User Guide 1: Conducting a Nutrition Survey (2011) by The Power Is In People

User Guide 1

Conducting a Nutrition Analysis Survey www.oxfam.org.au

Title User Guide: Conducting a Nutrition Analysis Survey Author Moeti Kgware Editor Cheryl Goodenough Photographs Matthew Willman, Cedric Nunn & Gcina Ndwalane Design LUMO creative www.lumo.co.za Oxfam Country Office in South Africa 56 Clark Road Glenwood, Durban, 4001 South Africa Tel +27 31 201 0865 | Fax +27 31 201 4026 Email infosouthafrica@oxfam.org.au www.oxfam.org.au Published July 2011 by Oxfam Australia Oxfam Australia 132 Leicester Street Carlton VIC 3053 Australia Tel +61 3 9289 9444 | Fax +61 3 9347 1983 Email enquire@oxfam.org.au | ABN 18 055 208 636 www.oxfam.org.au Copyright Oxfam Australia gives permission for excerpts of this guide to be photocopied or reproduced provided that the source is properly and clearly acknowledged. Disclaimer The views of this publication are those of the author and do not necessarily represent those of Oxfam Australia or any funding agency. The development of the guide and tool was participatory with field testing by Oxfam program partners. Acknowledgments Our thanks to HIV/AIDS Prevention Group Bela Bela and CHoiCe Trust for their assistance with field testing the tool within their communities.

PHOTO [FRONT COVER] Philisiwe Ndwandwe (49 years old) is one of the food security gardeners supported by Sibambiseni outside of Jozini. Here she is seen standing proudly next to her healthy corn harvest. Photo ÂŠ Matthew Willman / Oxfam PHOTO [BACK COVER] Nesta Phakathi poses for the camera showing the food she eats. Photo ÂŠ Matthew Willman / Oxfam

Contents Introduction About Oxfam Australia

About this Guide

How to Use this Guide

Further reading

The study that led to the development of this guide looked at different approaches from around the world

The following resources may be useful if you wish to do

as applied by various organisations working in the field

further independent research on food security and some

of nutrition and household food security. It considered

of the issues raised in this manual.

some of the vast amount of literature that covers household food security and nutrition as two separate

• Department of Agriculture, Forestry and Fisheries

entities, as well as some of the more limited information

in South Africa

that covers nutrition as an indication of food security.

www.daff.gov.za

• Food and Agriculture Organisation of the The study, which also reviewed a few approaches

United Nations

to household food security and nutrition baseline

www.fao.org

assessments, resulted in the formation of this guide.

• Food and Agriculture Organisation of the United

The first part of the guide briefly examines the concept

Nations in South Africa

of food security and the context of food security issues

www.fao.org/world/southafrica

in South Africa, while the second provides tools for

• Food and Nutrition Technical Assistance Project

conducting a Nutrition Baseline Survey.

(FANTA)

www.fantaproject.org

How to use the guide

• Food for the Hungry

This guide consists of two sections. The first part briefly

• Human Sciences Research Council

examines the concept of food security and the context of

food security issues in South Africa. It is included to

• Humanitarian Practice Network

assist users of the guide to gain an understanding of the

background and context.

• Integrated Nutrition Program, Department of Health

www.fh.org www.hsrc.ac.za www.odihpn.org

in South Africa

The second part contains tools to conduct a Nutrition

www.doh.gov.za/programmes/index.html

Baseline Survey. You can refer to Part Two on its own in

• Rome Declaration on World Food Security (1996)

order to conduct the survey.

www.foddjustice.net/international-standards

• Statistics South Africa Throughout the manual there are activities to assist

you to think about some of the information and to

• World Food Programme: Food Security Analysis

www.statssa.gov.za

think through some of the processes. You may find it

www.wfp.org/food-security

PHOTO [LEFT]: Bongani Noyo and Lunga Blouw, graduates from the Umzi Wethu Training Academy, demonstrate some of their skills in the Wilderness Foundation’s kitchen. Photo © Gcina Ndwalane / Oxfam

Part

This section sets out to give readers an overview of food security, the situation in South Africa, and some of the challenges relating to the issue of food security. It also provides an overview of the legislative framework and roleplayers in the food security sector.

1.1 What is Food Security? Along with a constant supply of safe water, food is an absolute necessity for human survival for more than a very short period.

Activity: Spend some time thinking or talking about what food security means to you. How would you define the concept? What do you think it means for a household to be food-secure? Once you’ve completed the activity see how your definition and understanding compares with the definitions below.

