Food insecurity, low dietary diversity and poor mental health among Syrian refugee mothers living in vulnerable areas of Greater Beirut, Lebanon

Abstract

Syrian refugees in Lebanon are facing vulnerabilities that are affecting their food insecurity levels. The objectives of this study were to measure dietary diversity, food insecurity (FI), and mental health status of Syrian refugee mothers in Lebanon and to explore its associations with their anemia and nutritional status. A cross-sectional study was conducted among mothers with children under 5 years (n=433) in Greater Beirut, Lebanon. Dietary diversity was measured using the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) and FI using the global Food Insecurity Experience Scale (FIES) at the individual level. Depression and post-traumatic stress disorder (PTSD) were measured to assess the maternal mental health status. Data on socio-economic characteristics, anthropometric measurements, and hemoglobin concentrations were collected. Overall, 63.3% of the mothers had a low dietary diversity (LDD) and 34.4% were moderately to severely food insecure, with 12.5% being severely food insecure. The prevalence of PTSD, moderate depression, and severe depression were 13.2%, 11.1%, and 9.9%, respectively. A significant correlation was found between LDD and FI (P<0.001). A low-income was significantly associated with LDD and FI. Poor mental health was significantly associated with FI. LDD and FI were not associated with anemia and nutritional status of mothers. Low-income households had significantly higher intakes of grains and refined starchy staples, whereas high-income households consumed more nutritious foods and sweets. Evidence of inadequate diet quality, FI, and poor mental health among Syrian refugee mothers in Lebanon are presented. Multifaceted actions are needed to reduce FI and improve dietary diversity.

Supporting Factors and Barriers Related to Early Initiation of Breastfeeding and Exclusive Breastfeeding among Infants of Syrian Refugees in Greater Beirut, Lebanon: A Mixed Methods Study

“…In addition, Syrian refugees in Turkey reported that malnutrition and fatigue of mothers were often the biggest obstacles to breastfeeding [59]. These findings shed the light on the role of adequate maternal nutrition during pregnancy and lactation as it impacts the development and health of the offspring [75,76], which was particularly difficult to achieve among Syrian refugee mothers in Greater Beirut, Lebanon [17,18].…”

“…Crowded spaces were also reported to negatively impact breastfeeding practices among Syrian refugees in Lebanon [51]. This can be explained by the strong association between poor maternal mental health, food insecurity, and a high crowding index found among Syrian refugee mothers in Lebanon [18]. Particularly, stress related to conflicts was recognized as a major contributor to the discontinuation of breastfeeding among refugees and displaced persons, as it may interfere with the mother's let down reflex and lactation [1,44,46,51].…”

Infant Feeding Practices, Nutrition, and Associated Health Factors during the First Six Months of Life among Syrian Refugees in Greater Beirut, Lebanon: A Mixed Methods Study

“…Low dietary diversity among mothers was also associated with higher odds of early initiation of breastfeeding. Poor dietary diversity was also linked to low income and food insecurity among Syrian refugee mothers in Greater Beirut, Lebanon [ 16 ]. This suggests that mothers facing increased economic vulnerabilities would be more inclined to initiate breastfeeding early as breast milk is known to be more cost-effective.…”

“…In addition, Syrian refugees in Turkey reported that malnutrition and fatigue of mothers were often the biggest obstacles to breastfeeding [ 61 ]. These findings shed the light on the role of adequate maternal nutrition during pregnancy and lactation as it impacts the development and health of the offspring [ 77 , 78 ], which was particularly difficult to achieve among Syrian refugee mothers in Greater Beirut, Lebanon [ 15 , 16 ].…”

“…Lebanon hosted more than 1.5 million Syrian refugees, making it the country with the highest per capita concentration of refugees worldwide [ 12 , 13 ]. Syrian refugees in Lebanon have been subjected to harsh living conditions affecting their food security, nutritional status, and mental health, particularly among mothers and children [ 14 , 15 , 16 ]. Exposure to wars and conflicts could negatively impact maternal mental health and nutrition, resulting in long-lasting intergenerational effects on the health of the child.…”