(P07-008-25) Co-occurring Vulnerabilities: The Impacts of Food and Water Insecurity on Maternal and Child Nutrition in Haiti

Objectives: Globally, food and water insecurity (FI/WI)– limited access to adequate food and water–pose significant challenges to child nutrition, particularly in the first 2 years of life. Poor infrastructure and recurrent shocks (e.g., violence, weather hazards) exacerbate these challenges, disrupting resource access and increasing vulnerability. Evidence suggests that caregivers may ‘buffer’ children from adverse impacts by preferentially allocating resources, but how this behavior impacts maternal and child nutrition remains unclear, especially in shock-prone contexts.

Methods: This study used baseline data from a USAID-funded Resilience Food Security Activity in Haiti among a subset of 425 women and their < 24m children. FI was assessed using the Household Hunger Scale (HHS); WI using the Household Water Insecurity Experiences Scale (HWISE-4); maternal (MDDS) and child dietary diversity (CHDDS) scores based on consumption of ≥5 pre-specified food groups. Linear and logistic regressions examined relationships, controlling for water source (basic vs. not), child diarrhea, and maternal sociodemographics. Interaction terms for FI and WI were used in multivariable models to account for joint effects.

Results: Only 33.3% of dyads accessed a basic water source, 30.4% reported WI, and 89.9% reported household hunger. Just 5.6% of children and 6.4% of mothers met minimum dietary diversity (mean±SD: 2.34±1.19; 2.20±1.42). Mothers with minimum DD were 14.6x more likely to have children with minimum DD (p < 0.0001). Despite poor water access, WI was not associated with MDDS or CHDDS, though FI and WI were clearly linked (for every 1-point in HHS, WI increased by 0.29 points, p = 0.01). In bivariate models, higher HHS led to worse MDDS and CHDDS (β-0.22, p< 0.001; β -0.17; p=0.002); relationships were maintained in multivariable models without interaction terms (MDDS: β -0.22, p=0.001; CHDDS: β -0.14; p=0.04). With interaction terms, HHS was only associated with CHDDS (β -0.07; p=0.001).

Conclusions: FI was pervasive, WI was less pronounced, despite poor access. MDDS and CHDDS were strongly linked. Maternal buffering may mitigate FI impacts but warrants further study. Findings highlight the importance of addressing FI/WI jointly, especially in shock-prone regions.

Funding Sources: IMPEL evaluation of the Resilience and Food Security (RFSA) 'Ayiti pi Djanm' in Haiti.