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研究生: 席坦可
Temcolo, Loveness Silolo
論文名稱: 史瓦濟蘭兒童戶主家庭青少年在 COVID-19 封鎖期間和之後的社會人口特徵與糧食不安全之間的關係
The association between sociodemographic characteristics and food insecurity during and after COVID-19 lockdown among adolescents living in child-headed households in Eswatini
指導教授: 莊佳蓉
Strong, Carol
學位類別: 碩士
Master
系所名稱: 醫學院 - 公共衛生學系
Department of Public Health
論文出版年: 2024
畢業學年度: 112
語文別: 英文
論文頁數: 69
中文關鍵詞: COVID-19青少年封鎖糧食不安全復原力
外文關鍵詞: COVID-19, Adolescent, Lockdown, Food insecurity, Resilient
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  • 介紹
    2020 年 COVID-19 大流行的發展導致了許多破壞,不僅導致人們對感染未知疾病的恐懼或焦慮,而且還破壞了食物鏈,這在以孩童為戶主的家庭中可能更為明顯。這些孩童已經生活在貧窮線以下,而 COVID-19 可能會使他們的糧食安全狀況變得更糟。因此,本研究的目的是探討封鎖期間和之後糧食不安全的嚴重程度,以及史瓦濟蘭以孩童為戶主的家庭中青少年的恢復能力。
    方法
    這是一項橫斷面研究,使用結構化問卷收集了史瓦濟蘭 Mayiwane 地區兒童戶主家庭中 12-18 歲青少年在 COVID-19 封鎖期間和之後的飲食體驗數據。
    分析
    採用SPSS 20版對資料進行分析。使用多變量邏輯迴歸研究糧食不安全與社會人口特徵之間的關係。使用多項迴歸研究了社會人口特徵變化與糧食安全狀況之間的關係。 P 值小於 0.05 表示有統計意義。
    結果
    在 284 名青少年中,67.6% 的青少年在封鎖期間糧食不安全,但只有 25.7% 的青少年在封鎖後糧食不安全。與封鎖期間(78.5%-33.8%)相比,封鎖後存在糧食不安全的 13 至 18 歲青少年比例下降了 44.7%。約 47.2% 的受訪者表現良好,27.1% 的受訪者未受影響,25.1% 的受訪者面臨糧食不安全問. 根據 COVID-19 封鎖期間和封鎖之後的糧食安全變化,參與者分為 3 組。恢復力強的群體在封鎖後能夠反彈,未受影響的群體根本沒有糧食不安全,而陷入困境的群體則始終存在糧食不安全。
    收入也是貧困群體的重要決定因素,因為沒有家庭收入的青少年中有更多(90.4%)在糧食不安全中掙扎,而不是有彈性且不受糧食不安全影響的青少年。在封鎖期間和之後,沒有收入的青少年比來自 ≥ E 1000-E2000 家庭的青少年更有可能出現糧食不安全(AOR=4.01,CI 1.99-8.09,p <0.001,AOR=8.11,CI 2.94,22.35, p <0.001)。與在疫情封鎖期間從未接受過任何捐贈的青少年相比,從政府糧食計劃獲得食物的青少年出現糧食不安全的可能性較小(AOR-0.24,95% CI 0.07-0.86,p 值0.03) 。與完全沒有家庭收入的青少年相比,收入低至< E500的受訪者和≥ E500 - E 2000的青少年更有可能適應而不是陷入困境(AOR=3.65,CI:1.40-9.55,p=0.008, AOR =3.67,CI 1.71-7.91,p=0.001)
    結論
    COVID-19 大流行導致以兒童為戶主的家庭中青少年的糧食不安全狀況顯著增加。應制定針對史瓦濟蘭兒童戶主家庭兒童糧食不安全問題的政策和乾預措施,以消除糧食不安全,即使在未來出現大流行等災難性情況時也是如此。

