Public Health Nutrition: 21(12), 2200–2210 doi:10.

1017/S136898001800068X

Review Article

Assessing food security using household consumption expenditure

surveys (HCES): a scoping literature review
Joanna Russell1,*, Anne Lechner2, Quentin Hanich2, Aurélie Delisle2, Brooke Campbell2
and Karen Charlton3,4
1
School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia:
2
Australian National Centre for Ocean Resources and Security (ANCORS), University of Wollongong, Wollongong,
Australia: 3School of Medicine, University of Wollongong, Wollongong, Australia: 4Illawarra Health and Medical
Research Institute, Wollongong, Australia

Submitted 8 September 2017: Final revision received 11 January 2018: Accepted 23 February 2018: First published online 16 April 2018

Abstract
Objective: To meet some of the UN’s seventeen Sustainable Development Goals
by 2030, there is a need for more effective policy to reduce food insecurity in low-
income and lower-middle-income countries (LMIC). Measuring progress towards
these goals requires reliable indicators of food security in these countries.
Routinely conducted household consumption and expenditure surveys (HCES)
provide potentially valuable and nationally representative data sets for this
purpose. The present study aimed to assess methods used to determine national
food security status using proxy measures from HCES data in LMIC globally.
Design: A scoping literature review was conducted using electronic databases. Of
the 929 abstracts identified, a total of twenty articles were reviewed against strict
inclusion and exclusion criteria and included for further analysis.
Results: Fourteen LMIC globally were represented in the twenty articles. The
simplest metric used to indicate food insecurity compared household food
expenditure against a level of expenditure considered to be below the poverty
line. Data on acquisition of food was commonly converted to available energy for
the household using local food composition tables and expressed as a proportion
of household total energy requirements. Dietary diversity was also assessed in
Keywords
some studies as well as experience of food insecurity.
Food security
Conclusions: The review demonstrated that routinely collected HCES data sets Food poverty
provide a useful resource for the measurement of household food security in often Household consumption and
resource-limited LMIC. Standardisation of methods used to assess food security is expenditure surveys
needed to allow for more useful comparisons between countries, as well as to Low- and middle-income countries
assess temporal trends. Sustainable Development Goals

Currently, it is estimated that 1·2 billion people live in SDG including: poverty (SDG1); health and well-being
extreme poverty and about 870 million are under- (SDG3); clean water and sanitation (SDG6); work and
nourished globally(1). Strategies to improve livelihoods economic growth (SDG8); reduced inequalities (SDG10);
and income in the poorest sectors of communities are sustainable communities (SDG11); responsible consump-
essential to achieve food security for all, and accordingly tion and production (SDG12); life below water (SDG14)
this is a significant focus of the UN’s 2015 Sustainable and on land (SDG15)(2). The widespread presence of food
Development Goals (SDG). The SDG, with an outlook to security dimensions within multiple SDG is a clear indi-
2030, renew the focus of previous efforts (e.g. Millennium cation of the need to develop globally relevant, consistent
Development Goals) to address food security and other and comparable measures of progress towards a more
development issues on a global scale. We see this food food-secure future.
security focus explicitly in SDG2 (‘End hunger, achieve Food security is defined as the physical, social and
food security and improved nutrition and promote sus- economic ability to access sufficient, safe and nutritious
tainable agriculture’) but also implicitly in relation to other food(3,4). The four pillars of food security intrinsic to this

