Food and Humanity 1 (2023) 614–625

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Food and Humanity

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Food security and coping strategies for COVID-19 disruptions among

farming households in Cameroon ]]
]]]]]]
]]

Neville N. Suha, , Richard A. Nyiawungb, Canan F. Abaya

⁎

a
Department of Agricultural Economics, Ege University, Izmir, Turkey
b
Department of Geography, Environment and Geomatics, and Guelph Institute of Development Studies, University of Guelph, Guelph, Ontario, Canada

A R T I C L E I N F O A B S T R A C T

Keywords: The uncertainty of a secure next meal has continued to bedevil global economies and undermine households’
COVID-19 well-being. The COVID-19 pandemic has affected farming households’ livelihood through diverse pressures on
Female and male-headed households global food systems. In this study, we assessed the association between the COVID-19 shocks and farming
Food systems households’ food and nutrition security and the different coping strategies adopted in Cameroon. Focus group
Food and nutrition security
discussions were conducted to identify the COVID-19 shocks affecting farming households and the different
Coping strategies
response strategies implemented. A multi-stage random sampling method was employed to interview 249
Cameroon
households. Through the ordered probit model and other empirical strategies, we show that the COVID-19
pandemic significantly reduced farming households’ access to food, dietary diversity, and consumption fre­
quency of essential food groups. Our results show that male-headed and rural households are significantly more
food insecure than female-headed and semi-urban households. Moreover, our analysis shows that female-headed
and semi-urban households reported a positive and statistically significant association with coping strategies,
indicating that female-headed and urban households contributed more to sustaining household food security
than male-headed and semi-urban households. The most implemented coping strategy is consuming less pre­
ferred and less expensive food. This study provides evidence for targeted interventions such as capacity build and
training to strengthen farming households’ food and nutrition security resilience to emerging and unpredictable
shocks. Strengthening and improving farming households’ coping strategies through capacity building and skills
acquisition in off-farm income opportunities are crucial to improving their adaptive capacity and reducing their
vulnerability to food and nutrition insecurity in Cameroon.

1. Introduction especially for small local farmers in developing countries. Moreover,

The COVID-19 pandemic has affected food systems through diverse
pressures on food supply chains with profound implications for global
food and nutrition security (Barrett et al., 2021; Harris et al., 2020).
During the COVID-19 pandemic, many people reduced their food con­
sumption or ran out of food, reduced calorie intake, and compromised
their nutritional needs, threatening years of gains in achieving food and
nutrition security, dietary diversity, and healthy lifestyles across scales
(Kansiime et al., 2021; World Bank (WB), 2022b). In 2020, the food
security status of approximately 135 million people was categorized as
crisis level, and it was forecasted that this number could double if
adequate responses are not implemented (Bhavani & Gopinath, 2020).
The FAO (2020a) reports show that food import and mobility restric­
tions significantly disrupted global food production and supply chains,
the disruptions further increased the number of vulnerable individuals
and households already experiencing an unstable food system and
limited access to food resources and livelihoods (FAO, 2020b).
Current trends show that the United Nations Sustainable
Development Goal two (zero hunger by 2030) might be missed out by
over 660 million people, with over 30 million of the 660 million people
forecasted to be due to the effects of the COVID-19 pandemic (Saccone,
2021; WHO, 2021b; UN, 2020). In 2020, the pandemic’s effects resulted
in over 2.3 billion of the global population (30 %) lacking year-round
access to adequate food, a more than five-fold increase in one year
compared to the preceding five years combined. Moreover, in 2021 the
situation got worse, with over half of the world’s undernourished po­
pulation (about 418 million) living in Asia, more than a third (nearly
282 million) in Africa and a smaller fraction (about 60 million) in the

⁎
Corresponding author.
E-mail address: suhneville@gmail.com (N.N. Suh).

