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Abstract
Background: Uganda is largest host of refugees in Africa with an estimated 1.5 million refugees, yet the
prevalence of global acute malnutrition (GAM) remains unacceptable at 8.2%. In Palabek, refugee
settlement, micronutrient deficiency is notably high as evidenced by the high prevalence (62.9%) of
anemia. Improving dietary diversity (DD) in Palabek refugee settlement is pivotal to reducing all forms
of malnutrition and this requires more attention to be paid on determining evidence-based food accessing
strategies that offer an ideal solution to diversified diet in vulnerable refugee communities. The aim of
the study was to compare the contribution of food accessing strategies to and to determine factors that
affect household dietary diversity (HDD) in Palabek refugee settlement in order to provide guiding
recommendations to policy makers, partners.
Methods: A quantitative cross sectional study design using face to face interview and semi-structured
questionnaire was conducted among 398 household (HH) caregivers selected through multistage
sampling approach in Palabek refugee settlement in Northern Uganda. A 24-hour recall method was used
to capture different type of foods consumed by the HH in relation to the sources of food. Questionnaire
also captured data on demographic and socio-economic characteristics of HHs. Data was analyzed using
SPSS version 20.0 and Excel.
Results: The mean household diversity score (HDDS) was 5.05, diets were dominated by cereals while
animal sourced foods and fruits were the least consumed. Own food production, market purchase and
food donations had a significant effect on HDD. Poisson regression results show that education level of
the HH head, access to agricultural land, presence of kitchen garden, acres of agricultural land and
average HH income per month had significant effect on HDD.
Conclusion: Although, own food production had a greater contribution towards the HDD of the study
population, all the three acquisition strategies had a significant positive association with the HDD.
Education level of the HH head, access to agricultural land, presence of kitchen garden, acres of
agricultural land and average HH monthly income had significant effect on HDD.
Recommendations: Emergency and development programs should therefore target all the three food
acquisition strategies to increase HDD; UNHCR and other partners should negotiate for refugee friendly
land reform policy; Livelihood programs involving access to finance and rearing of small animals should
be promoted by agencies to increase food purchasing power and intake of animal sourced foods and;
Intervention programs should incorporate market access as one of the strategies of food access.
Recommendations: Emergency and development programs should therefore target all the three food
acquisition strategies to increase HDD; UNHCR and other partners should negotiate for refugee friendly
land reform policy; Livelihood programs involving access to finance and rearing of small animals should
be promoted by agencies to increase food purchasing power and intake of animal sourced foods and;
Intervention programs should incorporate market access as one of the strategies of food access.
