Determinants of Household Food and Nutrition Security Status Between Peri-urban and Rural Areas in Mbale District, Eastern Uganda

Food and nutrition security (FNS) is essential for health and well-being. Although traditionally associated with rural areas, rapid urbanization has raised concerns about food and nutrition insecurity in peri-urban communities. This study assessed FNS status and socio-economic and demographic predictors among rural and peri-urban households in Eastern Uganda. Using a descriptive cross-sectional study conducted among 221 households in Mbale District, data were collected using the Household Food Insecurity Access Scale (HFIAS) to determine food security status, while nutrition security, socio-economic and demographic characteristics were assessed using a semi-structured questionnaire. Descriptive statistics were used to summarize data, and binary logistic regression identified predictors of FNS. Findings indicated that food insecurity was highly prevalent among rural (81.1%) and peri-urban (85.5%) households, with no significant difference between settings (p>0.05). Peri-urban households had better access to safe water (90.0% vs. 67.6%) and more commonly treated water by boiling (43.6% vs. 22.1%) and filtering (4.2% vs. 1.5%). Rural households had better access to toilet facilities (95.5% vs. 90.0%). Household size significantly predicted rural food security (p<0.05). In rural areas, education level, household size, spouse’s occupation, and monthly income predicted nutrition security, while in peri-urban areas, education level and means of obtaining food were significant predictors (p<0.05). The study findings demonstrated that food insecurity remains highly prevalent in both settings. Peri-urban households had better water safety and treatment practices, while rural households had better sanitation facilities. The study recommends strengthening income-generating opportunities, backyard gardening, and water, sanitation and hygiene interventions which could improve household FNS in Eastern Uganda.