1. Food & Nutrition Security
M.H. Suryanarayana
Indira Gandhi Institute of Development Research, Mumbai
INDIA

2. Food & Nutrition Security:Importance (contd.)
Human Development
Efficiency & productivity of labor, the only asset of the poor;
Wages & incomes
Undernourished population - poor
11/13/2018
Food Security: Introduction

3. Food & Nutrition Security:Importance
Different World Food Summits avowed to reduce hunger
One of the Millennium Development GoalsMDGs
Incidence of hunger to be reduced by half during
11/13/2018
Food Security: Introduction

4. Food Security: Introduction
Nutrition Security:
Nutrition: Essentially an investment:
To realize MDGs: Poverty alleviation, education, health, gender equality: (cont.)
Malnutrition is a poverty outcome; good nutrition is a solution to poverty
Nutrition facilitates learning & hence, achieve universal primary education
Girl’s nutrition promotes gender status & incentives for small family size: Gender equality and empowerment
60% U5 mortality is due to malnutrition: hence, nutrition would reduce child mortality
20% of maternal deaths – iron deficiency anemia: Hence, important to improve maternal health
11/13/2018
Food Security: Introduction

5. Food Security: Introduction
Nutrition Security:
Nutrition: Essentially an investment:
To realize MDGs: Poverty alleviation, education, health, gender equality:
Nutrition – improves immunity, HIV related infection, decelerates progression from HIV to AIDS: To combat HIV/AIDS, malaria & other diseases
Facilitates environmental sustainability because its conservation is low priority for the under-nourished
11/13/2018
Food Security: Introduction

6. Food Security: Introduction
Policy Relevance:
Micro Perspective:
Health and nutritional outcomes
Labor productivity
Wages and earnings; hence, incomes
Deprivation and human development
11/13/2018
Food Security: Introduction

7. Food Security: Introduction
Policy Relevance:
Macro:
Human capital of the society & implications for productivity, incomes and deprivation
Million Development Goals
11/13/2018
Food Security: Introduction

8. Food Security: Definition
World Food Summit, November 1996, Rome Italy: World Food Summit Plan of Action:
Food security exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
11/13/2018
Food Security: Introduction

9. Food Security: Introduction
Dimensions:
Availability
Access
Stability of food supply and access (weather, prices, conflicts, political manipulation, etc. can affect them adversely)
Safe and Health food use
11/13/2018
Food Security: Introduction

10. Food Security: Introduction
Food Insecurity:
Occurs when:
Food is available but is not nutritionally adequate
When not everyone get enough to eat
Food is available but households cannot buy because of high prices or high costs of transportation, do not meet local preferences
Food is inedible
11/13/2018
Food Security: Introduction

11. Food Security: Introduction
Policy Imperatives
Capacity of families, households, communities: To be improved
Education, Health care and AIDS-prevention
Targeted social protection programs, cash transfers, school-based food programs etc
Sustainable livelihoods in both rural and urban areas
Prioritise issues related to food security and fair trade
11/13/2018
Food Security: Introduction

12. Food Security: Introduction
Measurement Issues:
Developed Countries:
Macro Perspective:
Little scope for structural change & hence, for misinterpretation of estimates and finings
11/13/2018
Food Security: Introduction

13. Developed Countries: Macro Perspective
Economic access: Per capita income & distribution parameters like poverty estimates
Physical access: (i) Per capita food grain availability (Production+ Δ stocks + net trade – seeds – wastage) ; (ii) per capita food consumption (iii)per capita calorie intake etc.
11/13/2018
Food Security: Introduction

14. Concepts & Data Sources
Nutrition Security
Concepts & Data Sources

15. Food Deprivation: Under-nourishment:
Prevalence of undernourishment in total population
Proportion of the population in a condition of undernourishment.
Undernourishment:
Condition of people whose dietary energy consumption is continuously below a minimum dietary energy requirement (MDER) for maintaining a healthy life and carrying out a light physical activity.
11/13/2018
Source: FAO

