A Sustainability Challenge Food Security for All: Report of Two Workshops (2012) / Chapter Skim
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[Part I]: ANNEX A: WHAT DO WE REALLY KNOW? METRICS FOR FOOD INSECURITY AND MALNUTRITION
[Part I]: ANNEX A: WHAT DO WE REALLY KNOW? METRICS FOR FOOD INSECURITY AND MALNUTRITION
Pages 87-124
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From page 87... ...
published an estimate of hunger in 12 sub-Saharan African countries. Based on an analysis of household surveys the authors found that in the late 1990s 59 percent of the population was food energy deficient (Smith et al., 2006)
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The second purpose relates to chronic food insecurity, caused by long term food deprivation linked to structural poverty and poor nutrition. One such indicator is "undernourishment", a measure of ‘chronic food insecurity, in which food intake is insufficient to meet basic energy requirements on a continuing basis' (FAO, (SOFI, 1999)
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The first, used by FAO, calculates food available for human consumption from national food balance sheets (FBS) and uses different information sources for a statistical measure of dispersion to approximate the distribution of food consumption levels within countries.
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depicts the proportion of the population corresponding to different dietary energy consumption levels (x) , µx the mean dietary energy intake per person and rl the minimum acceptable dietary energy requirement (MDER)
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It is noted that the indicator measures food available for human consumption at the household level, and not actual food intake. However, FAO considers it to be a close enough approximation of actual dietary energy consumption.
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in the world and thus facilitate global and regional governance of food security, while also advocating for stepped up efforts in hunger reduction. The indicator measures chronic food insecurity at national levels.
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intervals between publications of the indicator make such ‘over-interpretation' more likely. Various authors have also criticized methodological issues, including the focus on food energy, the compilation of the dispersion of the intra-national distribution of food consumption and the standards used for calculation of minimum dietary requirements.
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As the dietary energy supply includes foods, which are subsequently lost or wasted at the retail and household levels, the method by definition overestimates the actual food energy intake.
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hypothesis that people's food consumption is not only influenced by income, but also by their age/sex specific energy requirement. The following formula is used to calculate the CV: where CV(x)
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between the early 1980s and the mid 1990s; since then trends are more heterogeneous.4 Secondly, even if the relative income distribution remains unchanged while average incomes grow, the food demand will grow faster in the lower income brackets due to their higher demand elasticity. This alone would make it likely that the CVs of food consumption would decline as average incomes and food consumption grow; similarly, one would presume that drastic rise in global food prices, as witnessed in 2007/08 and again 2010 would have a differential impact on food consumption patterns of different income groups, thereby affecting the CV.
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He suggests therefore replacing the singular cutoff point by a bivariate distribution according to which the probability of an individual not meeting the food energy requirements is not only determined by the distribution of food intake but also by the covariance between food energy intake and requirements. According to Svedberg, following this approach would as such result in a notably higher incidence of undernourishment.
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. This discussion underlines the importance of further research on the best way of accounting for the non-determinate nature of food energy requirements.
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The latter will be done in the subsequent parts of this paper. The basic problem associated with the FAO method is presumably not the choice of the theoretical approach, but uncertainties and gaps in the data base and parameters.
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3. HOUSEHOLD CONSUMPTION SURVEYS Survey Format Useful for Nutritional Analyses Surveys conducted with the purpose of measuring household living standards usually contain a module on household expenditures.
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First, food consumption is measured where it actually occurs, so that fewer assumptions about lacking data on agricultural production, trade, post-harvest losses and non-food uses have to be made. Commonly, household consumption surveys use 14 or 30 day recall periods for food items.
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Moreover, in addition to merely describing the situation of food insecurity, causes and determinants of undernourishment can be analyzed, because consumption and living standard surveys also include data on a multitude of socioeconomic household characteristics, such as educational levels, occupation, ethnicity, and infrastructure conditions, among others. Likewise, food consumption data can be used to determine the income and price responsiveness of food energy and nutrient consumption, which is crucial in order to predict nutritional impacts of policies and external shocks (Behrman and Deolalikar, 1987; Ecker and Qaim, 2010)
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Overall Assessment of the Consumption Survey Based Approach The household survey based approach has several advantages over the FAO method, especially in terms of the micro level data being used, which captures household food availability and access much better than is possible with food balance sheet data and distributional assumptions. Analysis based on household consumption surveys also yields more actionable information, because the results can be presented in a disaggregated way and used for policy analysis and predictions of nutritional impacts of shocks and policy changes at subnational levels.
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4. ANTHROPOMETRIC MEASUREMENTS While the first two approaches to measuring food insecurity and malnutrition essentially measure inadequate food consumption at household level as a proxy of poor nutritional status of a population, anthropometric measures assess the nutritional outcomes at the level of the individual.
