الفهرس 
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Abstract
Food security is a condition achieved when all members of a household have access to nutritionally adequate, safe, socially acceptable food at all times for a healthy, active life. Globally, Food insecurity in on the run in recent years after a prolonged decline, nearly 10 percent of world population suffered from severe food insecurity in 2017. In Egypt, latest political and economic changes are seemed to increase poverty and increased food prices affecting the food security status. Food insecurity is adversely affecting the health of household members notably women and children.
Aim of the study:
This study was conducted to assess the food insecurity status of rural households and its association with negative health impacts among children (2-5 years) and their mothers in a rural area in Minia Governorate.
Subjects and methods:
This study is a community-based sectional study among rural households in Minia. A total of 497 children and their mothers chosen randomly from Qulubba village, Mallawi were interviewed during the period from November 2017 to March 2018 after taking a verbal consent.
Approval of The University Ethical Committee was taken. Approval of the Ministry of Health and Population beside approval of the manager of the rural health unit in the previously mentioned village were taken.
An interview questionnaire was made and included: sociodemographic characteristics of the participants, food insecurity status using household food insecurity access scale, maternal mental health as measured by Hopkins symptoms checklist-25, dietary intake of mothers and children using 24 hour recall method and weekly frequency of common foods consumed by the households. Anthropometric measurements were taken for mothers and children.
Results:
The mean age for all the studied mothers were (29.1±5.5) years, all of them were married except for 2.4% were divorced or widowed. Secondary education is prevailing among mothers and their husbands (nearly the half). More than half of their husbands are skilled manual workers or farmers. Meanwhile, the majority of mothers were housewives (89.5%). The mean age of the studied children was 40 months. The ratio of males to females was almost fifty-fifty.
The mean family size was (5.96±2.58). 80% had ration cards, 35% were able to save money while 10.9% were in debt. SES score ranged between 13 and 71 with mean of (41.64±10.48).
The mean household food insecurity access scale was (7.9 ± 6.5). High food insecurity prevalence was reported among rural households in the study area, (69.6%) experienced some degree of food insecurity (14.3%, 38% and 17.3% of mild, moderate and sever food insecure) respectively.
Regarding anthropometric indices, (74.4%) of mothers were overweight or obese (BMI ≥25 kg/m2). The prevalence of stunting, underweight, and wasting among the studied children were 19.1%, 1.6%, and 1.8%, respectively. Food insecurity was found to be a predictor of stunting in multivariate logistic regression (AOR=2.71, 95% CI=1.3-5.65), but was not associated with wasting or underweight.
High prevalence of anxiety (49.9%) and depression symptoms (49.1%) were reported by mothers. Nearly 60.7% of food insecure and 25.2% of food secure mothers reported anxiety symptoms, while 61.6% of food insecure and 20.5% of food insecure mothers reported depression symptoms, with statistically significant differences.
One fourth of mothers reported exposure to violence committed by their husband. There was a significant difference between mothers from food insecure and food secure households regarding their violence exposure as 0ne third of mothers from food insecure households reported violence exposure compared to 9.3% of mothers from food secure households, with significant difference.
Analysis of 24 hour recall for total calories and macronutrients, showed that increased caloric and macronutrient intake among mothers (lactating or not) and children was not associated with food insecurity but rather with food security. Moreover food secure households consumed meat, poultry, fish, eggs, milk, milk products, fruits and vegetables more often than food insecure households. While foods belonging to legumes and tubers group were consumed more often by food insecure households, these differences were statistically significant. Additionally stunted children significantly consumed poultry, eggs and fruits less often than non-stunted children, while consumed legumes more frequently (p=0.014).
Recommendations:
This study highlights the need for:
• Strategies to improve poverty and overall socioeconomic wellbeing of families.
• Reforming of the existing food subsidy system and improve targeting of the poor. Also, including more nutritious food items.
• Improving food security policies and targeted interventions for rural households to improve nutritional status are required.
• Promotion health and nutritional education on healthy eating habits and low-cost wholesome food.