16. Depth of Hunger Intensity of food deprivation:
Measures the extent (absolute) shortfall of food from the minimum food needs in terms of dietary energy
Given by (minimum dietary energy - the average dietary energy intake of the undernourished population)
Intensity:
Low < 200 kilocalories per person per day
High if > 300 kilocalories per person per day.
The greater the deficit, the greater the susceptibility for health risks related to under nutrition.
11/13/2018
Source; FAO

17. Food Needs: Minimum dietary energy requirement (MDER):
For a specific age and sex group, the amount of dietary energy per person is that considered adequate to meet the energy needs for minimum acceptable weight for attained-height maintaining a healthy life and carrying out a light physical activity.
For the entire population, the minimum energy requirement is the weighted average of the minimum energy requirements of the different age and sex groups in the population.
11/13/2018
Source: FAO

18. Food Consumption Nutrients: Dietary Energy, Protein and Fat
Dietary Energy, Protein, Fat Consumption:
Amount of food, in kcal per day, for each individual in the total population.
Dietary protein consumption per person:
Amount of protein in food, in grams per day, for each individual in the total population.
Dietary fat consumption per person:
Amount of fat in food, in grams per day, for each individual in the total population.
11/13/2018
Source: FAO

19. Food Consumption Energy:
Kilocalorie is a unit of measurement of dietary energy
One kcal equals calories and one kJ equals joules.
In the International System of Units (ISU), the universal unit of dietary energy is the joule (J). One kcal = kJ.
11/13/2018
Source: FAO

20. Food Security: Introduction
Food Deprivation
Depth of Hunger
Food Needs
Food Consumption
Data source:
FAO Statistics Division
11/13/2018
Food Security: Introduction

21. Nutritional Status: Children
Prevalence of underweight in children under five years (U5):
Moderate underweight: Proportion of children U5 with weight < that of 2 standard deviations below the median of weight-for-age of the WHO reference population
Severe underweight: Proportion of children U5 with weight < that of 3 standard deviations below the same median
11/13/2018
Source: FAO

22. Nutritional Status: Children
Prevalence of stunting in children U5:
Moderate: Proportion of children U5 with height or stature less than that of 2 standard deviations below the median height or stature-for-age of the WHO reference population
Severe: Proportion of children U5 with height or stature less than that of 3 standard deviations below the same median
11/13/2018
Source: FAO

23. Nutritional Status: Children
Prevalence of wasting in children U5:
Moderate: Proportion of children U5 with weight less than that of 2 standard deviations below the median of weight-for-height or stature of the WHO reference population
Severe: Proportion of children U5 with weight less than that of 3 standard deviations below the same median
11/13/2018
Source: FAO

24. Nutritional Status: Children
Prevalence of overweight in children U5:
Moderate: Proportion of children U5 with weight greater than that of 2 standard deviations above the median weight-for-height or stature of the WHO reference population
Severe: Proportion of children U5 with weight greater than that of 3 standard deviations above the same median
11/13/2018
Source: FAO

25. Children - Stunting, Underweight, Wasting, Overweight
Data sources:
WHO Global Database on Child Growth and Malnutrition
World Bank World Development Indicators.
11/13/2018
Food Security: Introduction

26. Nutritional Status: Adults
Body Mass Index (BMI):
An index of weight-for-height
Weight in kilograms divided by the square of the height in meters (kg/m²)
Generally used to classify underweight, overweight and obesity in adults
Also called Quetelet index after Adolphe Quetelet ( )
11/13/2018
Source: FAO

27. Nutritional Status: Adults
International Classification
BMI(kg/m²)           
Cut-off points
Underweight
< 18.50
Normal range
18.50 – 24.99
Overweight
>= 25.00
Overweight (pre-Obese)
25.00 – 29.99
Obese
> = 30.00
11/13/2018
Source: FAO

28. Adults - Underweight, Overweight, Obesity
Data sources:
The WHO Global Database on Body Mass Index (BMI)
11/13/2018
Food Security: Introduction

29. Health: Life expectancy at birth (years): Child mortality rate:
Number of years a newborn infant would live if prevailing patterns of mortality at the time of birth were to stay the same during the lifespan.
Child mortality rate:
Probability of dying between birth and exactly five year of age, expressed per 1000 live births.
Infant mortality rate:
Probability of dying between birth and exactly one year of age, expressed per 1000 live births
11/13/2018
SOurce: FAO