There are various recognised definitions of food security. The World Food Summit of 1996 defined food security as: A situation when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Also in 1996, the Science Academies Summit in India defined nutrition security as: A state where every individual has the physical, economic and environmental access to balanced diet that includes the necessary macro and micro nutrients and safe drinking water, sanitation, environmental hygiene, primary health care and education so as to lead a healthy and productive life. PHOTO [LEFT]: Children at Joe Slovo Junior Primary School are fed during lunch break by food prepared and served by Sophakama CBO volunteers. Photo © Matthew Willman / Oxfam PHOTO [BELOW]: Cast iron pots are synonymous with rural Africa, every house hold has at least one heavy, sturdy pot. These pots are versatile enough to help prepare all of the community’s varying food choices. Photo © Matthew Willman / Oxfam

1.2 The Context: Food Security in South Africa 1.2.1 Policy and Legislation

Activity: Make a list of laws, policies, programs or activities carried out by the government that you are aware of that relate to food security.

There are a wide range of laws and policies that relate to the issue of food security, or that impact on food security in some way. There are also a wide range of programs and activities implemented by the government. These include the following: • South Africa’s Constitution (in Section 27): The Constitution affirms the right to food security. • Reconstruction and Development Program (RDP): The strategic framework for action to achieve food security was first outlined in the RDP, which identified food security as a basic human need. The RDP food security framework was refined in subsequent policy papers such as the Agriculture White Paper of 1995 and the Agricultural Policy Discussion Document (1999). • Integrated Rural Development Program (IRDP): In 1999 the policies in the Agriculture White Paper and the Agricultural Policy Discussion Document were consolidated and updated in the IRDP, which is the policy of the government of South Africa. • Integrated Food Security Strategy (IFSS): Adopted by the government in 2002, the IFSS aimed to integrate and streamline the implementation of various food security programs under the control of different government departments. The aim of the IFSS is to provide physical, social and economic access to safe and nutritious food for a healthy and active life for all South Africans. • Integrated Food Security and Nutrition Program (IFSNP): The IFSS was translated into the IFSNP with a task team in the national Department of Agriculture (DoA) overseeing its implementation. • At a regional level: South Africa is working together with the Southern African Development Community towards food security at a regional level. • At an international level: South Africa has committed to support the World Summit Plan of Action outlined in the 1996 Rome Declaration on World Food Security.

1.2.2 South Africa’s Food Security Challenges

Activity: What are some of the challenges faced by South Africa when trying to achieve food security?

Your responses may include some of the following (including some defined in the IFSNP): 1. Ensuring that enough food is available to all, now and in the future. This requires South Africa to maintain and increase its ability to meet its national food requirements. This involves domestic agricultural production, importing food items that cannot be produced efficiently, and exporting commodities with comparative advantage. 2. Matching incomes of people to prices in order to ensure access to sufficient food for every citizen. This may involve eradicating inequalities and poverty as well as addressing unemployment. 3. Empowering citizens to make optimal choices for nutritious and safe food. 4. Ensuring that there are adequate safety nets and food emergency management systems to assist people who are unable to meet their food needs through their own efforts â&#x20AC;&#x201C; and mitigate the extreme impact of natural or other disasters on people.

1.2.3 Access to Food: The Situation in South Africa The 2009 General Household Survey report published by Statistics South Africa estimated that at least 19.6% of South African households had inadequate or severely inadequate access to food. Provincial statistics were as follows:

Province

Households that have inadequate or severely inadequate food access

Free State

33,5%

KwaZulu-Natal

23,1%

Eastern Cape

21,4%

Mpumalanga

21,5%

Northern Cape

19,6%

North West Province

19,6%

Gauteng

17,5%

Limpopo

11,9%

Western Cape

14,5%

Research has found that the main income source for people to purchase food is salaries. The number of people unemployed in South Africa (an estimated 4,3 million) poses a serious challenge in this regard. These numbers are significant enough to go a long way in destabilising the food security status of many South Africans. Families are also further vulnerable to external factors because statistics show that less than 20,7% of South Africans produce food (for commercial or subsistence purposes). The levels of HIV and AIDS in South Africa â&#x20AC;&#x201C; in 2008, an estimated 10,9% of all South Africans over two years old were living with HIV â&#x20AC;&#x201C; has an impact on food security. The HIV prevalence among females is highest in those between 25 and 29 years, while among males it is highest in the 30 to 34 year old age group. This indicates that the highest prevalence rates are amongst the economically viable age groups, which can have a negative impact on the ability of households and communities to stay food-secure.

