Household Food Consumption

See Also: Food Aid; Food Security; Infant and Child Nutrition; HIV/AIDS; Assessments, Monitoring and Evaluation

Access to and consumption of adequate and appropriate food by households is an important component of food security. Improved access to food and other resources has significant implications for the success of USAID and PVO programs and achievement of measurable relief and development results. For PVOs, measuring access is problematic, due in part to a wide range of interventions and expected outcomes (e.g., improved roads and flow of goods, increased household incomes). Guidance is limited to assisting cooperating sponsor staff increase knowledge, selection, and measurement of access indicators, particularly at the field level. Moreover, existing tools have not been made widely available. Techniques such as 24-hour recall of food intake provide detailed data on food consumption at the household level, but are very time-consuming and expensive and require a high level of technical skill, both in collection and analysis.

In addition to the indicator guide designed to improve capacity to collect data using 24-hour recall techniques, FANTA is carrying out a set of activities aimed at developing and documenting user-friendly, cost-effective approaches to measure changes in food security, food access, and dietary quantity and quality at the household level. USAID and PVO stakeholders have identified this work as a high priority. The results from technical assistance, facilitation, and operations research will help USAID and its partners better address program monitoring and evaluation in this area and will influence future data collection instruments, such as the Knowledge, Practice, and Coverage (KPC) and Demographic Health Survey (DHS).

		A brief description of each publication is provided below. By choosing the publication title, you are able to read a detailed description and to download the publication.

1. Strengthening and Evaluating the Preventing Malnutrition in Children under 2 Approach (PM2A) in Burundi: Baseline Report(2012): This report presents the findings from the first of three cross-sectional baseline surveys to evaluate the impact of the Tubaramure program, a Preventing Malnutrition in Children under 2 Approach (PM2A) program being implemented in eastern Burundi. Tubaramure, a United States Agency for International Development (USAID) Title II food aid development program, has three core components: distribution of family and individual food rations; required participation of beneficiaries in a behavior change communication (BCC) strategy focused on improving health- and nutrition-related behaviors; and required use of preventive health services for pregnant and lactating women and children under 2 years of age.

2. A Single-Centre, Randomized, Single-Blind, Parallel Group Clinical Trial in Rural Malawi, Testing the Growth Promoting Effect of Long-Term Complementary Feeding of Infants with a High-Energy, Micronutrient Fortified Spread (2012): The low energy and nutrient content of complementary foods in low-income countries has been associated with growth faltering, increased morbidity, and delayed motor milestone acquisition. Complementation of diet in infancy and early childhood with lipid-based nutrient supplements (LNS) that have high nutrient and energy density has been suggested to improve growth and might also reduce morbidity. FANTA conducted a trial in rural Malawi to compare the incidence and prevalence of severe linear growth failure and symptoms of common childhood illnesses among infants receiving dietary supplementation with LNS, a corn-soy blend (CSB), or nothing.

3. Acceptability of Lipid-Based Nutrient Supplements and Micronutrient Powders among Pregnant and Lactating Women and Infants and Young Children in Bangladesh and Their Perceptions about Malnutrition and Nutrient Supplements (2012): FANTA and partners University of California-Davis; the International Centre for Diarrhoeal Disease Research, Bangladesh; and the World Mission Prayer League (LAMB Hospital) conducted an assessment of the acceptability of lipid-based nutrient supplements (LNS) and micronutrient powders (MNP) among pregnant and lactating women and infants and young children in Bangladesh. Two different flavored LNS products, and one MNP (for infants and young children only) were tested for each group through a 2-day test feeding trial and a 2-week take-home trial.

4. Haiti Prospective Food Security Assessment (2011): This food security assessment for Haiti describes and analyzes current and anticipated near-term food security trends in the country and the events, policies, and strategies shaping them to inform USAID planning and guidance development for FY 2012 Title II development food aid programs. The data and information in this report, including areas particularly vulnerable to food insecurity, are also meant to assist potential future Title II Awardees in designing the next round of development food aid program proposals in the country. USAID staff in Haiti and Washington, DC, and international and nongovernmental organizations, donors, and Government of Haiti (GOH) colleagues working on food security in Haiti may also find this report useful.

5. Household Hunger Scale (2011): FANTA, in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and Tufts University, developed the Household Hunger Scale (HHS), a field-practical method and simple tool to measure household food deprivation and compare data across cultures. The HHS can help improve geographic targeting of food insecurity interventions and monitoring and evaluation of food security policies and programs. The HHS will soon be an indicator for both the USAID Food for Peace program and Feed the Future initiative.