https://doi.org/10.1016/j.foohum.2023.07.001
Received 29 December 2022; Received in revised form 24 June 2023; Accepted 1 July 2023
2949-8244/© 2023 Elsevier B.V. All rights reserved.
N.N. Suh, R.A. Nyiawung and C.F. Abay
Caribbean and Latin America (World Bank (WB), 2022a; WHO, 2021b).
The projected prevalence of undernourishment was more than double
in Africa, with a 21 % increase compared to other regions (World Bank
(WB), 2022a; WHO, 2021b). Hence, this study investigates how the
COVID-19 pandemic affected farming households’ food and nutrition
security in Cameroon, Central Africa.
The disruptive effects of the COVID-19 pandemic and other poli­
tical, economic, and environmental-related shocks led to the dete­
rioration in livelihoods and social wellbeing of people in Cameroon,
including about 2.4 million people who were severely food insecure in
2021 (FAO, 2021b). In Cameroon, the agricultural sector dominates the
economy, provides jobs for over 62 % of the labor force and constitutes
about 15 % of the GDP (Fokam et al., 2019; WFP, 2022). With an al­
ready existing high poverty level of over 55 % and severely im­
poverished levels of 37.7 %, the COVID-19 outbreak further worsened
the vulnerabilities of the poor farming households in Cameroon (WFP,
2022). As of March 2022, about 119,544 active COVID-19 cases and
1727 related fatalities were reported in Cameroon (WFP, 2022).
Cameroon’s first, second, and third waves of the COVID-19 pan­
demic slowed economic activities. The containment measures, which
were intended to curb the COVID-19 outbreak, rather disrupted the
food systems, resulting in a dramatic increase in hunger and food and
nutrition insecurity (Adjognon et al., 2020; Egoh & Fuein, 2020;
Nchanji & Lutomia, 2021). Many sectors of the economy were nega­
tively affected, with the farming sector most disrupted, resulting in
limited farmers’ access to inputs and reduced crop production in 2021
and 2022 (FAO, 2021b; Fews, 2020; Nchanji & Lutomia, 2021). The
pandemic affected food demand and supply, increased unemployment,
and reduced household income, thus, altering the food and nutrition
security status of farming households and, in turn, deepening the se­
verity and duration of the virus and measures to contain it (Fews, 2021;
Webb et al., 2021). The situation was even worse in the North-West and
South-West regions, and by June 2020, the most vulnerable farming
households in these regions had emptied their food reserves, with staple
food prices rising by 30 % (FAO, 2021b; Fews, 2020). Although the
COVID-19 containment measures led to economic hardship and re­
duced livelihood options for farming households; moreover, poor and
inadequate response strategies limited their ability to cope and adapt to
the COVID-19 containment measures in Cameroon.
Containment measures such as border closure and mobility restric­
tions were put in place by the government of Cameroon in March 2020
as a response to the virus, i.e., shortly after the first case was reported in
Cameroon. These policy measures adversely affected the incomes, em­
ployment and food and nutrition security of farming households in rural
and semi-urban communities. Thus, this study assesses the implications
of the COVID-19 pandemic on farming households’ livelihood and
wellbeing. It also serves as an avenue to inform better policies that will
equip farming households and improve their preparedness for future
shocks. The objectives of the study are to; (a) assess the association
between the COVID-19 shocks and farming household food and nutri­
tion security and the different coping strategies implemented in re­
sponse to the shocks and (b) assess the gendered dimensions of the
implications of the COVID-19 shocks on farming households in semi-
urban and rural communities in Cameroon.
Based on the available literature, no previous studies have been
carried out to quantitatively analyze the relationship between COVID-
19 disruptions and farming households’ food and nutrition security and
their coping strategies in Cameron. Moreover, no studies have explored
the gender differences in the COVID-19 disruptive outcomes in rural
and semi-urban communities and the gender differences in the food and
nutrition security status in rural and semi-urban communities in
Cameroon. This is one of the first studies to document the effect of
containment measures and policy responses for farming households,
including rural and semi-urban communities, that provide decent li­
velihood and nutritious diets in Cameroon. This study adds to the
growing body of literature on the association between the COVID-19
615
Food and Humanity 1 (2023) 614–625
pandemic and farming households’ food and nutrition security, and the
different coping strategies adopted.
2. Data and method
2.1. Assessing food and nutrition security indicators
Relying only on one or a few food and nutrition security indicators’
assessments can misclassify a significant percentage of households as
either food insecure or food secure (Maxwell et al., 2013). Maxwell
et al. (2014) and Tiwari et al. (2013) posit the importance of a com­
prehensive examination of the core food and nutrition security pillars
(utilization, accessibility, availability, and stability), including the use
of different indicators to examine the extent to which households are
food secure and food insecure. In this study, we employ the standard
food and nutrition security measure, i.e., food consumption score (FCS),
household dietary diversity score (HDDS), months of adequate house­
hold food provisioning (MAHFP), household food insecurity access
scale (HFIAS), and coping strategy index (CSI) to assess the implications
of COVID-19 shocks on farming households. Each indicator represents
different food and nutrition security pillars over different intervals,
such as a 7-day recall period, a four-week recall period and a 12-month
recall period. The stability dimension cuts across the other dimensions
of food and nutrition security, including stability in food access, utili­
zation, and availability. Thus, the study provides relative merits of the
multidimensional assessment of different food and nutrition security
indicators to identify food secure and food insecure households and the
different coping strategies adopted. Data were analyzed using STATA
15 and SPSS 23.
2.1.1. Household food insecurity access scale (HFIAS)
The HFIAS explores the accessibility pillar of food and nutrition
security over a four-week recall period (Coates et al., 2007). Moreover,
it reflects insufficient quantity and quality, anxiety, and uncertainty
about a household’s food situation. It consists of nine generic questions
that reflect the severity of household food insecurity and hunger and
nine follow-up questions that assess the frequency of each generic
question to determine the extent to which a condition occurred in a
household (Coates et al., 2007). The score varies from 0 to 27; the
higher the score, the more food insecure the household. The cut-off
points are food secure (0–1), mild food insecure (2–8), moderately food
insecure (9–16), and severely food insecure (17–27) (Brück et al.,
2019). Accordingly,
HFIASi = (Xi )*(fXi ) (1)
where HFIASi is the HFIAS for the i-th household, Xi is a set of nine
occurrence questions reflecting an increase in household food in­
security during the past 30 days for household i, and fXi is the frequency
of occurrence of the Xi question for households i.
2.1.2. Household dietary diversity score (HDDS)
The HDDS explores the utilization dimension of food and nutri­
tion security over a 24-hour recall period (Swindale & Bilinsky,
2006). It is a nutritional indicator of the household dietary quality
and food frequency score (FAO, 2020c, 2021a). It reflects a house­
hold’s economic ability to access different food options (Hoddinott
and Yohannes, 2002). The HDDS is computed by adding 12 different
food items consumed by a household over a 24-hour recall period
following the guidelines of Kennedy et al. (2011). This study adopted
three cut-off thresholds for HDDS: low dietary diversity (0–3),
medium dietary diversity (4–5), and high dietary diversity (6–12),
similar to that proposed by Kennedy et al. (2011). The HDDS is
computed from Eq. (2):
HDDSi = Xi (2)
N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Table 1
Coping strategies and severity ranking during a series of FGDs.

Coping strategy Severity ranking Av Ran

F1 F2 F3 F4 F5 F6 F7 F8

Consume less preferred, less expensive food 1 2 1 1 1 1 1 1 1.1 1

Borrowed money to buy food 1 2 3 2 2 2 3 2 2.1 2
Relied on support from relatives and friends 3 4 5 4 4 3 4 3 3.8 4
Consume seed stock held for next season 5 4 4 3 4 4 4 3 3.9 4
Harvest immature crops (e.g., green maize) 4 3 3 4 3 3 3 2 3.1 3
Send household members to eat elsewhere 2 1 2 1 2 2 1 2 1.6 2
Send household members to beg 2 3 2 2 2 2 2 3 2.3 2
Restrict consumption by adults for small children to eat 2 2 2 2 2 2 2 2 2.0 2
Limit portion size at mealtimes 2 3 2 2 3 3 2 2 2.4 2
Feed working members at the expense of non-working members 1 1 1 2 1 1 1 1 1.1 1
Reduce number of meals eaten daily 2 2 2 2 2 3 2 4 2.4 2
Limit consumption to staple food 5 3 4 4 4 4 3 4 3.9 4

Where: Av is the average ranking score; Ran is the consensus ranking score; and F represents each focus group discussion.

