Development of a Food Security Assessment Tool for Pregnant Women to Integrate Into Antenatal Care in the Health System: Protocol of a Mixed-Method Study

Abstract

The food security status of pregnant women not only affects their current health status and that of their newborn, but also plays an important role in the health status of children and adults in the future. Food security is a complicated and multidimensional concept. In pregnant women, it is the result of several complex individuals, family, social, cultural, economic, and political factors such as lack of health services, gender inequality, and lack of resources. Public instruments that mainly measure food insecurity at the household level have been used to investigate the food security status of pregnant women. Therefore, we aimed to define the concept of food security based on the experience of both pregnant women and experts, and then develop and validate the assessment tool for assessing food security in pregnant women. In this article, only the protocol of this study is discussed. This research is a mixed-method study with a sequential-exploratory approach, which will be conducted in two phases. In the qualitative phase, the concepts and dimensions of food security will be explained based on the experiences of pregnant women by using inductive content analysis. Data integrity will be guaranteed with five criteria of validity, verifiability, reliability, transferability, and authenticity. In the second phase, the primary tool will be developed based on Waltz and Basel's approach, and then it will be validated. The design of a specific tool for pregnant women, taking into account the cultural, economic, and social conditions of Iran, can be a practical solution to scientifically assess the food security status of pregnant women, so that the country’s policymakers and planners can take accurate and long-term steps towards improving the food security of Iran pregnant women, their health and that of the future generations by implementing basic policies.