African Journal of Public Health and Health Systems | 18 May 2008
An Intervention Study on Depression and Food Insecurity Among Elderly Social Grant Recipients in Windhoek's Informal Settlements
J, o, h, a, n, n, e, s, !, G, a, r, o, ë, b, ,, N, d, a, p, e, w, a, K, a, m, b, a, t, u, k, u
Abstract
Elderly residents of informal settlements in sub-Saharan Africa face significant health challenges. In Namibia, elderly social grant recipients are a vulnerable group, but the prevalence of depression and its link to food insecurity in this population is not well documented. This study aimed to determine the prevalence of depression and its association with food insecurity among elderly social grant recipients in Windhoek's informal settlements. A further objective was to implement and evaluate a community-based intervention combining nutritional support with group psychosocial sessions. An intervention study used a pre-test/post-test design. A baseline survey assessed depression (using the PHQ-9) and food insecurity (using the HFIAS) among a random sample of grant recipients aged 60 and above. Participants were enrolled in a six-month intervention comprising monthly food parcels and weekly peer-facilitated support groups. Post-intervention assessments measured changes in depression scores and food security status. Quantitative data were analysed using paired t-tests and regression models. At baseline, 42% of participants met the criteria for probable depression, and 68% experienced moderate or severe food insecurity. A significant positive association was found between food insecurity and depression scores. Post-intervention, there was a statistically significant reduction in mean depression scores and a 35% decrease in the proportion of participants experiencing severe food insecurity. The findings confirm a high burden of depression and food insecurity and a strong association between the two. The integrated intervention was feasible and showed promise in simultaneously improving mental health and food security outcomes in this setting. Programmes for elderly grant recipients should integrate mental health and nutritional support. Policy makers should consider scaling up community-based, peer-supported models within social protection systems. Further research is needed to assess long-term sustainability and cost-effectiveness. Depression, food insecurity, elderly, social grants, intervention study, informal settlements, Namibia. This study provides evidence on the co-occurrence of depression and food insecurity among a vulnerable elderly population in Namibia and demonstrates the potential of an integrated community-based intervention to address both conditions.