where HDDSi is the household dietary score for the i-th household,
and Xi is the total number of food items consumed by the i-th household
within the recall period.
2.1.3. Food consumption score (FCS)
The FCS indicator is a more complex indicator of household food
and nutrition security and relies on food frequency, dietary diversity,
and the relative nutritional importance of nine food items (VAM, 2008).
It is a proxy for the utilization dimension of food and nutrition security
over a 7-day recall period (WFP, 2008). The FCS is disaggregated into
three cutoff points. The first is poor food consumption (FCS < 28),
characterized by households not consuming staples or vegetables daily.
The second is the borderline food consumption indicator (28.5 ≤ FCS
< 42). The third is the acceptable food consumption indicator
(FCS ≥ 42) (VAM, 2008). The food groups are weighted according to
nutritional importance and used to compute the household food con­
sumption index (Maxwell et al., 2014). The current household FCS
during the COVID-19 pandemic was computed as follows:
FCSi = (wXi )(fXji )
where FCSi is the FCS for the i-th household, wXj is the nutrition
content-based weight for food group Xj, and fXji is the frequency of
consumption of a food group Xj by the i-th household.
2.1.4. Months of adequate household food provisioning (MAHFP)
The MAHFP indicator refers to the minimum number of months in
which the household had access to food to meet the household re­
quirement (FAO, 2020c, 2021a). This indicator measures the avail­
ability and accessibility dimensions of food and nutrition security over
a 12-month recall period. The score is computed by summing the
months the households declared no food shortages (Bilinsky &
Swindale, 2010). Households were categorized as food secure with
sufficient access to food (10–12), moderately food insecure (6–9), and
food insecure with the least food access (≤ 5) (Bilinsky & Swindale,
2010). The MAHFP score is computed as follows:
MAHFPi = 12 Xi (4)
where MAHFPi is the score for the MAHFP for the i-th households, 12
is the last twelve months from the interview period, and Xi is the
number of months in which households were unable to meet their food
needs.
2.1.5. Consumption-based coping strategies
This is a fast and reliable instrument for predicting household con­
sumption coping strategies as a response to inadequate access to food
(Maxwell et al., 2008). This indicator measures the accessibility di­
mension of food and nutrition security over a 7-day recall period. When
faced with food shortages, people engage in several reasonably new
behavioral responses to curb the effects of food and nutrition insecurity,
which are their coping strategies (Maxwell et al., 2008). Unlike other
food and nutrition security indicators, the CSI requires some up-front
work that considers that all the potential answers to the questions that
will be raised are known and that it is context specific to the local si­
tuation (Maxwell et al., 2008).
In this study, focus group discussions (FGDs) were held with ran­
domly selected farming household heads. Moreover, a checked list of
consumption coping strategies was used from previous studies in
Uganda, Ghana, and Ethiopia (Bela et al., 2017; Maxwell et al., 2003,
2008; Mayanja et al., 2015) to be sure we have an effective list for
different response behaviors. Participants were asked to list out all
strategies adopted during the crisis. One FGD was held per community
with 5–10 participants purposively selected with the help of extension
agents and community leaders, taking into consideration their age and
gender homogeneity. According to Maxwell et al. (2008), the re­
commended number of coping strategies should vary from 12 to 15;
thus, this study identified the 12 most prominent strategies im­
(3) plemented by farming households during the FGDs. The strategies were
similar to those used by other households in Uganda, Ghana and
Ethiopia during shocks (Maxwell et al., 2003, 2008), indicating simi­
larities in coping strategies to shocks by farming households in Africa.
The recall period was limited to 7 days because people can easily
remember their behaviors more accurately during this period (Maxwell
et al., 2008). Eight FGDs were held to assign a severity weight to each of
the 12 identified coping strategies adopted by the households. Ac­
cording to Maxwell et al. (2008), a severity weight range between 1 and
4 is best for analysis, thus in this case study context and for simplicity,
we limited our severity weight to a scale of 1 to 5, with 5 being the most
severe, 1 being the least severe and 2, 3, and 4 being intermediaries.
The different strategies were “weighted” differently based on how se­
verely the participants in the FGDs viewed a strategy. The average of all
the weights identified was computed, and a consensus ranking based on
the severity of the strategy was also computed, which ranged from 1 to
4, with 1 being the least severe, 4 being the most severe, and 2 and 3
being intermediaries (Table 1).
The weighted score of the relative importance of each coping
strategy is used to compute a composite index for the household. This
index was used to group households according to their level of food and
nutrition insecurity. Data was collected for a 7-day recall period that
relied on the frequency at which a household adopted the various
coping strategies, ranging from every day (7 days) to never used (0
days). The severity score for each strategy was estimated by multiplying
its frequency score (0–7 days) by the consensus-weighted value (1–4).
The final severity of the coping score, which is the CSI of each house­
hold, is the summated score for the twelve coping strategies. The

616
N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

minimum severity of coping score for a household that did not ex­ Prob[Zi = k ] = ( µj xi ) ( µj 1 xi ) (8)
perience any of the 12 strategies over the 7-day recall period is 0 points
((4 × 0 × 3) + (3 × 0 × 1) + (2 × 0 × 6) + (1 × 0 × 2)) and the where Φ (·) is the standard normal cumulative distribution function,
maximum severity of the coping score for a household that experienced and J are the categories of dependent variables (0,1,2,3).
all of the 12 strategies over the 7-day recall period is 203 points The discretely observed food and nutrition security status of farming
((4 × 7 × 3) + (3 × 7 × 1) + (2 × 7 × 6) + (1 × 7 × 2)). In this households is predicted from the model as follows:
study, based on our computed CSI, which ranges from 0 to 203, we FSij = +
i 1 COVID 19i + 2 femedui + 3 femi + 4 surban i + 5
categorized the CSI into three cutoff points: low (CSI = 0–50), medium
(CSI = 50–100), and high (CSI > 100). Higher scores for CSI indicate disti + 6 farmi + 7 agei + µi (9)
food and nutrition insecurity, thus, low levels of well-being where FS are the different food and nutrition security indicators -
(Knippenberg et al., 2019). The CSI is predicted as follows: CSI, MAHFP, FCS, HDDS and HFIAS; FSi represents the ith individual
D farming household; j represents the different cutoff points - food secure,
CSI = (wd)(daysd ) mildly food insecure, moderately food insecure, and severely food in­
d (5) secure for each food and nutrition security indicator; COVID-19 is the
where CSI is the coping strategy index, days denotes the number of score of the COVID-19 related shocks; femedu is the years of schooling
days a household has committed to strategy d, and w is the weight of of female-headed household; fem is the household head is a female;
each coping strategy based on the weights computed from the FGDs. surban is households in semi-urban areas; dist is the distance to the
nearest market opened during the lockdown; farm is household head
employed full-time in farming; age is the age of the household head, and
2.2. COVID-19 shocks and food and nutrition security
µi is the disturbance term.

