Evaluating pictorial charts as a means of collecting participant-recorded data on household dietary diversity in low-literacy communities in Tanzania.

Julia De Bruyn,John Msuya,Elaine Ferguson

doi:10.1017/s0007114519002587

Abstract

Innovative methods to collect dietary data at multiple times across the year are needed to better understand seasonal or temporal changes in household diets and measure the impact of nutrition-sensitive agricultural programmes in low-income countries. The present study aims to validate a picture-based research tool for participants to self-record their household's dietary diversity each month in villages of Manyoni District, Tanzania. Pictorial record charts were developed to reflect local food resources. In 113 randomly selected households, the person responsible for food preparation was trained to mark all items consumed by any household member within the home, or prepared for consumption outside the home, for a single recording day. The next day, an interview-based household 24-h food recall (H24HR) was collected for the same period. Separate analyses tested agreement (a) between picture charts and H24HR and (b) between H24HR following chart completion and on an alternative day. Concordance between methods differed between food groups and items but was high to very high for all cereals, vegetables, pulses, legumes and nuts and almost all fruits. Recording of ten items (including non-cultivated fruits and ingredients of mixed dishes) differed significantly between H24HR assessments, all of which were reported by more households in interviews following chart completion. Results suggest potential for visual prompts and the contemporaneous nature of data collection to improve the accuracy of interview-based recall. With adequate investment in developing and implementing context-adapted tools, pictorial charts may also offer an effective standalone method for use at multiple time-points in agricultural programmes.

Highlights

With approximately 2·5 billion people involved in smallholder farming[1], opportunities for agriculture to influence human diets have long been a focus of international development efforts
Indicators of improved food access, food consumption and dietary adequacy are proposed to be closer to the plausible measurable impact pathways for agricultural programmes than changes in child stunting, which has multiple non-dietary causes[8]
Alternative approaches relate to measures of dietary diversity, whereby the number of different food groups or individual food items consumed over a given reference period is recorded[10,11,12]

Summary

Introduction

With approximately 2·5 billion people involved in smallholder farming[1], opportunities for agriculture to influence human diets have long been a focus of international development efforts. The effectiveness of any method in documenting diets relies on an understanding of the full spectrum of food resources in a given setting and is aided by development of or access to existing locally adapted food lists These may include non-cultivated plants, undomesticated animals and insects which are utilised to varying degrees according to demographic, sociocultural and seasonal influences[16]. Estimates of the accuracy of dietary assessments in low-income countries are limited and may face challenges associated with cultural and linguistic differences, a heightened power imbalance between investigators and participants and unfamiliarity with processes of and motivations for data collection[20] Innovative technologies, such as wearable cameras, offer value in enhancing the quality, objectivity and efficiency of data collection, but their feasibility and validity in rural settings in low-income countries remain under investigation

Methods

Results

Conclusion