Comprehensive Food Security Assessment

We used household and child dietary diversity score (DDS) and the reduced coping strategies index (rCSI) to assess food security. We applied a 24-hour food recall to a checklist of 12 food groups for estimating the household DDS, as recommended by the Food and Agriculture Organisation of the United Nations [23 (link)]. The household DDS food groups were as follows: (1) cereals; (2) white tubers and roots; (3) vegetables; (4) fruits; (5) meat; (6) eggs; (7) fish and seafood; (8) pulses, nuts, and seeds; (9) dairy products; (10) oils and fats; (11) sweets; and (12) spices, condiments, and beverages. The household DDS has a range of 0 to 12. Similarly, we applied a 24-hour food recall to a checklist of 7 food groups to estimate child DDS, as recommended by WHO [24 ]. The child DDS food groups were as follows: (1) grains, roots and tubers; (2) legumes and nuts; (3) dairy products; (4) flesh foods; (5) eggs; (6) vitamin A-rich fruits and vegetables; and (7) other fruits and vegetables. The child DDS has a range of 0 to 7. The rCSI is a simple tool applied in different contexts that assesses the frequency, in days within a 7-day period, and the severity of 5 coping strategies commonly used by households, when they cannot access enough food [25 ]. The 5 coping strategies are consuming less preferred foods, borrowing food, reducing meals, reducing portion sizes, and restricting adult’s food consumption to preserve children’s food consumption. As per recommendations, we weighted and summed the frequency responses to these strategies to create an index where higher scores indicate greater food insecurity. The rCSI range is 0 to 56. Rations of prepared food were distributed in this setting, so we asked how many days, within a 7-day period, the household relied on these wet rations. We asked how many meals were consumed in the household in the past 24-hour period.