Public health challenges · 2026
Severe Household Food Insecurity and Malnutrition Among School-Going Adolescents in South Punjab, Pakistan: Implications for Sustainable Development Goal 2 (A Cross-Sectional Study).
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Shauket Rameesha, Okon Inibehe Ime, Maroof Saira
Аннотация
INTRODUCTION: Food insecurity and malnutrition remain major public health concerns among adolescents in low- and middle-income countries. Adolescence is a critical period for growth and development, yet school-going adolescents remain underrepresented in nutrition research and policy in Pakistan. This study aimed to assess household food insecurity, nutritional status, and their association among school-going adolescents in peri-urban South Punjab.
METHODS: This cross-sectional study included 384 school-going adolescents aged 15-18 years from public and private schools in peri-urban Lodhran district, South Punjab, Pakistan. Household food access was assessed using the Household Food Insecurity Access Scale (HFIAS), and nutritional status was classified using WHO BMI-for-age (BAZ) and height-for-age (HAZ) z-scores. Data were collected using a pretested, interviewer-administered questionnaire. Associations were examined using chi-square and Fisher's exact tests, multivariable logistic regression (adjusted for age, sex, school type, family size, socioeconomic score, and school grade) for the continuous HFIAS score, and Benjamini-Hochberg correction for multiple comparisons.
RESULTS: The mean age was 16.6 ± 1.1 years, and 207 (53.9%) were female. Overall, 365 households (95.1%, 95% CI 92.4%-96.8%) were severely food insecure. Thinness was observed in 131 adolescents (34.1%, 95% CI 29.6%-39.0%), stunting in 107 (27.9%, 95% CI 23.6%-32.6%), and overweight/obesity in 35 (9.1%, 95% CI 6.6%-12.4%). Overall HFIAS categories were not significantly associated with stunting, thinness, or overweight/obesity. After correction for multiple comparisons, four individual HFIAS experience domains remained robustly associated with thinness specifically, and in multivariable analysis, a higher continuous HFIAS score was independently associated with greater odds of thinness (aOR 1.056, 95% CI 1.009-1.104, p = 0.019).
CONCLUSION: School-going adolescents in peri-urban South Punjab experienced a very high burden of severe household food insecurity alongside substantial thinness, stunting, and overweight/obesity. These findings support adolescent-focused food security screening, school-based nutrition interventions, and locally targeted policies aligned with Sustainable Development Goal 2.
METHODS: This cross-sectional study included 384 school-going adolescents aged 15-18 years from public and private schools in peri-urban Lodhran district, South Punjab, Pakistan. Household food access was assessed using the Household Food Insecurity Access Scale (HFIAS), and nutritional status was classified using WHO BMI-for-age (BAZ) and height-for-age (HAZ) z-scores. Data were collected using a pretested, interviewer-administered questionnaire. Associations were examined using chi-square and Fisher's exact tests, multivariable logistic regression (adjusted for age, sex, school type, family size, socioeconomic score, and school grade) for the continuous HFIAS score, and Benjamini-Hochberg correction for multiple comparisons.
RESULTS: The mean age was 16.6 ± 1.1 years, and 207 (53.9%) were female. Overall, 365 households (95.1%, 95% CI 92.4%-96.8%) were severely food insecure. Thinness was observed in 131 adolescents (34.1%, 95% CI 29.6%-39.0%), stunting in 107 (27.9%, 95% CI 23.6%-32.6%), and overweight/obesity in 35 (9.1%, 95% CI 6.6%-12.4%). Overall HFIAS categories were not significantly associated with stunting, thinness, or overweight/obesity. After correction for multiple comparisons, four individual HFIAS experience domains remained robustly associated with thinness specifically, and in multivariable analysis, a higher continuous HFIAS score was independently associated with greater odds of thinness (aOR 1.056, 95% CI 1.009-1.104, p = 0.019).
CONCLUSION: School-going adolescents in peri-urban South Punjab experienced a very high burden of severe household food insecurity alongside substantial thinness, stunting, and overweight/obesity. These findings support adolescent-focused food security screening, school-based nutrition interventions, and locally targeted policies aligned with Sustainable Development Goal 2.