Household Food Security and Maternal and Child Dietary Diversity among Pregnant and Lactating Women in Ngozi Province, Burundi

Abstract

Introduction: Household food insecurity and poor dietary diversity contribute to maternal and child undernutrition in low-income settings. Aim: This study assessed household food security status and examined its association with maternal and child dietary diversity among pregnant and lactating women in Ngozi Province, Burundi. Methods: A community-based cross-sectional study was conducted among 1,620 pregnant and lactating women with children aged 6–23 months. Participants were selected through multi-stage cluster sampling. Household food security was assessed using the Household Food Insecurity Access Scale, while maternal and child dietary diversity were assessed using the Minimum Dietary Diversity for Women and Minimum Dietary Diversity for Children indicators. Multivariable logistic regression was used to identify predictors of household food insecurity and dietary diversity outcomes. Results: Food insecurity affected 94% of households, with 87% experiencing moderate or severe food insecurity. Adequate dietary diversity was achieved by only 9.2% of women and 2.4% of children. Larger household size and agriculture-based livelihoods were associated with higher odds of food insecurity, whereas smaller households had lower risk. Maternal dietary diversity was associated with maternal education and formal employment but not with household food security. Child dietary diversity was associated with household food security, household size, and maternal marital status. Conclusions: Household food insecurity and inadequate dietary diversity are widespread in Ngozi Province. Integrated strategies addressing livelihoods, maternal empowerment, nutrition education, and child feeding practices are needed.