This paper operationalizes household food security and links it to household food consumption patterns in rural Nepal. Food security has long been used as a macro-level indicator of agricultural stability by both agricultural and economic researchers. However, little work has been done to operationalize it at the household level. We view household food security as reflecting three different dimensions: past food supply, current food stores, and future supply of food adequate to meet the needs of all household members. A key method is the construction of scales that capture these different aspects of household food security. When operationalized in this way, household food security is associated with increased consumption of non-staple foods in this setting. Past household food security is associated with increased frequency of meat consumption and increased variety of food consumed. Current household food security predicts a higher frequency of meat and dairy intake and greater dietary variety. Future household food security is associated with increased total dietary variety and future consumption of dairy products. We feel that this conceptual approach to assessing household food security, i.e., the use of scales to measure past, current, and future components of food security, can be used as a framework in other settings.
A variety of nutrition interventions are needed to meet national and global goals for women and children, and scarce resources necessitate integration of those activities. Haiti's national nutrition strategy includes 3 priority intervention areas: 1) promotion of age‐appropriate infant and young child feeding (IYCF) practices 2) prevention of micronutrient deficiencies (PMD) in young children, adolescent girls and pregnant women and 3) management of severe acute malnutrition (SAM) in children under 5. Policy makers need to identify program delivery models that effectively integrate these areas at the community level. To address the question of integration, we mapped the program impact pathways for 3 large‐scale nutrition programs serving rural Haitian communities. Two programs were managed by NGOs and one by the public sector. For each program, we assessed how activities related to IYCF, PMD, and SAM were integrated at the service delivery level. Data was collected through document review and semi‐structured interviews with program staff and beneficiaries. Analyses and findings reveal ways that various community‐based nutrition activities can be most efficient and synergistic. Research support: UNICEF Haiti
Objectives Food systems are increasingly recognized as critical to advancing better nutrition, with the food environment as the nexus between food systems and dietary consumption. Developing a robust measurement framework of the market food environment is a research priority particularly for low and middle income countries (LMIC), where market food environments are rapidly shifting, accompanied by shifts in diet patterns and nutrition outcomes. The objective of this work was to identify existing metrics of the food environment and develop a measurement framework that can be used to assess the outcomes of nutrition-sensitive, market-focused interventions in LMIC. Methods We conducted a narrative review of the food environment literature using targeted searches of peer-reviewed articles, agency websites, and bibliographies to identify measures of the food environment in current or recent use. First, we extracted 182 unique measures from and compiled them into a list. Second, a pile-sorting exercise was conducted online by 5 nutrition experts, selected for their expertise in food environment, ethnographic, food choice, and/or nutritious value chain research. Participants were asked to sort the measures into piles that belonged together and create a label for each pile. An in-depth debriefing was conducted with each sorter to obtain the reasoning for their sorts. We then categorized the results into emergent groups based on the percentage agreement of the assignment of individual items into the piles. Results Eight broad categories with at least 75% measure agreement emerged pertaining to both perceived and objective measures of the built/physical food environment. Etic measures included the availability of food stores, the availability and quality of foods within a store, food prices, and marketing. Emic (perception) measures included perceptions of access to food stores, perceptions of food availability and quality in stores, and affordability. Personal characteristics and values determining food choice also emerged; these are not measures of the food environment per se. Conclusions These results begin to outline a measurement framework for assessing the market food environment that can be adapted to LMIC. The next step will be to test the framework and evaluate its utility as a tool to further understanding around consumer food choices. Funding Sources GAIN.
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