30. Life expectancy at birth, under five mortality, infant mortality
Data sources:
Life expectancy at birth: World Bank World Development Indicators
Child mortality rate: UNICEF Child mortality.
Infant mortality rate: UNICEF Infant mortality.
11/13/2018
Food Security: Introduction

31. Food Security: Introduction
Poverty:
Poverty rate / Headcount Index:
National poverty rate / headcount index:
Percentage of the population living below the national official poverty line.
Urban poverty rate / headcount index:
Percentage of the urban population living below the urban poverty line.
Rural poverty rate / headcount index:
Percentage of the rural population living below the rural poverty line.
Data sources:
World Bank World Development Indicators.
11/13/2018
Food Security: Introduction

32. Global Hunger Index
IFPRI Index

33. Food Security: Introduction
Global Hunger Index
Objectives:
Rank countries
Compare international experience for policy guidance.
Draw global attention
11/13/2018
Food Security: Introduction

34. Food Security: Introduction
Global Hunger Index
Sample:
Based on 120 developing and transitional countries countries;
Compares 88 only
Three indicators
Un-weighted average as an index
11/13/2018
Food Security: Introduction

35. Food Security: Introduction
Indicators: #
Indicator
Purpose to measure 1
% of calorie deficient / under-nourished population
Hunger 2
% children underweight U5
Malnutrition of children, the most vulnerable to hunger 3
U5 mortality rate (%)
Child deaths caused by malnutrition & disease
11/13/2018
Food Security: Introduction

36. Hunger Index Scale: Source: IFPRI
Classification
Color Code
≥ 30.0
Extremely alarming
20.0 – 29.9
Alarming
10.0 – 19.9
Serious
5.0 – 9.9
Moderate hunger
≤ 4.9
Low hunger
11/13/2018
Source: IFPRI

37. Country Classification: n= 120 Source: IFPRI
11/13/2018
Food Security: Introduction

38. Food Security: Introduction
Global Trends:
Hunger (Global index): decreased by less than one-fifth
1990: 18.7
2008: 15.2
Performance by indicator:
% underweight children: declined by by 5.9 points
11/13/2018
Food Security: Introduction

39. Food Security: Introduction
Regional Profile: 2008
Status: Alarming
Sub-Saharan Africa: 23.3
South Asia: 23.0
Ten countries (highest levels of hunger); nine are in Sub-Saharan Africa
Ten best performers since 1990: None from Sub-Saharan Africa
11/13/2018
Food Security: Introduction

40. Country Profiles Source: IFPRI
Best score
Mauritius, followed by Jamaica, Moldova, Cuba, and Peru
Worst score
Democratic Republic of Congo (DRC), followed by Eritrea, Burundi, Niger, and Sierra Leone
Most progress
Kuwait, Peru, Syrian Arab Republic, Turkey, and Mexico
Regress
DRC, North Korea, Swaziland, Guinea-Bissau, and Zimbabwe
11/13/2018
Food Security: Introduction

41. Country Profiles Source; IFPRI
Highest proportion of population with calorie deficiency
Eritrea: 75%
DRC: 74%
Highest prevalence of underweight children
(a measure of malnutrition)
India, Yemen, and Timor-Leste: more than 40%
Highest child mortality (under 5) rate
Sierra Leone: 27%
Angola: 26%
11/13/2018
Food Security: Introduction

42. Poverty Profile: Source; IFPRI
11/13/2018
Food Security: Introduction

43. Where Do The Poor Live? Source: IFPRI
11/13/2018
Source: IFPRI

44. Global Index Scale Source; IFPRI
Classification
Color Code
≥ 30.0
Extremely alarming
20.0 – 29.9
Alarming
10.0 – 19.9
Serious
5.0 – 9.9
Moderate hunger
≤ 4.9
Low hunger
11/13/2018
Food Security: Introduction

45. 2008 Global Hunger Index Source; IFPRI
11/13/2018
Food Security: Introduction 45

