Factors associated with household food security of participants of the MANA food supplement program in Colombia / Factores asociados con inseguridad alimentaría del hogar en participantes del programa alimentario MANA en Colombia

The objective of this study was to explore demographic and economic characteristics associated with household food security of 2,784 low-income households with pre-school aged children receiving food supplements from the Colombian Plan for Improving Food and Nutrition in Antioquia -MANA (Mejoramiento Alimentario y Nutricional de Antioquia) in the Department of Antioquia, Colombia. Included in the study was a 12-item household food security survey was collected from a cross-sectional, stratified random sample of MANA participants in which households were characterized as food secure, mildly food insecure, moderately food insecure, and severely food insecure. It was hypothesized that household food security status would be strongly associated with demographic characteristics, food expenditure variables, and food supplement consumption by children in MANA. Food insecure households were characterized by more members, older parents, and lower income (p<0.0001). Rural residence and female head of households had higher rates of food insecurity (p<0.01). Food insecure households had the lowest monthly expenditures food (p<0.0001). Severely food insecure households saved the highest percentage of per capita food expenditure from consuming MANA supplements (p<0.0001), similarly, MANA food supplement intakes were greatest in households reporting the most food insecurity (p<0.001). The results of this study are important to describe characteristics of the population benefiting from the MANA nutrition intervention by their unique level of household food security status.

El objeto de este estudio fue explorar la asociación de la inseguridad alimentaria en el hogar con las características demográficas, el gasto alimentario del hogar y el consumo del complemento alimentario de 2,784 hogares de bajos ingresos con niños preescolares que recibían el complemento alimentario de MANA (Programa de Mejoramiento Alimentario y Nutricional de Antioquia) en el Departamento de Antioquia, Colombia. En los hogares seleccionados mediante un muestreo probabilístico, se aplicó una escala de seguridad alimentaria compuesta por 12 ítems. Los hogares fueron clasificados como seguros, y con inseguridad alimentaria leve, moderada o severa. Se hipotecaron que el estado de seguridad alimentaria seria asociado de una manera fuerte con las características demográficas, el gastos alimentarias, y el consumo del complemento por los niños participantes en MANA. Los hogares con inseguridad alimentaria estaban compuestos por un mayor número de personas, los padres eran de mayor edad, y tenían menores ingresos y menor gasto alimentario (p<0.0001), de la misma manera, el consumo del complemento de MANA fue más alto en los hogares que reportaron inseguridad severa (p<0.001). Los resultados son importantes para describir las características de la población que se beneficie de la intervención nutricional de MANA por su nivel de seguridad alimentaria en el hogar.

Household food insecurity associated with stunting and underweight among preschool children in Antioquia, Colombia / Inseguridad alimentaria en los hogares asociada con el retraso del crecimiento y el bajo peso en niños preescolares de Antioquia, Colombia

OBJECTIVE: To assess criterion validity of a household food security scale through its associations with child health status in participants of the Colombian Plan for Improving Food and Nutrition in Antioquia (Mejoramiento Alimentario y Nutricional de Antioquia (MANA)). METHODS: A 12-item household food security survey (Colombian Household Food Security Scale, CHFSS) was applied to a cross-sectional stratified random sample of 2 784 low-income households with preschool children receiving MANA food supplements in Antioquia, Colombia. Anthropometrics and health status of the children were also assessed. Chi-square tests were used to initially compare child health status and household food security status. Logistic regression models were further developed to assess this relationship in bivariate and multiple regression models. RESULTS: Statistically significant associations were found between household food insecurity and diagnoses of children's diarrhea, respiratory infections, and parasitosis (P < 0.0001). The risk for child stunting and underweight increased in a dose-response way as food insecurity became more severe. CONCLUSIONS: Our research establishes an important link between household food insecurity and child nutritional status in participants of a food assistance program. The results affirm the criterion validity of the CHFSS, establishing the proposed instrument as a valid measure for food insecurity with high-risk populations.