Part

Activity: If you are trying to determine whether a particular household is food-secure or food-insecure, what factors would you take into account? How could you determine whether a household is food-secure?

2.1 Measuring Household Food Security and Nutrition Levels One of the major problems experienced by researchers trying to measure household food security is that there is no single indicator that could capture the definition of “food-insecure households”. Some research has found that determining food security and insecurity can involve assessing the following: • Feelings of uncertainty or anxiety over food (situation, resources, or supply); • Perceptions that food is of insufficient quantity (for adults and children); • Perceptions that food is of insufficient quality (includes aspects of dietary diversity, nutritional adequacy, preference); • Reported reductions of food intake (for adults and children); • Reported consequences of reduced food intake (for adults and children); and • Feelings of shame for resorting to socially unacceptable means to obtain food resources. Factors considered by the World Food Program to be important in determining food security or otherwise include the following: i.

Dietary diversity: This is defined as the number of unique food items (such as pulses, sorghum, meat and sugar) consumed during the previous seven days; this includes two components (a) food consumption frequency, defined as the number of days for which each food item was consumed over the previous seven days; and (b) the primary source of each food item.

ii.

Sustainability of consumption: This looks at where the food comes from, whether it is through aid or through the household’s own efforts.

iii.

Intra-household distribution: There may be cases where the food consumption pattern is acceptable at household level, but poor for some members of the household. A household may qualify as food-secure on the basis of its food consumption pattern, and might seem not to be in need of assistance, while there might be a need for support in the form of targeted food aid (e.g. supplementary feeding, school feeding) or non-food interventions (e.g. behaviour change communication on care practices).

2.2 Conducting a Nutrition Baseline Survey The study that informed the development of this guide looked at different approaches from around the world as applied by various organisations working in the field of nutrition and household food security. After reviewing a few approaches to household food security and nutrition baseline assessments, a data collection tool (which is included as Appendix 1 in this manual) was developed. It is based on the Household Food Insecurity Access Scale Generic Questions and the United States Department of Agriculture Guide to Measuring Household Food Security.

PHOTO [LEFT]: Ubombo Support Group member Uthembekile Bompontshane, of Jozini, South Africa, harvests beetroot to include in food parcels for orphaned children. Photo © Matthew Willman / Oxfam

The adopted tool looked at the inclusion of availability, access, utilisation, stability and food preparation as elements of food security and nutrition. 1. Access refers to whether households and individuals within those households have sufficient resources to obtain appropriate foods for a nutritious diet. It takes into account the level of household resources â&#x20AC;&#x201C; capital, labour and knowledge â&#x20AC;&#x201C; and prices. It also refers to the ability of households to generate sufficient income which, together with own production, can be used to meet food needs. 2. Utilisation takes into account socio-economic and biological aspects, and includes the decisions made in a household regarding what food is consumed and how the food is allocated within the household. In addition, it considers food security on an individual level referring to the ability of the human body to take food and translate it into energy used to undertake daily activities or to store it. Utilisation requires an adequate diet, as well as a healthy physical environment, including safe drinking water and adequate sanitary facilities (so as to avoid disease) and an understanding of proper health care, food preparation, and storage processes. 3. Stability or Sustainability: This refers to the time frame over which food security is being considered. Chronic food insecurity is regarded as an inability to meet food needs on an ongoing basis, while transitory food insecurity is the inability to meet food needs on a temporary basis.

2.3 The Survey Questionnaire The framework is included in this guide as Appendix 1 and is in the format of a data collection tool or survey questionnaire. It comprises of four sections and has a total of 17 questions.

Section A B

Content Information relating to household background Food quality and quantity, including information pertaining to food variety, preferences and amount and type of food

Number of Questions 2 7

Availability of resources and the sustainability of food security

Nutrition and the types of food that people eat

The questions are all closed-ended, but there is a box for capturing additional information relevant to the questions in the section. The collection tool or survey questionnaire is designed to collect data in the simplest and quickest way. It can be completed by people with basic knowledge of research gained from a short introductory workshop on the completion of the data collection tool. The tool may be used in its current format, but it may also be used just as a guide, with additional information obtained from other sources. The questionnaire can be used to collect enough relevant data to make conclusive remarks on the state of food and nutrition security at household level. However, you may find that lean periods and geographical conditions require a different approach to data collection.

Note: The impact of HIV and AIDS, although a major factor in terms of the economy and the ability of affected households to maintain themselves, was not addressed in this study. This was mainly due to the fact that the study looked at availability, access and utilisation in general, regardless of the specific impediments to availability and access.