46. Progress – Regress Source; IFPRI
11/13/2018
Food Security: Introduction

47. GHI-Winners and Losers: 1990 – 2008 Source; IFPRI
11/13/2018
Food Security: Introduction

48. Global Food Price Crisis Source; IFPRIs
11/13/2018
Food Security: Introduction

49. Food Security: Introduction
11/13/2018
Food Security: Introduction

50. Dietary Energy Consumption
11/13/2018
Food Security: Introduction

51. Food Security: Introduction
11/13/2018
Food Security: Introduction

52. Child Nutritional Status
11/13/2018
Food Security: Introduction

53. Food Security: Introduction
11/13/2018
Food Security: Introduction

54. Food Security: Introduction
11/13/2018
Food Security: Introduction

55. Food Price Crisis and Political Stability
11/13/2018
Food Security: Introduction

56. Global Policy Response:
Special Program for Food Security:
National Program for Food Security (NPFS): country driven solution to eradicate hunger within local population
Regional Programs for Food Security (RPFS)L Involves regional economic organizations to promote regional integration among neighboring countries in order to maximize the impact of national programs
Since 1995, US $ 770 million invested in FAO-designed food security programs
11/13/2018
Food Security: Introduction

57. Global Policy Response:
Special Program for Food Security:
FAO flagship initiative to halve the number of poor by 2015.
Seeks to ensure food security for the poor households
It is a multidisciplinary and holistic approach to all aspects of food security
It is focused o low income food deficit countries, where majority of chronically undernourished live.
At present over 800 million food insecure in the world; 86% live in 106 countries participating in the SPFS
Launched in 1994, initially SPFS sought to augment food production to reduce hunger and malnutrition
After 2002 World Food Summit, SPFS shifted focus from pilot projects to national programs & regional programs to address food insecurity
11/13/2018
Food Security: Introduction

58. Food Security: Introduction
MDGs
Eradicate extreme poverty and hunger
Achieve universal primary education
Promote gender equality and empower women
Reduce child mortality
Improve maternal health
Combat HIV/AIDS, malaria and other diseases
Ensure environmental sustainability
Develop a global partnership for developmentFood & Nutrition Security:Importance
11/13/2018
Food Security: Introduction

59. Food Security: Introduction
Thank you
11/13/2018
Food Security: Introduction

60. Food Security: Introduction
Data source:
11/13/2018
Food Security: Introduction

61. Food Security: Introduction
11/13/2018
Food Security: Introduction

62. Food Security: Introduction
Food intake indicators
Average energy intake ( 2350 kcal/d : Provisional)
Average food intake of major food groups
Daily per caput protein intake (1 g/kg BW)
Percentage of energy from protein ( 12-15% of total dietary energy)
Daily per caput carbohydrate intake ( g/d)
Percentage of energy from carbohydrates ( % of total dietary energy)
Cont.
11/13/2018
Food Security: Introduction 62

63. Food Security: Introduction
Daily per capita fat intake
Percentage of energy from fat (25-30% of total dietary energy)
Percentage of protein from animal source
(at least 25%)
Percentage of protein from vegetable source
Dietary Energy Supply (DES) *
Percentage of undernourished population *
11/13/2018
Food Security: Introduction 63

64. Food Security: Introduction
Nutritional Norms
These norms refer to quantitative threshold or cut-off values to assess the the nutritional status of a population under review.
Malnutrition can occur at any stage of one’s life cycle; accordingly there are different indicators to assess nutritional status of population of different age and gender groups.
11/13/2018
Food Security: Introduction 64

65. Food Security: Introduction
1. Intra-uterine Undernutrition: Low Birth Weight (LBW)
Malnutrition can begin from intra-uterine life: Thic could be mainly be due to maternal malnutrition.
Maternal malnutrition during pregnancy retards the growth and development of the foetus.
The foetus therefore is born with birth weight lower than normal.
 When the birth weight of a full-term foetus is below a cut-off level, the newborn is termed as a LBW baby.
According to WHO, the cut-off value for birth weight is 2.5 kg. (India 21.5 % babies are LBW (NFHS III; p. 226). Therefore, babies born with birth weight <2.5 kg are LBW babies.
11/13/2018
Food Security: Introduction 65

