Abstract Objectives Massive influx of Rohingya refugees increases the risk of food insecurity in host communities in Bangladesh. This study explores intervention-related factors associated with food insecurity in the Bangladesh host households living near Rohingya refugees. Methods This secondary data analysis used the endline survey data from 660 host households who participated in the World Vision US Emergency Food System Security Project from 2019 to 2021. Logistic regression analysis was performed to explore the associations between program interventions and household dietary diversity score [HDDS: low (≤ 8) vs high (> 8)] and reduced coping strategy index [rCSI: high (> 3) vs. low (≤ 3)]. Results A total of 64.7% of households (n = 427) had low HDDS, and 10.6% (n = 70) had high rCSI. Purchasing food using cash transfer was associated with higher odds of high rCSI (adjusted odds ratio [AOR] = 2.10; 95% CI 1.25–3.53) and low HDDS (AOR = 1.57; 95% CI 1.13–2.18). Those who received food aid had higher odds of low HDDS (AOR = 3.16; 95% CI 1.69–5.89). Participants who farmed had lower odds of having high rCSI and low HDDS [AOR = 0.41 (95% CI 0.21–0.77) and AOR = 0.57 (95% CI 0.34–0.98), respectively]. Conclusion Our findings suggest that interventions focused on livelihood or farming training may yield the greatest reduction in food insecurity among host communities experiencing refugee influx. Humanitarian organizations should consider interventions that develop these farming skills over direct cash or food transfers to promote long-term self-sufficiency in the host population.

Background: Minimally invasive pancreatic surgery (MIPS), when selectively utilized, has been shown to hasten recovery with outcomes comparable to open approaches, but access may not be equitable. This study explored variation in utilization of MIPS for pancreatic cancer. Methods: The National Cancer Database was queried to identify patients diagnosed with a primary pancreatic neoplasm from 2010 to 2020. Study participants had diagnoses of clinical or pathologic stage 1-3 disease and received curative-intent surgery. Multivariable analyses assessed the association between surgical approach and patient and disease factors. Results: Inclusion criteria identified 73,137 patients: 51,408 underwent open surgery and 21,729 received MIPS. In our multivariable analysis, Black race was associated with reduced odds of MIPS (AOR 0.88; p = 0.02), while older age (AOR 1.17; p = 0.01), later year of diagnosis (AOR 1.57; p < 0.001), and private insurance coverage (AOR 1.30; p = 0.05) were associated with increased odds. When patients with adenocarcinoma were analyzed in isolation, disparities in MIPS utilization persisted even when controlling for disease stage. Conclusion: Sociodemographic factors like age, race, and insurance coverage appear to vary in the utilization of MIPS technologies for the treatment of pancreatic malignancy. Addressing variation with robust mixed methods approaches in the future is proposed to incorporate prospective interventions with highly annotated outcomes for additional study.

Background This cross-sectional study aimed to explore the association between cash voucher assistance on building community resiliency and improving food security among 1371 households (HH) living in northern and southern regions of Somalia. The secondary data analysis used endline data from participants in World Vision’s Emergency Food Security Program from May 2018 to May 2019. The participants received unconditional cash vouchers, conditional cash for work vouchers, and nutrition and livelihood trainings. Logistic regression analysis was conducted to explore the association between program interventions and food consumption score (FCS, borderline/poor: 0–35, acceptable: > 35) and reduced coping strategy index (rCSI, acceptable: 0–3, emergency/crisis: 4–56). Results A total of 41.5% of all HH that received cash vouchers reported borderline/poor FCS and 71.1% had emergency/crisis rCSI. Utilization of vouchers for food purchase (0.34; 0.23, 0.51) and purchase of more types of food for greater dietary diversity (0.70; 0.55, 0.89) were negatively associated with acceptable FCS. Participants who redeemed cash vouchers were less likely to have an emergency/crisis rCSI (0.68; 0.61, 0.76). Utilization of cash vouchers had a positive association with increased conflict within the HH (2.90; 1.29, 6.48). Participants reporting benefits from improved community rehabilitation through increased check dams were more likely to have acceptable rCSI (2.37; 1.45, 3.89). Conclusions Our findings suggest that interventions utilizing cash vouchers have to consider contextual factors in calculations of voucher entitlements, increase investment in water management and livelihood skills training, and expand nutrition and livelihood trainings to men and boys to foster women empowerment and improve food security outcomes.

Food systems in fragile contexts are hardly investigated. We examined the crop value chain activities, agriculture income, coping strategy, and food consumption score (FCS) among South Sudan refugees ( n = 394; refugee HH) and Uganda host communities ( n = 420; host HH) living on the northern border of Uganda. Secondary data analysis was conducted using baseline data collected from an NGO-supported project. Linear regression analysis was conducted to test the association between the type of crop for growing and selling, agriculture income, coping strategy, and FCS in the refugee HH and host HH, separately. The mean number of growing and selling crops was 2.7 (SD 1.7) and 0.6 (1.0) in the refugee HH and 3.6 (1.4) and 1.3 (1.1) in the host HH. Overall food insecurity and FCS was poor in both refugee and host HH. Larger land access was associated with diverse crop production and crop selling in both groups ( p < 0.05). The greater number of crop types grown was marginally associated with FCS in host HH only (β = 1.00; p = 0.05). Selling more types of crops was associated with agriculture income in both groups ( p < 0.05) and was not related to rCSI in either group, but marginally associated with FCS among only host HH (β = 0.84; p = 0.04). An inequitable food system existed between the host community and South Sudan refugees residing on the northern border of Uganda. The findings suggest that diversifying crops for selling and enhancing marketing channels could aid both host and refugee communities in establishing resilient food systems.