*Corresponding author: Email [email protected] © The Authors 2018

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 Assessing food security using HCES: a review 2201
definition are: (i) availability of food; (ii) access to ade- potential tool and resource to measure aspects of the
quate food; (iii) utilization of food; and (iv) stability of the access dimension of food security. Here, access is defined
food supply. Each of these pillars has determinants as ‘the resources available to obtain food, generally at the
that span national food economies and population-level household level through economic, physical and social
factors, household-level factors and individual character- dimensions’(9). HCES is an umbrella term that refers to
istics. Despite food security’s well-defined determinants, several different types of household-level surveys,
there is little consistency in the way measures are applied including household income and expenditure surveys
in practice to assess its presence or absence and thus (HIES), integrated household surveys (IHS), household
guide successful food security policy development(5,6). It is budget surveys (HBS) and living standard measurement
important to recognise that no single measure can surveys (LSMS)(10). Historically, HCES have been admi-
encompass all dimensions of food security; current mea- nistered at national level to obtain data on how household
surement efforts often focus on one or a combination of income is spent and includes household acquisition of
these four pillars(4). items that may be donated, given as gifts or home-
Interchangeable use of the terms ‘hunger’, ‘under- produced(10). These data are typically used by national
nourishment’ and ‘food insecurity’ further complicates the governments to construct consumer price indices, calcu-
understanding of appropriate food security measurement late national accounts and monitor national poverty(11).
indicators(4,7). These concepts are related but are not The potential of HCES to provide proxy measures of food
synonymous. Food insecurity refers to periods when people consumption and dietary patterns at the household level has
do not have safe access to a nutritious diet required for been recognised by food and nutrition analysts and gov-
normal growth and development and an active and healthy ernment agencies as a useful source of apparent food con-
life for all. To measure the ‘hunger target’ of the Millennium sumption data(12). Indeed, the use of HBS to calculate
Development Goals, the FAO considered two indicators, the individual food consumption has been examined exten-
prevalence of undernourishment and the prevalence of sively in European countries through the DAFNE (DAta
underweight in children under the age of 5 years(7). If the Food NEtworking) project(13,14) and the benefit of analysing
specific aspect of food security being measured is not clearly nutrition data collected in HBS has been demonstrated. Use
or consistently defined, the effectiveness of interventions of survey data in this way provides one proxy measure for
cannot be determined, nor can comparisons be made household food security, as the quantities and types of foods
between or within countries, thereby hindering efforts to acquired by the household, in a given time period, can be
benchmark progress and improve food security of high-risk divided by predetermined nutritional requirements of the
groups. These groups include populations affected by con- household members. Other proxy measures for food that
flict and political instability which can occur in both urban can be obtained from HCES include income expenditure on
and rural areas(7). food and dietary diversity(12).
A need for effective measures of food security is most In addition, HCES-based data have been used to develop
urgent in low-income and lower-middle-income countries evidence-based food fortification programmes in response
(LMIC), which are defined by a Gross National Income of to disproportionately high levels of micronutrient defi-
less than $US 3955 and similar non-monetary measures of ciencies(11,15). These micronutrient deficiencies are also
quality of life(8). These LMIC account for the majority of associated with food insecurity, particularly nutrition
global food insecurity; for example, between 2014 and 2016, insecurity or ‘hidden hunger’. In this setting, HCES can be
LMIC in Southern Asia were predicted to account for over used to identify commonly acquired foods that are poten-
35 % of undernourished people globally compared with just tially fortifiable and then used to monitor intakes of fortified
over 1 % for those in developed countries such as the USA(6). foods over time(10). The advantages of HCES as a source of
However, difficulty adopting globally standardised measures information for household access to food are centred on:
is compounded by lack of resources to routinely collect
1. their relative frequency of implementation, between 3
quality data, especially in LMIC where the food insecurity
and 5 years(10);
situation is most pronounced(6). Hence, it is prudent to
2. their ability to provide multiple proxy indicators
develop an understanding of how best to use existing
relevant to food security(16) (e.g. economic access to
resources in such countries, particularly where routine
food, diet quality and diet quantity); and
national surveys are administered to evaluate a country’s
3. their potential to offer a relatively comprehensive
social and economic trends and assist in the identification of
dietary ‘snapshot’ of food acquisition of which the
priority areas for policy action. Exploring the utility of such
length of recall period typically relates to the previous
resources to facilitate regular monitoring and evaluation of
7 d but may span up to the past month(11,12).
food security dimensions in LMIC may reveal useful sources
of data for secondary analysis of food security status with The similar methods employed in HCES also allow
relatively low additional resource impact. within-country differences in food security risk to be
Household consumption and expenditure surveys determined(17). For example, differences in the food
(HCES) are regularly conducted in LMIC and provide a acquired between urban and rural areas of a country can