66. Food Security: Introduction
LBW babies – a bad start in life.
Poor chances of survival; less resistance to diseases, hence, frequent infection, and severe malnourishment
 High infant mortality rate
11/13/2018
Food Security: Introduction 66

67. Food Security: Introduction
2. Childhood Malnutrition
The consequences of malnutrition are most severe if it happens very early in life.
Malnutrition from this time in life onward has long lasting effects on subsequent growth, morbidity, cognitive development, educational attainment and productivity in adulthood.
For these reasons, nutrition status of young children, particularly those aged below 5 years, has been shown to be one of the most sensitive indicators of food security, vulnerability and overall socio-economic development of a country.
11/13/2018
Food Security: Introduction 67

68. Food Security: Introduction
Several anthropometric indicators have been identified for assessment of nutrition status of U-5 children. These are Stunting, Wasting and Underweight.
The Z-score classification of these indicators is most widely used.
11/13/2018
Food Security: Introduction 68

69. Food Security: Introduction
A. Stunting (low height-for-age)
Undernutrition for a long time retards the growth of a child by height. The child is shorter than for its age. This is called “Stunting”. For this, both height and age are to be known.
The child is said to be of normal height, if its height-for-age is within 2 standard deviations (-2SD) of the median height-for-age of a reference population.
In India % children (0-59 months) Below 3SD is 23.7 and Below 2SD is 48 (p. 271)
11/13/2018
Food Security: Introduction 69

70. Food Security: Introduction
If the height falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD), then the child is classified to moderately stunted.
If the height falls below 3 SD of the reference median (<-3SD), then the child is classified as severely stunted.
11/13/2018
Food Security: Introduction 70

71. Food Security: Introduction
The classification can be summarized as follows:
Stunting: Height-for-age up to –2SD = Normal
Height-for-age <-2SD to –3SD = Moderate
Height-for-age <-3SD = Severe
11/13/2018
Food Security: Introduction 71

72. Food Security: Introduction
B. Wasting (low weight–for-height)
 Acute, short-term malnutrition does not affect the height, but the body weight.
This is seen as “Wasting” of the body, i.e. loss of body mass compared to the body size.
Weight-for-height is therefore a useful indicator for assessing body wasting.
For this, age does not need to be known.
11/13/2018
Food Security: Introduction 72

73. Food Security: Introduction
The child is said to be of normal weight-for-height, if its weight-for-height is within 2 standard deviations (-2SD) of the median weight-for-height of a reference population.
If the weight-for-height falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD), then the child is classified as moderately wasted.
If the weight-for-height falls below 3SD of the reference median (<-3SD), then the child is classified as severely wasted.
11/13/2018
Food Security: Introduction 73

74. Food Security: Introduction
The classification can be summarized as follows:
Wasting:
Weight-for-height up to –2SD = Normal
Weight-for-height <-2SD to –3SD = Moderate
Weight-for-height <-3SD = Severe
In India % of children below 3SD w/h is 6.4 % and below 2SD is 20 %.
11/13/2018
Food Security: Introduction 74

75. Food Security: Introduction
C. Underweight (low weight-for-age)
This is a composite indicator of long-term and acute short-term malnutrition. The body weight may be lost from malnutrition for a long time. The child is then low weight-for-age. Weight may also be lost from acute, short-term malnutrition. In this case also, the child is low weight-for-age.
11/13/2018
Food Security: Introduction 75

76. Food Security: Introduction
The child is said to be of normal weight-for-age, if its weight-for-age is within 2 standard deviations (-2SD) of the median weight-for-age of a reference population.
If the weight-for-age falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD), then the child is classified as moderately underweight.
If the weight-for-age falls below 3SD of the reference median (<-3SD), then the child is classified as severely underweight.
11/13/2018
Food Security: Introduction 76

77. Food Security: Introduction
The classification can be summarized as follows:
Underweight :
Weight-for-age up to –2SD = Normal
Weight-for-age <-2SD to –3SD = Moderate
Weight-for-age <-3SD = Severe
In India % below, 3 SD is 16 and below 2 SD is 42.5
(p. 271)
11/13/2018
Food Security: Introduction 77

