Iowa State University Capstones, Theses and Graduate Theses and Dissertations Dissertations 2019 Impact of nutrition education centers on food and nutrition security in Kamuli District, Uganda Samuel Ikendi Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/etd Part of the Agriculture Commons Recommended Citation Ikendi, Samuel, "Impact of nutrition education centers on food and nutrition security in Kamuli District, Uganda" (2019). Graduate Theses and Dissertations. 17032. https://lib.dr.iastate.edu/etd/17032 This Thesis is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. Impact of nutrition education centers on food and nutrition security in Kamuli District, Uganda by Samuel Ikendi A thesis submitted to the graduate faculty in partial fulfillment of the requirements for the degree of MASTER OF COMMUNITY AND REGIONAL PLANNING MASTER OF SCIENCE Co-majors: Community and Regional Planning; Sustainable Agriculture Program of Study Committee: Francis Owusu, Major Professor Carmen Bain Ann Oberhauser The student author, whose presentation of the scholarship herein was approved by the program of study committee, is solely responsible for the content of this thesis. The Graduate College will ensure this thesis is globally accessible and will not permit alterations after a degree is conferred. Iowa State University Ames, Iowa 2019 Copyright © Samuel Ikendi, 2019. All rights reserved. ii DEDICATION To the NECs hosts, NEC Trainers, and my mum Christine Lubaale, may the Gracious Lord reward you all abundantly for your generosity. iii TABLE OF CONTENTS Page LIST OF TABLES ......................................................................................................................... vi LIST OF FIGURES ..................................................................................................................... viii LIST OF ACRONYMS ................................................................................................................. ix ACKNOWLEDGEMENTS ........................................................................................................... xi ABSTRACT ................................................................................................................................. xiv CHAPTER 1: BACKGROUND STUDY ....................................................................................... 1 1.1 Introduction ........................................................................................................................... 1 1.2 The State of Food Insecurity in Uganda ............................................................................... 3 1.3 Agricultural Production, and Food and Nutrition Security Strategies in Uganda ................ 5 1.4 Nutrition Education Program Approach to Food & Nutrition Security in Uganda .............. 9 1.5 Research Objective ............................................................................................................. 13 1.6 The Significance of the Research ....................................................................................... 14 CHAPTER 2: LITERATURE REVIEW ...................................................................................... 16 2.1 Introduction ......................................................................................................................... 16 2.2 The Concept of Food and Nutrition Security ...................................................................... 16 2.3 The Four Pillars of Food and Nutrition Security ................................................................ 18 2.4 Measurement of Food and Nutrition Security .................................................................... 25 2.5 Food and Nutrition Security Intervention Programs ........................................................... 28 2.6 A Conceptual Framework for the Analysis of Food and Nutrition Security ...................... 30 2.7 Participation in Nutrition Education Programs, and Food and Nutrition Security ............. 32 2.8 Intervention Through Training in Rural Communities ....................................................... 32 2.9 Household Socio-economic Characteristics, and Food and Nutrition Security .................. 40 CHAPTER 3: STUDY AREA AND METHODOLOGY ............................................................ 47 3.1 Study Area Background ...................................................................................................... 47 iv 3.2 Case Study: The Nutrition Education Centers of CSRL/ISU-UP ....................................... 52 3.3 Research Design.................................................................................................................. 64 3.4 Research Variables.............................................................................................................. 68 3.5 Statistical Analysis and Interpretation of Anthropometric Indicators ................................ 74 3.6 Independent Variables ........................................................................................................ 77 3.7 Regression Analysis ............................................................................................................ 81 3.8 Ethical and Logistical Consideration .................................................................................. 83 CHAPTER 4: RESULTS AND FINDINGS................................................................................. 84 4.1 Introduction ......................................................................................................................... 84 4.2 Characteristics of Households that Influence their Food and Nutrition Security ............... 84 4.3 Participation in the Food and Nutrition Security Programs of NECs ............................... 115 4.4 Food Security Status of Households in Kamuli District ................................................... 133 4.5 Nutrition Security Status of Households in Kamuli District ............................................ 144 4.6 Factors Influencing Food Security in Kamuli District ...................................................... 154 CHAPTER 5: DISCUSSION OF RESULTS AND FINDINGS ................................................ 160 5.1 Introduction ....................................................................................................................... 160 5.2 Food Security Status and Trends ...................................................................................... 160 5.3 The Nutrition Security Status of Household ..................................................................... 166 5.4 Stunting Among Infants and Children .............................................................................. 169 5.5 Underweight Among Infants and Children ....................................................................... 171 5.6 Wasting Among Infants and Children .............................................................................. 172 5.7 Overall Infants and Children’s Nutrition and Health Status. ............................................ 174 5.8 Association between Children’s Nutrition Health and their Primary Caretakers ............. 175 5.9 Factors Distinguishing Food Insecure from Extremely Food Insecure ............................ 177 CHAPTER 6: CONCLUSION, RECOMMENDATIONS, AND FUTURE RESEARCH ........ 188 6.1 General Conclusions ......................................................................................................... 188 6.2 Recommendations for Program Improvement .................................................................. 200 6.3 Areas of Future Research .................................................................................................. 204 v REFERENCES ........................................................................................................................... 205 APPENDIX 1: SURVEY INSTRUMENT ................................................................................. 227 APPENDIX 2: MAIN FOODS CONSUMED IN KAMULI, 2018 ........................................... 246 APPENDIX 3: LINEAR REGRESSION TESTING FOR MULTICOLLINEARITY .............. 247 APPENDIX 4: IRB APPROVAL ............................................................................................... 248 vi LIST OF TABLES Page Table 1.1 Estimated Trend of Hunger Reduction in the World by Region 1990/92 - 2014/16 ...... 2 Table 2.1 Child Malnutrition across the Globe between 2000 and 2017 ...................................... 39 Table 3.1 Nutrition Education Center Training Schedule for the Month of February 2019 ........ 56 Table 3.2 Adapted Household Food Insecurity Access Scale (HFIAS) model ............................ 70 Table 4.1 Estimated Livestock Numbers Kept, and Sales, 2014-2018 ......................................... 91 Table 4.2 Crop Production Before ISU-UP, in Season-1 2017, and during Survey Time ........... 94 Table 4.3 Crop Production and Sales in Season One, 2017.......................................................... 95 Table 4.4 Changes Experienced Attributed to a given Crop Grown in Season-1, 2017 ............... 97 Table 4.5 Possession and Condition of WASH