A COVID-19 shock index was computed to explore its association

2.3. Study sites and sampling methods
with farming households’ food and nutrition security. The household
food and nutrition security cutoff points are food secure, mildly, mod­
Fig. 1 shows the map of the study area. The research data was
erately, and severely food insecure. The food and nutrition security
collected from farming households in the South-West and North-West
thresholds are discrete and ordered; thus, an ordered probit model will
regions of Cameroon from October 2020 to March 2021. Among the ten
consider this ordinal nature (Greene, 2008). The ordered probit model
regions in Cameroon, the South-West and North-West regions were
is expressed in Eq. (6) as follows:
among the most affected by the COVID-19 pandemic, including about
Zi* = x i + i, i = 1, 2, …, N (6) 11 % and 4 % reported positive cases from the North-West and South-
West regions, respectively (WHO, 2021a). Moreover, the pandemic
where E(εi /Xi) = 0; Var(εi/Xi) = 1; and Zi is an observed random severely affected food supply chains, with staple food prices rising by
variable having J response categories and is a proxy for the unobserved 30 % in the South-West and North-West regions (FAO, 2021b; Fews,
random variable Zi*. 2020). The World Health Organization (WHO, 2021a) also reported
Let µ = µ-1, µ0, µ1…, µJ-1, and µJ represent a vector of latent that Limbe and Buea subdivisions in the South-West regions and Ba­
threshold to be estimated. Accordingly: menda III and Tubah subdivisions in the North-West regions were
Zi = k if µj < Zi* µj , j = 0, 1, 2, …, J among the most affected subdivisions. Thus, a four-stage sampling
1 (7)
technique was used to select study participants from these subdivisions.
where µ-1 = -∞, µ0 = 0, µJ = ∞ and µ-1 < µ0 < µ1 < …, < µJ. First, the South-West and North-West regions were purposively se­
The probability is expressed as follows: lected. Second, the Fako and Mezam divisions were purposively

Fig. 1. Map of study area.

617
N.N. Suh, R.A. Nyiawung and C.F. Abay
selected from the South-West and North-West regions, respectively.
Third, Limbe and Buea subdivisions were purposively selected from the
Fako division, while Bamenda III and Tubah subdivisions were purpo­
sively selected from the North-West region.
The minimalist approach proposed by Maxwell et al. (2008) was
used to guide the sample size selection process from the selected
semi-urban and rural communities at the fourth stage of sampling.
The minimalist method provides a scientific approach to selecting
participants, identifying household food and nutrition security
challenges and coping strategies implemented by farming house­
holds. Maxwell et al. (2008) recommended a minimum of 20 clusters
(communities) selected randomly from the study area and a random
sample of 20 households per cluster (400 households) as ideal for
studies involving consumption coping strategies. This study adopted
the simple random sampling approach to survey farming households,
i.e., 30–40 households from four rural and four semi-urban com­
munities. A simple random sampling approach was adopted at this
stage since it reduces selection bias. In total, 280 farming households
were interviewed. However, 249 questionnaires were completed and
retained for analysis. Survey-based tablets were used to collect in­
formation on household socioeconomic characteristics, food and
nutrition security, coping strategies, and COVID-19 shocks. The
sample size was limited to 249 due to resource constraints and be­
cause most household members were reluctant to encounter sur­
veyors for fear of being infected with the virus.
3. Results
3.1. Farming household socioeconomic characteristics
Table 2 presents the socioeconomic factors of farming households.
About 45.0 % of households are found in semi-urban communities.
Most respondents are female (65 %), while 49 % of the households are
employed full-time in farming. The mean years of schooling of the fe­
male-headed household is 12 years.
3.2. Implications of the COVID-19 pandemic on gender and location
The fisher’s exact or chi-square test was used to assess gender and
location differences of the disruptive and non-disruptive implications of
the COVID-19 containment measures on farming households (Table 3).
COVID-19 disruptions significantly differ between male and female-
headed households in terms of access to farm inputs, access to labor and
access to farmland. Significant differences were reported between
farming households in rural and semi-urban areas for disruptions in
access to farms, market access, access to planting, and access to farm
inputs.
Approximately 77 % of male-headed households experienced dis­
ruptions in farm access due to the COVID-19 containment measures
compared to 68 % of female-headed households. Farm access is more
undermined in semi-urban settings (83 %) than in rural settings (61 %).
Moreover, 71.5 % of the female and male-headed households in semi-
urban and rural communities experience farm access disruptions. Other
Table 2
Socio-demographic factors (n = 249).
Variable Description Measurement
Female Female HHH 1 = if female; 0 = otherwise
Semi-urban Geographical location 1 = if semi-urban; 0 = otherwise
Distance Markets opened during COVID-19 1 = if far (> 50 m); 0 = otherwise (1–50 km)
Employ Employment in farming 1 = if full-time; 0 = otherwise
COVID-19 COVID-19 shocks Shock index
Femedu Education of female HHH Years
Age Age of HHH Years
Where: SD is the standard deviation; and HHH is household head.
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Food and Humanity 1 (2023) 614–625
COVID-19 shocks and their disruptions on farming households’ liveli­
hood and social wellbeing are presented in Table 3.
3.3. Farming households’ food and nutrition security and response strategies
3.3.1. Food consumption score
Fig. 2 show the frequency of consumption of nine food groups over a
7-day recall period. Cereals, vegetables, fats and oils were the most
consumed food group. Moreover, households ate cereals within 2–7
days of the 7-day recall period. Milk and dairy products, fruits and
condiments were least consumed by households, with no household
consuming milk and dairy products and pulses for the entire 7-day. The
nutritional weight of each food group adopted for this study is also
shown in parenthesis.
About 15.3 %, 40.7 %, and 40.0 % of male-headed households are in
the poor (severely food insecure), borderline (moderately food in­
secure), and acceptable (food secure) consumption categories, respec­
tively, while nearly 16.5 %, 48.2 %, and 35.3 % of female household
heads are in the poor, borderline, and acceptable consumption cate­
gory, respectively. The food consumption score of rural and semi-urban
households and for the entire sample is presented in Table 4.
3.3.2. Household dietary diversity score
All 12 food groups were consumed during the 24-h recall period
(Fig. 3). Cereals are the most consumed food group, followed by fats
and oil, roots and tubers and vegetables, while eggs, condiments, milk
and dairy products, pulses, and fruits, are the least consumed food
group during the recall period. All 12 food groups were assigned the
same nutritional weight, which was used to compute the dietary di­
versity score.
About 37.2 %, 40.2 %, and 22.6 % of female-headed households
were food secure (high dietary diversity), moderately food insecure
(medium dietary diversity), and severely food insecure (low dietary
diversity), respectively, compared to 36.5 %, 37.6 %, and 25.9 %, re­
spectively, for male-headed households (Table 5). Table 5 shows the
dietary diversity score for rural and semi-urban households and the
entire sample.
3.3.3. Household food insecurity access scale
Of the 249 farming households interviewed, 226 were worried
about food (90.8 %) and 30.5 %, 57.0 %, and 3.2 % of the households
rarely, sometimes, and often, respectively, worried about food (Figure
4). About 88.4 % of respondents could not eat nutritious and healthy
food, 74.3 % ate only a few meals daily, and 54.6 % ate small meals.
About 88.8 % of household members eat only a few kinds of foods in a
day. Nearly 67.9 % of the household members went to sleep at night
hungry.
Nearly 11.8 %, 23.5 %, 43.5 %, and 21.2 % of male-headed house­
holds are food secure, mildly food insecure, moderately food insecure,
and severely food insecure, respectively, compared to 9.1 %, 34.8 %,
40.9 %, and 15.2 % for female-headed households (Table 6). The food
insecurity experience of semi-urban and rural households is depicted in
Table 6.
Mean SD
0.66 0.48
0.45 0.49
0.85 0.36
0.49 0.50
10.98 1.26
12.32 4.37
43.79 10.36
N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Table 3
Differences in the implications of the COVID-19 lockdown measures by gender and location.

