Valid and timely nutrition assessment is the foundation on which effective interventions and programmes can be built to improve the food and nutrition situation of people. Standardized indicators are crucial for making cross-country comparisons and estimating trends.

The Nutrition Assessment and Nutrient Requirements Group of the Nutrition and Consumer Protection Division of FAO promotes the use of simple assessment indicators for measuring dietary consumption and food security.

Because individual quantitative dietary intake surveys are expensive and difficult to implement, the dietary diversity tool has been validated as a simple proxy of intake. At household level, it is a measure of access to food (Hoddinott and Yohannes, 2002). At individual level, it has been validated as a proxy of micronutrient adequacy of diets of women and children (Arimond et al., 2010; Working Group on Infant and Young Child Feeding Indicators, 2006).

The Nutrition Assessment team has developed guidelines for operationalizing dietary diversity using the FANTA questionnaire (FANTA, 2006).

Dietary diversity is defined as the number of food groups consumed over a given reference period. The tool uses a qualitative open recall method to gather information on all the foods and drinks consumed over the previous 24 hours, which are then classified into standard food groups. It can be administered either at the household or individual level. The guidelines describe adaptation of the tool to local food systems. The analytical approach includes dietary diversity scores, proportions of households/individuals consuming food groups of nutritional interest (e.g. vitamin A rich), and dietary diversity patterns.

The dietary diversity tool is particularly useful for ensuring that agricultural development, food security and nutrition education programmes effectively lead to more nutritious diets. Being quick and simple to use, it can be integrated easily into impact evaluation protocols.

Measuring food security is difficult and there is a dearth of food security indicators at the level of the household. Several food insecurity scales have been developed for use in resource poor settings; they aim to describe modifications households make to their diet or food consumption patterns when their resources to acquire or obtain food are limited.

- The new Household Hunger Scale (HHS) is a simple 3 questions indicator for assessing household hunger in highly food insecure areas developed by FANTA in collaboration with FAO. The HHS is unique in having been intentionally developed and validated for cross-cultural use.

- The Household Food Insecurity Access Scale (HFIAS) is the 9 question tool from which the HHS was derived. Although it is not validated for cross cultural use, it is useful for contexts with less severe food insecurity.

- The Escala Latinoamericana y Caribeņa de Seguridad Alimentaria (Latin American Household Food Security Measurement Scale, ELCSA), a standard and valid measurement tool widely used in Latin America and the Caribbean, is now being adapted for use in other parts of the world. For example, it was included in Albania for a baseline survey of the MDG joint UN programme on reducing child malnutrition.

These tools, being easy to implement and analyze, are very relevant in countries for the national as well as the decentralized level (e.g. they can be used by extension workers). The Nutrition Assessment team provides technical assistance for adaptation, use and integration of these tools in food and nutrition security information systems.Under the umbrella of the European Commission/FAO Food Security Programme, the dietary diversity tool and the HFIAS have been adapted to the local context and translated into local language in Mozambique (Portuguese), Malawi (Chichewa) and Kenya (Kiswahili).

Contacts: Marie Claude Dop and Maylis Razes

Guidelines for measuring household and individual dietary diversity New: 2011 revision
> Download the PPT presentation
Who is Hungry in this House? An Interview with Terri Ballard about the Household Hunger Scale (HHS)
Other resources for assessment
Assessing Impact of Development Programmes on Food Security: an e-learning course produced by FAO in collaboration with Wageningen University.

© FAO 2010