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Many researchers use data from Household Consumption and Expenditure Surveys (HCES) to estimate individual food and nutrient intake when individual dietary data are not available. They assume that food is allocated within households according to members’ proportional energy requirements relative to an adult male (called an adult male equivalent, or AME). This study sought to validate AME-based estimates of individual consumption of calories, protein, iron, and animal source protein (ASP) across 10 age-sex categories, using data from Bangladesh and Ethiopia containing both household and individual-level consumption data. The study also assessed the accuracy of adjusting for meal partakers and physical activity levels (PAL), and compared energy-weighted AMEs to nutrient-specific AME predictions. Energy AME-based predictions of nutrient intake were generally accurate within ten percentage points of individually reported intakes, but were less accurate for infants 6–23 months and children in Bangladesh than for other demographic groups. AME predictions were more accurate: (1) in Ethiopia than in Bangladesh, (2) for predicting intake of the three nutrients rather than ASP, (3) for estimating nutrient intake rather than adequacy, (4) using energy-weighted AMEs rather than nutrient specific weights, and (5) using moderate PAL for youth and adults rather than high PAL. Adjusting for meal partakers did not consistently improve the AME-based predictions. Energy based AME estimates from household data can produce a useful proxy of average intake for certain population subgroups, however individually measured dietary assessment remains the best approach to identify groups at risk of nutrient inadequacy. [ABSTRACT FROM AUTHOR]

Abstract: Using panel data from Ethiopia covering 1994–1997, we estimate the impact of prime age adult mortality on household composition, household expenditures and dietary diversity. We employed propensity score matching with a difference-in-difference estimator to control for endogeneity of mortality to the outcomes of interest. Households losing a productive adult did not replenish the lost labor, regardless of economic status, sex or status of the deceased adult. With the exception of non-poor households, adult mortality resulted in increased dependency ratios, but did not adversely affect households’ expenditure patterns (total, food and non-food expenditures) regardless of the sex and position of the deceased and the economic status of the households. Although food expenditures were protected, a decline in dietary diversity, especially among the poorest households, reflected increased nutrition insecurity associated with adult mortality. [Copyright &y& Elsevier]

Highlights • Rural Ethiopian households exhibited significant intra-household nutrient inequities. • Conventional 'vulnerable groups' were not always most affected by inequity. • Inequities were greatest for 'invisible' nutrients (iron) • No factor consistently predicted detrimental inequity across groups and nutrients. • Programs must consider intra-household nutrient allocation for optimal targeting. Abstract Background Food assistance interventions directed at households may miss undernourished individuals if intra-household equity in nutrient allocation is assumed. A recent study from Ethiopia revealed that, while all age groups consumed calories in proportion to their fair share, iron and protein were inequitably allocated among household members. Further exploration of individual and household characteristics associated with these allocation patterns is necessary to gain a more complete understanding of existing disparities. Objective This paper sought to quantify energy, protein, and iron allocation inequity between four age and sex groups of household members (children and adults) commonly assumed to be disadvantaged versus preferentially treated in intra-household resource distribution. It then sought to identify individual and household factors that explained the inequity of intra-household nutrient allocation among these paired groups. Methods Data from a survey of 1185 households located in rural Oromiya and SNNPR regions of Ethiopia. A single quantitative 24-hour household-level dietary recall was collected from the primary food preparer who reported the proportion of household food distributed to each household member. Continuous ratios of relative calorie, protein, and iron adequacy for four pairs of age-sex groups (any child vs. any adult, any child vs. adult male, female child vs. male child, and adult female vs. adult male) in the household were computed and compared, along with a binary indicator of inequity. Logistic regressions and standard linear regression with Huber-White heteroscedasticity-adjusted standard errors were run to determine the predictors of household inequity for each pair-group and nutrient, on the full sample as well as on nutrient inadequate households. Results Common assumptions about inequitable distribution of nutrients within households were not consistently supported by this analysis. Significant intra-household nutrient inequities did exist in these rural Ethiopian households for certain nutrients, but household subgroups commonly presumed to be nutritionally vulnerable in the Ethiopian context were not always affected by detrimental inequity. Generally, household inequity favored children over adults or adult males, and female children over male children for protein consumption. Inequities were greatest against presumed vulnerable groups (adult women, children) for 'invisible' nutrients (iron) rather than calories or protein. There were relatively few households in which one of the interest groups (groups presumed vulnerable) experienced inequitable nutrient allocation and nutrient inadequacy. The number of households where inequity was present for a subgroup who also experienced nutrient inadequacy while the reference group (group presumed to be preferred) was nutrient adequate was negligible, suggesting that in very few of these household are there members who are "haves", benefiting nutritionally to the nutritional detriment of "have nots". The analysis of determinants did not reveal any single, consistent set of factors driving decisions across all pair groups and nutrients, but these factors were not substantially different for households that were and were not nutrient adequate. Household dependency ratio, higher relative male education, female household headship, and women's decision-making power provided mixed results for pairwise comparisons. Conclusions The variable pattern of nutrient inequities underscores the risk of overlooking intra-household nutrient allocation disparity or making assumptions about a particular intra-household food and nutrient distribution pattern in any context where programs are intended to benefit particular household members. [ABSTRACT FROM AUTHOR]

Nutrition-sensitive agricultural interventions have the potential to improve child dietary quality in rural households, as evidenced by a growing body of work which concurrently measures agricultural and nutrition indicators. Our objective was to investigate whether children in rural farming communities of Nepal participating in a community-level, nutrition-sensitive development intervention had improved dietary quality compared with children living in non-participating matched rural communities. Six rural communities of Nepal where livelihoods were predominantly agricultural were selected to participate in the phased implementation of a community-level development intervention by Heifer International . Households and children in each community were surveyed at baseline, and follow-up surveys were implemented every six months for twenty-four months. Detailed data on food consumption for children older than 6 months of age were collected using a 24 h recall for 17 foods and food groups; parents responded for children. A difference-in-differences model with household fixed-effects and an analysis of covariance model were used to analyze the resulting panel data. Results indicated that the impacts of the intervention varied by agro-ecological region and by season. In the Hills region, which is poorer on average and more conducive to livestock production, children who had received the intervention for two years were 2.2 times as likely to have consumed food from an additional food group, 1.27 times as likely to have achieved minimum dietary diversity and 1.38 times as likely to have consumed animal source foods as children who received the intervention for only one year. In the Terai region, which is more conducive to crop production, there was no significant change in dietary quality attributable to the intervention. These results provide evidence that particularly vulnerable families can take advantage of community-level development activities. Given that the effects of community-level development activities were disparate across communities within the same country, we conclude that tailoring development activities for particular locations is necessary for success. [ABSTRACT FROM AUTHOR]