6. Acceptability of a Lipid-Based Nutrient Supplement among Guatemalan Infants and Young Children (2011): This study assessed the acceptability of lipid-based nutrient supplements (LNS) among children 6–18 months of age in Suchitepéquez, Guatemala. A new flavor (cinnamon) was developed and tested alongside the “regular” peanut LNS flavor. A 2-day test-feeding trial using a cross-over design was carried out to test both LNS flavors, followed by a 2-week home-use trial. LNS was mixed with a small quantity of home-prepared complementary food. The proportion of LNS consumed by the children, and the caregivers’ organoleptic preferences and perceptions of product use were assessed. The study concluded that both LNS flavors were acceptable in this population, with a tendency toward a higher acceptability for the peanut flavor.

7. Gender Integration in USAID Bureau for Democracy, Conflict, and Humanitarian Assistance Office of Food for Peace Operations (2011): This occasional paper, developed by FANTA with extensive input from FFP staff in Washington and at Missions, as well as from implementing partners, recommends various stages and steps to strengthen FFP and Title II Awardees’ capacity to integrate and mainstream gender in all FFP-funded activities. This guidance will enable FFP to develop a strategy on how to strengthen its capacity and understanding of gender mainstreaming and identifies milestones to monitor progress and evaluate results.

8. Household Hunger Scale: A Cross-Cultural Method to Measure Household Hunger (2011): After nine years of research and testing, FANTA, in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and Tufts University, has developed the Household Hunger Scale (HHS), a field-practical method and simple tool to measure household food deprivation that allows for valid comparison across cultures. The HHS can help improve geographic targeting of food insecurity interventions and M&E of food security policies and programs. The HHS will soon become a USAID Food for Peace required indicator, as well as a Feed the Future indicator.

9. CMAM Costing Tool (2011): Community-Based Management of Acute Malnutrition (CMAM) is an innovative approach for managing acute malnutrition in children within the community that enables early detection of cases, expanded access to treatment in decentralized sites, greater community involvement and support, and extended coverage. The CMAM Costing Tool is a Microsoft Excel-based application that estimates the costs of implementing CMAM at the national, sub-national, and district levels. The Costing Tool calculates the inputs and financial resources required to establish, maintain, or expand CMAM services. This information helps managers determine whether their plans for CMAM are financially feasible, identify the resources needed, and formulate an effective implementation plan. The Costing Tool can also support the promotion and management of CMAM services. Government or NGO stakeholders in a country or region where acute malnutrition is prevalent can use the CMAM Costing Tool to plan for implementation of specific CMAM components and forecast the resources required.

10. The Nutrition Program Design Assistant: A Tool for Program Planners (NPDA) (2010): This two-part tool was developed to help nutrition program planning teams design community-based nutrition programs. A simple Reference Guide and Workbook, the NPDA is best used in collaboration with a range of partners, including ministry staff, community leaders and representatives and local organizations. The NPDA provides a framework for programmers to analyze the nutrition situation and offers guidance for design teams to choose the most appropriate nutrition approaches based on the specific context and need. It also helps programmers avoid an approach that would be inappropriate or ineffective in the specific context.

11. Validation of a Measure of Household Hunger for Cross-Cultural Use (2010): This report describes the findings from a study carried out by FANTA in partnership with FAO and Tufts University.  The aim of the study was to evaluate the internal, external and cross-cultural validity of the Household Food Insecurity Access Scale (HFIAS), a 9 item 4 frequency measurement scale to assess the access component of household food insecurity in resource-poor areas. Statistical methods based on the Rasch measurement model were used to assess the validity of HFIAS data collected in seven diverse contexts: Mozambique (2 datasets), Malawi, West Bank/Gaza Strip, Kenya, Zimbabwe, South Africa.  The results of these analyses were then used to revise the HFIAS, as necessary.

12. Trigger Indicators and Early Warning and Response Systems in Multi-Year Title II Assistance Programs (2007): USAID's Office of Food for Peace (FFP) and FANTA have published FFP Occasional Paper 5, Trigger Indicators and Early Warning and Response Systems in Multi-Year Title II Assistance Programs to allow Cooperating Sponsors (CSs) a greater degree of flexibility in responding to emerging crises and shocks in their areas of operation without the risk of potentially undermining advances being achieved by development interventions. Occasional Paper 5 is designed to briefly review CSs' experiences with operationalizing trigger indicators (TIs) and early warning and response (EWR) systems to-date, outline the key characteristics of EWR systems and TIs within the Title II-supported multi-year assistance program (MYAP) context, and provide suggestions on how to best operationalize FFP guidance on incorporating EWR mechanisms, including TIs, into MYAPs.