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For a number of conceptual and technical reasons (see WHO, 1995) , this standard was seen as problematic and in 1994 WHO decided to undertake a multi-center child growth study to derive a new reference standard (WHO, 1999)
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than household survey based assessments of food consumption discussed above. Unfortunately, DHS and MICS cannot be 12 The complete and selected sample of micro data is not yet available beyond the research team that contributed to the new sample so that one cannot precisely identify possible biases that might have arisen from the selection procedures.
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have made anthropometric data particularly widely available in a highly standardized format so that monitoring of childhood anthropometry using these indicators is feasibly across space and time in ways that is currently not possible using household food consumption-based methods. Disadvantages of Using Anthropometric Measurements Despite these advantages, there are a range of issues and problems associated with the use of anthropometry as indicators of childhood undernutrition.
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. Fifth, while the surveys used to measure anthropometric shortfalls are quite comprehensive, they lack some critical covariates to better analyze the determinants of food insecurity and undernutrition.
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If we believed the difference is 3 percent, South Asia's rate of undernutrition in 1990 would have been below the rate observed for Sub-Saharan Africa in that year, where there is little evidence of a similar genetic difference in the growth of children, compared to the USA.16 Thus a large share of the South Asian undernutrition enigma would simply disappear if the reference standard differed by just a minor amount.17 The data used to create the new standard shed an interesting light on possible inter-population differences in child growth, suggesting that (small) genetic differences appear to exist but which needs further research.18 For example, from 14 This was supported by studies showing that the difference in growth and weight gain between privileged children from developing countries and the US reference standards were very small (Martorell et al.
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5. COMPARING THE THREE METHODS Contradictions and Complementarities between Indicators We already commented above on the apparent incongruence between assessment of food insecurity based on the FAO method and food expenditure/consumption based methods for a sample of Sub-Saharan African countries.
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20 Thus major unanswered questions remain regarding the actual regional distribution of food insecurity and undernutrition and much may be related to the shortcomings of the various indicators which we discussed above. 20 As already mentioned above, there is a second South Asian enigma referring to the very slow improvements in anthropometric indicators despite rapid economic growth and poverty reduction.
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350 SubSaharanAfrica South Asia Caribbean 300 Other 250 Under five mortality rate 200 150 100 50 0 0 10 20 30 40 50 60 Share Underweight FIGURE I A-5: Childhood underweight and under five mortality rates 2000. SOURCE: Klasen (2008)
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TABLE I A-1: Performance of three assessment approaches as currently in use with respect to different criteria Criterion Undernourishment Consumption Anthropometry (FAO approach) survey Ability to draw a regular picture for total global, ++ - + regional and national populations Ability to draw a regular picture for special - - ++ population groups at global level Usefulness to assess inequality of food -- ++ -consumption within countries Usefulness to assess consumption consistent with ++ - -national supply and demand Accuracy in terms of measuring the adequacy of + ++ -food intake Accuracy in terms of measuring and identifying - + ++ determinants of nutritional status at a point in time Accuracy in comparing nutritional status across -- + ?
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In the longer term, a regular availability of results from representative surveys could greatly enhance the worldwide information on food insecurity and malnutrition and reduce the need for additional indicators derived from macro food balance sheets. However, even if this suggestion is followed, data availability would only improve gradually.
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In our view, the most important ones are the following: Data availability: Improvements are required, especially with respect to nationally representative household consumption surveys, which are usually integrated in more comprehensive living standard surveys. Such living standard surveys with sufficiently disaggregated food consumption modules should be carried out more frequently, and in a larger number of countries, to improve the micro level information base.
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Indeed, while information on the depth of hunger is of great interest for comprehensive assessments of the state of food insecurity, compiling such an indicator can only add value if the estimates are derived from empirical data with regard to people's real consumption and not from assumptions about the intra-national inequality of food consumption. More research is needed in this field and a resumption of depth of hunger compilations could be considered once the compilation and regular updating of empirically reliable CVs of food consumption has been completed.
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A complete inventory of estimates of relevant national indicators of food insecurity and malnutrition should be established, published, and regularly updated. This could not only include the main indicators, the food balance sheet approach of FAO, household surveys and anthropometry, but also, as available, other useful indicators such as micronutrient deficiency and dietary diversity.
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• Reconcile data on food consumption derived from FBS and from household surveys. In principle, mean levels of consumption per person derived, respectively, from national FBS on and from representative household surveys should be similar.
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We believe that this is possible through improved data and methodological approaches. While in the short run, an improved FAO method may be used, we argue that, in the longer run, global measures of food insecurity and malnutrition should increasingly be based on household surveys that combine food consumption and anthropometric measurements.
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2010. Review of food insecurity assessment and trends in India and the provinces.
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2010. The State of Food Insecurity in the World.
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2000. The Nutritional Status of Elites in India, Kenya, and Zambia: An appropriate guide for developing reference standards for undernutrition?
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2006. Food Insecurity in Sub-Saharan Africa: New Estimates from Household Expenditure Surveys, IFPRI (International Food Policy Research Institute)
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1983. Measuring Change in Nutritional Status.
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