Investigating the Association Between Food Insecurity and Mental Distress Among South Sudanese Refugees in Bidibidi Settlement, Uganda: A Research Protocol

Food insecurity is a pervasive challenge in refugee settings with significant implications for mental health. South Sudanese refugees in the Bidibidi settlement face protracted displacement and resource constraints. The association between food insecurity and mental distress in this context is not well characterised. This protocol outlines a study to investigate the prevalence of mental distress and its association with food insecurity among adult South Sudanese refugees in Bidibidi settlement. The specific objectives are to: 1) assess the prevalence of mental distress; 2) measure the level of household food insecurity; and 3) analyse the association between food insecurity and mental distress, controlling for socio-demographic factors. A cross-sectional, community-based survey will be conducted. A sample of adult refugees will be selected using multi-stage cluster sampling. Data will be collected via structured interviews using validated tools: the Household Food Insecurity Access Scale (HFIAS) and the Self-Reporting Questionnaire (SRQ-20) for mental distress. Socio-demographic data will also be collected. Analysis will involve descriptive statistics and multivariable logistic regression. As this is a protocol for a future study, no empirical findings are presented. The analysis will test the hypothesis that a higher degree of food insecurity is associated with increased odds of reporting mental distress. The study aims to generate evidence on the mental health burden and its link to food insecurity in a major refugee settlement. This will inform the understanding of how material deprivation impacts psychological wellbeing in humanitarian contexts. Findings will be used to recommend integrated programme interventions that concurrently address food security and mental health support within refugee response frameworks. Advocacy for strengthened food assistance and accessible mental health services will be prioritised. Food insecurity, mental distress, refugees, South Sudan, Uganda, Bidibidi settlement, public health. This protocol details a study designed to provide specific evidence on the food insecurity-mental distress nexus among South Sudanese refugees, an under-researched population. The findings are intended to inform humanitarian programming and public health practice in refugee settlements.