78. Food Security: Introduction
D. Mid-upper-arm Circumference (MUAC)
Between the ages of 1 and 5 years, there is very little change in a normal child’s arm circumference.
Thus, this measurement gives a simple anthropometric measure of wasting which is almost age-independent.
The degree of severity of malnutrition in children on the basis of MUAC is given below.
 MUAC >14 cm = Normal
12.5 – cm = Mild/moderate wasting
<12.5 cm = Severe wasting
11/13/2018
Food Security: Introduction 78

79. Food Security: Introduction
3. Maternal malnutrition
The most common nutritional problem in women, especially the poor, is chronic energy deficiency (CED).
CED is measured by height as well as by Body Mass Index (BMI).
11/13/2018
Food Security: Introduction 79

80. Food Security: Introduction
A. Height <145cm is indicative of chronic CED.
 India, such women (15-49 years) are 11.4 percent (p.304)
BMI is derived by dividing weight (in kg) by height squared (in meters).
Weight (kg)
BMI = (kg/m2)
Height2 (meter)
Women (15-49) with BMI <18.5 are 36 % (p. 304)
Men (15-54) with BMI <18.5 are 34% (p. 306)
11/13/2018
Food Security: Introduction 80

81. Food Security: Introduction
B. BMI is widely used to assess nutritional status of children above 10 years of age and the adults as follows:
BMI > = Obese
25.1 – = Overweight
= Normal
< = Malnourished
< = Severely malnourished
11/13/2018
Food Security: Introduction 81

82. Food Security: Introduction
C. Mid-upper arm circumference (MUAC)
As with children, MUAC can be used to grade the degree of body wasting in adults.
Appropriate cut-off points of MUAC for adults are given below.
Male
≥23 cm
<23 cm
Normal
Malnourished
Female
≥22 cm
<22 cm
11/13/2018
Food Security: Introduction 82

83. Food Security: Introduction
4. Micronutrient malnutrition
The most widely prevalent micronutrient malnutrition problems are vitamin A deficiency, iodine deficiency and iron deficiency.
11/13/2018
Food Security: Introduction 83

84. Food Security: Introduction
A. Vitamin A deficiency
Chronic dietary vitamin A deficiency first leads to night blindness and then, in untreated cases, to total blindness.
 Sub-clinical vitamin A deficiency is present in a much larger population than clinical blindness.
 Serum retinol (vitamin A) level is a dependable indicator for sub-clinical vitamin A deficiency.
11/13/2018
Food Security: Introduction 84

85. Food Security: Introduction
The cut-off value for serum retinol is given below:
Serum retinol ≥ 20 µg/100 ml = Normal
Serum retinol <20 µg/100 ml = Vitamin A
deficiency
Serum retinol <10 µg/100 ml = Severe vitamin
A deficiency
11/13/2018
Food Security: Introduction 85

86. Food Security: Introduction
B. Iodine deficiency
Chronic dietary iodine deficiency first leads to enlargement of the thyroid gland such that it is not yet visible. This goiter is called Grade 1 goitre.
In untreated cases, Grade 1 goiter develops into Grade 2 goitre, which now becomes visible.
11/13/2018
Food Security: Introduction 86

87. Food Security: Introduction
As with vitamin A deficiency, sub-clinical (also called biochemical) iodine deficiency is present in a larger population than goiter.
 Urinary iodine level is an internationally accepted and widely used indicator of iodine deficiency.
Iodine content of salt being used by hhlds:
Rural (Urban) 60 (30) percent inadequate or zero, inadequate defined as <15ppm (p.297)
11/13/2018
Food Security: Introduction 87

88. Food Security: Introduction
The cut-off vale for urinary iodine is given below:
Urinary iodine excretion (UIE) ≥100 micrograms/litre = Normal
Urinary iodine excretion (UIE) <100 micrograms/litre = Iodine deficiency
Urinary iodine excretion (UIE) <20 micrograms/litre = Severe iodine deficiency
11/13/2018
Food Security: Introduction 88