COVID-19 shock indicators Male HH Female HH X2 test/Fishers’ Semi-urban Rural HH X2 test/Fishers’ Total
head N = 85 head exact test HH N = 112 N = 137 exact test n = 249
N = 164

N (%) N (%) Sign N (%) N (%) Sign n (%)

Disrupted farm access Yes 66 (37.08) 112 (62.92) 0.12 94 84 (47.19) 0.00* 178 (71.49)
(52.81)
No 19 (26.76) 52 (73.24) 18 53 (74.65) 71 (28.51)
(25.35)
Disrupted harvesting Yes 85 (34.41) 162 (65.59) 0.55 111 (44.94) 136 (55.06) 1.00 247 (99.20)
No 0 (0.00) 2 (100.0) 1 1 (50.00) 2 (0.80)
(50.00)
Disrupted access to Yes 73 (35.10) 135 (64.90) 0.47 100 (48.08) 108 (51.92) 0.03* 208 (83.53)
markets No 12 (29.27) 29 (70.73) 12 (29.27) 29 (70.73) 41 (16.47)
Disrupted access to Yes 81 (33.75) 159 (66.25) 0.49 110 (45.83) 130 (54.12) 0.19 240 (96.39)
extension services No 4 (44.44) 5 (55.56) 2 (22.22) 7 (77.78) 9 (3.61)
Disrupted access to Yes 79 (34.20) 152 (65.80) 0.94 108 (46.75) 123 (53.25) 0.04* 231 (92.77)
planting No 6 (33.33) 12 (66.67) 4 (22.22) 14 (77.78) 18 (7.23)
Disrupted access to Yes 45 (26.79) 123 (73.21) 0.00* 87 (51.79) 81 (48.21) 0.00* 168 (67.47)
farming inputs No 40 (49.38) 41 (50.61) 25 (30.86) 56 (69.14) 81 (32.53)
Disrupted access to non- Yes 71 (39.67) 108 (60.33) 0.00* 80 (44.69) 99 (55.31) 0.88 179 (71.89)
family labor No 14 (20.00) 56 (80.00) 32 (45.71) 38 (54.29) 70 (28.11)
Disrupted access to Yes 33 (27.27) 88 (77.73) 0.02* 61 (50.41) 60 (49.59) 0.94 121 (48.59)
farmland No 52 (40.63) 76 (59.37) 51 (39.84) 77 (60.16) 128 (51.41)

Where: N is the frequency; % is the percentage; HH is household; and *significant p < 0.05.

Fig. 2. Frequency of consumption of nine food groups and nutritional weights. Where: values in parenthesis are the nutritional weights used for computing the index.

Table 4
Gender sensitivity for FCS indicator in semi-urban and rural communities.

FCS category Male HH head (N = 85) Female HH head (N = 164) Semi-urban HH (112) Rural HH (137) Total (n = 249)

N % N % N % N % n %

Poor 13 15.29 27 16.46 18 16.07 22 16.06 40 16.06

Borderline 38 44.71 79 48.17 57 50.89 60 43.80 117 46.99
Acceptable 34 40.00 58 35.37 37 33.04 55 40.15 92 36.95
Total 85 100 164 100 112 100 137 100 249 100

Where: N is the frequency; % is the percentage; and HH is the household.

3.3.4. Months of adequate household food provisioning
About 98 % of farming households did not have access to adequate
food over a 12-month recall period (Fig. 5).
For female-headed households, 22.6 %, 58.5 % and 18.9 % are food
secure, moderately food insecure and food insecure, respectively. About
36.5 %, 55.2 % and 8.2 % of male-headed households are food secure,
moderately food insecure and food insecure, respectively. The months
of households’ food provision for semi-urban and rural households are
presented in Table 7.
3.3.5. Coping strategy index
The COVID-19 containment measures pushed many households to
adopt consumption coping strategies (Fig. 6). About 97.2 % of house­
holds consumed less preferred and less expensive food and borrowed

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N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Fig. 3. Household dietary diversity for 12 food groups.

