News


Focus on Nutrition Activities: Innovative Tools for Assessing Household Food Security and Dietary Diversity

“Did you worry that your household would not have enough food?”

“Did you or any household member go to sleep at night hungry because there was not enough food?”

These are just two of the nine key questions in the Household Food Insecurity Access Scale (HFIAS) for measuring households' access to food and their level of anxiety about obtaining enough food.

The HFIAS and the Dietary Diversity Score (DDS) are currently being adapted by nutritionists in Kenya, Malawi, and Mozambique, with technical assistance from FAO's Nutrition and Consumer Protection Division and support from the EC-FAO Food Security Programme.

These tools provide information about household food access and the diet quality of households and individuals. They

"The HFIAS and DDS aim at identifying food security problems at a much earlier stage so that there is time to plan appropriate interventions."

address a lack of simple tools for examining food access and the consumption situation within households. To compensate for this lack, information systems often rely on anthropometric indicators (such as wasting or underweight) which identify late-stage and non-specific outcomes caused by food deficits or poor utilization of food. The HFIAS and DDS, however, aim at identifying food security problems at a much earlier stage so that there is time to plan appropriate interventions.

Easy to use

The HFIAS and DDS have a limited number of questions and simple scoring techniques so they are easy to administer and analyze. Households can be quickly classified by their food access status and the degree of variety in their diets. Indeed, the strength of the HFIAS and the DDS is that standardized scores with a common interpretation can be derived from them. Thus, indicators can be compared among countries and different time periods.

However, concepts and customs related to food vary greatly within and among countries. Thus, the tools must be adapted to the context in which they will be used. For example, it is important to accurately use local terminology for concepts such as household, food, and lack of resources, as well as compile lists of locally available foods for the dietary diversity questionnaires. This is done in close collaboration with local key informants who help translate the questions and clarify their meaning so they make sense in the local context.

Spotlight on the Household Food Insecurity Access Scale (HFIAS): The HFIAS has nine questions that measure problems related to household food access including anxiety about procuring food, diet quality and diet quantity. Its classification system identifies a household's food access status by capturing the severity and frequency of experiences over the previous 30 days. Households are then classified as having: a) adequate food access b) a mild food access deficit c) a moderate food access deficit d) a severe food access deficit The HFIAS (originally developed by FANTA) has been adapted for use in Kenya , Malawi , and Mozambique by local nutritionists with technical assistance from FAO's Nutrition and Consumer Protection Division, in collaboration with the EC-FAO Food Security Programme and FANTA.

Example of discussion points key informants use when adapting HFIAS questions In order to make the questions very clear when translated into languages other than English, while maintaining a common meaning across countries, it is important to work with key local informants to: - make sure the questions are understood; - verify the appropriateness of specific terms; and - elicit local examples to help respondents give more accurate answers. An example HFIAS Q2: Were you or any household member not able to eat the kinds of foods you preferred because of a lack of resources? This question addresses one aspect of diet quality - having control over the kinds of foods that people eat. Kinds of foods you preferred refers to foods that food secure people eat and that food insecure people may not be able to afford to eat. A key informant might explain this question by saying: What are some examples of foods that food secure people eat that food insecure people cannot afford to eat? How do people here usually talk about a “lack of resources”? Is there a specific word in your language that can be used to mean “lack of resources?” This question asks whether preferred foods were inaccessible due to a “lack of resources.” A lack of resources means not having enough money or the ability to trade or grow the food one needs.

Spotlight on the Dietary Diversity Score (DDS): Dietary diversity is a key element of high quality diets and helps ensure adequate intake of essential nutrients. Studies have shown that dietary diversity is related to the nutrient adequacy of the diet, women and children's anthropometry and socio-economic status. The dietary diversity tools used in the EC-FAO Programme examine different food groups. The dietary diversity score consists of a simple count of food groups that a household or an individual consumed over the previous day and night. The percentage of households or individuals consuming specific types of foods, such as Vitamin A-rich fruits or vegetables, can also be obtained. FAO uses standard questionnaires for measuring household and individual dietary diversity. However, they need to be adapted to local conditions and local languages. This is especially important when compiling comprehensive lists of foods belonging to different food groups and making sure their common names are used.

Information for action

The simplicity of the questionnaires and the type of information they capture make them ideal for rapid assessments. Since they allow comparisons across time and space, they may be used for:

- situation and vulnerability assessments;

- monitoring change resulting from an intervention or policies;

- decentralized monitoring and planning;

- targeting specific households for food security interventions; and

- evaluating the outcomes of strategies and programmes such as nutrition education or crop and livelihood diversification.

The tools will be tested for their appropriateness in early warning and humanitarian crisis assessments as well. Dietary diversity has been included in the Integrated Humanitarian and Food Security Phase Classification (IPC).

The tools are not intended to be used alone but complement other indicators that measure food availability, access and utilization, and vulnerability to food insecurity. They may be used under the umbrella of larger food security information and classification systems already in place.

There is a great deal of interest in using the HFIAS and dietary diversity scale in Africa. The Nutrition and Consumer Protection Division of FAO has been in touch with several organizations currently integrating these tools into their surveys. These include a WFP livelihoods survey in South Africa and food security and nutrition surveys conducted by Wageningen University in Kenya, Uganda and Zambia. Current and potential users of the tools are encouraged to network in order to address technical matters and share their experiences.