The purpose of this study was to determine the magnitude and determinants of urban household food insecurity in East Africa.

Systematic review and meta-analysis.

Studies conducted in East Africa.

Seventeen studies (fifteen cross-sectional and two cohort) that enrolled 156 996 households. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL, African Journals OnLine, Web of Science, Scopus and Google Scholar; date of last search: 10 June 2020) for studies reporting the prevalence and associated factors of urban household food insecurity.

A total of 17 studies with 156 996 households from 8 countries were used for the analysis. The pooled prevalence of urban household food insecurity in East Africa was 60·91 % (95 % CI 47·72, 74·11; I 2 = 100 %; P < 0·001) where the highest (91 %) and lowest (36·5 %) was observed in Sudan and Burundi, respectively. Household head educational status (illiterate) (AOR = 2·53; 95 % CI 2·11, 2·95, I 2 = 90 %; P < 0·01), female as household head (AOR = 1·45; 95 % CI 1·16, 1·75; I 2 = 0·0 %; P = 0·993), large family size (AOR = 1·43; 95 % CI 1·09, 1·76, I 2 = 0·0 %; P = 0·863) and poorest wealth quantile (AOR = 3·95; 95 % CI 1·93, 5·98; I 2 = 57·2 %, P = 0·053) were factors which significantly increased odds of urban household food insecurity in East Africa.

The prevalence of urban household food insecurity in East Africa remains high. Therefore, policies and intervention programmes should be designed to reduce the high burden of food insecurity among urban households considering the identified factors.