Housing, water and sanitation implications on food insecurity and diet diversity in landslide affected communities: A cross-sectional survey of two districts in Uganda
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical nutrition
Abstract
The major landslide of 2010 in Bududa district in Eastern Uganda is the most catastrophic
natural disaster in Uganda's recorded history. An estimated 350 people died and some of the affected
were resettled in Kiryandongo district. We assessed housing, water and sanitation practises of affected
households and controls to establish possible implications on food insecurity and diet diversity.
Methods: This cross-sectional study assessed 1078 affected and control households in Bududa and Kiryandongo
districts. The head of the households were either affected, selected from landslide disasteraffected
communities, or controls from a random sub-county bordering the affected. Structured interviews
were used and entries were tested statistically to report crude estimates based on the Pearson
x2 and ANOVA, while adjusted analysis used multivariate analysis of co-variance (MANCOVA) and Wald's
Odds Ratio (OR) of Binary Logistic Regression at the 95% CI.
Results: On adjusting for the disaster and covariates, households who had insufficient access to water
scored higher mean (SE) on food insecurity than those who reported sufficient access: 13.1 (0.4) vs. 9.5
(0.3) (P < 0.01). Intriguingly, households who owned a toilet and those who reported always using soap
to wash hands scored higher food insecurity than their counterparts: 11.1 (0.3) vs. 9.0 (0.6) (P < 0.01) and
11.3 (0.3) vs. 9.1 (0.5) (P < 0.01), respectively. However, not owning a toilet increased the likelihood of
being food insecure (OR 3.43; 95% CI 1.31, 8.97; P ¼ 0.02). In Kiryandongo, affected households scored
higher food insecurity than controls: 9.5 (0.5) vs. 5.4 (0.5) (P < 0.01) and higher diet diversity scores
(DDS): 6.7 (0.2) vs. 6.2 (0.2) (P ¼ 0.04). Type of housing also predicted food insecurity (P < 0.01) and DDS
(P ¼ 0.03). Like Bududa, households with insufficient water access scored higher food insecurity while
those owning toilet scored higher DDS. Uniquely, only number of rooms was linked to a high likelihood
of being food insecure (OR 1.60; 95% CI 1.19, 2.15; P < 0.05).
Conclusion: Disaster, food security and diet were sensitive to housing, water and sanitation and were
integral to an adequate standard of living of victims of this landslide.
Description
Keywords
Water Sanitation, Food insecurity, Diet diversity
Citation
Rukundo, Peter Milton, Byaruhanga Rukooko, Bård Anders Andreassen, and Per Ole Iversen. "Housing, water and sanitation implications on food insecurity and diet diversity in landslide affected communities: A cross-sectional survey of two districts in Uganda." Clinical nutrition ESPEN 33 (2019): 47-56.