Household food insecurity and its associated factors in Ethiopia: a systematic review and meta-analysis

Household food insecurity continues to be a public health concern, especially in developing countries, including Ethiopia. Despite efforts by the Ethiopian Federal Government to address food insecurity, it has persistently remained one of the top problems. The pooled prevalence of the national is crucial for interventions by clear insight for policy makers, decision makers, and planners of the country by addressing the limited evidence of the household prevalence in Ethiopia. Given the importance of addressing household food insecurity in Ethiopia, there is a growing body of research that examines its prevalence, determinants, and consequences. However, existing evidence is spread across various regions, with variability in the findings. This study aimed to determine the pooled prevalence of household food insecurity and its associated factors in Ethiopia.

We used PRISMA to identify eligible studies. The inclusion criteria for this study were published in English, publication year, Ethiopian studies, relevant to topics, while editorial letters, complex abstracts and difficult to obtain full texts were excluded from the eligibility criteria. The data was analyzed using STATA version 14 with random-effects model. The forest plot was used to determine the odds ratio for each study of prevalence and associated factors and the general studies with 95% CI presented. The heterogeneity among the studies was checked by I²with 95% CI and p-value. Publication bias was checked with funnel plot graphical visualization and statistically using the Egger test.

Examination of 768 studies, ten studies involving 4734 households, and ten out of 768 published articles evaluated satisfied the inclusion criteria and were added to the systematic and meta-analysis. In this systematic review and meta-analysis, the pooled prevalence of household food insecurity of 51.46 % (95% CI: 41.52%, 61.40%). However, subgroup analysis by region was performed in which the highest prevalence of household food insecurity was observed in the Amhara region (61.14% (95% CI 26.00, 68.77) while the lowest prevalence of household food insecurity was observed in the Oromia region (41.52% (95% CI 21.27, 61.78), I2 = 98.9%). Furthermore, this review, pooled factor illustrated that households with larger families were 6.43 times (OR=6.43, 95% CI: 2.98, 13.87, p=0.016, I2 =67.0%) more likely to be food insecure compared to households with small families.

In this review, the prevalence of households and more than half of the households in Ethiopia had experienced food insecurity. Therefore, the food insecurity of households in Ethiopia continues to be a public health problem. The subgroup analysis showed that the Amhara region had the highest prone region for food insecurity and the size of the family was the potential significant factor for food insecurity in the household. Strategies to reduce household food insecurity must be implemented by sharing the best food secure region with the food insecurity region, community education and improving contraceptive use to reduce the number of family sizes. The study registered on the PROSPERO registration ID number is CRD42024532143.