money to buy food. Nearly 94.8 % of households harvested immature
crops like green maize at least once in the 7-day recall period. Relying
on staple food consumption is the most implemented response strategy
with the highest severity weight. Other consumption coping strategies
are presented in Fig. 6.
About 18.8 %, 58.8 % and 22.4 % of male-headed households are
food secure, moderately food insecure and severely food insecure, re­
spectively, compared to 19.5 %, 64.0 % and 16.5 % of female-headed
households, respectively. Table 8 shows the percentage of semi-urban
and rural households that employed coping strategies.
3.4. Independent samples t-Test for food and nutrition security indicators by
gender and location
Significant differences were reported for semi-urban and rural
households for the food and nutrition security indicators – food in­
security access, food consumption, months of adequate food provi­
sioning and consumption coping strategy (Table 9). Male and female-
headed households significantly differ for the months of adequate food
provisioning indicator.
3.5. COVID-19 shocks and household food and nutrition security
The association between COVID-19 shocks and households’ food and
nutrition security is presented in Table 10. The chi-square values are
significant, at least at a 5 % level, confirming that the regression coef­
ficients of the explanatory variables differ from zero. Thus, the ordered
probit model was suitable for analysis. The COVID-19 shocks sig­
nificantly undermined farming households’ food consumption, months
of adequate food provisioning and household dietary diversity in­
dicators. Female-headed households, female-headed households’ years
of schooling, households found in semi-urban communities, distance to
the nearest markets opened during the COVID-19 pandemic, house­
holds engaged full-time in farming and age of household heads were
significantly associated with farming households’ food and nutrition
security.
4. Discussion
This study investigated the association between the COVID-19
containment measures and farming households’ food and nutrition se­
curity and the different response strategies adopted. The first, second
and third waves of the COVID-19 pandemic and the associated con­
tainment measures severely disrupted food systems, adversely affecting
household food and nutrition security in rural and semi-urban com­
munities in Cameroon. The containment measures also constrained
farming households’ ability to adopt suitable response strategies. Thus,
differing effects of the pandemic were reported on male and female-
headed households in semi-urban and rural communities in Cameroon.
We found that the disruptive outcomes of the COVID-19 lockdown
measures significantly affected female-headed households more than
male-headed households, indicating that female-headed households
were more vulnerable to the disruptive outcome of the shocks. Our
findings confirm the results of Dang and Nguyen (2021), who reported
that the pandemic affected female-headed households more than male-
headed households. However, female-headed households were sig­
nificantly more food secure than male-headed households, indicating
that female-headed households were less vulnerable to food and nu­
trition insecurity challenges during the COVID-19 lockdown. Our
finding that female-headed households are more food secure may be
linked to the fact that female-headed households’ decision-making
concerning managing household food purchases and meeting

Table 5
Gender sensitivity for HDDS indicator in semi-urban and rural communities.

DDS category Male HH head (N = 85) Female HH head (N = 164) Semi-urban HH (N = 112) Rural HH (N = 137) Total (n = 249)

N % N % N % N % n %

Low 22 25.88 37 22.56 24 21.43 35 25.55 59 23.70

Medium 32 37.65 66 40.24 41 36.61 57 41.61 98 39.36
High 31 36.47 61 37.20 47 41.96 45 32.85 92 36.95
Total 85 100 164 100 112 100 137 100 249 100

Where: N is the frequency; % is the percentage; and HH is the household.

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N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Fig. 4. Indicators of household food insecurity access. Where: clues to the severity status; Rarely (once or twice); Sometimes (three to ten times); Often (more than
ten times).

households’ diet needs, contributed to supporting household food and
nutrition security. Furthermore, despite being affected more by the
COVID-19 containment measures, female-headed households were
more equipped with the capacity to respond adequately and cope with
the effects of the shocks. This is confirmed by the positive and sig­
nificant relationship between female-headed households and their
coping strategies. These findings contradict the work of Akalu and
Wang (2023), who reported that female-headed households were more
food insecure than male-headed households.
Our results further suggested that many semi-urban and rural house­
holds experienced disruptions from the COVID-19 containment measures.
This indicates that the COVID-19 containment measures exposed sig­
nificant weaknesses in the ability of farming households in rural and semi-
urban areas to cope and mitigate the disruptive outcomes of the COVID-19
shocks, affecting households’ socio-economic activities. Our results are
consistent with Obayelu et al. (2021), who found that COVID-19 shocks
disrupted market access in Nigeria. A positive and significant relationship
was established between households in semi-urban areas with household
food insecurity access and consumption coping strategies. Semi-urban
households were less vulnerable to food and nutrition insecurity during
the COVID-19 lockdown than rural households. This shows that semi-
urban households’ coping strategies significantly help them mitigate the
adverse outcomes of the COVID-19 containment measures on their food
and nutrition security. Moreover, the high vulnerability of rural house­
holds to food insecurity compared to semi-urban households suggests that
rural households consumed less healthy and nutritious diets and ate
smaller meals. Furthermore, rural households were less equipped with the
capacity to adequately respond and cope with the rising level of food and
nutrition insecurity during the pandemic. Our findings contradict the
findings of Adjognon et al. (2020) in Mali.
Our analysis shows that the COVID-19 shocks significantly under­
mined farming households’ frequency of consumption of nine essential
food groups. Moreover, about 63.1 % of farming households were food
insecure for the food consumption score indicator. Most farming
households frequently consumed the food groups cereals, vegetables,
fats and oils, with low nutritional weights. In contrast, milk and dairy
products and fruits, which have the highest nutritional weights, were
the least frequently consumed food groups. Thus, the high level of food
insecure households is due to the low frequency of consuming food
groups with high nutritional weights. The reduced frequency of con­
sumption of these food groups with high nutritional weights further
indicates that the disruptive outcomes of the COVID-19 shocks ad­
versely affected households’ consumption behavior, thereby reducing
food utilization over the 7-day recall period. These findings are similar
to Ouoba and Sawadogo’s (2022) findings. Moreover, there were re­
ported increases in severe food insecure (16.1 %) and moderately food
insecure (47.0 %) farming households. Before the COVID-19 pandemic,
16 % and 1 % of households were moderately and severely food in­
secure in Cameroon, respectively (Bela et al., 2017). Comparatively, the
adverse outcomes of COVID-19 shocks increased the number of severely
food-insecure and moderately food-insecure households to 16.1 % and
47.0 %, respectively. The pandemic generally resulted in a 31 % in­
crease in food and nutrition insecurity and a 15.1 % increase in severely
food-insecure farming households in Cameroon. These results are si­
milar to the findings of Ouoba and Sawadogo (2022), who noted that
23.0 % of households were food insecure before the pandemic, while
38.4 % became food insecure due to the COVID-19 shocks – an increase
of 15.5 %. However, the reported percentage of food-insecure house­
holds due to COVID-19 shocks in Cameroon (31 %) is relatively lower
than those reported by Kansiime et al. (2021) in Kenya (38 %) and
Uganda (44 %) and higher than those reported in Burkina Faso (15.5 %)
by Ouoba and Sawadogo (2022).
Consistent with earlier studies from Nigeria by Balana et al. (2023)
and Obayelu et al. (2021), our findings show that COVID-19 shocks

Table 6
Gender sensitivity for HFIAS indicator in semi-urban and rural communities.

