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Dietary Diversity Score
Dietary diversity is a measure that examines the variety of foods consumed at the individual and households levels. At the individual level, the score may be used as proxy for nutritional quality of the diet, and at the household level the score is indicative of access and consumption of diverse macro and micronutrients (FAO, 2013). In addition, the household dietary diversity score can be used as a proxy measure for household food access based on the following assumptions: 1) a more diversified diet is associated with improved outcomes such as birth weight, hemoglobin concentrations, and child anthropometric status; 2) diversified diet is correlated to caloric and protein adequacy, household income, and high quality protein (animal); 3) this metric can be assessed at the household and individual level to allow for household and intrahousehold assessment; and 4) data collection to estimate this metric is easy to implement as a survey (Swindale and Bilisky, 2006).
How to operationalize the metric
Method of data collection and data needed to compute the method:
Data for this measure is collected at the household level via survey and is implemented at the individual or household level (questions about individual or household consumption). In this case, we focus on the household consumption. The survey is best implemented in a period of the year with greatest food deficiency (for example, lean months prior to harvest). If the similar survey is to be performed the next year, it is best performed at the same time of the year in order to have relevantly comparable data. The questions should be asked to the person responsible for food preparation. A 24-hour reference period (1 day)[1] is recommended because longer recall periods may lead to inaccuracies. Data should be to determine if household members consumed food from the 12 food groups (Table 3). (Note that the table provides both groups that can be used for the household and individual surveys.)
Questions should be asked so that household food preparer responds “yes” or “no.” Please note that for given contexts, one also should ask about locally consumed foods and map them to the food groups listed. For example, millet is not specifically on the list but may be a food crop in some settings, it should be included in the cereal list.
Unit of analysis:
Once the data is collected, the calculation of the score is fairly straightforward. If within the last 24 hours, the household consumed maize, then for cereal a value of 1 is assigned if not then 0. Once all the values are assigned per group, sum the values across the 12 groups. If a food item from each food group was consumed, then the max summed value is 12 and if none then 0. The higher the value, the more diversified the diet and more likely the household is to have a nutritious diet.
Limitations regarding estimating and interpreting:
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[1] Some studies have chosen longer recall periods like 4 weeks to deal with other issues like seasonality and survey intensity (Hammond et al., 2016)