ownership of a house and land for agriculture, wealth index (richest quintile), and absence of fever were significantly associated with food security (P < 0.05). Conclusions: Our analysis shows that the VGD rice distribution program significantly improves the food security status of vulnerable women; however, ownership of a house and land for agriculture were the most significant factors associated with household food security in VGD program areas of Bangladesh.