Section A

Activity: Read through Section A of the survey. Think or talk about how you would answer this question for your household or your colleagues’ households, and what you would be able to interpret from this information.

Section A is used to collect the information about: 1. The number of people in a household 2. The number of people per age group in the household In addition to providing information about the size of households, this section gives you an indication of the age of the people living in the household. As a result, you will have an understanding of the number of members who fall within economically viable age groups.

Note: For the purpose of this survey, the size of a household is concerned with the number of people sleeping under the same roof, sharing food from the same pot or taking meals together at least four days a week. In practice you may find that homesteads, particularly in rural areas, may consist of more than one household in a compound. Nevertheless, while each household may have its own abode, several households share food from the same pot. We suggest that the common factor in situations like this is “sharing food from the same pot”. It is most important to ensure that the same definition of “household” is used by all data collectors in carrying out one survey.

Section B

Activity: Read through Section B of the survey. Think or talk about how you would answer this question for your household or your colleagues’ households, and what you would be able to interpret from this information.

This section requires the person answering the questions to think about how things have been in their household during the previous 30 days. It looks at: 1. Whether people were able to eat food of their own choice 2. Whether there was sufficient food – that is, whether the amount of food that people were able to consume was deemed sufficient by the household members 3. Whether the food was of a good quality 4. Whether there was a variety of food

Section C

Activity: Read through Section C of the survey. Think or talk about how you would answer this question for your household or your colleagues’ households, and what you would be able to interpret from this information.

This section looks at whether a household has faced a challenge relating to resources when preparing food, and, if so, what resources are lacking. The resources could be: 1. Coal, wood, electricity 2. Money to buy food 3. Someone to prepare food 4. Water

Note: Food preparation is concerned with the extent to which the family cooks and preserves food, and to the availability of resources necessary to prepare the food. Keep in mind that if food is overcooked, it loses nutrients and the family may not receive adequate nutrition levels, even in food-secure situations. Undercooked foods may also lead to infections, while food that is properly cooked, but not properly stored or preserved may become spoiled or lead to food poisoning. In some communities, households have access to food, mostly through communal means, but end up not being able to prepare food due to a lack of other resources.

Section D

Activity: Read through Section D of the survey. Think or talk about how you would answer this question for your household or your colleaguesâ&#x20AC;&#x2122; households, and what you would be able to interpret from this information.

This section is concerned with the type of food that was consumed by a household. It enables us to consider whether people have a balanced diet of: 1. Carbohydrates (starch) 2. Protein (meat, soya or fish) 3. Vitamins (fruits and vegetables)

2.4 Conducting the Research 2.4.1 Preparation Selection of Data Collectors The results from the fieldwork testing of the data collection tool showed that the tool can be used to collect baseline household food security and information in a rapid and easy manner. The data can be collected by caregivers, who are trained in the use of the data collection tool and who already work in the communities where the survey is carried out. In this way, large-scale surveys can be undertaken as part of their day-to-day activities. These caregivers are easily accepted by the communities because they come from and work within the communities. The use of the caregivers can also reduce the cost of a large-scale survey or study as they may be able to collect the data as part of their day-to-day house-to-house visits. Training of Data Collectors Data collectors need to receive comprehensive training on the research and the questionnaire, but this training is not laborious, and does not require specialised training venues and equipment. During the fieldwork testing, this training took about two hours. It included a presentation on the background and rationale of the survey. It is best not to divulge the objectives of the study to prevent bias on the side of the data collectors. A document detailing the information to be conveyed during this training is included in this guide as Appendix 2. Sampling Sampling for the survey should be stratified per area. The results show that even within the same geographic setting, access to resources differs amongst the areas within a certain square-metre range. It is important that collection of baseline information be done amongst a cohort of participants with similar exposures.

Timing It should be noted that information will change from month to month and season to season, so the data collection period should be well planned out. December is the one month with a high possibility of out of average food consumption data due to a short-term abundance of resources and food. As a result it is recommended that data collection not take place in January for the food consumption in December or that data for December is excluded from data sets and analysis.

Materials Needed It is ethical research practice for participants to sign consent forms after data collectors have explained the purpose of the study and requested their participation. Prior to embarking on the data collection, ensure that each data collector has sufficient copies of the survey and a consent form for each household to be visited. Further information in this regard is provided in the document on training of data collectors (Appendix 2).

