Abstract
Background Until recently, Sri Lanka did not have a validated instrument with which to assess household food insecurity. The objective of this study was to adapt and validate the Household Food Insecurity Access Scale, which has been developed and used by the United States Agency for International Development's Food and Nutrition Technical Assistance project, in Sri Lanka. Methods This tool, Household Food Insecurity Access Scale, consists of nine questions which were adapted to the local setting with input and approval from both local content experts and target community members. The adapted tool was pretested and identified as the Household Food Insecurity Access Scale-Sri Lanka (HFIAS-SL) and was used to assess the household foodinsecurity. One hundred and fifty households from different socio-economic levels were purposively identified and included in the sample. Wealth index and household per capita income were assessed as indicators of socio-economic status. Food intake was assessed using a food group frequency questionnaire. Results Cronbach's Alpha was 0.879 (95% CI: 0.847 - 0.906) and scale question response curves were parallel across the socio-economic strata of the households. The two extreme levels, 'food secure' and 'severely food insecure' households, showed a statistically significant dose-response relationship (P Conclusion The Household Food Insecurity Access Scale-Sri Lanka is a valid tool to assess household food insecurity in Sri Lanka. DOI: http://dx.doi.org/10.4038/jccpsl.v19i2.7580 Journal of the College of Community Physicians of Sri Lanka 2014 June 19(2): 17-28
Highlights
Malnutrition is a multifaceted problem and its associated factors have been comprehensively illustrated in the UNICEF conceptual framework (1), where household food insecurity (HFI) is identified as an important underlying factor for malnutrition.Food insecurity is a complex multidimen-sional concept and measuring it has been an ongoing challenge to researchers and practitioners (2)
The distribution of the households by levels of household per capita income (HPCI), wealth index (WI) and HFI is presented in Table 2.Cronbach's Alpha for all nine questions was 0.879
The response curves for each stratum of the WI were parallel to each other and the percentage of 'yes' responses to each question decreased with increasing level of wealth index, and vice versa (Figure 1)
Summary
Food insecurity is a complex multidimen-sional concept and measuring it has been an ongoing challenge to researchers and practitioners (2) It has been assessed indirectly using energy balance sheets and child anthropometry. These approaches have not always been useful for guiding food insecurity, the need for the use of more direct experiential approaches (3) In response to this need, the Food and Nutrition Technical Assistance (FANTA) project of the United States Agency for International Development (USAID) has developed Household Food Insecurity Access Scale (HFIAS), a direct and user-friendly approach for measuring household food insecurity (2). The objective of this study was to adapt and validate the Household Food Insecurity Access Scale, which has been developed and used by the United States Agency for International Development's Food and Nutrition Technical Assistance project, in Sri Lanka
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