1. Nutritional Status Assessment
through Household Income and Expenditure Survey (HIES),
Child and Mother Nutrition Survey (CMNS), and
Multiple Indicator Cluster Survey (MICS)
By
Dipankar Roy, PhD
Bangladesh Bureau of Statistics
Training on Assessment of Nutritional Status 18-22 December 2011
Date : 22 December 2011,
Venue: FPMU Meeting Room
The Training is organized by the National Food Policy Capacity Strengthening Programme (NFPCSP) . The NFPCSP is jointly
implemented by the Food Planning and Monitoring Unit (FPMU), Ministry of Food and Disaster Management and Food and
Agriculture Organization of the United Nations (FAO) with the financial support of the EU and USAID.

2. Introduction
• The Bangladesh Bureau of Statistics (BBS) has
a long history of conducting Child Nutrition
Surveys (CNS) to determine the nutritional
status of children in Bangladesh
• Five such surveys were conducted every 3-5
years between 1985 and 2000
• Child and Mother Nutrition Survey 2005
• Child and Mother Nutrition Survey 2011-12 is
on process

3. Method of Data Collection
• A questionnaire was designed to record data
on several indicators
• Direct interview method taking some
measurements
• Logistics
– UNISCALE
– Stadiometer
– MUAC tape
– HemoCue Photometer

4. Data Processing
• Data entry was done through IMPS software
• Validation was confirmed using Epi-Info
• Data were analyzed with SPSS

5. Nutritional Status Indicators
• Anthropometry
– Weight-for-age
– Weight-for-height
– Height-for-age
– MUAC
– BMI

6. Data Interpretation
• Mean
• Standard deviation
• Z-score
• Confidence interval

7. Data Availability
• Food Security-Nutritional Surveillance Project
(EU-BRAC-HKI-BBS)
– State of Food Security & Nutrition in Bangladesh
2010
• BBS has been doing PEC of the survey

8. Conclusions
• Malnutrition is difficult to address because it has
numerous causes including
– immediate (inadequate dietary intake, diseases…)
– underlying (food insecurity, lack of maternal and child
caring practices, unhealthy environment, poor health
services…)
– basic (poverty and inequality in the society)
• A multi-sectoral approach is crucial, because the
multiple causes of malnutrition require a
coordinated response from multiple sectors

9. Data Combination
• Anthropometric measurements combined
with various socio-economic, health and
sanitary variables are an effective way to
assess nutritional status of children

10. Introduction
• Bangladesh Bureau of Statistics has been
conducting HES since 1973-74
• Thereafter surveys were conducted in
1974-75, 1975-76, 1976-77, 1977-78, 1978-79,
1981-82, 1983-84, 1985-86, 1988-89, 1991-92,
1995-96, 2000, 2005 (HES became HIES in
2000)
• The 15th round of HIES, the latest one, was
conducted in 2010

11. Objectives
• Obtaining estimates on household income,
expenditure, and consumption
• Determining poverty lines and estimating
poverty and inequality measures
• Providing information about living standards
and nutritional status of the population
• Determining weights for consumer price
indices

12. Measurement of Poverty Line
• Direct Calorie Intake (DCI) method
• Food Energy Intake (FEI) method
• Cost of Basic Need (CBN) method (since 1995-96)
• In DCI method, only calorie intake is considered.
There are three types of poverty a) Absolute poverty:
the threshold is <=2122 k. calorie; b) Hardcore
poverty: the threshold is <=1805 k. calorie; and c)
Ultra poverty: the threshold is <=1600 k. calorie.

13. Measurement of Poverty Line (2)
• In DCI method, only calorie intake is considered.
• In FEI method, per capita expenditure is taking into
account with calorie intake.
• In this case food basket is dynamic while in CBN
method fixed bundle is considered.
• There are two poverty lines in poverty measurement
such as lower poverty line and upper poverty line.
• However, BBS refers upper poverty line and CBN
method to estimate poverty officially.

14. Measurement of Poverty Line (3)
Quantity per capita Price per kg.
Item Calorie (K. cal.) Value
per day (gm.) (in TK.)
Rice (Coarse) 397 1389 17.50 6.95
Wheat 40 136 18.62 0.74
Pulses 40 136 46.37 1.85
Milk 58 36 15.71 0.91
Oil 20 180 67.55 1.35
Meat 12 14 109.03 1.31
Potato 27 24 8.46 0.23
Vegetables 150 65 8.50 1.28
Fish 48 66 72.75 3.49
Sugar 20 66 38.30 0.77
Fruits 20 10 28.46 0.57
Total 832 2122 19.45
FPL = 583.45

15. Measurement of Poverty Line (4)
• Pricing of the food bundle yields the food
poverty line and 16 food poverty lines are
constructed for 16 strata.
• Computing two non-food allowances (lower &
upper) for non-food consumption.
• Lower non-food allowance is obtained by
taking the median amount spent for non-food
items whose per capita total expenditure is
close to the food poverty line.

16. Measurement of Poverty Line (5)
• Upper non-food allowance is obtained by
taking the median amount spent for non-food
items whose per capita food expenditure is
close to the food poverty line.
• Adding lower and upper non-food allowances
to food poverty line yield lower poverty line
and upper poverty line respectively.

17. Poverty Incidence

18. Poverty Depth

19. Poverty Severity

20. Inequality

21. Average per capita daily intake (grams)

22. Average per capita daily calorie intake
(k.cal)

23. Average per capita daily protein intake
(grams)

24. Introduction
• The Bangladesh Bureau of Statistics has been
conducting the Multiple Indicator Cluster Survey
(MICS) since 1993.
• The objective of the MICS 2009 was to provide
disaggregated data on children and women at the
national and subnational levels
• The survey was the first attempt ever in Bangladesh by
a national household survey to collect data at the sub-
district level for a number of key social sector
indicators covering the education, environment, health
and child protection sectors

25. Data Availability in MICS
• MUAC
• Timely initiation of breastfeeding, exclusive
breastfeeding
• Colostrum given
• Infant feeding patterns
• Adequately fed infants
• Iodized salt consumption
• Vitamin A administration
Lecture X: Title of the Presentation -Name
of Presenter

26. REACH Initiatives
• REACH (Renewed Efforts against Child Hunger
and under nutrition) is an interagency
(UNICEF, WFP, WHO, and FAO) UN initiative
that assists governments in countries with
high burdens of child and maternal under
nutrition to implement, and to mobilize
resources for, food and nutrition security
programs.

27. Introduction
• The REACH initiative has selected Satkhira
District in Southern Bangladesh as the first
demonstration area
• Prior to initiating REACH-supported activities
in Satkhira District, there is a clear need to
carry out a district-wide food security and
nutrition survey that encompasses the key
indicators under the initiative

28. Objectives
• The purpose of the Satkhira baseline survey is
to assess the nutrition and food security
characteristics of the population of young
children (0-59 months), their mothers, and
pregnant women in Satkhira before REACH
implementation

29. Field and Data
• REACH has commissioned Helen Keller
International (HKI) to conduct a baseline
survey in consultation/coordination with the
Bangladesh Bureau of Statistics (BBS) that will
provide robust household food security and
nutrition data that is statistically
representative for the district

30. • Field works in pictures