2.4.2 Collecting the Data During the fieldwork testing, data collectors took an average of 15 minutes, from entering a household to completing the questionnaire. A few important pointers: â&#x20AC;˘ The respondents on behalf of the household should be the people who are responsible for preparing the food, or whose responsibility it is to ensure that there are resources for procurement and preparation of food. This is an important factor to ensure the validity of results. â&#x20AC;˘ Timing is paramount to the validity of the survey. It is important that the data collectors clearly specify that the information required is for a specified period of time (30 days) and to ensure that they follow-on with this information throughout the interview.

2.5 Interpreting the Survey Results This survey has been designed in a way that is easy to analyse and leads to results that can be made available in a short period of time. These results can be used for planning, policy development and advocacy for food and nutrition security.

Section A: Household Background This section is designed to collect the following information: 1.

The number of people in the household

The number of people per age group in the household.

The actual numbers need to be added up to get a total. These results can be expressed as graphs such as those below:

Number of people in the household

15 10 5 0 <5

6–9

>10

Number of people per age group

30 20 10 0 <5

6–14

>15

This information can be used to identify intervention levels and types based on the numbers and the ages. Food requirements differ at different ages, and where relief is to be provided this information can be used for planning.

PHOTO [LEFT]: Children are fed as part of “Mealtime” at the Hluhluwe Advent Creche in KwaZulu-Natal. Photo © Cedric Nunn / Oxfam

Section B: Food Quality and Quantity This section enables you to consider whether there was sufficient food of good quality, quantity and variety and to assess if people were able to eat food of their own choice and preference. There are two methods that you can use to analyse these results. The first requires you to calculate the weighted sum of the responses or indicators. This is done by giving a number to each response:

Response

Number to be allocated

Never

Rarely

Sometimes

Often

Using the numbers in the table above, you would allocate a number to each response as in the example below:

Household

Question

Total

Note: Alphabetic letters should be used to count or denote household. Using numbers may lead to errors in counting. In order to interpret the results, you need to look at the total figure. The higher the total, the more food-insecure the household. These results can be depicted using graphs such as the following:

Quality and quantity of food

Never Rarely

Often

15 10 5 0 B1 18

Look at the survey results for information such as the following: • People not being able to eat the food they prefer due to a lack of resources • People eating fewer meals in a day because there was not enough food • People never having to reduce their intake of food • People eating fewer types of food every day due to a lack of resources • People feeling that meals they’ve had were not fulfilling • People going to bed without a meal due to a lack of resources It is also possible to use a chart such as the one below to make sense of the results. This chart shows, based on the weightings: 1. The number that shows the highest level of food insecurity [28] 2. Cautionary levels of food insecurity (Moderate to high) [21] 3. Moderate (average) levels of food insecurity [14] 4. Least levels of food insecurity [7]

Moderate to high, 21

Moderate, 14

High insecurity, 28

Least insecurity, 7

The second analysis option involves using the indicators to present the percent of households that responded positively to each question. This analysis does not take into account the frequency of the experience, but measures the percent of households experiencing the condition at any level of severity.

Example (using the first 3 questions of the Section)

Household A

Question B1 Never Rarely Sometimes Often Question B2 Never Rarely Sometimes Often Question B3 Never Rarely Sometimes Often

To calculate the percentage: Number of households with response to a question Total number of households responding to that question

100

Example:

Number of households responding to â&#x20AC;&#x153;rarelyâ&#x20AC;? in B1

Total number of households responding to question B1

60%

Section C: Resources and Food Security Stability This section provides information regarding whether people have resources like fuel and money to ensure food security. It will assist you to consider whether people have faced a challenge with resources to prepare food, and what resources people have most lacked. To explain how to conduct the analysis for Section C, we have used an abridged table with shortened questions as a guide. However, the full questionnaire should be referred to when analysis is being conducted.

Never

Rarely (once or twice)

Sometimes (3 to 10 times)

Often (10 times or more)

Number C1 (food preparation and resources) Number C2 (no money to buy food) Number C3 (no one to prepare food) Number C4 (no water) The first analysis option uses the weighted sum of indicators or responses. In this method of analysis, you need to give a number to each response:

Response

Number to be allocated

Never

Rarely

Sometimes

Often

Example:

Household

Question

Total

Note: Alphabetic letters should be used to count or denote households. Using numbers may lead to errors in counting. When interpreting the results, the higher the sum, the higher the likelihood that the resources the household has access to are not enough to ensure household food security and good nutrition.

