Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the
present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of
Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted
using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household
food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed
these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were
used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1 % (95 % CI 17·3, 23·2) were found
to be food secure, 35·5 % (95 % CI 32·0, 39·2) moderately food insecure and 44·4 % (95 % CI 40·8, 48·1) severely food insecure. Severe food
insecurity was associated with the respondent’s good self-reported health (OR 0·3, 95 % CI 0·2, 0·5), length of stay as a refugee (OR 1·1,
95 % CI 1·0, 1·2), very poor housing quality (OR 3·3, 95 % CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95 % CI 1·0,
1·4), and resulted in poor dietary diversity (P,0·0001). Anaemia was found in 41 % (95 % CI 30·6, 51·9) of children below 5 years of age,
but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi
refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.