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 2202 J Russell et al.
(12)
impact food security status across sub-populations .
Records identified through
However, despite an increase in the quality and frequency database searching
of these surveys in LMIC(15), it is important to recognise (n 929)*
that the data collection processes remain inconsistent in
some countries(16). There are also limitations regarding
assumptions applied in the analysis of HCES data, where it Excluded duplicates and
may be assumed that food acquisition is equal to food inappropriate titles
(n 681)
consumption(4), as well as limitations around the lack of
data on intra-household intake(16).
Notwithstanding, HCES are considered a reliable means Potentially relevant full- Records excluded based
to assess the access dimension of food security(16). How- text articles for screening on abstract
ever, a clear understanding of how, methodologically, (n 248) (n 211)
these data are being used to assess food security is much
needed and currently lacking in LMIC. The current scoping
review of the literature aimed to examine the methods
used by other authors to determine the access dimension
of food security using proxy measures from HCES data in Full-text articles assessed Full-text articles
for eligibility excluded, with reasons
LMIC, by answering the following research question: what (n 37) (n 17)
methodologies and proxy measures are used to assess
food security using HCES data in LMIC?

Methods Studies included in review

(n 20)
A scoping review was conducted to answer the research
question according to the framework developed by Ark- Fig. 1 Summary of search results on studies assessing food
security using household consumption expenditure surveys in
sey and O’Malley(18), with considerations of concurrent
low-income and lower-middle-income countries. *Initial search
methodological recommendations provided by Levac included using in-built screening options per database (such as
et al.(19) and Pham et al.(20). A number of scientific data- country selection)
bases were consulted, including MEDLINE, Scopus, Web
of Science, Wiley and Proquest. The search terms included
because the aim was to identify alternative ways to assess
‘food (in)security’, ‘household consumption’, ‘household
food security as opposed to specific, validated scales
expenditure’, ‘household income’, ‘household budget’,
developed for the measurement of food security. As such,
‘living standards’, ‘living measurement’, ‘integrated
review of food security experience scales is beyond the
household’ and ‘survey’. The database search strategies
scope of the present review. Studies published within the
included truncation, Boolean operators and the use of
past 15 years were eligible for inclusion.
proximity searching techniques. Search results were sorted
Two main phases of data screening were conducted: (i)
by ‘relevance’ and ‘cited by’ database filters, where
screening based on article title and abstract; and (ii)
irrelevant subject areas were excluded using database
screening to remove irrelevant articles based on the elig-
functions. While reviewing articles, tracking and hand-
ibility criteria described above (Fig. 1). Compiled data
searching of reference lists were also used to find any
were managed through EndNote version X3 or X5 (Clarivate
other related literature.
Analytics). Results were summarised, tabulated and arranged
Exclusion criteria were: (i) non-English language; (ii) not
via food security indicator and measure.
peer reviewed; (iii) lack of definition of food (in)security;
(iv) lack of a clear definition of food security indicators;
(v) assessment of poverty without distinguishing food Results
poverty; (vi) survey not defined as a HCES or similar;
(vii) countries not classified as low-income or lower- A total of twenty peer-reviewed articles were included in
middle-income according to World Bank data in the year the final review out of the 929 abstracts that were initially
of publication(8); and (viii) surveys that included additional identified (see online supplementary material, Supple-
questionnaires on health-related biomarkers and anthro- mental Table 1). Fourteen LMIC countries were included
pometry. Articles that used food security experience-based within these twenty articles. Nigeria, Vietnam and Malawi
questions and scales in addition to the original HCES- were represented in three articles each; Bangladesh and
based survey were eligible for inclusion in the review India were represented in two articles each; and Ethiopia,
but only information pertaining to analysis of data from Cambodia, Pakistan, Tanzania, South Africa and Nepal
traditional HCES were included in the review. This is were represented in one article each. One article also

