Monthly food insecurity assessment in rural mkushi district, Zambia: a longitudinal analysis

Muzi Na,Bess L Caswell,Sameera A Talegawkar,Amanda Palmer

doi:10.1186/s12889-017-4176-0

Muzi Na, Bess L Caswell + Show 2 more

Open Access

https://doi.org/10.1186/s12889-017-4176-0

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Abstract

BackgroundPerception-based scales are widely used for household food insecurity (HFI) assessment but were only recently added in national surveys. The frequency of assessments needed to characterize dynamics in HFI over time is largely unknown. The study aims to examine longitudinal changes in monthly reported HFI at both population- and household-level.MethodsA total of 157 households in rural Mkushi District whose children were enrolled in the non-intervened arm of an efficacy trial of biofortified maize were included in the analysis. HFI was assessed by a validated 8-item perception-based Likert scale on a monthly basis from October 2012 to March 2013 (6 visits), characterizing mostly the lean season. An HFI index was created by summing scores over the Likert scale, with a possible range of 0–32. The Wilcoxon matched signed-ranks test was used to compare distribution of HFI index between visits. A random effect model was fit to quantify the sources of variance in indices at household level.ResultsThe median [IQR] HFI index was 4.5 [2, 8], 5 [1, 8], 4 [1, 7], 4 [1, 6], 3 [1, 7] and 4 [1, 6] at the six monthly visits, respectively. HFI index was significantly higher in visit 1 and 2 than visit 3–6 and on average the index decreased by 0.25 points per visit. Within- and between-household variance in the index were 10.6 and 8.8, respectively.ConclusionsThe small change in mean monthly HFI index over a single lean season indicated that a seasonal HFI measure may be sufficient for monitoring purposes at population level. Yet, higher variation within households suggests that repeated assessments may be required to avoid risk of misclassification at household level and to target households with the greatest risk of food insecurity.

Highlights

Perception-based scales are widely used for household food insecurity (HFI) assessment but were only recently added in national surveys
Research carried out in rural Bangladesh indicated that two or three repeated food insecurity assessments can reflect a static HFI status, with the degree of food insecurity remaining almost unchanged over a few months [12] to approximately one year [13]
Panel food insecurity data was missing for 10–27 households at each monthly visit (Fig. 1); no statistically significant difference was found between the included and excluded households in terms of socio-economic and demographic variables collected at baseline

Summary

Introduction

Perception-based scales are widely used for household food insecurity (HFI) assessment but were only recently added in national surveys. The study aims to examine longitudinal changes in monthly reported HFI at both population- and household-level. The proportion of households considered food insecure is the highest in Sub-Saharan Africa, where almost one in four individuals have inadequate dietary energy intakes [1]. Despite the utility of perception-based indicators of food insecurity and their increasing use in monitoring and program evaluation, little is known about the frequency of assessments required to adequately quantify longitudinal changes in HFI. Assessments in Sub-Saharan Africa conducted in lean and harvest months suggest seasonal variation in reported food insecurity status [14, 15]

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