Using household food consumption data to assess nutrient adequacy in Ethiopia

Abstract

Abstract Introduction: Monotonous low-quality diets are the norm in resource-limited environments like Ethiopia. Understanding household dietary diversity and nutrient adequacy is crucial for guiding nutrition initiatives. While a comprehensive understanding is best achieved by combining household and individual data, collecting data at the individual level may not always be practical due to resources and time limitations. Objective: The aim of this study was to assess household dietary diversity and adequacy of energy, iron and Vitamin A using Household Consumption and Expenditure survey data in Ethiopia. Methods: The study utilized data from Socioeconomic Survey 2018-2019 of Ethiopia (The World Bank, 2021). Household Dietary Diversity Score (HDDS) was calculated at the national level and regionally. The adult male equivalent approach was used for calculating nutrient access. Mann-Whitney U test was applied to explore potential differences in dietary diversity between urban and rural areas. Chi square statistic was used to test for the difference in household adequacy of energy and nutrient between rural and urban areas. Finally, a linear regression model was utilized to analyze the relationship between sociodemographic variables and adequacy of energy as well as between socioeconomic variables and household mean prevalence of adequacy of iron and vitamin A. Results and conclusion: In this study, the national median Household Dietary Diversity Score (HDDS) was 7 (IQR 2). Prevalence of dietary energy adequacy at national level was found to be 57.5% (3142/5467). Prevalence of dietary iron adequacy was 50.8% (2779/5467) and prevalence of dietary vitamin A adequacy was found to be 25.9% (1416/5467). Urban households exhibited higher HDDS than rural households, and this difference was statistically significant (z = 26.07, p = <.001). Chi-square tests revealed significant associations between rural/urban location and adequacy of energy (p < .001), iron (p < .001), and vitamin A (p < .001). Specifically, rural households were more likely to have inadequate access to energy, iron, and vitamin A compared to urban households. HDDS, residence location, age and years of education of household head, income quintile, agroecological zone, household size, and proximity to major roads are factors associated with nutrient adequacy. Targeted interventions should focus on enhancing income-generating opportunities, and education.

Keywords: Nutrient adequacy, Household food consumption data, Household dietary diversity, Urban-Rural disparities, Socioeconomic determinants