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 Assessing food security using HCES: a review 2203
represented a total of three LMIC, namely Burkina Faso, Five of the cited papers assessed food security through
Bolivia and the Philippines. All articles included HCES data per capita food expenditure(21,22,28,29,35). Where defined, a
from nationally representative samples, except for one household was considered food insecure if it spent more
article that surveyed a random sample within three than 75 % or a weighted two-thirds of the mean per capita
countries (Bolivia, Burkina Faso and the Philippines)(21). food expenditure(22,35) (see also Table 1). In the remaining
Table 1 summarises seven different indicators used by studies that used this proxy measure, food expenditure
authors in the reviewed articles to determine household was considered a continuous, rather than bivariate mea-
food security status. These indicators are further classified sure of food security(21,28,29).
into eighteen different criteria. Dietary diversity, i.e. the number of food groups avail-
Clearly, a number of different measures were used able for consumption, was also used to measure food
across the papers included in the present review as shown security in four of the cited studies(24,28,29,41). For the
in Table 1. Because of the nature of the data collected in assessment of dietary diversity, foods reported in HCES
HCES, indicators of food insecurity focused mainly on were grouped into similar categories, and then further
poverty and lack of economic access to food. Authors of aggregated into eight to ten food groups. The way in
the reviewed articles attempted to deal with the limitations which foods were aggregated was often determined by the
by using complex statistical methods to account for error food consumption patterns of the population being stu-
and bias. Ordinary least-squares regression analysis was died. For example, in countries where rice (e.g. Vietnam)
commonly used and compared with other types such as or maize (e.g. Malawi) was the predominant staple and
quantile regression(21–35). provided over 50 % of total available energy, these foods
The use of the different indicators by HCES type is were allocated their own food category(24,42).
shown in Table 2, with data from the majority of HCES All HCES cited included home-produced foods as well
being used to measure more than one indicator. The as those that had been gifted or provided in-kind. In nine
simplest and most common metric used to indicate food articles, food security was reported as a bivariate variable
insecurity in nine of the reviewed articles was to compare (i.e. food secure or food insecure)(23,26,27,30,33–37), three
household food expenditure against a level considered to studies used a ranking in the range of 1, 2 or 3
be below the food poverty line, as per the reference (i.e. food secure, moderately food insecure, severely
minimal food cost for that household composition, or food insecure)(22,28,38) and five studies assessed the vari-
against a reference food poverty line suggested by ables as continuous measures(21,24,25,28,29). Five studies
World Bank or FAO criteria for the respective coun- also explored food security qualitatively, where coping
try(27,30–34,36–38). In the nine articles, the cost of a basic strategies and participant experiences were asses-
subsistence diet was often calculated for the household sed(21,24,25,30,41). The variables reported to influence the
composition of its members. This cost was based on local risk of food insecurity were common across studies,
food costs and a household’s actual reported expenditure namely larger household size and gender of head of
on food, which takes account of home-grown food and household.
food provided as gifts. This metric was used to distinguish
between households considered to be experiencing ‘food Discussion
poverty’ and those that were not considered to be in ‘food
poverty’. The present scoping review has identified a range of
Eight of the cited papers also expressed the data on methods and proxy measures used to assess household
acquisition of food in terms of available energy (in ‘cal- food security using data collected as part of HCES. Data
ories’, i.e. kilocalories; 1 kcal = 4·184 kJ) for consumption obtained through HCES-based surveys may therefore
by the household(23,25,26,28,29,33,35,39). Six studies further prove useful in monitoring and surveillance efforts
expressed this as a proportion of the household’s total focused on food security and progress towards other
energy requirements(23,26,28,33,35,39). To determine avail- associated SDG in LMIC.
able nutrients the food acquisition data were converted to HCES data are able to provide a measure of apparent
standardised quantities, such as grams or kilograms, and food consumption but at the household, rather than the
then to available nutrients including energy, but some- country level, and therefore provide information relating
times also protein and micronutrients such as Fe, thiamin to the access pillar of food security. The type of dietary
and vitamin C(27,37), using local food composition tables. information differs from the country-level apparent con-
Cut-off values regarding the level of available energy to sumption food balance sheets compiled by the FAO. Food
determine whether a household was food insecure ranged balance sheets provide a comprehensive picture of the
from 7121 kJ (1702 kcal)(39) per person per day to 12 134 kJ pattern of a country’s food supply during a specified
(2900 kcal)(31,32) per person per day. These values were reference period and thus information on the availability
based on either country-specific calculated requirements pillar of food security by demonstrating the quantity per
or the pre-existing FAO criterion of 8786 kJ (2100 kcal) per capita of individual foods available for human consump-
person per day(40). tion – this corresponds to the sources of the food supply.