Refer to the chart below to make sense of the results. Based on the weightings, this chart shows: 1. The highest figure is for households with the lowest levels of access to resources [16] 2. Households that have cautionary levels of food insecurity or a lack of access to resources (Moderate to high) [12] 3. Households with moderate (average) levels of access to resources [8] 4. Households with good access to resources or are least likely to be food-insecure [4]

Average access, 8

Good access, 4

Moderate access, 12

Low access, 16

The results can be depicted in a graph format such as the following:

Resources and food security sustainability 35

Never Rarely

Often

25 20 15 10 5 0 C1

The second option for the analysis of the results in this section is to calculate rates and percentages. This analysis does not take into account the frequency of the experience, but measures the percent of households experiencing the condition at any level of severity.

Example

Household A

Question C1 Never Rarely Sometimes Often Question C2 Never Rarely Sometimes Often Question C3 Never Rarely Sometimes Often Question C4 Never Rarely Sometimes Often

To calculate the percentage: Number of households with response to a question Total number of households responding to that question

100

Example: Number of households responding to â&#x20AC;&#x153;sometimesâ&#x20AC;? in C4

Total number of households responding to question C4

80%

When analysing these results, you could consider factors such as the following: • A high number of respondents being unable to buy food because they did not have money could indicate a high level of unemployment. • A high number of participants not having water to prepare food could lead you to investigate the issue further and identify interventions.

Section D: Food Type and Nutrition The results from this section will provide information regarding the consumption of carbohydrates (starch), protein (meat, soya or fish) and vitamins (fruits and vegetables). Information obtained could include the following: • How many times respondents have eaten vegetables in the 30 days prior to the survey • How regularly respondents eat protein • Whether participants regularly consume fruit Further information in this regard may relate to whether such food is available in the area and to whether the household has money to purchase the food. To explain how to conduct the analysis for Section D, we have used an abridged table with shortened questions as a guide. However, the full questionnaire should be referred to when analysis is being conducted.

Never

Rarely (once or twice)

Sometimes (3 to 10 times)

Often (10 times or more)

Number D1 (consumption of starch) Number D2 (consumption of vegetables) Number D3 (consumption of protein) Number D4 (consumption of fruits) There are two options for analysing these results. The first involves the use of giving weight to indicators or responses. In this method of analysis, you need to give a number to each response:

Response

Number to be allocated

Never

Rarely

Sometimes

Often

Example:

Household

Question

Total

Note: Alphabetic letters should be used to count / denote households. Using numbers may lead to errors in counting. When you analyse the results, you will find that the higher the sum of responses, the higher the consumption of that food type by the individual or the household. In addition to indicating the types of foods that individuals and households have access to and the number of times in a month these foods are consumed, this section may also be a good indicator of what foods people do not access and can give good pointers for nutrition levels in households. The desired responses are in moderation, as too much or too little of a food type might lead to a deficiency in individual nutrition requirements. Refer to the chart below to make sense of the results. This chart shows, based on the weightings: 1. The number of times a food type is consumed; highest number may indicate high access, but may also indicate excessive intake [16] 2. Moderate to high consumption rates; [12] 3. Moderate or average levels of consumption, showing a balance with other food types [8] 4. Not too much variation in the food types; the level of variation or access to different types of foods is too low [4]

Average / balanced, 8

Low consumption, 4

Moderate to high, 12

High consumption, 16

Information obtained in this section can be presented in a graph format such as the following:

Food type and nutrition 40

Never Rarely

Often

30 25 20 15 10 5 0 C1

The second analysis option involves calculating rates and percentages. In this way the indicators are used to present the percent of households that responded positively to each question. This analysis does not take into account the frequency of the experience, but measures the percent of households experiencing the condition at any level.

Example

Household A

Question D1 Never Rarely Sometimes Often Question D2 Never Rarely Sometimes Often Question D3 Never Rarely Sometimes Often Question D4 Never Rarely Sometimes Often

To calculate the percentage: Number of households with response to a question Total number of households responding to that question

100

Example: Number of households responding to “often” in D4

Total number of households responding to question D4

PHOTO [LEFT]: These images were taken when Oxfam’s Publications Editor Maureen Bathgate visited Oxfam projects. Photo © Matthew Willman / Oxfam

40%

One way in which you may be able to use this information is to consider whether households have vegetable gardens in the backyard. More backyard gardens may result in a higher consumption of vegetables. Perhaps communities need training and encouragement to take up subsistence farming or have backyard gardens, especially in areas where there is sufficient land and good weather. This is also a good option for people when households mostly depend on money as a resource to secure food, but where most of the primary caretakers are unemployed.

