How geographical access shapes relationship between food security indicators and nutritional status in Indonesia

Introduction: Evidence-based food security interventions are more likely to be effective and impactful. Despite substantial investments in food and nutrition programmes, empirical evidence connecting community-level food security conditions with nutrition status across diverse rural contexts remains limited. This study aimed to link key food security indicators with nutritional status to support more targeted interventions. Methods: Cross-sectional household surveys were conducted in 2023 among 1,016 farming households across 36 rural villages in South Sumatra, South Sulawesi, and East Nusa Tenggara, Indonesia, categorised as high, moderate, and low geographical accessibility. Anthropometric data were collected from mothers in the household, with body mass index (BMI) representing nutritional status. Five key food security indicators that measured food availability, access, and utilisation were analysed: food source, household food insecurity, food expenditure share, dietary diversity, and nutrition knowledge. Pearson’s chi-square test assessed associations between BMI and the indicators within each accessibility group; significant indicators were identified as key determinants. Results: Food source, particularly reliance on homegrown foods, was a key determinant of nutritional status in low-accessibility villages. In moderately accessible villages, nutrition knowledge and food expenditure share were significantly associated with BMI. No significant associations emerged in highly accessible villages, suggesting more complex food environments in periurban settings. Conclusion: Geographical accessibility shapes the determinants of nutritional status. Recommended interventions include enhancing subsistence food production in low-accessibility areas, strengthening financial and nutrition literacy in moderately accessible areas, and expanding nutrition education in highly accessible areas. Tailored approaches can improve the effectiveness of food and nutrition programmes across rural Indonesia.