Abdulhalik Workicho, Garumma Tolu, Beyene

Wondafrash, Shibani Ghosh, Jennifer Coates

October,2014

Adama, Ethiopia

PREDICTORS OF HOUSEHOLD DIETARY DIVERSITY

IN ETHIOPIA: ANALYSIS OF THE 2011 WELFARE

MONITORING SURVEY (WMS) DATA,

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Background

• An adequate supply of nutrients is needed to maintain all thefunctions of human body and daily activities at maximumefficiency, thus ensuring healthy living [Edris M., 2004].

• Dietary diversity, a simple count of food items or food groups usedin the household or by the individual over a certain time period, hasbeen considered a potential ‘proxy’ indicator to reflect nutrientadequacy [Ruel MT, 2002].

• In developing countries where people often share food from acommon bowl [Hudson GJ,1995], dietary diversity, food variety andconsumption of animal source foods are indicators commonly usedto assess dietary intake [Hop LT 2003]

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Contd’…

• Studies demonstrated that dietary diversity scores are usefulproxy indicators of adequate intake across a range of keymicronutrients[Kenedy G, 2009].

• It has also been indicated that both Food variety Score (FVS)and Dietary Diversity Score (DDS) had a positive correlationwith mean adequacy ratio (MAR).

• Thus, food diversity patterns and their determinants need to beexamined in order to carry out tailored nutritionalinterventions.

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Objectives

• To identify the variety of foods consumed at house hold level

• To determine house hold level Dietary Diversity Score (DDS)

• To identify the determinants of house hold level dietary

Diversity

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Methods

• A secondary data from 27,695 HHs, sourced from welfare monitoring

survey (WMS) data set was analyzed.

• The sample was allocated based on a probability proportional to size.

• The participants were drawn from urban and rural areas of the country.

• Structured questionnaire was used to collect socio demographic, economic

and dietary data.

• The respondents were asked to report number of days in the past week they

consumed the food items listed on the food frequency questionnaire.

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• Consumers of a food item were defined if they had consumed

the food item at least once in the past week [Kant AIL, 1997 ].

• The food items [table 1] were grouped into six groups

[cereals/vegetables/fruits/dairy/protein foods/oils] [Table 2]

according to the My Pyramid classification for healthy eating

[Mirmiran P, et al, 2006].

• A Dietary Diversity Score (DDS) was constructed by counting

the intake of the food groups in the reference period (one

week) [19] based on the definition that it is the sum of food

groups consumed over the reference period.

Contd’…

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• The DDS was converted into tertile and the highest tertile was

used to define ‘‘high’’ household dietary diversity score, while

the two lower tertile were combined and labeled as ‘‘low’’

household dietary diversity score.

• Mean DDS was reported and logistic regression analysis was

used to identify determinants for HHDD. The statistical

significance was determined by using a P value < 0.05 as a

cutoff point.

• All the analysis was performed with SPSS version 20.

Contd’…

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Result and Discussion

Individual food items frequency of consumption in aweek

• A total of 27,695 households were involved in the study out ofthe selected 28,032 households giving a response rate of99.8%.

• The mean HH size was 4.77+2.26.

• while 75% of the HH heads were males.

• Overall, a total of 19016 (67.9%) of the households have lowDDS.

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Contd’…

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Description of food groups consumed

• Six food groups were constructed from the individual food

items based on My pyramid food group classification.

• Cereals were consumed daily by 95.1% of the household.

• It was found that, the mean consumption per week was highest

for cereals (6.8+1) and lowest for fruits (0.8+1.6). (Table 2)

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Contd’…

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Regional distribution

• Low HHDDS was recorded in more than 70% of

households in Benishangul Gumuz while more than

60 % of households in Harari region categorized

under the high HHDDS.

• Only 11.4% of the households in Addis Ababa had

high HHDDS while majority of its households (47%)

ranking in low HDDS.

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0

10

20

30

40

50

60

70

80

percent

region

Low

Mediun

High

Contd’…

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• A multiple logistic regression analysis showed that, wealth

index of the middle and higher category, engaging in farming

activity, were positively associated with higher HHDDS.

• Experience of shortage of food, experience of shock, residence

in large cities and towns, were negatively associated with

having higher DDS.

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Multiple logistic regression analysis

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Summary

• 68% of HHs have low DDS

• Low HHDDS in (70%) and high HHDDS (60%)

were exhibited in Benishangul and Harari

respectively

• Only 11% of HH in AA with High DDS

• Fruits were less consumed food groups.

• Higher income and engaging in farming activity were

positively related to having high HHDDS

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Recommendation

• Educating the public more about benefits of consuming

fruits alongside increasing the availability of the products

is important

• strengthening strategies that help HHs increase their

income will also have a direct effect to help people

diversify their diet.

• Multi-sectoral collaboration to prevent and build up the

capacity of the HHs to withstand different calamities.

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Acknowledgment

• We are extremely thankful for Ethiopian CSA for providing

the data and

• USAID/ENGINE funding the data analysis.

• We also are grateful for Professor Tefera Belachew for his

technical support.

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Thank you

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