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Table 1 Summary of food security measures used by study

Food security No. of

indicator papers Measure and criterion to determine food security status Country(ies) Reference
Food costs and 9 Food basket or similar: Vietnam Cuong(36)
nutrient ∙ HH considered food poor if per capita expenditure < food poverty line of 2100 kcal/d
requirements ∙ Energy requirements as per GSO and World Bank, no date provided
(food baskets or Food basket or similar: Nepal Geniez et al.(37)
similar, food ∙ Based on the average cost of a basket of food items that meets minimum daily requirements of 2220 kcal/d, at
poverty lines) 13 294 rupees/person per year (mountain region) and 14 610 rupees/person per year (Kathmandu)
∙ Energy requirements as per Ministry of Agriculture, 2014
Food basket or similar: Tanzania Osberg(30)
∙ Based on basket consumed by the poorest 50 % of Tanzanians. Food poverty line: 13 098 Tanzanian shillings
in Dar es Salaam; 10 875 shillings in other urban and 9574 shillings for rural to meet daily energy requirements/
male equivalent of 2200 kcal
∙ Energy requirements without reference
Food basket or similar: Bangladesh Khandker(38)
∙ Assessed as one of three poverty metrics, i.e. moderately poor, food poor and extremely poor. HH considered
food poor if its per capita food consumption < the food poverty line of 2112 kcal/capita per d
∙ Energy requirements as per FAO/WHO, 1973
Food basket or similar: South Africa Rose & Charlton(33)
∙ HH considered in food poverty if food expenditure < cost of a basic nutritionally adequately diet
∙ Cost of a nutritionally adequate diet varied between HH, based on HH member age and sex
∙ Nutrient recommendations as per US RDA, 1989
Food basket or similar: India Mahal & Karan(27)
∙ Developed by calculating minimum expenditure for predefined nutrient basket for rural and urban areas.
Nutrients: energy, proteins, fat, Fe, Ca, β-carotene, riboflavin, thiamin, niacin, vitamin C and Zn. Nutrient
requirements based on the RDA weighted for age and gender of the population
∙ Nutrient recommendations as per Indian Council for Medical Research RDA, 2002
Food basket or similar (cost of energy approach): Pakistan Sultana & Kiani(34)
∙ HH considered food insecure if per capita expenditure < minimum energy required/person in family. Based on
1702 rupees to achieve minimum daily energy requirements/AE of 2260 kcal
∙ Energy requirements as per FAO, no date provided
Vulnerability to food poverty: Nigeria Ozughalu & Ogwumike(31)
∙ Based on least-cost food expenditure and energy intake at 2900 kcal/AE per d
∙ Energy requirements as per National Bureau of Statistics, no date provided
Vulnerability to food poverty: Nigeria Ozughalu(32)
∙ Based on least-cost food expenditure and energy intake at 2900 kcal/AE per d
∙ Energy requirements as per National Bureau of Statistics, no date provided
Food and energy 8 Energy consumption: Malawi Fisher & Lewin(23)
consumption or ∙ HH considered food insecure if its daily per capita energy consumption ≤ energy requirements based on BMR
availability and light activity of all HH members
∙ Energy requirements not specified
Energy consumption: Vietnam Mishra & Ray(28)
∙ HH considered undernourished if consuming <2100 kcal/AE per d
∙ Considered severely undernourished if consuming <1680 kcal/capita per d
∙ Energy requirements as per GSO, no date provided

J Russell et al.
Energy consumption: Vietnam Nguyen & Winters(29)
∙ Criterion unspecified as continuous measure
Energy consumption: India Mahajan et al.(26)
∙ Food poverty criterion based on 2700 kcal/CU per d. Based on requirements of an average male, sedentary
work, aged 20–39 years. Average energy requirements of males and females of other age groups were
expressed as ratios to this
∙ Energy requirements as per Ministry of Statistics and Programme Implementation, Government of India, 2012
https://doi.org/10.1017/S136898001800068X Published online by Cambridge University Press

