Food security, maternal food safety practice, and nutritional outcomes among children in UPSNP-supported households of Addis Ababa, Ethiopia

This study examined the relationship between household food security, mothers’ food safety Knowledge, Attitudes, and Practices (KAP), and the nutritional status of children under five. The research focused on households supported by the Urban Productive Safety Net Program (UPSNP) in the Bole Sub-city of Addis Ababa, addressing major public health issues in low-income urban Ethiopia. A cross-sectional study was conducted among 301 UPSNP-supported households. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS). Food safety KAP was evaluated using structured questionnaires, and child nutritional status was determined through anthropometric measurements and classified according to WHO guidelines. The study population showed high vulnerability, marked by low maternal education and low income (mean = 2578.00 ETB). Food insecurity was nearly universal at 93.7%, with 66.8% of households facing moderate-to-severe food shortages. Education and marital status were significant predictors; educated mothers were 1.76 times more likely, and married mothers 2.2 times more likely, to live in food-secure households. Higher income increased the chances of food security by 1.6 times, while smaller households were 0.71 times as likely to be food secure. Although mothers demonstrated moderate overall food safety knowledge, attitudes, and practices (KAP), critical gaps remained in areas such as food storage and prevention of cross-contamination. Child undernutrition was common, with an overall growth failure rate of 41.7%, including high rates of thinness (43.8%) and underweight (70.8%), though stunting was less prevalent at 10.4%. The findings revealed a significant gap in food safety knowledge and hygiene, worsened by severe food insecurity, which together compromised child health. The study concluded that interventions need a comprehensive approach, combining programs to boost maternal income and education with targeted community training on food safety, water treatment, and best practices for infant feeding and sanitation.