Children's anthropometric indices as proxies for measuring household food security.
Food security is a complex concept with no definite measure. Measures of household food security are needed for many different applications in situations where households are chronically vulnerable due to deepening poverty, environmental and climatic shocks, rapid economic change and conflict. Indeed, measurement problems remain a major challenge, not only for research, but particularly for targeting, programme management, monitoring and evaluation. The objective of the study was to develop a specific analytical approach for measuring food security, by making a comparison of approaches that use children’s anthropometric indices (CAI) and Household Food Insecurity Access Scale (HFIAS). The study was specifically aimed at determining the relationship between children’s anthropometric indices and household food security. The pros and cons of using children’s anthropometric indices as indicators of food security were then assessed. The study area was Msunduzi Municipality in Pietermaritzburg, KwaZulu-Natal Province, South Africa. A total of 180 children, aged between 0 and 60 months, took part in the study and the sample was geographically broken down equally between two clusters: Edendale and Northdale Hospitals. The study found that using univariate analysis, “overweight” in “weight-for-height” was statistically significantly associated with HFIAS categories (p<0.05). From the bivariate, multiple linear regressions were conducted and the result was that “height-for-age” index was statistically significantly associated with “mild household food insecurity” (p<0.05). On the other hand, “weight-for-age” and “weight-for-height” were not statistically significantly associated with categories of HFIAS. The lack of significant association between household food insecurity and these two indices was not expected, because of the substantial evidence that a household’s access to food is one of the key determinants of the nutritional status of children. Alternative indicators were used to make up for the established weak association, so that proxies indicators of poverty, including “households which are continuously using wood fuel for cooking”, “households without clean water”, “households with access to the child grant” were ii statistically significantly associated with children’s anthropometric indices. Indeed, It was found that “height-for-age” (≤-2SD) and “weight-for-height” (≤-2SD) indices were statistically significantly associated with “households which are continuously using wood fuel for cooking (p<0.1) and (p<0.1), respectively. “Weight-for-age”, “height-for-age” and “weight-for-height” were statistically significantly associated with “households without clean water” (p<0.01, p<0.1 and p<0.01), respectively, and all these three indices were statistically significantly associated with “households with access to the child grant (p<0.01, p = 0.1 and p<0.01), respectively. The relationship found between anthropometric indices, especially “overweight” in the “height-for-age” and “weight-for-height” index, proxy indicators of poverty and HFIAS categories suggest that children’s anthropometric indices can be good indicators for household food security measurement. However, they have to be used in combination with other indicators. It is concluded that food security strategies should consider socio-economic characteristics of households in order to achieve more than a marginal reduction in the number of chronically undernourished people. Policy recommendations should focus on addressing overweight children whose anthropometric measures are associated with the physical environment and the accompanying levels of physical activity. Further research may need to assess the relationship between food security and quality of life.