Assessing food security using HCES: a review

Table 1 Continued

Food security No. of

indicator papers Measure and criterion to determine food security status Country(ies) Reference
Energy consumption: Malawi Harttgen et al.(39)
∙ HH considered food deprived if total energy consumption < age- and sex-specific energy needs for all HH
members. Recommended mean energy requirement was 1702 kcal, adjusting for age and sex of the
population
∙ Energy requirements as per FAO, WHO and UNU (2001)(40). Recommended mean energy intakes as
supported by Ecker and Qaim (2010)(54)
Food consumption: Ethiopia Kumar & Quisumbing(25)
∙ Adequacy of food consumption in past month; adequacy unspecified, continuous variable
Energy availability: Bangladesh Szabo et al.(35)
∙ HH considered food insecure if daily energy needs > reported intake. No other detail provided
Energy availability: South Africa Rose & Charlton(33)
∙ HH considered to have low energy availability when energy available in HH food supply < total energy
requirements of the members of the HH. Total requirements dependent on HH member age and sex
∙ Nutrient recommendations as per US RDA, 1989
Per capita food 5 Percentage of expenditure on food: Bangladesh Szabo et al.(35)
expenditure or ∙ HH considered food insecure if total expenditure on food is >75 %
percentage of Percentage of expenditure on food: Nigeria Adebayo et al.(22)
income spent on ∙ HH considered food secure when per capita food expenditure > weighted 2/3rds of mean per capita
food expenditure, i.e. the food poverty line. Three categories of food poverty used: core food poor, moderately food
poor and food non-poor
Percentage of expenditure on food: Vietnam Mishra & Ray(28)
∙ Criterion unspecified as continuous measure
Food expenditure per capita: Vietnam Nguyen & Winters(29)
∙ Criterion unspecified as continuous measure
Daily per capita expenditures: Bolivia, Burkina Melgar-Quinonez et al.(21)
∙ Food expenditure, based on World Bank’s LSMS. Criterion unspecified as continuous Faso,
Philippines
Dietary diversity 4 Dietary diversity as per Food Consumption Score (FCS) Malawi Jones(24)
∙ FCS as per WFP, 2007. Weighted continuous measure
Dietary diversity: Vietnam Mishra & Ray(28)
∙ Criterion unspecified as continuous measure
Dietary diversity: Vietnam Nguyen & Winters(29)
∙ Criterion unspecified as continuous measure
Dietary diversity: Cambodia Sophal(41)
∙ Considered food poor based on WFP scoring. Little detail provided
Experience based 5 Coping Strategies Index (CSI): Malawi Jones(24)
∙ Adapted version of CSI; used six questions related to HH’s direct experiences with food insecurity during the
previous 7 d (as per survey)
Coping strategies: Cambodia Sophal(41)
∙ Coping strategies obtained via survey. Questions used not outlined
Experience scale: Bolivia, Burkina Melgar-Quinonez et al.(21)
∙ HH food security determined by modified nine item US HFSSM (incorporated into LSMS). Scores from 0 to 9 Faso,
(where 0 is most food secure) Philippines
Experience of food deprivation: Tanzania Osberg(30)
∙ Self-reported food deprivation, using the question: ‘Have there been times during the last year when you didn’t
have enough food to eat?’ Considered food insecure if response is ‘always/often’

2205
 2206 J Russell et al.

HH, household; GSO, General Statistical Office; AE, adult equivalent; CU, consumer unit; UNU, United Nations University; LSMS, living standards measurement survey; WFP, World Food Programme; HFSSM, Household
Poverty is a major contributor to food insecurity;

Kumar & Quisumbing(25)

therefore it is not surprising that many papers chose to
use a method focused on measuring the economic

Mahal & Karan(27)

Mahajan et al.(26)
access to food, particularly in terms of the affordability

Geniez et al.(37)
of sufficient energy required to meet the needs of the

Osberg(30)
Reference

entire household. Many studies used a metric termed

the ‘food poverty line’. This metric compares the amount
of money spent by a household on food against the
predetermined amount required to purchase sufficient
energy for all household members. The food poverty
line is determined by individual countries but often
Country(ies)

Tanzania
involves the World Bank in discussion with respective
Ethiopia

governments(43).
Nepal

India

India
In line with this approach is the cost of basic needs
approach, as described by Ravallion(44). This approach
∙ Food security assessed by number of months the HH had difficulty ‘satisfying its food needs’ and whether food

∙ Based on 18 628 rupees/person per year (mountain region) and 22 945 rupees/person per year (Kathmandu).

was also commonly used in the cited papers that focused

Nutrients: energy, proteins, fat, Fe, Ca, β-carotene, riboflavin, thiamin, niacin, vitamin C and Zn. Nutrient
∙ Developed by calculating minimum expenditure for predefined nutrient basket for rural and urban areas.

