Household food security and nutritional

status of rural elderly women

Presented By:
Mst. Nazira Begum
Roll No : 22019
Session: 2022-2023
MPH(Community Nutrition)
Department: Nutrition and Biochemistry

National Institute of Preventive and Social Medicine

(NIPSOM)
 Introduction
• Food and nutrition are among the basic needs of husocieties and
providing adequate and suitable food for all people lies in the
category of food security (Bickel et al.,2000)

• As the United States Department of Agriculture, food security

means that all people, at all times have access to adequate food
to maintain a healthy and active lifestyle (Coleman -Jensen et
al., 2014 ). It includes providing healthy and adequate food in
terms of nutrition, ability , and ensuring that acceptable foodsare
obtained through acceptable means (Thomas, 2006 ).

• Important factors affecting food security, such as social,

economic, and ecological factors, including household size,
home -ownership, acquiring educational skills, savings and
access to insurance health services, and independent household
Justification
• Household food security is an emerging public health issue and the rural elderly
people are one of the most vulnerable groups for the household food security.

• Food insecurity, under nutrition and poor health status are the most common
features of elderly people in rural Bangladesh and they require targeted
assistance.

• The majority of older people live in rural areas where services, healthcare
provision and access to clean water are more precarious.

• Due to socio-economical condition the rural elderly people are more victim of
socio-economical injustice and the malnutrition is more seen in rural than urban
area.
 Research Question

• What is the state of household food security and

nutritional status of rural elderly women ?
 General Objective
• To assess the household food security and nutritional status
of rural elderly women .
 Specific Objectives
• To assess household food security of rural elderly women.

• To assess nutritional status of rural elderly women in terms of

MNA.

• To find out sociodemographic characteristics of the respondents.

 Operational Definition

Household food security:

Household food security refers to the ability of the household to
secure through purchases of food, adequate food for meeting the
dietary needs of all members of household . It is measured by
household Food insecurity access scale(HFIAS, 2007).

FFH’s scale : Food for Hunger scale (USDA’s)

Total score:
0-1 meant Non Food Insecure (NFI)
2-3 meant Moderately Food Insecure (MFI)
>5 meant Severely Food Insecure (SFI)
 Operational Definition
Elderly women: A woman of the age above 60 years .
Nutritional status: It is the current body status of a person or a
population, related to their state of nourishment , which is manifested
by their height , weight , BMI, physical activity and disease.
Mini Nutritional assessment: It is used to assess nutritional status in
older adult. MNA score is determined by physicians , using the
standard extensive nutritional assessment including complete
anthropometric , clinical biochemistry, and dietary parameters. By
adding up the scores, labeled as MNA-LF, individuals can be divided
in 3 groups using threshold values of <17 for malnourished , 17-23.5
for ‘at risk of malnutrition’ and ≥normal nutritional status with a
maximum total score of 30 points.
List of Variables
Dependent Variable
• Nutritional status of rural elderly women.

Independent Variables:
A. Sociodemographic characteristics:
• age
• Education
• marital status
• household size
• number of children,
• Income
• Housing
• occupation
 Variables Continue…
B. Variables related to food security:
• Financial ability to buy food
• Number of daily intake of food
• Frequency of complete meal
• Frequency of incomplete meal
• Skip meals how often in 30 days
• Tendency to borrow loan
• Physically unstable to cook foods
• Availability of foods consuption
• Stop eating for an entire day.
• Loss of weight
Variables….Continued
C . Variables to Co-morbidity:
• Hypertension
• Cardiovascular disease
• Gastrointestinal
• Hyperlipidemia
• Diabetes.
 Conceptual Framework
Food security status:
• Financial ability to
buy food
Socio demographic • Number of daily
Nutritional
characteristics: intake of food
Status Of Rural
• age, • Frequency of
• education, Elderly Women:
complete meal
• marital status, • Frequency of
household size, • Height incomplete meal
• number of • Weight • Skip meals how
children, income,
• housing, • BMI often in 30 days
• occupation, • Tendency to borrow
• smokeless tobacoo loan
use. • Physically unstable
Comorbidities: to cook foods
• Availability of foods
• Hypertension consuption
• cardiovascular • Stop eating for an
disease entire day.
• gastrointestinal
• Loss of weight
• Hyperlipidemia
• diabetes.
Materials and Methods
Study design: Cross-sectional study.

Study place: The study will be conducted in a selected area of

Joypurhat.

Study period: 1st January 2023 to 31st December 2023.

Study population: Elderly women of a rural area in Joypurhat

Methodology…..Continued
Selection criteria:
Inclusion criteria
• Women of age above 60 years.
• Women who are willing to participate and give
informed written consent.

Exclusion criteria:
• Women who are severely ill and mentally unstable.
• Women who are not willing to participate in the study.
 Methodology…..Continued
Sample Size determinations:

Sample size will be calculated by using formula

n= z2pq/d2
Here, n = sample size
z = Standard normal deviation = 1.96 , at 95% CI
p = Percentage of the household who get sufficient amount of food
for active and healthy life is 56%= 0.56
q = 1 – 0.56 = 0.44
d = 5% = 0.05, degree of error
(1.96) 2 × (0.56×0.44) / (0.05) 2 = 3.841 × 0.2464 / 0.0025=
0.9664221 / 0.0025 = 378
Methodology…..Continued
Sampling technique:
Convenience sampling technique.

Data collection instruments:

Semi- Structured questionnaire.

Data collection tools :

• Food frequency questionnaire
• Digital weight machine
• Measurement tape
• MUAC tap
Data collection technique:
Face to face interview
MNA
FFH’s scale
Methodology…..Continued
Data Management Plan:
• Initially data will be checked for completeness and correctness
in order to exclude missing or inconsistent data.
• Then data will be entered into the computer using Statistical
Package for Social Science(SPSS).
Data Analysis Plan:
• Then data will be analyzed by using the Statistical Package for
Social Science(SPSS).
• Descriptive data will be analyzed by simple frequency
distribution ( mean , standard deviation, percentage).
• Data will be presented using frequency table, graph and chart.
Ethical Issues

• The protocol will be approved by protocol approval

committee of NIPSOM.
• Ethical clearance of the study will be obtained from the
Institutional Review Board (IRB) of NIPSOM.
• Informed written consent will be taken from each and every
participant.
• Privacy and confidentiality will be maintained strictly.
• Participants will have all rights to withdraw from the study.
• They will be assured that there would be no harm to them
during study as there is no invasive procedure will be
applied.
References
• Bickel G, Nord M, Price C, Hamilton W & Cook J 2000. Guide
to measuring household food security.
• Coleman-Jensen A, Gregory C & Singh A 2014. Household food
security in the United States in 2013. USDA-ERS Economic
Research Report. 2014(173).
• Modirwa S & Oladele O 2012. Food security among male and
female -headed households in Eden District Municipality of the
Western Cape, South Africa. Journal of human ecology. 37 (1):
29 -35.
• Thomas HC 2006. Trade reforms and food security: country case
studies and synthesis. Food & Agriculture Org
Thank you