Longitudinal Investigation of the Relationship Between Household Food Security, Maternal Nutrition, and Child Development Outcomes in Rural Sokoto State, North West Nigeria

The relationship between household food security, maternal nutritional status, and child developmental outcomes involves complex bidirectional and temporal dynamics that cross-sectional research cannot adequately capture. In rural Sokoto State, where food insecurity, maternal undernutrition, and child developmental delays co-occur at high rates, longitudinal investigation is critically needed. This study conducted a longitudinal investigation of these relationships over a 24-month period in rural communities of Sokoto State, North West Nigeria. A prospective cohort of 350 pregnant women was enrolled in the third trimester and followed through 18 months postpartum. Household food insecurity was assessed biannually using the Household Food Insecurity Access Scale. Maternal nutritional status was evaluated quarterly through anthropometry and biomarker analysis for iron, folate, and vitamin A. Child developmental outcomes at 12 and 18 months were assessed using validated developmental milestone tools adapted for the Hausa cultural context. Growth status was monitored using WHO standards. Generalised estimating equations and growth curve models were applied to account for repeated measures and clustering. Results demonstrated that persistent household food insecurity across gestation and infancy was associated with 2.6-fold increased risk of delayed developmental milestones at 18 months. Maternal anaemia at 28 weeks significantly predicted child stunting at 12 months. Improvements in household food security were associated with improved maternal micronutrient status and mitigated developmental delay risk. Keywords: household food security, maternal nutrition, child development, Sokoto State, longitudinal study