∙ Combines vulnerable groups identified in experience-based survey with calculation of imputed share of
on economic access to food. The cost of basic needs is
constructed first by assessing the household expenditure
required to purchase a ‘basket’ of food to meet basic
energy needs per capita (i.e. the ‘food basket’ measure).
consumption in the HH for the previous month was adequate (energy criterion not used)

An amount for non-food spending required to meet basic

needs (e.g. clothing, housing and health care) is then
∙ Nutrient recommendations as per Indian Council for Medical Research RDA, 2002

added to this amount, to determine overall poverty lines.

requirements based on the RDA weighted for age and gender of the population

The basket of food is designed to meet minimum energy

requirements rather than optimal nutrient requirements of
low-income households.
consumption within HH that contain members of this vulnerable group

Focusing on access to sufficient energy for the entire

∙ Recommendation of 60 g protein/CU per d. Reference not provided

household via methods such as the cost of basic needs

Nutrient requirements for sex, age and physiological condition

approach provides useful information that allows identi-

fication of sub-sectors of the population that are at greatest
risk of inadequate access to sufficient quantities of food.
papers Measure and criterion to determine food security status

However, care should also be taken when using daily

energy requirements for the purpose of food security
∙ Nutrient requirements as per WHO/FAO, 2014

assessment, as some populations may be less active due to

transportation associated with urbanisation and increas-
Nutrient poverty line, basket approach:

ingly sedentary lifestyles related to the nutrition transition.

Nutrient poverty line, basket approach

Energy requirements may also vary regionally based on

the type of labour force participation. For example,
Estimated probability of hunger:

populations living in rural areas where farming and

Experience of food gaps:

agricultural-based activities are common would have

higher energy requirements than those living in urban
To convert to kilojoules, multiply kilocalorie values by 4·184.
Protein consumption:

areas where jobs may involve more sedentary behaviours.

The daily energy requirement calculations include a phy-
sical activity level component that could be altered to
allow for increasing sedentary behaviour or differences in
regional activity levels(45). Energy requirements that are
based on differences related to ethnicity and associated
ratio of lean mass to fat mass may also need further con-
No. of

Food Security Survey Module.

3

sideration to avoid overestimating the proportion of the

population that is considered to be food insecure(46).
Combined methods
Table 1 Continued

Of the sixteen papers included in the present review

Nutrient poverty

that used energy requirements in their assessment of food

Food security

(nutritional

security, three(28,36,38) based their measurements on the

security)

2001 FAO human energy requirements of 8786 kJ

indicator

(2100 kcal) per person per day(40). This requirement was

originally created to calculate the food needs of adults

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 Assessing food security using HCES: a review 2207
Table 2 Food security indicators included in country surveys according to the type of household consumption expenditure survey

Survey type Food security indicator Reference(s)

Nigeria Living Standards Survey Percentage of expenditure on food Adebayo et al.(22)
Vulnerability to food poverty Ozughalu & Ogwuimike(31)
Ozughalu(32)
Vietnamese Household Living Standards Percentage of expenditure on food Cuong(36)
Survey Food expenditure per capita Mishra & Ray(28)
Food basket or similar Nguyen & Winters(29)
Dietary diversity
Energy consumption
Malawi’s 2nd and 3rd Integrated Household Dietary diversity using Food Consumption Score Fisher & Lewin(23)
Survey, part of the Living Standards Energy consumption Harttgen et al.(39)
Measurement Survey Coping Strategies Index Jones(24)
Nepal Living Standards Measurement Survey Food basket or similar Geniez et al.(37)
Energy consumption
Nutrient poverty line, basket approach
Living Standards Measurement Survey (Bolivia, Daily per capita expenditures including food experience Melgar-Quinonez et al.(21)
Burkina Faso, Philippines) scale
Pakistan Social and Living Standards Food basket of similar (cost of energy approach) Sultana & Kiani(34)
Measurement Survey
Bangladesh Household Income and Percentage of expenditure on food Khandker(38)
Expenditure Survey Food basket or similar Szabo et al.(35)
Energy availability
Household Income and Expenditure Survey Percentage of expenditure on food Khandker(38)
Food basket or similar Rose & Charlton(33)
Energy availability (low energy indicator) Szabo et al.(35)
Ethiopian Rural Household Survey Food consumption Kumar & Quisumbing(25)
Experience of food gaps
Household Consumption & Expenditure Energy consumption Mahajan et al.(26)
Surveys Nutrition security; protein consumption
Consumer expenditure survey data from the Food basket or similar Mahal & Karan(27)
National Sample Survey Organization, India Nutrient poverty line using basket approach
Household Budget Survey (Tanzania) Food basket or similar Osberg(30)
Experience of food deprivation
Combined methods: estimated probability of hunger
Cambodia Development Research Institute’s Dietary diversity Sophal(41)
Nationally Representative Household Survey Coping strategies