    Introduction
    The development of the COVID-19 pandemic in 2020 has led to many disruptions not only the fear or anxiety of getting unknown diseases but also disruption in food chains which is likely more pronounced in child-headed homes. These children have already been living under the poverty line and COVID-19 might have made their food security status worse. jobs. Thus, the objective of this study was to explore the magnitude of food insecurity during and after the lockdown and the resilience of adolescents living in child-headed households in Eswatini.
    Methods: This was a quantitative cross-sectional study that used a structured questionnaire to collect data on food experiences during and after the COVID-19 lockdown amongst adolescents aged between 12-18 years old living in child-headed families in the Mayiwane area in Eswatini.
    Analysis: SPSS version 20 was used to analyze data. Multivariate logistic regression was used to investigate the relationship between food insecurity and sociodemographic traits. The relationship between changing sociodemographic traits and food security status was investigated using multinomial regression. P-values of less than 0.05 indicated statistical significance.
    Results
    Of the 284 adolescents, 67.6% were food insecure during the lockdown, however, only 25.7% were food insecure after the lockdown. The percentage of adolescents aged ≥ 13 to 18 years with food insecurities declined by 44.7% after the lockdown compared to during the lockdown (78.5%-33.8%). About 47.2%were resilient, 27.1% were not affected and 25.1% were struggling with food insecurity. Almost half (47.2%) were resilient, 27.1% were not affected and 25.1% were struggling with food insecurity. Income was also a strong determiner of the struggling groups as more (90.4%) of the adolescents without household income were struggling with food insecurity than resilient and unaffected by food insecurity. Adolescents with no income were more likely to be food insecure than those from households with ≥ E 1000- E2000 during and after the lockdown (AOR=4.01, CI 1.99-8.09, p <0.001, and AOR=8.11, CI 2.94,22.35, p <0.001). Adolescents receiving food from government food programs were less likely to be food insecure than adolescents who never received any donations during the pandemic lockdown (AOR- 0.24, 95% CI 0.07-0.86, p-value 0.03). Compared to adolescents with no household income at all, respondents with incomes as low as < E500 and adolescents with ≥ E500 - E 2000 were more likely to be resilient than struggling (AOR=3.65, CI:1.40-9.55, p=0.008 and AOR=3.67, CI 1.71-7.91, p=0.001).
    Conclusions
    The COVID-19 pandemic has led to a significant increase in food insecurity among adolescents living in child-headed households. Policies and interventions that will target food insecurity in children living in child-headed families in Eswatini should be in place to eradicate food insecurity even in future catastrophic situations like the pandemic.

    Abstract 3 Chinese Abstract 4 Chapter 1 8 Introduction 8 1.1 Background and Rationale 8 1.2 Purpose and Significance of the study 9 1.3 Research Aims and Hypothesis 11 Chapter 2: Literature Review 13 2.1 Food Insecurity 13 2.1.1 Global food insecurity 13 2.1.2 Food Insecurity in the Southern sub-Sahara Region 13 2.1.3 Food Insecurity and Child-Headed Households in Eswatini 14 2.1.4 Food in Security Amidst COVID-19 15 2.2 Socio-demographics as determinants of Food insecurity 16 2.3 Effects of Food Insecurity 16 2.4 Child-Headed Household Resilience to Food Insecurity During and After COVID-19 Lockdown 17 2.5 COVID-19 in Eswatini 19 Chapter 3: Research Design and Methodology 20 3.1 Overview of paper and pencil survey 20 3.1.1 Study setting 20 3.1.2 Target Population 20 3.2 Survey Framework 21 3.2.1 Study design 21 3.2.2. Participants 21 3.3 Data collection tool 22 3.4 Data Collection Procedure 23 3.5 Data Management 24 3.6 Data analysis 24 3.7 Ethical considerations 24 Chapter 4 25 Results 25 CHAPTER 5 30 DISCUSSION AND CONCLUSIONS 30 Conclusion 36 References 38 TABLES 43 Table 4.1: Sociodemographic characteristics of respondents 43 Table 4. 2: Food insecurity proportions by socio-demographics during and after COVID-19 using Chi-square comparisons 45 Table 4. 3 Association between risk factors and food insecurity during the lockdown —univariable and multivariable logistic regression 48 Table 4.4: Association between risk factors and food insecurity after the lockdown —univariable and multivariable logistic regression 50 Table 4.5: Participants’ grouping based on food security status transitioning by socio-demographics during and after COVID-19 using Chi-square comparisons 52 Table 4. 6: Unadjusted multinomial logistic regression models examining the association between food insecurity status transitioning (3 groups) and sociodemographic 54 Table 4. 7: Adjusted multinomial logistic regression models examining the association between food insecurity status transitions and sociodemographic characteristics 56 Appendix I: Participant Information Sheet and Consent Form 58 Appendix II: Paper and Pencil Survey 63

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