Magnitude of urban household food insecurity in East Africa: a systematic review and meta-analysis

Objective: The purpose of this study was to determine the magnitude and determinants of urban household food insecurity in East Africa. Design: Systematic review and meta-analysis. Setting: Studies conducted in East Africa. Participants: Seventeen studies (fifteen cross-sectional and two cohort) that enrolled 156 996 households. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL, African Journals OnLine, Web of Science, Scopus and Google Scholar; date of last search: 10 June 2020) for studies reporting the prevalence and associated factors of urban household food insecurity. Results: A total of 17 studies with 156 996 households from 8 countries were used for the analysis. The pooled prevalence of urban household food insecurity in East Africa was 60 center dot 91 % (95 % CI 47 center dot 72, 74 center dot 11; I (2) = 100 %; P < 0 center dot 001) where the highest (91 %) and lowest (36 center dot 5 %) was observed in Sudan and Burundi, respectively. Household head educational status (illiterate) (AOR = 2 center dot 53; 95 % CI 2 center dot 11, 2 center dot 95, I (2) = 90 %; P < 0 center dot 01), female as household head (AOR = 1 center dot 45; 95 % CI 1 center dot 16, 1 center dot 75; I (2) = 0 center dot 0 %; P = 0 center dot 993), large family size (AOR = 1 center dot 43; 95 % CI 1 center dot 09, 1 center dot 76, I (2) = 0 center dot 0 %; P = 0 center dot 863) and poorest wealth quantile (AOR = 3 center dot 95; 95 % CI 1 center dot 93, 5 center dot 98; I (2) = 57 center dot 2 %, P = 0 center dot 053) were factors which significantly increased odds of urban household food insecurity in East Africa. Conclusions: The prevalence of urban household food insecurity in East Africa remains high. Therefore, policies and intervention programmes should be designed to reduce the high burden of food insecurity among urban households considering the identified factors.