Validity of the Latin American and Caribbean Household Food Security
Scale (ELCSA) in South Haiti
Rafael Pérez-Escamilla, PhD 1, Michael Dessalines BS 1, Mousson Finnigan, MD2, Amber Hromi-Fiedler, MPH PhD 1, Helena Pachón, PhD3
1University of Connecticut, Storrs, CT, USA, 2Organization for the Rehabilitation of the Environment (ORE), Camp Camperrin, Haiti, 3Centro Internacional de Agricultura Tropical, Cali, Colombia
ABSTRACT ELCSA ITEMS RESULTS: CONVERGENCE AND CRITERION VALIDITYa,b
We tested the validity of ELCSA in a convenience sample of 153 Questions referring to respondent and/or other adults in the householda Maternal Dinner Weekly Consumption
Maternal Breakfast Weekly Consumption Maternal Lunch Weekly Consumption
women with children under five in South Haiti. ELCSA was applied to 1) During the last 3 months, were you worried about running out of food?
by FI Level by FI Level by FI Level
the women in Creole, contained 16 items and used a reference period 2) Did your home run out of food at any time during the last 3 months?
didn't eat 1- < 3 times 3-6 times every day didn't eat 1- < 3 times 3-6 times every day
didn't eat 1- < 3 times 3-6 times every day
of 3 months. Cronbach’s alpha was 0.92. Based on affirmative 3) Was your home unable to eat the kinds of foods that make you healthy at any time
100 100 100
during the last 3 months? 91
response prevalence, the items referring to child hunger tended to be 4) Did you or anybody in your home usually have to eat the same foods almost every
90 85.1 p=0.002
90 p=<0.001 90
77.6
p=<0.001
80 80 80
the most severe. However, social unacceptability of procuring food day during the last 3 months? 70
70.7
70 70
60
was the most severe item. This question asked ‘Was there any time 5) Was there any day during the last 3 months that you or any other adult in your home 60 60 54.5 60
48
54.5
48
%
%
50
%
45.5 50
during the past 3 months when you had to do something that you skipped a meal because of lack of food? 50
40 36 40 40
would have preferred not to do (such as begging or sending the 6) During the last 3 months did any adult in your home eat less food than what they 30 30 27.3 30
29.3 27.3
needed because there wasn’t enough food? 16 17.3 14.7 20 14.9 17.3
children to work) to be able to get food?’. There were no food secure 20
11.9
8 9.1 9.1
20
8 9.1 9.1 5.3
9.1
7) During the last 3 months was there any day when you or any other adult in your home 10 3 5.3 10
1.5
4.5 3
10 3 4.5
households in the sample, 44% were food insecure (FI), 49% were felt hungry but did not eat because there wasn’t enough food? 0
0
0 0
FI very FI extremely FI FI very FI extremely FI
very FI, and 7% were extremely FI. Criterion validity was strong. 8) Was there any day when you or any other adult in your home didn’t eat for a whole
FI very FI extremely FI
Those reporting having good/very good health ranged from 38.8% day or just ate once during the day because there wasn’t enough food during the last
3 months? Malaria in Children Under 5 by FI Level Energy/Fuel Source by FI Level Land Ownership by FI Level
among those FI to 9.1% among those extremely FI (p=0.02).
9) During the last 3 months, did you do things that you would have preferred not to do,
Households with children who had recently had malaria were more such as begging or sending children to work, to get food? malaria healthy
electricity other& yes no
likely to be very/extremely FI than households where the index child Questions referring to children under 5 years old in the householda
80
70.6
80
71.4
80
70.2
p<0.001 70 p=0.023 70 p<0.001
had been free of malaria (82.0% vs. 37.1%, p<0.001). Additional 10) During the last 3 months were you unable to provide the children in your home with
70
60 56.9 60 60
factors associated with very/extreme FI (p<0.05) were: female-headed the kinds of foods they need to be healthy?
