Public Health Nutrition

Assessment and methodology

Proxy measures of household food consumption for food security assessment and surveillance: comparison of the household dietary diversity and food consumption scores

Gina Kennedya1 c1, Andrea Berardoa2, Cinzia Papaveroa2, Peter Horjusa2, Terri Ballarda1, MarieClaude Dopa1, Jan Delbaerea2 and Inge D Brouwera3

a1 Nutrition and Consumer Protection Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153 Rome, Italy

a2 Vulnerability Analysis and Mapping Branch (ODAV), World Food Programme, Rome, Italy

a3 Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands


Objective To provide an overview of the household dietary diversity score and the food consumption score, two indicators used for food security assessment and surveillance, and compare their performance in food security assessments in three countries.

Design Cross-sectional cluster sampling design using an interview-administered structured questionnaire on household food security, including household-level food group consumption measured over 1 d and 7 d.

Setting Survey data are from Burkina Faso, Lao People’s Democratic Republic (Lao PDR) and northern Uganda.

Subjects Households in Burkina Faso (n 3640), Lao PDR (n 3913) and northern Uganda (n 1956).

Results Spearman’s correlation coefficients between the scores were 0·73 in Burkina Faso, 0·65 in Lao PDR and 0·53 in northern Uganda. Prevalence-adjusted kappa coefficients showed substantial strength of agreement in two countries. The proportion of agreement between the two scores ranged from 85 % in Lao PDR to 65 % in northern Uganda. Dietary profiles based on food group consumption using score tertiles were comparable. Rankings of the most food-insecure areas within a country corresponded well in northern Uganda and Burkina Faso but not in Lao PDR. Both indicators showed moderate correlations with other proxy measures of food security.

Conclusions The comparative study highlights the similarities and differences between the food consumption and household dietary diversity scores. Similar classification of the most food-insecure areas within sub-national levels was obtained. The choice of indicator for food security assessment and surveillance will vary depending on user needs.

(Received September 21 2009)

(Accepted April 14 2010)

(Online publication July 06 2010)


c1 Corresponding author: Email