Changes in household food security, access to health services and income in northern Lao PDR during the COVID-19 pandemic: a cross-sectional survey
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Abstract
We assessed the relative difficulty in meeting food needs during the COVID-19 pandemic compared with before; determined the relationship between pandemic-associated difficulties in food access and household, maternal and child food security; and identified resiliency-promoting strategies.
Design
A cross-sectional survey of households undertaken in November 2020.
Setting
Rural districts of Luang Prabang Province, Lao People’s Democratic Republic.
Participants
Households (N=1122) with children under 5 years.
Primary and secondary outcomes measured
Survey respondents reported the relative ease of access of food and healthcare as well as changes in income and expenditures compared with before March 2020. We determined indicators of food security and source of foods consumed for households, women and children, as well as prevalence of malnutrition in children under 5.
Results
Nearly four-fifths (78.5%) found it harder to meet household food needs during the pandemic. The most common reasons were increased food prices (51.2%), loss of income (45.3%) and decreased food availability (36.6%). Adjusting for demographics, households with increased difficulty meeting food needs had lower food consumption scores and child dietary diversity. Over 85% of households lost income during the pandemic. Decreased expenditures was associated with reliance on more extreme coping strategies to meet food needs. The households who experienced no change in meeting food needs produced a greater percentage of their food from homegrown methods (4.22% more, 95% CI 1.28 to 7.15), than households who found it more difficult.
Conclusions
Pandemic-associated shocks may have large effects on food insecurity. Action is needed to mitigate consequences of the pandemic on nutrition. Local food production and safety net programmes that offset income losses may help.
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SciScore for 10.1101/2021.07.27.21261221: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This study has limitations. First, the results of this survey may not be generalizable to other countries, particularly those with higher COVID-19 incidence and greater restrictions on within-country movement. At the time of the survey (November 2020), fewer than 50 cases had been reported in Lao PDR, and health systems were not …
SciScore for 10.1101/2021.07.27.21261221: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This study has limitations. First, the results of this survey may not be generalizable to other countries, particularly those with higher COVID-19 incidence and greater restrictions on within-country movement. At the time of the survey (November 2020), fewer than 50 cases had been reported in Lao PDR, and health systems were not experiencing the same overwhelming of capacity as in many other countries [45]. Additionally, while initial control measures limited local movement, these restrictions were largely relaxed by May 2020, seven months prior to the survey, with the main intervention remaining being strict border closure. We expect, therefore, that compared to other LMICs, the effects of food security and access to health care found in this study may be smaller than would be seen in other countries. At the same time, however, the effects of the pandemic on food security and income and expenditures may be seen more strongly in Luang Prabang as compared to other provinces within Lao PDR. As the province is home to the UNESCO World Heritage City of Luang Prabang, Luang Prabang province receives a greater proportion of its income from tourism as compared to other provinces [20]. Indeed, our survey found a greater proportion of household reduced expenditures (64%) compared to another, unpublished, survey in a different rural province, where 46% of households reduced expenditures (personal communication). As mentioned, households in the study population had been receiving educat...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a protocol registration statement.
Results from scite Reference Check: We found no unreliable references.
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