13. Version 3 of Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide (2007): FANTA, in collaboration with Cornell and Tufts Universities, has developed a Household Food Insecurity Access Scale (HFIAS) measure and a guide, "Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide," with a standardized questionnaire and data collection and analysis instructions. The HFIAS is composed of a set of nine questions that have been used in several countries and appear to distinguish food insecure from food secure households across different cultural contexts. These questions represent universal domains of the experience of insecure access to food that can be used to assign households and populations along a continuum of severity. The information generated by the HFIAS can be used to assess the prevalence of household food insecurity (access component) (e.g., for geographic targeting) and to detect changes in the food insecurity situation of a population over time (e.g., for monitoring and evaluation). The questions can be added to a standard baseline and final evaluation survey. In August 2007, Version 3 of the guide was released. The new version offers an updated questionnaire section.

14. Household Dietary Diversity Score (HDDS) for Measurement of Household Food Access: Indicator Guide, Version 2 and Months of Adequate Household Food Provisioning (MAHFP) for Measurement of Household Food Access: Indicator Guide (2006): In light of the need to build consensus on household food access impact indicators, two strategic objective level indicators of household food access (HDDS) and months of inadequate household food provisioning (MIHFP) were identified during the development of USAID Office of Food for Peace (FFP)'s FY05-08 strategy, through a process of consultation and discussion with CSs, researchers, and other technical groups. These two indicators focus on the desired outcome of improved food access - improved household food consumption. FFP will be requiring all new Title II Multi-Year Assistance Programs (MYAP) with improved household food access as an objective to include these indicators in their results frameworks. In addition, a Household Food Insecurity Scale (HFIS) to measure the experience of household food insecurity is being tested for future inclusion as an indicator. These two indicator guides provide background on the indicator as well as guidance on data collection (including questionnaire format) and analysis.

15. Journal of Nutrition Supplement, May 2006: The Journal of Nutrition has been the principal forum for disseminating US-based research on food insecurity scales. It has also published most of the studies dealing with the application of food insecurity scales in developing countries. Publication of the process of developing the Household Food Insecurity Access Scale (HFIAS) offers the opportunity to continue this "conversation" by presenting, in one place, one of the most significant advances in food insecurity measurement to emerge over the last decade. The Journal of Nutrition Supplement, published in May 2006, presents the results of the FANTA-led HFIAS initiatives, including: findings of the first studies to develop and validate food insecurity scales from the "ground-up" in a developing country context; findings of the first cross-country study to compare the performance of the same set of food insecurity items in four dramatically different cultures; results of a cross-country review of food insecurity scale applications and its implications for the development of a universal measurement tool; and, status of the process to develop a universal measurement tool.

16. Measuring Household Food Consumption: A Technical Guide (2005): The guide describes the process and procedures for collecting information to assess the food intake requirements of a household and a step-by-step analysis of the food consumed. Appendices present detailed information about analyzing the data.

17. Measuring Household Food Insecurity Workshop II Report, October 2005 (2006): Following the initial 2004 workshop to develop the Household Food Insecurity Access Scale (HFIAS) for use by Title II and Child Survival and Health programs, a second FANTA workshop was held on October 19, 2005. This workshop was organized for participants to refine the Household Food Insecurity Access Scale (HFIAS) questionnaire, suggest approaches for creating meaningful indicators from the HFIAS data, and discuss a process for continued feedback and collaborative field validation of the HFIAS tool.

18. Measuring Household Food Insecurity Workshop Report (2004): During the past four years FANTA has supported activities to validate the US Household Food Security Scale (HFSS) for use in developing countries and test its usefulness as an impact indicator for the access component of food security in program evaluations. Cornell and Tufts Universities, Africare, World Vision and Freedom from Hunger have collaborated with FANTA in implementing these activities. In addition, a range of researchers and food security program managers have used and adapted the USDA approach in a number of countries in order to answer a range of different objectives. As a next step in the effort to develop simple, standardized, questionnaire-based approach to measure household food insecurity, FANTA held a two-day workshop of researchers, practitioners, USAID staff and FANTA staff. Participants at the workshop presented the results of the field validation work and took the initial steps in developing the Household Food Insecurity Access Scale (HFIAS) for use by Title II and Child Survival and Health programs. This report provides a description of the workshop and its findings.