Additional Comments At the bottom of each section, there is space provided for further explanation by the respondents where necessary. Information collected in this form is usually not substantive, and its use can be confined to clarifying some of the responses to get a context. For example when an individual answers Question C1: “Has there ever been a time when there were no resources in the household to prepare food” with the response “often” (response 4), the data collector may discuss this further. The individual may indicate that the resource was electricity and that the lack was due to outages, rather than an inability to pay for electricity. It is not necessary to probe when using the data collection tool, but where respondents feel they need to explain, openended responses should be allowed.

PHOTO [BELOW]: Monica Mbokazi was interviewed by Oxfam Australia on her work in the district on healthcare and food security projects. Her she is seen with Philisiwe Ndwandwe (49 years old) tending to her food garden. Photo © Matthew Willman / Oxfam PHOTO [RIGHT]: Jozini is a bustling trading post on the edges of Jozini dam. Traders come from far and wide to sell their wares, from food to toys, blankets and soap, you can find anything in this small town of only one road. Photo © Matthew Willman / Oxfam

Appendix Nutrition Baseline Survey: Questionnaire Section A: Household Background

For each of the following questions, please consider what has happened in the past 30 days only. <5

<10

>10

<5 years

6–14 years

>15 years

How many people are there in your household? By “household” we mean Number A1

those of you that sleep under the same roof or share food from the same pot, and take meals together at least four days a week.

Please indicate the number of Number A2

people per age group in the household

Notes:

Section B: Food Quality and Quantity (includes variety, preferences and amount of the type of food)

For each of the following questions, consider what has happened in the past 30 days. Please answer whether this happened: Never, Rarely (once or twice), Sometimes (3â&#x20AC;&#x201C;10 times), or Often (more than 10 times) in the past 30 days?

Never

Were you or any household member not able to eat the kinds of foods you preferred because of a lack of resources? (money, Number B1

transport, fuel) Preference can refer to the form of a particular food (i.e., whole rice vs. broken rice), or a high quality food (i.e., a piece of meat or fish) Did you or any other household member eat fewer meals in a day

Number B2

because there was not enough food? (less than 3 meals a day; only once a day) Did you or any household member eat just a few kinds of

Number B3

food day after day due to a lack of resources? (money, transport, other) Did you or any household member eat a smaller meal than

Number B4

you felt you needed because there was not enough food? (Meal was not filling)

Was there ever no food at all in Number B5

your household because there were not resources to get more?

Did you or any household Number B6

member go to sleep at night hungry because there was not enough food?

Rarely

(once or twice)

Sometimes (3â&#x20AC;&#x201C;10 times)

Often

(more than 10 times in the past 30 days)

Never

Rarely

(once or twice)

Sometimes (3â&#x20AC;&#x201C;10 times)

Often

(more than 10 times in the past 30 days)

Did you or any household member Number B7

go a whole day and night without eating anything because there was not enough food?

Notes

Section C: Resources and Food Security Sustainability

For each of the following questions, consider what has happened in the past 30 days. Please answer whether this happened: Never, Rarely (once or twice), Sometimes (3-10 times), or Often (more than 10 times) in the past 30 days?

Never

Rarely

(once or twice)

Sometimes (3â&#x20AC;&#x201C;10 times)

Often

(more than 10 times in the past 30 days)

Has there been a time when there were no resources to Number C1

prepare food in the household? (Resources: coal, wood, electricity)

Number C2

Has there been a time when there was no money to buy food? Has there been a time when

Number C3

there was no one to prepare food? (Reason...)

Number C4

Have you been without water in the household?

Notes

Section D: Food Type and Nutrition

your meal? (Find out what starch that was) Did you have vegetables in

Number D2

your meal? (No potatoes) Did you have meat / fish / soya

Number D3

with your meal? (differentiate between different types of meat)

Number D4

Notes

Did you eat fruit? (How often...)

Rarely

(once or twice)

Sometimes (3â&#x20AC;&#x201C;10 times)

Often

(more than 10 times in the past 30 days)

Appendix Training of Data Collectors

1. Background and Rationale of Survey This survey will determine food security and insecurity by considering factors such as: • Availability of and access to food • Food quality and quantity • What food is consumed and how it is allocated • Food resources

2. Methodology This survey is being conducted using the questionnaire, which is Appendix 1 in this guide. The information will be gathered by yourselves. As caregivers you have been selected to collect the data as you are easily accepted by the communities and can collect the data as part of your day-to-day house-to-house visits. The information gathered will be analysed to provide a comprehensive picture of the situation of the community members. By administering the exact same survey we hope to determine the extent to which households in the area in which we work are food-secure or food-insecure.

