Voices of the hungry: A qualitative measure of household food access and food insecurity in South Africa

Background: South Africa is rated a food secure nation, but large numbers of households within the country have inadequate access to nutrient-rich diverse foods. The study sought to investigate households' physical and economic access and availability of food, in relation to local context which influences households' access to and ability to grow food which may affect the dietary quality. We sought to understand self-reported healthy diets, food insecurity from the perspective of people who experienced it, barriers to household food security and perceptions and feelings on food access as well as strategies households use to cope with food shortages and their perceptions on improving household food security. Methods: Focus group discussions were conducted along a rural-urban continuum in three South African towns situated along an agro-ecological gradient. Participants were asked about their knowledge of healthy diets, factors influencing their food consumption, their perceptions regarding food insecurity, barriers to food security, coping strategies and solutions to improve access to nutrient-rich foods. Results: A total of 91 people participated in 11 focus groups, with 76% females. The majority of participants aged between 31 and 50 years. Participants were knowledgeable about healthy diets but had limited access to it hence consumed monotonous diets. The perceptions provided insights into the pressing issues of inadequate access to food, food insecurity, coping strategies and ideas on improving food security. The majority of participants reported on experiencing food insecurity and female-headed households, unemployed and orphaned children were most vulnerable. Focus group participants highlighted the complexity of the food system in their communities which relies on own production, collecting from open spaces, donations and to a larger extent purchase, in the context of unemployment, low income, water and land shortages as well as theft. Conclusion: The results provide a significant contribution from a needs assessment perspective from the communities, identify "hidden" constrains in household food access and provide effective future solutions for improving food security in the communities. Government should assist with capacity building, employment creation and providing resources (especially, land and water) for communities to practise agriculture which they all agreed can improve food security. © 2017 The Author(s).