How well does the Food Consumption Score capture diet quantity, quality and adequacy across regions in the Democratic Republic of the Congo (DRC)?

Abstract

The Food Consumption Score (FCS), a food frequency indicator developed by the World Food Programme (WFP) that aims to capture both diet quantity and quality of household food consumption, has been validated only against calorie intake in a limited number of rather small countries. This article examines the potential of FCS to capture variation in diet quantity and quality using the 2004/5 Household Consumption and Expenditure Survey (HCES) conducted in the DRC. In addition to quantifying the strength of association between FCS and a series of benchmark variables, a set of nutrient-consistent regional adequacy levels is proposed as an alternative to the standard WFP’s cut-off in identifying food insecure households. We point out several key issues. First, for a country the size of the DRC, but possibly in other settings too, it is necessary to adopt a geographically disaggregated approach to account for regional diversity in food systems and resulting diets. Second, FCS can indeed capture qualitative aspects of food consumption in addition to quantitative ones. Third, increasing the number of food groups, removing their associated weights or truncating their food group score does not structurally improve FCS’s correlation with the benchmark variables. Fourth, the WFP’s threshold is only weakly consistent in terms of nutrient adequacy, marginally relevant to each of the country’s regions and markedly less sensitive and specific compared to the set of nutrient-consistent regional thresholds, which we propose based on the empirical relation between FCS and the mean adequacy ratio (MAR). Lastly, despite several methodological challenges, this work demonstrates the potential use of HCES to conduct this sort of food security validation exercises.