3. Basic Research Principles Some essential factors in conducting good research include the following: • Clearly explain the purpose or aim of the research at the outset. • Obtain informed consent from the respondent before asking the questions. Respondents can choose not to answer questions or participate in the survey. • Do not raise expectations by promising payment or reward. • Respondents can choose to change their minds or not continue to answer at any time. • Be a good listener. • Develop a good relationship with your respondent. • Never impose your own views or values on the research. • Ensure that you are accurate in recording all responses. • Ensure that all questions are answered fully. • Maintain confidentiality at all times. Do not discuss any of the responses to the questionnaire with anyone except the research manager. Do not show completed questionnaires to anyone else. • Do not take respondents’ names or link them to the questionnaire.

PHOTO [LEFT]: Children at Joe Slovo Junior Primary School are fed during lunch break by food prepared and served by Sophakama CBO volunteers. Photo © Matthew Willman / Oxfam

4. Administering the Questionnaire Step by Step Guide to Administering the Questionnaire Step 1 Before handing out the questionnaire, introduce yourself and read the introductory statement, which is Appendix 3 of this guide. Use this introduction and set of instructions EACH TIME you administer the questionnaire. Remember that it will be the first time that the other person has heard it, so read it slowly and carefully and be sure that the person understands what you are doing before continuing with the survey. Note: Administer the questionnaire where respondents feel most comfortable. Step 2 Read the instructions for completing the questionnaire. Make sure the person understands that they must: • Give their informed consent before the survey begins; • Complete the questionnaire in full; • Answer each question; • Be honest in their responses; • Ask if they have a question or need clarification. Note: This study is voluntary and at any time if the respondent wishes not to participate or to stop participating, they are free to do so, without any threat or coercion from those administering the questionnaire. If the person does not wish to continue, stop the interview and thank them for their time. Step 3 Read out the instructions and questions from the questionnaire. Enter the correct response as given by the person being interviewed. The survey will take about 15 minutes to complete and answers will be kept confidential. Remind them that this is confidential and we are not asking for their names on the questionnaire. Note: • You should NOT act as an expert on any topic. Your role is to administer the questionnaire, give instructions on how to complete it, provide clarity on any question that is unclear, collect the questionnaires and ensure that the survey has been completed according to protocol and that the information is kept confidential. • If a question does not need to be filled in or the respondent refuses to answer do not leave it blank. You can either write “REFUSED” to show the person refused to answer the question or “DID NOT KNOW”. • You are encouraged to translate the questions for respondents into another language that is more familiar to them. However, do not lead them or give them the answer. • When a respondent gives you more detailed responses, write a short summary of what the person has to say, but do not change the meaning of what he or she is conveying. • It is of vital importance that the questionnaires are completely filled out in full. If the person does not wish to continue, stop the interview, and thank them for their time.

PHOTO [RIGHT]: Carer Nonhlanhla Mngomezulu and Minah Mlungwana with examples of the food parcels Minah receives at the Hluhluwe Advent Creche in KwaZulu-Natal. Photo © Cedric Nunn / Oxfam

Step 4 If you notice that respondents seem confused by what they are hearing, it is okay to make a few general remarks, such as: • “It is okay to ask me if you aren’t clear about the meaning of a question.” • “Remember that this information is needed to help make programs better, so please be honest in your responses.” Step 5 At the end of the interview, thank the respondent for his or her time and responses. Ask if they have any questions to ask you about the survey.

Appendix Introduction Script and Consent

Introduction Script for Survey Note: Data Collectors to read this intro to each and every person prior to administering the survey. Good day. My name is ____________________________. I work for ____________________________. (name of your organisation). ____________________________ (name of your organisation) is taking a survey to look into food security and insecurity. We are interested in issues such as the quantity and quality of food, reductions or increases in food intake and the food resources relating to your household. The answers you give will be used to measure the needs and strengths in this community, and can help to make any necessary adjustments to improve the work that we do. All information will be kept private. No names will be written on the questionnaires and there is no way that the information you write will be connected to you. The consent slip you will sign will be kept separate from the questionnaire. The results of the survey will only be used to improve the program. Please make sure that you respond to all the questions. You are not being forced to be a part of this survey, but your answers will be very helpful to ____________________________ (name of your organisation) and for the community in general. If you agree to complete the questionnaire, it is very important that you fill in every question on the form completely and honestly. If you have any questions you can ask me for help. If you feel uncomfortable at any time you can stop filling in the form. It will take about 15 minutes to complete the survey. We would appreciate your help in this survey. Are you willing to take part in the survey? If not, you are free to say so now. If YES, let us beginâ&#x20AC;Ś