Patient-Reported Outcomes of Palatopharyngeal Surgery Without Tonsillectomy: A Meta-Analysis.

Many low- and middle-income countries (LMICs) continue to struggle with social inequalities and poverty, thus directly affecting food security and health of household members []. Household socioeconomic status, income, and poverty are key factors for the health of children [–]. The World Food Program defines household wealth as “the value of all natural, physical and financial assets owned by a household, reduced by its liabilities” []. Evidence suggests that food insecurity in LMICs is shaped by basic causes, which are socioeconomic, structural, and upstream determinants, including low income, unstable employment [], and constraints in the local food environment such as limited market availability and poor transport infrastructure []. At the unit of the household, the presence of children and adolescents, female-headed households, educational attainment, and reliance on social grants have been identified as factors associated with experiencing hunger [, ]. On the other hand, household food insecurity and low dietary diversity are linked independently or together to undernutrition [], especially stunting [], among young children. Although South Africa – currently classified as a middle-income country – has made improvements in reducing poverty rates and food insecurity, and lowered the prevalence of stunting, high inequalities between socioeconomic quintiles and extreme poverty remain [, ]. According to South African statistics from 2015 to 2023, the socioeconomic inequalities nationwide remain high, with 55.5% of the population living under the poverty line [, ]. A distributional analysis examining the household socioeconomic status dynamics from 2001 to 2013 in a rural South African region demonstrated that households with low socioeconomic status have greater difficulty to overcome this inequality gap; and that achieving higher socioeconomic status is faster if household wealth has already shifted toward a wealthier level []. Hence, there is a pressing need for the government to focus on households that are at highest risk of being affected by public health concerns. Previous studies in LMICs, including South Africa, have illustrated that an increase in socioeconomic status is linked to an increase and greater food consumption, also with higher energy, saturated fat, and cholesterol intakes [, ]. With regard to South Africa, representative data from all provinces showed a mean dietary diversity score of 4.02 (out of 9 food groups) at the national level, indicating poor dietary diversity []. Additionally, recent studies from South Africa revealed a high prevalence of food insecurity among households living in rural and peri-urban areas [, ].