Recent Household Food Insecurity and Child Weight-for-Age in Two West Nusa Tenggara Settings

Abstract

Household food insecurity may be associated with child undernutrition, but evidence based on continuous weight-for-age measures in Indonesia remains limited. This study examined the association between recent household food-insecurity experiences and weight-for-age z-scores (WAZ) among children under five in West Sumbawa and Bima and assessed whether the association differed between settings. We analysed cross-sectional data from 170 child–household pairs (85 per setting) collected in 2025. Eight household-referenced items adapted from the Food Insecurity Experience Scale were administered using a one-month reference period, with at least one affirmative response defining exposure. WAZ was calculated using WHO Anthro software and the 2006 WHO Child Growth Standards. Linear regression with HC3 robust standard errors was adjusted for setting, child age, sex, and household size. Overall, 66 households (38.8%) reported recent food-insecurity experiences, with a higher proportion in Bima than in West Sumbawa (51.8% vs 25.9%). Mean WAZ was −2.31 ± 0.70 among exposed children and −0.84 ± 0.80 among unexposed children. After adjustment, exposure was associated with a 1.44-unit lower WAZ (β = −1.44; 95% CI: −1.69 to −1.18; p < 0.001; R² = 0.497). There was no statistical evidence that the association differed by setting (interaction p = 0.481). This substantial cross-sectional association warrants cautious interpretation because the exposure measure was broad and uncalibrated, and the study used selected sampling frames. Recent food-access questions may complement anthropometric assessment, although longitudinal studies are needed to establish temporality.