Determinants of food security among women of reproductive age in Masindray, Madagascar

In Madagascar, food security among women of reproductive age remains a major public concern. Assessments vary depending on the indicators used, making it more difficult to identify effective entry points for action. This study examined the determinants of food security among women of reproductive age in Masindray. It aimed to characterize food-security levels through a multi-indicator assessment and respondents’ perceptions, and to identify the factors associated with these levels. The study used a cross-sectional quantitative survey of 396 women aged 15-49 years. It combined a multi-indicator diagnosis, an analysis of perceptions, and the identification of socioeconomic determinants associated with food security levels. Hierarchical cluster analysis (HCA), refined by discriminant factor analysis (DFA), generated three profiles using the Household Food Insecurity Access Scale (HFIAS), the Livelihood Coping Strategies Index (LCS), the Food Consumption Score (FCS), the Minimum Dietary Diversity for Women (MDD-W), and lean-season duration. A discourse analysis then informed a Program Evaluation and Review Technique (PERT) network, while benchmarking linked the profiles to 25 qualitative variables. The results show non-convergence across measures: anthropometric status and coping strategies often appear favorable, whereas the Minimum Dietary Diversity for Women (MDD-W) frequently indicates insufficient dietary diversity. The typology identifies an intermediate profile (58%), a food-insecure profile (35%), and a favorable profile (7%). Differences between profiles reflect combinations of access costs, domestic constraints, water access, human capital, and decision-making latitude. These findings support the value of a multi-indicator approach.