Background Small Island Developing States (SIDS) often lack food and nutrition security and sovereignty due to historically poor infrastructure to support local food systems, reduced domestic food production and increased reliance on generally processed imported foods. We aimed to estimate the prevalence of food insecurity (FI) and to investigate associations between FI and socio-demographic factors, food sources and dietary diversity score (DDS) in two SIDS: Fiji and Saint Vincent and the Grenadines (SVG).
Methods We conducted a cross-sectional survey with adults (≥15years) from 95 and 86 sampled households in Fiji and SVG, respectively. We recruited households from urban, rural, higher and lower income areas (n=184 individuals Fiji; n=144 SVG) and administered a context-relevant toolkit to collect individual-level information on FI, dietary intake to calculate DDS (scored out of 10, based on food groups consumed), food sources, socio-economic and health data. We administered the Food and Agriculture Organization’s (FAO) Food Insecurity Experience Scale, and as recommended by FAO scaled the data using Rasch modelling, and defined FI as those in the moderate or severe categories. We undertook bivariate analyses to assess associations followed by multivariable logistic regression with FI as the dependent variable, adjusted for household clustering.
Results In Fiji and SVG respectively, 12.5% (95%CI 7.6, 17.9) and 35.4% (95%CI 27.6, 43.1) individuals experienced FI. A greater proportion of those experiencing FI were female and older adults, had less than secondary education, were urban residents and smaller (<3 members) households. In Fiji, mean DDS did not differ by FI status. However, in SVG mean DDS was lower among those experiencing FI (Diff -0.5, 95%CI: 0.0, -1.0; p=0.048). Regularly (>weekly) sourcing food from small shops was associated with FI in both countries, particularly in Fiji (47.8% FI vs 18.4% not FI, 95%CI on diff: 8.2, 50.7). In the multivariable analysis, FI was associated with females and regularly sourcing food from small shops in both countries. In Fiji, but not SVG, FI was associated with older age (Fiji OR 1.05; 95%CI 1.02, 1.08). Regularly sourcing food through borrowing/exchanging was associated with lower FI in SVG but not Fiji (SVG OR 0.38; 95%CI 0.15, 0.97).
Conclusion Policy action is needed to improve food security, particularly among women and older adults. Our findings indicate avenues for future research, such as the association between small shops and FI and the role that food borrowing/exchanging may play in improving food security and health in SIDS.
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