Household food insecurity in urban slums and its association with nutritional status of under-five children in Salem District, Tamil Nadu.

Background and objectives Household food security is defined as physical and economic access to sufficient, safe, and nutritious food for an active and healthy life. Evidence suggests that urban poor are more food insecure (51%-Delhi and 74.6%-Vellore) than rural poor. Food insecurity adversely affects under-five children's nutritional status. This study aimed to assess prevalence, determinants, and its association with child-nutrition in urban slums of Salem district, Tamil Nadu. Methods A community-based cross-sectional study was conducted among 363 randomly selected households between January to September 2023 using multi-stage random sampling. Data were collected from primary-care-givers using a validated-semi-structured-questionnaire (USAID-HFIAS) followed by measurement of daily raw food consumption and anthropometry of under-five children. Statistical analysis was performed in SPSSv16.0 using Chi-square/Fisher's test, ANOVA and regression with P<0.05 taken as significant. Results Household food insecurity prevalence was 82.1%, with 20.1% severe. Mean food consumption was significantly lower among insecure households. Determinants included age/gender of household head, single earning member, dependents, and irregular use of public distribution system. Children with normal nutrition had 2.75 [P<0.05;95% confidence interval (C.I):1.31-5.75] times odds of belonging to secure households. Interpretation and conclusions Food insecurity was closely linked to under-five malnutrition, underscoring the need for interventions addressing affordability and structural factors such as housing, healthcare access, and resource distribution.