ArticlePLOS global public health2026
Pathways linking household food insecurity to undernutrition among under 5 children in migrant populations along the Thailand-Myanmar border: A Structural Equation Modeling approach.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Child malnutrition remains a global crisis, exacerbated in border regions by Myanmar's post-2021 conflict. This study utilized Structural Equation Modeling (SEM) to examine the pathways linking household food insecurity (HFI) to undernutrition among migrant children along the Thailand-Myanmar border. A cross-sectional survey was conducted among 384 mothers in Tak and Mae Hong Son provinces with children aged 6-59 months. Data were collected via multistage sampling, face-to-face interviews, and anthropometric assessments. HFI was measured using the HFIAS scale. Undernutrition affected 37.0% of children, with specific prevalence for stunting (18.0%), wasting (19.8%), and underweight (18.5%). HFI was prevalent in 63.8% of households and served as a central structural mediator; notably, nearly 40% of stunted children resided in severely food-insecure households. SEM results indicated that higher socio-economic status (SES) consistently improved HAZ (β = 0.230, p < .001) and WAZ (β = 0.294, p < .001). Improved water availability, safe sanitation, and higher SES were strong predictors of better HFI status across all models (β ranging from 0.127 to 0.318, p < .023). Conversely, a higher number of children under five in the household negatively impacted food security (β ranging from -0.155 to -0.159, p < .003). This improved HFI status directly enhanced dietary diversity (β = 0.183, p = .001) and HAZ (β = 0.113, p = .033). Regarding acute outcomes, fever (β = -0.147, p = .008) and diarrhea (β = -0.131, p = .049) significantly reduced WHZ, while respiratory infections (β = -0.144, p = .014) negatively influenced WAZ. Addressing undernutrition in this migrant population requires integrated multi-sectoral interventions. Strategies must prioritize economic stability and HFI mitigation to address chronic growth failure, alongside WASH infrastructure and rapid illness response to mitigate acute and composite nutritional deficits through a synergistic, cross-sectoral approach.
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