HFIAS category Male HH head (N = 85) Female HH head (N = 164) Semi-urban HH (N = 112) Rural HH (N = 137) Total (n = 249)

N % N % N % N % n %

Food secure 10 11.76 15 9.15 14 12.50 11 8.03 25 10.04

Mildly food insecure 20 23.53 57 34.76 45 40.18 32 23.36 77 30.92
Moderately food 37 43.53 67 40.85 38 33.93 66 48.18 104 41.77
insecure
Severely food insecure 18 21.18 25 15.24 15 13.40 28 20.44 43 17.27
Total 85 100 164 100 112 100 137 100 249 100

Where: N is the frequency; % is the percentage; and HH is the household.

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N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Fig. 5. Monthly household food provision.

significantly reduced farming households’ consumption of diverse food
groups. Few households were consuming diverse food groups (36.9 %),
resulting in a high proportion of households being reported to be food
insecure (63.1 %). Moreover, the high level of food and nutrition in­
security is confirmed by the fact that 50 % of the households did not
consume roots and tubers, vegetables, fruits, meat, egg, fish and sea­
food, pulses, milk and dairy products, sugar and honey, and condiments
during the recall period. Indeed, the households’ dietary quality was
low, with households consuming more cereals such as maize to replace
more expensive foods like milk, egg, fruits and fish and seafood,
indicating that most households lacked stability in ensuring continuous
consumption of the 12 food groups. The reduced consumption of di­
verse food groups caused by the COVID-19 shocks confirms that the
pandemic significantly lowered the utilization of the 12 diverse food
groups.
For the months of adequate food provisioning indicator, our findings
suggest that COVID-19 containment measures significantly reduced
farming households’ access to adequate food for the 12 months recall
period. About 98 % of households did not have adequate access to food
over the 12 months recall period, indicating that the prolonged effects of

Table 7
Gender sensitivity for MAHFP indicator in semi-urban and rural communities.

MAHFP category Male HH head (N = 85) Female HH head (N = 164) Semi-urban HH (112) Rural HH (N = 137) Total (n = 249)

N % N % N % N % n %

Food secure 31 36.47 37 22.56 26 23.21 42 30.66 68 27.31

Moderately food 47 55.29 96 58.54 65 58.03 78 56.93 143 57.43
insecure
Food insecure 7 8.24 31 18.90 21 18.75 17 12.41 38 15.26
Total 85 100 164 100 112 100 137 100 130 100

Where: N is the frequency; % is the percentage; and HH is the household.

Fig. 6. Consumption coping strategy and their weighted scores in parenthesis.

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N.N. Suh, R.A. Nyiawung and C.F. Abay Food and Humanity 1 (2023) 614–625

Table 8
Gender sensitivity for CSI indicator in semi-urban and rural communities.

CSI category Male HH head (N = 85) Female HH head (N = 164) Semi-urban HH (N = 112) Rural HH (N = 137) Total (n = 249)

N % N % N % N % n %

Low 16 18.82 32 19.51 30 26.79 18 13.14 48 19.29

Medium 50 58.82 105 64.02 71 63.40 84 61.31 155 62.25
High 19 22.35 27 16.46 11 9.82 35 25.55 46 18.47
Total 85 100 164 100 112 100 137 100 249 100

Where: N is the frequency; % is the percentage; and HH is the household.

Table 9
Samples t-Test results of farming household food and nutrition security by location and gender (n = 249).

Food and nutrition security indicators Semi-urban HH Rural HH T-stat Sign. Male HH head Female HH head T-stat Sig.

Mean Mean
(stdv) (stdv)

HFIASa 10.38 12.53 -3.14 0.00 12.07 11.29 1.06 0.29

(5.41) (5.31) (5.82) (5.25)
a
FCS 37.08 39.65 -1.94 0.05 39.37 38.03 0.93 0.35
(8.79) (12.06) (12.09) (10.03)
HDDSa 5.16 4.74 1.86 0.07 4.82 4.98 -0.66 0.51
(1.81) (1.78) (1.63) (1.89)
MAHFPb 7.21 7.98 -2.15 0.03 8.44 7.22 3.72 0.00
(2.91) (2.69) (2.05) (3.06)
a
CSI 69.38 79.45 -4.18 0.00 76.22 74.25 0.76 0.45
(19.21) (18.64) (20.03) (19.28)

Where: *significant p < 0.05; and robust standard errors in parentheses.

Table 10
Results of the ordered probit model for the association between the COVID-19 shocks and household food and nutrition security.

Independent variables HDDS FCS MAHFP HFIAS CSI

COVID-19 shock -0.14** -0.27*** -0.10* -0.07 0.03

(0.06) (0.06) (0.06) (0.06) (0.06)
Female education 0.08*** 0.05** 0.05*** 0.02 -0.01
(0.02) (0.02) (0.02) (0.02) (0.02)
Female-headed household 0.88*** 0.55* 0.09 0.02 0.99***
(0.32) (0.33) (0.32) (0.31) (0.33)
Semi-urban 0.19 -0.11 -0.16 0.39*** 0.72***
(0.16) (0.16) (0.16) (0.16) (0.17)
Markets opened during COVID-19 are far -0.82*** -1.21*** -0.43* -0.53*** 0.68***
(0.23) (0.26) (0.23) (0.22) (0.23)
Engaged full-time in farming -0.43*** -0.18 -0.32** 0.05 -0.11
(0.16) (0.17) (0.17) (0.16) (0.16)
Age of household head 0.01* 0.00 0.01 -0.00 -0.00
(0.01) (0.01) (0.01) (0.01) (0.01)
Cutoff points
µ1 -2.46 -5.25 -0.39 -1.88 -0.66
(0.77) (0.83) (0.76) (0.73) (0.77)
µ2 -1.25 -3.72 1.38 0.36 1.23
(0.77) (0.80) (0.77) (0.73) (0.77)
µ3 0.47
(0.72)
Observations 249 249 249 249 249
LR chi2(7) 47.69*** 56.11*** 29.50*** 15.92** 25.85***
Pseudo R2 0.09 0.11 0.06 0.03 0.06
Log likelihood -243.57 -225.06 -224.26 -288.09 -217.25

Where: ***p < 0.01, **p < 0.05, *p < 0.1; and robust standard errors in parentheses.