50
52.5 54.7
50 43.8 50
household, lack of electricity at home, no land ownership, and poorer 11) Did any children in your home usually have to eat the same foods almost every day 38.2 39.6
%
%
%
40 40 40
during the last 3 months?
dietary quality. Results suggest that ELCSA is a valid tool for 30 30 30
12) During the last 3 months did any child in your home eat less food than what s/he
assessing household FI in rural Haiti. Funded by CIDA (7034161) needed because there wasn’t enough food? 20
17.6
11.8
20 14.3 14.3 20
19.1
through a grant to the Centro Internacional de Agricultura 13) During the last 3 months did you have to serve less food to any child because there
10 4.9 10 6.5 10 5.7
10.6
Tropical (CIAT). wasn’t enough food? 0 0 0
FI very FI extremely FI FI very FI extremely FI FI very FI extremely FI
14) During the last 3 months was there any day when any child in your home felt hungry
but could not be fed because there wasn’t enough food? Marital Status by FI Level Good/Very Good Maternal Health
BACKGROUND 15) Did any child in your home go to bed hungry in any day during the past 3 months
by FI Level*
because of lack of food? married common law single
45
At a recent FAO-sponsored Regional meeting in Antioquia, Colombia, 16) Was there any day when any child in your home didn’t eat for a whole day or just ate
80
72.7 40
38.8
p=0.024
70 p=0.041
consensus was reached on the importance of testing a single once during the day because there wasn’t enough food during the last 3 months? 60 35
60 54.6
experience-based household food security measurement scale in a Participant responses for each item were yes, no, don’t know or refused.
50
30
different Latin American and Caribbean countries. The ‘Escala PARTICIPANT CHARACTERISTICS (N=153) 39.2 25 21.3
%
%
40
20
Latinoamericana y Caribeña de Seguridad Alimentaria’ (ELCSA) was 30
30
15
developed mostly based on the national household food insecurity n % 20
18.2 9.1
10
10
measurement experiences in Brazil, Colombia and the USA*. The Sewage at home 4 2.6 10 6.2
9.1
5
data reported herein represents the first application of ELCSA in the Electricity at home 14 9.2 0 0
FI very FI extremely FI FI very FI extremely FI
field. Income < $30 per month 100 65.4 * Self-reported
ap values base on chi-squared analyses
* Pérez-Escamilla R, Melgar-Quiñonez H, Nord M, Alvarez Uribe MC, Segall-Correa AM.Escala Married 40 26.1 b N=153
Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) [Latinamerican andCaribbean Food Good/very good health (self-reported) 43 28.1
Security Scale]. Perspectivas en Nutrición Humana (Colombia) 2007 (supplement):117-134.
Child diarrhea (past 2 wks) 39 25.5 RESULTS: PSYCHOMETRIC PROPERTIESa,b,c
Child malaria (past 2 mo) 51 33.3
STUDY DESIGN ELCSA Item Prevalence 12 ELCSA Item Severity Values
Child stunting (height-age Z <-2) 62 43.4 100
90
• Location: Camp Camperrin, South Haiti
% affirmative responses
Maternal BMI 80 10
Severity Value
70 8
Rasch Item
• Cross-sectional, convenience sample Underweight (<18.0 kg/m2) 52 34.0 60
50 6
Adequate weight (18.0 - <25.0 kg/m2) 77 50.3 40
• N=153 mothers with children < 5 y 30 4
Overweight (25.0 - <30.0 kg/m2) 19 12.4 20
• Household food security measured with the ‘Escala 10 2
Obese (≥ 30.0 kg/m2) 5 3.3 0
Latinoamericana y Caribeña de Seguridad Alimentaria’ (ELCSA) 0
ea hild 2)
w od i e )
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od ng hil (7)
)
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ea )
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ac hi 6)
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ri e ng 5)
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)
ip -ch y (8
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m 11
va d (1
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pt (15
Mean SD
(9
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ild 7)
ac hi 16)
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pe hi ( 8
r m -c t (
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al y (
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d d(
od
l-c (
hu d-c ry
m ch t (
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(
ss d
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m (1
• ELCSA translated from Spanish to French and then to local Creole
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ip -c y
t
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Mother’s age (y) 30.7 7.0 f o an
h
th or
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l
ld h
fo ran
r
-
before application
o
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&
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Study child’s age (mo) 32.9 12.6
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• ELCSA validated in the context of a larger study whose objective
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CONCLUSIONS
th
al
no
was to evaluate the potential for biofortified sweet potato to improve