19. Development and Validation of an Experience-based Tool to Directly Measure Household Food Insecurity Within and Across Seasons in Northern Burkina Faso (2004): FANTA funded two multi-year field validation studies that used the HFSS approach to develop experiential food insecurity scales and validate them primarily as impact indicators for the access component of household food security (see Measuring Food Insecurity: Going Beyond Indicators of Income and Anthropometry below). The objectives of the studies were to develop a household food access measure (Household Food Insecurity Scale: HFIS) based on locally recognized behaviors that distinguish food insecurity in developing countries, test the HFIS's relationship to conventional indicators of food insecurity (such as income or food consumption), and test the HFIS's performance and sensitivity to change related to program impact.

20. Local Capacity Building in Title II Food Security Projects: A Framework (2004): This paper establishes a conceptual framework for local capacity building within food security projects. It is designed to provide Title II policy-makers and cooperating sponsors with a basic reference tool for the design, implementation, monitoring and evaluation of projects’ capacity building activities at the local level. This framework builds on the USAID food security framework, in which food availability, access and utilization constitute the three pillars of food security.

21. Measuring Food Insecurity: Going Beyond Indicators of Income and Anthropometry (2003): FANTA funded two multi-year field validation studies that used the HFSS approach to develop experiential food insecurity scales and validate them primarily as impact indicators for the access component of household food security (see Development and Validation of an Experience-based Tool to Directly Measure Household Food Insecurity Within and Across Seasons in Northern Burkina Faso above). The objectives of the studies were to develop a household food access measure (Household Food Insecurity Scale: HFIS) based on locally recognized behaviors that distinguish food insecurity in developing countries, test the HFIS's relationship to conventional indicators of food insecurity (such as income or food consumption), and test the HFIS's performance and sensitivity to change related to program impact.

22. Food Access Indicator Review (2003): The measurement of food access is critical to food security programming. However, for most Title II Cooperating Sponsors, determining changes in food access has not been easy, particularly because appropriate indicators are not standardized and are hard to measure and interpret. Guidance and tools to assist in measuring access indicators are limited or not readily available to the field. The objective of this study was to review how Title II Development Assistance Programs designs address food access, assess how Title II PVOs currently monitors and evaluates food access and identify good measurement practices. The results of the review will provide the basis for a follow-on food access monitoring and evaluation guide to be used by CS field staff.

23. Dietary Diversity as a Household Food Security Indicator (2002): Both the report and the technical note describe a user-friendly, cost-effective approach to measuring changes in dietary quantity and quality and feeding behaviors at both the household and individual levels. Dietary diversity, defined as the number of unique foods consumed over a given period of time, appears to show promise as a means of measuring food security and monitoring changes, particularly when resources for such measurement are scarce. As described in the report, FANTA's subcontractor, the International Food Policy Research Institute (IFPRI), analyzed ten household data sets (collected in India, Mozambique, Mexico, Bangladesh, Egypt, Mali, Malawi, Ghana, Kenya and the Philippines) to assess whether dietary diversity can be used as a tool in evaluating the efficacy of food security interventions. The study validated the dietary diversity indicator as a measure of access to food (per capita expenditures) and a measure of consumption (caloric availability at the household level).

24. Building Household Food Security Measurement Tools from the Ground Up (2001): Wolfe and Frongillo's paper explores the potential to develop improved measures of the access component of household food security. The report discusses relevant conceptual and measurement issues and reviews the U.S. approach and examples of efforts in developing countries. It includes an outline of the elements needed to apply this approach, along with operations research needed for developing such experiential-based measures.

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*Please note that links to these sites do not imply that FANTA supports either the organization listed or the views and content presented.

United Nations Food and Agriculture Organization (FAO) Food Insecurity and Vulnerability Information and Mapping System (FIVIMS) [http://www.fivims.net/index.jspx?lang=en]
FIVIMS is an Inter-agency initiative to promote information and mapping systems on food insecurity and vulnerability.

United Nations Food and Agriculture Organization (FAO) International Network of Food Data Systems (INFOODS) [http://www.fao.org/infoods/index_en.stm]
The INFOODS website aims to mobilize resources for improving the quality, quantity and accessibility of food composition data in the developing world. Regional data bases have been prepared and developing countries are able to interchange data with each other.

U.S. Department of Agriculture (USDA) Food and Nutrition Service [http://www.fns.usda.gov/fsec/default.htm]
Very useful site from Eldis, a gateway to on-line information on development in countries of the South. Coverage includes social, economic, political and environmental issues. Major annual reports of relevant institutions can be accessed as well. The site has a simple search engine, but also features pre-prepared searches on a variety of topics (debt relief, agricultural marketing, etc.) and illustrative stories to put these topics into context.

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