Quantitative Indicators from a Food Expenditure Survey Can Be Used to Target the Food Insecure in South Africa

Rose, Donald; Charlton, Karen E

doi:10.1093/jn/132.11.3235

Cited by 45 publications

(48 citation statements)

References 6 publications

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“…2 Walking capacity, grip strength, level of independence (instrumental activities of daily living, IADL) and balance according to nutritional risk category as assessed using the new screening tool, where a longer time for walking capacity indicates poorer physical function and a higher score/time for the remaining activities indicates better physical performance. Significant difference between categories (analysis of variance): *, P , 0.05 reported level of inadequate access to food in the present study (detailed elsewhere) 17 , as well as to published secondary data analyses from a large income and expenditure survey, conducted in 1995, in a nationally representative sample of 28 704 South African households 18,19 . In that study, 50% of elderly-headed households (i.e.…”

Section: Discussionmentioning

confidence: 57%

Development of a novel nutrition screening tool for use in elderly South Africans

Charlton

Kolbe-Alexander

Nel

2005

Public Health Nutr.

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Objective: To develop a nutrition screening tool for use in older South Africans. Design: A cross-sectional validation study in 283 free-living and institutionalised black South Africans (60þ years). Methods: Trained fieldworkers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B 12 , red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis; identification of key questions; determination of internal consistency; correlational analyses with objective measures; determination of reference cut-off values for categories of nutritional risk; and determination of sensitivity and specificity. Results: The new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living (r ¼ 0.472) or the more complex instrumental activities of daily living (r ¼ 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished. Conclusion: A novel screening tool has been shown to have content-, construct-and criterion-related validity, and the individual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted.

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Section: Discussionmentioning

confidence: 57%

Development of a novel nutrition screening tool for use in elderly South Africans

Charlton

Kolbe-Alexander

Nel

2005

Public Health Nutr.

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“…The denominator is a sum of the daily recommended energy intakes for each member of the household, multiplied by thirty to convert it to the same monthly time frame as the numerator. Households that scored <1 on this ratio were defined as having low energy availability (Rose and Charlton 2002). & A household is said to be in Food Poverty (FP) when the amount of money it spends on food is not enough to purchase a basic diet that is nutritionally adequate.…”

Section: Methodsmentioning

confidence: 99%

“…The numerator of this ratio is the sum of a household's reported food expenditure plus the estimated monetary value of the food that it consumed from home production. The denominator is the cost of a nutritionally adequate food basket for a particular household (Rose and Charlton 2002) The food security indicators in this paper measure food access and to a lesser extend food availability, quality and safety. Sustainability issues are partly captured in the MAHFP index.…”

Section: Methodsmentioning

confidence: 99%

Food security in rural areas of Limpopo province, South Africa

et al. 2013

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Although South Africa is food secure as a nation, many households remain food insecure. The government has recognized several key food security challenges in the Integrated Food Security Strategy (IFSS). However, South Africa still lacks specific and accepted methods to measure food security and currently has no regulated way of monitoring the food security status of its population. This article reports on an investigation into the food security situation of rural households in the Limpopo Province. Qualitative and quantitative data were gathered across five districts in the province. The study sample eventually involved 599 households in the rural areas of Limpopo. This allowed a thorough description of household characteristics and livelihoods and an assessment of the food security and poverty levels in the area. The findings showed that 53 % of the sampled rural households declared themselves to be severely food insecure. Multivariate analyses were used to identify the main food security status. These determinants were mainly human capital (education, household size and dependency ratio), household income and district in which the households were situated. The findings indicated that policy priorities should be focused on the promotion of rural education and creating an enabling environment for the rural labour market.

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“…Female-headed households have become of increasing concern, due to their growing number attributable to migration and HIV/AIDS, as well as the correlation between female household headship and poverty. On the one hand, women who head households can have more control over household decisions 18 ; however, these same households may experience more food insecurity and economic vulnerability 19 . One recent South African study showed that even though femaleheaded households were worse off economically than male-headed households, women in these households reported that they experienced less food insecurity.…”

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confidence: 99%

Women's input into household decisions and their nutritional status in three resource-constrained settings

Hindin

2006

Public Health Nutr.

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Objective: To understand the role of women's input into household decisions as a possible factor contributing to women's undernutrition in settings where HIV/AIDS and drought have constrained household resources. Design and setting: Three cross-sectional surveys of non-pregnant women in partnerships without a birth in the last 3 months were analysed. Factors associated with chronic energy deficiency (CED), defined as body mass index of , 18.5 kg m 22 , were assessed among 1920 women in Zimbabwe, 2870 women in Zambia and 6219 women in Malawi. Results: Prevalence of CED was 4.2% in Zimbabwe, 13.5% in Zambia and 6.7% in Malawi. In Malawi, women with less input into decisions were more likely to have CED. After multivariable adjustment, each additional decision made by the partner increased the odds of CED in Malawi by 1.08 (95% confidence interval (CI) 1.02-1.15); each additional decision made by the woman decreased the odds of CED by 0.90 (95% CI 0.88 -0.97). Malawian women with all the final say or with partners with no final say had significantly more CED than expected (odds ratio (OR) ¼ 2.88, 95% CI 1.42-5.83 and OR ¼ 1.64, 95% CI 1.06-2.52, respectively), and removing these points increased the magnitude and significance of the linear trends. In Zambia, the relationship was found for urban women only and no associations were found in Zimbabwe. Conclusions: Input into household decisions may be a key factor in the cycle of drought and CED. Women with both low input and CED may lose productive capacity, putting them at greater risk of food insecurity and potentially HIV/AIDS in high prevalence settings.

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Quantitative Indicators from a Food Expenditure Survey Can Be Used to Target the Food Insecure in South Africa

Cited by 45 publications

References 6 publications

Development of a novel nutrition screening tool for use in elderly South Africans

Development of a novel nutrition screening tool for use in elderly South Africans

Food security in rural areas of Limpopo province, South Africa

Women's input into household decisions and their nutritional status in three resource-constrained settings

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