| Summary: | Achenef Motbainor, Alemayehu Worku, Abera Kumie School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Background: Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia. Materials and methods: This was a community-based comparative cross-sectional study conducted May 24–July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia’s Productive Safety Net Programme was used for grouping the study areas. A food-security access scale developed by the Food and Nutrition Technical Assistant project was used to measure food security. Sociodemographic data were collected using a structured questionnaire. A binary logistic regression model was used to assess the association of food insecurity and maternal undernutrition. Results: From the total participants, 12.6% (95% confidence interval [CI] 11.6%–13.6%) had a body mass index (BMI) <18.5 kg/m2. Comparison of maternal undernutrition in the two study areas revealed 8.8% (95% CI 7.6%–10.2%) in the program area and 16.4% (95% CI 14.8%–18.1%) in nonprogram areas were undernourished. Severe food insecurity was ­significantly associated with BMI of mothers (adjusted odds ratios [AORs] 3.6 and 2.31, 95% CI 2.32–5.57 and 1.52–3.5, respectively) in both program and nonprogram areas. Mild (AOR 1.77, 95% CI 1.21–2.6) and moderate (AOR 1.6, 95% CI 1.18–2.16) food insecurity significantly associated with maternal undernutrition in nonprogram areas. In the same way, all forms of food insecurity significantly associated with maternal middle upper-arm circumference in both program and nonprogram areas. The odds of mothers who did not exercise decision-making practice on the household income was also 4.13 times higher than those who did (AOR 4.13, 95% CI 2.2–7.77) in the program area.Conclusion: Food insecurity significantly associated with both maternal BMI and middle upper-arm circumference in both study areas. Female authority also significantly associated with BMI of the mothers in the program area. Maternal nutrition-intervention programs should focus on women-empowerment strategies that enable them to decide on the income for household-nutrition provision. Keywords: food insecurity, undernutrition, BMI, MUAC, Ethiopia, food-security, maternal nutrition
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