the COVID-19 shocks (first, second and third waves) had short-term and
long-term adverse outcomes on farming households’ food and nutrition
security. Thus, the COVID-19 containment measures disrupted farming
households’ access to domestic and local food markets, reducing house­
hold food availability and consumption. Our finding is similar to the work
of Obayelu et al. (2021), who reported that the COVID-19 pandemic had
long-term effects on household food and nutrition security.
We found that the COVID-19 containment measures led to house­
holds experiencing anxiety and uncertainty about their next meals,
which increased their doubts about a secure next meal, increasing their
food and nutrition insecurity. Moreover, as the lockdown measures
intensified through the first, second and third waves, farming house­
holds could not afford nutritious and healthy diets, increasing house­
hold food and nutrition insecurity. These findings also align with

623
N.N. Suh, R.A. Nyiawung and C.F. Abay
Pakravan-Charvadeh et al. (2021) work in Iran. Even more critical is
that household hunger levels were reportedly high as households re­
duced meals, with others not having any meals to eat on certain days,
consistent with the study of Headey et al. (2022).
Furthermore, our results illustrate that the effect of the COVID-19
lockdown measures led farming households to resort to several coping
strategies. Although farming households engaged in numerous coping
strategies in response to the containment measures which disrupted
livelihood and economic activities, over 80.8 % of households were
reported to be food insecure. The high level of food and nutrition in­
security based on the coping strategy indicator is due to the devastating
outcomes of the containment measures on farming households’ socio-
economic activities, affecting their ability to respond adequately to the
shocks. The most frequently adopted coping strategies reported were
consuming less preferred and less expensive food and borrowing money
to buy food. Moreover, most households implemented coping strategies
with high severity weights, reflecting the severity of the effects of the
containment measures on households’ food and nutrition security. The
most adopted coping strategy with the highest severity weight was
restricting household consumption to staple food such as maize. Our
findings are similar to the work of Das et al. (2020) in Bangladesh and
Jafri et al. (2021) in West Africa.
Farming households engaged full-time in farming reportedly con­
sumed less diverse diets and did not have access to adequate food over a
12-month recall period. With the disruptive outcomes of the COVID-19
shocks, farming households relying entirely on farming for livelihood
were more affected, increasing household food and nutrition insecurity,
similar to Balana et al. (2023) in Nigeria. A negative and statistically
significant relationship was established between distance to the market
opened during the COVID-19 lockdown with farming households’ food
consumption, dietary diversity, months of adequate food provisioning
and household food insecurity access indicators. In contrast, a positive
relationship was established with consumption coping strategies.
Farming households located further away from markets opened during
the COVID-19 lockdown could not easily access markets to sell farm
produce and purchase household food items. As a response to the re­
stricted access to markets, households reduced the frequency of con­
sumption and consumed less diverse food groups, resulting in short-
term food insecurity and hunger. Households located far from markets
that were opened during the pandemic adopted more coping strategies,
indicating that the disruptive effects of the COVID-19 lockdown mea­
sures were detrimental to the livelihood and well-being of farming
households. Elderly farming household heads could better cope and
withstand the adverse outcomes of the containment measures and, thus,
could better ensure the consumption of more diverse diets.
5. Conclusion
The various measures to contain and limit the spread of the COVID-19
virus affected farming households’ well-being, with a long-lasting adverse
outcome on their food and nutrition security. We assessed the implica­
tions of the COVID-19 shocks on farming households’ food and nutrition
security using a suite of food and nutrition security indicators. We equally
assessed the different coping strategies implemented by farming house­
holds in Cameroon. We show that the COVID-19 pandemic significantly
undermined farming households’ access to months of adequate food and
reduced their consumption frequency and dietary diversity for essential
food groups. This shows that the COVID-19 shocks were significantly and
negatively associated with farming households’ food utilization, accessi­
bility, and availability dimensions. Based on these findings, we suggest
the need for interventions to improve access to more diverse food groups
and the consumption of essential food groups through food aid programs.
Female-headed households were more food secure than male-headed
households for dietary diversity, food consumption and consumption
coping strategy indicators. Training and capacity-building opportunities
focusing on reducing households’ food and nutrition insecurity should
624
Food and Humanity 1 (2023) 614–625
target male-headed households, which are more affected. Semi-urban
households were more food secure than rural households for the food
insecurity access and consumption coping strategy indicators. Policies
that help improve access to food and equip rural households with coping
strategies to maintain/improve their food and nutrition security during
future shocks such as COVID-19 should be promoted.
The COVID-19 shocks affected households beyond their capacity to
cope with the negative effects of the shocks. With the closure of markets,
mobility restrictions, and other disruptive outcomes of the lockdown
measures, most households resulted in adopting several coping strategies.
The most frequently adopted coping strategies are consuming less pre­
ferred and less expensive food and borrowing money to buy food. Despite
adopting several coping strategies, many farming households were mod­
erately and severely food insecure, indicating that the coping strategies
adopted did not significantly contribute to maintaining/improving
households’ food and nutrition security. Moreover, a significant percen­
tage of farming households adopted coping strategies that reflected the
high severity of the detrimental outcomes of the COVID-19 shocks on their
livelihood and social well-being. Households engaged full-time in farming
were reported to be more food insecure than those engaged in farming and
non-farming activities. Based on the findings, the study suggests that in­
terventions and training to equip/improve farming households’ coping
strategies are crucial to improving/maintaining households’ food and
nutrition security during current and future shocks, such as the COVID-19
pandemic in Cameroon and other developing countries. Programs that aim
at training farming households to engage in off-farm income activities as
an important strategy to reduce vulnerability to future shocks, such as
COVID-19, should be supported. Moreover, interventions to improve
farming households’ long-term access to essential food groups and the
consumption of more nutritious foods and healthy diets should be
strengthened and promoted.
CRediT authorship contribution statement
Neville N. Suh: Conceptualization, Methodology, Software, Data
curation, Formal analysis, Investigation, Writing - original draft,
Writing - review & editing. Richard A. Nyiawung: Conceptualization,
Methodology, Writing - original draft, Writing - review & editing.
Canan F. Abay: Writing - review & editing.
Declaration of Competing Interest
None.
Acknowledgement
We appreciate the helpful comments from anonymous reviewers
and editors. Specifically, we would like to thank Prof. Daniel G.
Maxwell for comments on the initial draft, which significantly shaped
this manuscript. All the participants in Cameroon who participated in
this study are gratefully acknowledged.
Funding statement
None.
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