Understanding food consumption patterns and nutrient intakes is essential for informing evidence-based food and nutrition policies. The international food and nutrition community, however, faces a lack of accurate and reliable data.
Though individual dietary surveys, such as 24‐hour recall and observed-weighed food records, are typically viewed as the gold standards for measuring food consumption, they carry prohibitive costs and their methods are complex. For example, during a 24-hour recall, interviewers must exhaustively ask respondents to report the amounts of all foods and beverages consumed by each household member in the previous 24 hours and provide detailed information on the ingredients and preparation methods of mixed dishes. Few of these surveys have been conducted in developing countries and most at only a small scale, calling into question their validity in formulating national nutrition policies.
Household Consumption and Expenditure Surveys (HCES)—a collective term for multipurpose household surveys—are being increasingly recognized as an inexpensive and more readily available alternative for tracking food consumption patterns. More than 700 surveys have been conducted, covering over one million households in 116 low- and middle-income countries. HCES generally collect food consumption information using the recall method and a predetermined list of food items (potentially leaving out important foods). Interviewers ask respondents whether each food item was consumed during a given recall period (typically the last 7 or 14 days) and if so, how much was consumed. While HCES may be less precise than individual diet surveys by design, their relative costs and benefits make them a practical tool for enacting national policies and identifying communities where nutritional interventions are highly needed.
Among their strengths, HCES are:
- Routine: HCES are typically conducted every three to five years
- Low-cost: HCES are processed and paid for by institutions outside the health/nutrition sector, and thus relatively inexpensive to use for secondary analysis
- Representative: HCES are statistically representative at the national, and usually subnational, level
- Comprehensive: HCES contain detailed household food consumption and acquisition information and allow direct observation of the agriculture and nutrition nexus, through markets, value chains, and other such pathways
Since 2012, USAID’s Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project has focused efforts on improving HCES as a source of more relevant and precise food and nutrition data. Recently, SPRING provided technical guidance in using HCES for designing and monitoring food fortification programs—the process of adding micronutrients to food. SPRING presented the economic feasibility of maize flour fortification in Kenya, Uganda, and Zambia using HCES data at a meeting with the World Health Organization. SPRING has guided discussions on introducing a fortification monitoring module and identifying standard indicators to use in current or planned HCES at a workshop with the East, Central, and Southern Africa Health Community Technical Working Group on Monitoring and Evaluation. SPRING is also sponsoring a symposium on HCES at this year’s Micronutrient Forum Global Conference in Addis Ababa, Ethiopia. The conference is expected to draw hundreds of policymakers, program managers, and scientists from around the world.
The use of HCES data constitutes an exciting and unexploited opportunity to address food consumption information gaps. SPRING will continue to work with USAID and partner organizations to repurpose HCES to make them more attuned to countries’ nutrition policy needs and strategies. Country programs and funders are eager to adapt these tools and use the information they provide to improve policies, programs, resource allocation, and ultimately, nutrition outcomes.
SPRING is funded by USAID under a five-year cooperative agreement. SPRING’s experienced implementation team consists of experts from JSI Research and Training Institute, Inc., Helen Keller International, The International Food Policy Research Institute, Save the Children, and The Manoff Group. For more information about SPRING’s work in HCES, visit http://www.spring-nutrition.org/.