89. Food Security: Introduction
C. Iron deficiency and iron deficiency anaemia
Chronic dietary iron deficiency first leads to depletion of iron stores of the body (in the form of ferritin in liver). This is called iron deficiency.
 Serum ferritin <12 mg/100ml = Iron deficiency
Anemia in India: Men (15-54) 24.2 %, Women (15-49) % using above 12 mg benchmark (p. 313)
Children: Any anemia (<11 g/dl) 79 % (p. 291)
11/13/2018
Food Security: Introduction 89

90. Food Security: Introduction
When the iron store falls below such level that it cannot support haemoglobin synthesis, haemoglobin level begins to fall. If haemoglobin falls below a critical level, then it is anaemia.
The severity of anaemia depends on how low is haemoglobin level. This can be measured by determining haemoglobin concentration in whole blood. The biochemical indicators of iron deficiency and anaemia are as follows:
11/13/2018
Food Security: Introduction 90

91. Food Security: Introduction
The critical levels of haemoglobin (gm/L) vary according to different age and sex groups and also various physiological conditions
Group
Normal
Mild anaemia
Moderate anaemia
Severe anaemia
Children
( Mo)
≥110
100 – 109
<70
( Yr)
≥115
( Yr)
≥120
Male
15+ Yr
≥130
Female
Pregnant
women
Lactating
mothers
11/13/2018
Food Security: Introduction 91

92. Food Security: Introduction
Basic health indicators
Immunization rate for measles, tuberculosis, diphtheria, poliomyelitis and tetanus (one-year- olds)
Prevalence of infectious diseases and epidemics (malaria, cholera, AIDS and other)
Access to safe water (rural and urban)
Rural access to safe water
Urban access to safe water
11/13/2018
Food Security: Introduction 92

93. Food Security: Introduction
Access to adequate sanitation
Infant mortality rate
Under five mortality rate
Maternal mortality rate
Percentage of all cases of diarrhea in children under five of age treated with oral rehydration salts and/or recommended home fluids
Infants 0-6 months exclusively breastfed
Infants 6-9 months breastfed with complementary food
Infants at months, still breastfed
11/13/2018
Food Security: Introduction 93

94. Food Security: Introduction
Reproductive health indicators
Percentage of pregnant women immunized against tetanus
Percentage of births attended by trained health personnel
Percentage of pregnant women aged years with anaemia
Total fertility rate
Fertility rate in adolescents
Contraceptive prevalence
11/13/2018
Food Security: Introduction 94

95. Dimensions & methods for assessing food security and undernutrition
Availability of food
Access to food
Consumption of food
Utilization of nutrients
FAO Method
Household income
& expenditure surveys
Individual food intake surveys
Anthropometry
Qualitative measures of food insecurity
11/13/2018
Food Security: Introduction 95

96. ASSESSMENT OF FOOD INSECURITY : FIVIMS
Based on existing national and sub-national information systems related to food security
Responds to the information needs of different user groups/Action programs within the country
Operated and controlled by the country involved (except perhaps during complex emergencies)
Country driven and user focused, designed in response to the needs of national decision-makers (with guidance on best practices)
11/13/2018
Food Security: Introduction 96

97. Identifying nutritionally vulnerable groups
Prevalence & degree of low food intake;
National coverage of food insecurity
and vulnerability through FIVIMS;
WHO is food insecure?
WHERE are they?
WHY in that condition?
Access to food availability, access, health and care
Use of food and nutrition indicators
11/13/2018
Food Security: Introduction 97

98. Methods of assessing dietary intake
National food supply data
Household data
Individual data (Food records, 24 hr dietary recall, dietary diversity, diet histories,food habit questionnaires, combined methods
Selecting most appropriate dietary data collection method
RAP - rapid assessment procedure ( focus groups to gather information on food behaviours, beliefs and intakes)
11/13/2018
Food Security: Introduction 98

99. Issues for dietary assessment methods
Dietary assessment may be collected at national, HH or individual
Assessment of food composition at the national level is generally based on FBS
At HH /individual level it provides useful information on nutritional adequacy
11/13/2018
Food Security: Introduction 99

100. National and household level consumption surveys
Preferred source of food consumption surveys ( provide more information than FBS)
Provide consumption characteristics of specific vulnerable groups including those from urban /rural populations
Various types of methods used for HFCS
11/13/2018
Food Security: Introduction
100

