Chowdhury 8 introduction to key indicators

• 1. Measurement and Interpretation TRAINING COURSE ON ASSESSMENT OF NUTRITIONALSTATUS,National Food Policy Capacity Strengthening Programme (NFPCSP) 21 December 2011 Presentation by: Nusha Choudhury, WFP

2. Measuring Dietary DiversityThe gold standard tomeasure dietary diversity Costly is through measuringRequiresvarious food itemsTechnicalTimeconsumed by anexpertise consumingindividual or a household in energy or kilocalorieterms. Alternate/Proxy IndicatorsHousehold/Individual Food ConsumptionDiet Diversity Score/FCSScore/HDDS/IDDS 3. Household & Individual Diet Diversity Score(HDDS/IDDS) Measures no. of different food groups consumed over a givenreference period i.e. 24 hours/1 day (FANTA/USAID). HDD is also a proxy for hhs socio economic status. Whereas IDDis purely a proxy measure of an individuals quality of diet.12 Food Groups in HDD,8 Food Groups in IDD (Children),(Score: 0-12) (Score: 0-8)1. Cereals Roots and tubers 1. Grains, roots or tubers2. Vegetables 2. Vitamin A-rich plant foods3. Fruits3. Other fruits or vegetables4. Meat, poultry, offal5. Eggs 4. Meat, poultry, fish, seafood6. Fish and seafood 5. Eggs7. Pulses/legumes/nuts6. Pulses/legumes/nuts8. Milk and milk products 7. Milk and milk products9. Oils/ fats 8. Foods cooked in oil/fat10. Sugar/honey11. Miscellaneous 4. General Rules for HDD & IDD Data Collection Data should be collected during the food shortageperiod of the year. Recall period is 24 hours. The 24 hour recall period has to be anormal/usual food consumption day for thehousehold/individual. Generally for HDD food items consumed outsidethe house should not be included, unless it is acommon practice for majority of the householdmembers. 5. HDDS Calculation Step 1: Assign 1 if the food group/item consumed; 0not consumed. Sum all the scores for various foodgroups. Sum will be between 0-12. Step 2: The average HDDS for the sample populationSum HDDS Total no. of householdsSetting HDDS Threshold:Option 1: From a baseline survey take the HDDS for therichest income tercile (33%).Option 2: From a baseline survey take HDDS of the uppertercile (33%) of diet diversity. 6. Food Consumption ScoreFCS is a frequency weighted diet diversity score for ahousehold or an individual over past 7 days. Here the scoreis calculated using the frequency of consumption ofdifferent food groups by (WFP). Key features of FCS Total 9 food groups are considered. Consumption frequency by various food groups are recorded over 7 days recall basis. Consumption less than 10 grams/1tea spoon are not considered. Each food groups are assigned weights based on their micro and macro nutrient content. 7. Food Groups & Weights in FCSFood groupsWeight FOOD ITEMS (examples)(definitive) (definitive)Rice, wheat, maize , maize porridge, sorghum,millet pasta, bread and other cereals1 Main staples2Cassava, potatoes and sweet potatoes, othertubers, plantains2 Beans. Peas, groundnuts and cashew nutsPulses 33 Vegetables, relish and leavesVegetables 14 FruitsFruit 15 Beef, goat, poultry, pork, eggs and fishMeat and fish 46 Milk yogurt and other diary Milk47 Sugar and sugar products Sugar 0.58 Oils, fats and butterOil 0.5spices, salt, fish power, small amounts of milk for9 Condiments0tea. 8. FCS Calculation Group all the food items into specific food groups. Sum all the consumption frequencies of food items of the same group, and recode the value of each group above 7 as 7. Multiply the value obtained for each food group by its weight and creates new weighted food group scores. Sum the weighed food group scores, thus creating the food consumption score (FCS). Using the appropriate thresholds (see below), recode the variable food consumption score, from a continuous variable to a categorical variable. FCSProfiles0-21Poor21.5-35 Borderline> 35Acceptable 9. Bangladesh Specific FCS Given the importance of oil and fish in the diet of theBangladeshi people, the general thresholds wereelevated. As a result, FCS thresholds were revised forBangladesh (HFSNA 2009):Poor consumption (28),Borderline Consumption (>28 and 42),Acceptable Consumption (>42),An additional threshold was introduce todistinguish the acceptable households betweenacceptable low (43-52) and acceptable high (>52). 10. Diet Composition by FoodConsumption Score in BangladeshSugar, Molasses (gur)Cumulative no. of days of consumption56FruitsMilk&Milk product49Pulses (mansur, kesari, etc)Meats&Fish42VegetablesEdible oil35Cereals&Tubers282114 7 0 0 2943 53 Poor BorderlineAcceptableAcceptable high lowFood Consumption Score 11. Comparative Advantages of theTwo Scores HDD has more food groups FCS records frequency ofthan FCS therefore prevents consumption whichunder reporting.prevents over reporting. Short recall periods are more 7 days recall period providesreliable.a habitual food Easy to collect, enumeratorsconsumption.do not need extensivetraining . Disregards small quantities More suitable for rapid of consumption which overassessments duringrates the consumption.emergencies. Suitable for in depth food A child IDD module is security assessment.available. 12. Research findings on the two scores Gina Kennedy et al. conducted a study in Burkina Faso, LaoPDR, N. Uganda and found correlation between HDDS & FCSwere significant in all three countries. The best correspondence identified based in this study FCS 21 corresponded to HDDS between 2 & 3. FCS 35 corresponded to HDDS slightly higher than 3. FCS and HDD demonstrated similar strength of correlationwith other food security indicators.IFPRI research found that combination of frequency anddiversity in FCS correlates better with household energy intakethan only diet diversity (based on three countries)Another IFPRI research revealed that weighted FCS do not haveadded advantage over un weighted FCS in terms of relationshipto energy intake, unless they are locally adjusted. 13. Research findings on linkagebetween FCS & anthropometricmeasures P