OBJETIVO: Evaluar la validez de una escala de seguridad alimentaria en hogares mediante su asociación con el estado de salud de niños participantes en el plan colombiano Mejoramiento Alimentario y Nutricional de Antioquia (MANA). MÉTODOS: Se aplicó una encuesta de seguridad alimentaria en hogares (CHFSS), compuesta por 12 preguntas, a una muestra transversal estratificada y aleatoria de 2 784 hogares de bajos ingresos con niños preescolares que recibían suplementos alimenticios del programa MANA en Antioquia, Colombia. Se evaluó el estado de salud y antropométrico de los niños. Se comparó el estado de salud de los niños y de seguridad alimentaria de los hogares mediante la prueba de la ji al cuadrado. Se elaboraron modelos de regresión logística para evaluar esa relación mediante regresiones bifactoriales y multifactoriales. RESULTADOS: Se encontraron asociaciones estadísticamente significativas entre la inseguridad alimentaria de los hogares y el diagnóstico de diarrea, infecciones respiratorias y parasitosis en los niños (P < 0,0001). El riesgo de retraso del crecimiento y bajo peso en los niños se incrementó según una relación dosis-respuesta a medida que se agravaba la inseguridad alimentaria. CONCLUSIONES: Se estableció un vínculo importante entre la inseguridad alimentaria de los hogares y el estado nutricional de los niños participantes en un programa de asistencia alimentaria. Estos resultados confirman la validez del CHFSS, por lo que este instrumento es válido para evaluar la inseguridad alimentaria en poblaciones en alto riesgo.

Measuring household food security: the global experience: [review] / A medida da segurança alimentar: a experiência mundial: [revisão]

Measuring household food insecurity represents a challenge due to the complexity and wide array of factors associated with this phenomenon. For over one decade, researchers and agencies throughout the world have been using and assessing the validity of variations of the United States Department of Agriculture Household Food Security Supplemental Module. Thanks to numerous studies of diverse design, size, and purpose, the Household Food Security Supplemental Module has shown its suitability to directly evaluate the perceptions of individuals on their food security status. In addition, challenges and limitations are becoming clearer and new research questions are emerging as the process advances. The purpose of this article is to describe the development, validation procedures, and use of the Household Food Security Supplemental Module in very diverse settings. The most common Household Food Security Supplemental Module related studies have been conducted using criterion validity, Rasch modeling and Cronbach-Alpha Coefficient. It is critical that researchers, policy makers, governmental and non-governmental agencies intensify their efforts to further develop tools that provide valid and reliable measures of food security in diverse population groups. Additional work is needed to synthesize a universally applicable tool able to capture the global human phenomenon of food insecurity.

Medir a insegurança alimentar domiciliar representa um desafio devido à complexidade e ao vasto número de fatores associados a este fenômeno. Por mais de uma década, pesquisadores e agências em todo o mundo têm usado o Módulo Suplementar da Segurança Alimentar Domiciliar , do Departamento de Agricultura dos Estados Unidos (Household Food Security Supplemental Module), e avaliado suas variações. Graças a numerosos estudos com diversos formatos, extensões e propósitos, a adequação do Household Food Security Supplemental Module para avaliar diretamente a percepção dos indivíduos acerca de seu estado de segurança alimentar pôde ser comprovada. Além disso, as limitações desse módulo e os desafios que os pesquisadores ainda precisam enfrentar vêm se tornando mais claros, e novas questões a serem pesquisadas vêm surgindo à medida que o processo avança. O objetivo deste artigo é descrever o desenvolvimento, os procedimentos de validação e o uso do Household Food Security Supplemental Module em cenários distintos. A maioria dos estudos sobre o Household Food Security Supplemental Module foi efetuado usando critérios de validação, o modelo de Rasch e o Coeficiente Alfa de Cronbach Alfa. É vital que os pesquisadores, os responsáveis pela determinação de políticas públicas e as agências governamentais e não governamentais intensifiquem seus esforços para desenvolver novas ferramentas que forneçam medidas válidas e confiáveis de segurança alimentar em diferentes grupos populacionais. É necessário um esforço adicional para sintetizar uma ferramenta universalmente aplicável, que seja capaz de capturar o fenômeno humano global da insegurança alimentar.