101. Food consumption data needs
type of food consumed (raw, processed, cooked, preparation practices)
how much (serving size)
how often
by whom (e.g.; young ,elderly, immunocompromised)
affected by factors such as
season
region / culture
wealth / socio-economic factors
age
sex
11/13/2018
Food Security: Introduction
101

102. Food Security: Introduction
Conclusions
Need to use core indicators linked to food insecurity & nutrition outcomes
Identify food and nutrition vulnerability through information on food consumption patterns ; need to obtain information on intra household distribution of food for accurate assessment of individual intakes
Knowledge of HH food allocation patterns and underlying reasons for food / diet related behaviour, so that effectiveness of nutrition interventions can be improved.
Differential nutritional status associated with differences in morbidity or illness or other factors within HHs provides valuable information on food distribution
11/13/2018
Food Security: Introduction
102

103. Eleventh Plan on Food Security: Estimates & Interpretations
M.H. Suryanarayana
Indira Gandhi Institute of Development Research
Mumbai

104. 11th Five Year Plan on Food Security:
Sustained solution to morbidity
All the more so,
Stagnant incomes of the poor
Perverse changes in consumption patterns – decline in cereal share
Trend reduction in average cereal consumption
11/13/2018
Food Security: Introduction

105. 11th Five Year Plan on Food Security:
Trend reduction in calorie intake – 8% in rural India - 3% in urban India between 1983 and
Average calorie intake fall increasingly short of official poverty line norms: 2400 kcals rural India 2100 kcals urban India
11/13/2018
Food Security: Introduction

106. Food Security: Introduction
11/13/2018
Food Security: Introduction

107. 11th Five Year Plan on Food Security:
Consequences - Nutritional outcome parameters like low birth weights of newborn babies, anthropometric measures
11/13/2018
Food Security: Introduction

108. Food Security: Introduction
Review:
Estimates of consumption patterns
Averages at current prices conceal rather than reveal dynamics of change
Reflect changes in relative prices and not real changes in consumption patterns
Current price estimates exaggerate the extent of changes
11/13/2018
Food Security: Introduction

109. Food Security: Introduction
Review:
Cereal share, of course, has declined though not to the extent as revealed by current price estimates
Per capita cereal expenditure increased for the bottom three decile groups but not quantities – dynamics of agricultural development
Calorie intake increased for the bottom decile groups decreased for the top ones: convergence at a lower level
11/13/2018
Food Security: Introduction

110. Food Security: Introduction
11/13/2018
Food Security: Introduction

111. Food Security: Introduction
11/13/2018
Food Security: Introduction

112. Food Security: Introduction
11/13/2018
Food Security: Introduction

113. Food Security: Introduction
11/13/2018
Food Security: Introduction

114. Food Security: Introduction
Consequences:
Incidence of calorie deficiency increased by conventional norms but no so by convergence norms.
11/13/2018
Food Security: Introduction

115. What is the evidence by disaggregate population groups?

116. Food Security: Introduction
11/13/2018
Food Security: Introduction

117. Food Security: Introduction
11/13/2018
Food Security: Introduction

118. Food Security: Introduction
11/13/2018
Food Security: Introduction

119. Food Security: Introduction
11/13/2018
Food Security: Introduction

120. What is the evidence in terms of household perception on adequacy of food consumption?

121. Food Security: Introduction
11/13/2018
Food Security: Introduction

122. Raises important questions:
What would be an appropriate measure of food security?
Objective estimates of food consumption /calorie intake relative to exogenous norms?
Subjective perceptions of adequacy of food consumption?
How do we verify these two questions?
How far measures of association would validate these measures?
11/13/2018
Food Security: Introduction

123. Food Security: Introduction
What is the evidence?
Estimates of bivariate associations either do not make sense or are insignificant
Association subjective estimates of food adequacy and objective estimates of average calorie intake – inverse (rural) & insignificant (urban)
Objective estimates of calorie deficiency and IMR – insignificant (rural) & negative and significant (Urban)
What do they mean? What are the implications for methodology and policy?
11/13/2018
Food Security: Introduction

124. Thank You