using a minimum activity level to inform food assistance in fact, be meeting micronutrient requirements; hence, they
programmes during emergency situations(47) and may may not be considered nutritionally secure, even if they
therefore not be relevant for more active populations. appear to be meeting the availability requirement of a food-
Other energy requirements used in the cited papers varied secure population. Risk of inadequate micronutrient intakes
from 7121 kJ (1702 kcal) to 12 134 kJ (2900 kcal) per per- may be better identified through assessment of dietary
son per day, while some of the papers did not specify an diversity, using consumption data obtained through HCES.
energy requirement as kilojoule/kilocalorie amount. Dietary diversity, as a proxy measure for diet quality
Methods that focus on access to energy also often fail to and a measure of food security, was assessed in four of the
provide information regarding the nutritional quality of cited papers(24,28,29,41), thereby providing information on
food available to households, and it has been argued that potential micronutrient inadequacies at a household level.
this is likely to underestimate micronutrient deficiencies in Standard methodology for determining dietary diversity
LMIC(37). In some LMIC such as India that have a double from HCES data is available at the household level; how-
burden of disease including high rates of malnutrition ever, it does not account for intra-household food dis-
together with increasing obesity rates and prevalence of tribution nor does it account for the volume of food
non-communicable diseases, a refocus on dietary diversity acquired or consumed(49,50). Geniez et al.(37) used the
is needed. Here, dietary diversity is defined as the total minimum cost of a nutritious diet (MCND) method devised
number of different foods or food groups consumed over by Save the Children that calculates the minimum cost
a given reference period(48). If countries are consuming a (prices based on local food market surveys) required to
greater variety of foods but have high rates of overweight meet the nutrient requirements of a household. As with
and obesity, assessing dietary diversity is essential to other methods, the MCND method has its limitations,
determine if the increased variety is coming from impor- namely that food price data are collected at a single point
ted, energy-dense, nutrient-poor foods or from local, in time and it does not allow for seasonal price variations.
nutrient-rich foods(24,49). It is important to realise that In addition to objective assessments of food security
populations who are meeting energy requirements may not, using indicators of economic access and dietary diversity,

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 2208 J Russell et al.
as described above, there has also been progress made in review inclusion criteria calculated mean food availability
the development of qualitative measures of household using the DAFNE methodology. As such, there is potential
food security. The role of household food insecurity as an to include this methodology in future HCES in LMIC;
underlying determinant of malnutrition in the developing however, such analysis is beyond the scope of the
country context was first elucidated in the early 1990s in present paper.
the UNICEF causal framework(51). Since then, consider- Additionally, HCES data can provide considerable evi-
able progress has been made in defining and measuring dence regarding external influences that impact popula-
household food insecurity, using tools that are both qua- tion access to food. For example, the global food price
litative and subjective. crisis experienced in 2006–2008 was associated with the
For example, the Food Insecurity Experience Scale rise in prevalence of food insecurity, as demonstrated by
includes items that question whether respondents are the use of HCES in Cambodia(41). Another valuable use of
worried that their food will run out, or whether adults in HCES data in the context of food security is to highlight
the household eat less than they feel they should(2). vulnerability of certain sub-populations who are caught in
Experience-based scales have been used regularly in the war conflict situations or natural disasters, as was the case
USA, where a nationally representative food security to demonstrate the impact of civil conflict imposed by
module was introduced as a component of the Current Boko Haram in northern Nigeria(22). Routine collection of
Population Survey in 1995(52). In our review, only four of HCES data within the same country can demonstrate
the cited HCES papers also included experienced-based seasonal impacts on food availability and cost over time,
questions for food security assessment, and it is note- as was shown in Bangladesh(38). The analyses may also
worthy that these questions were different in each of the identify the impact of price shocks, natural disasters or
four papers(24,25,30,41). However, Jones(24) used an adapted climate change on household access to food(39,41).
version of the Coping Strategies Index as an indicator of An explanation why the included articles covered only
food insecurity that was included in the Malawi Third fourteen of the fifty-three LMIC classified by the World
Integrated Household Survey. Findings showed that those Bank Country and Lending Group may be related to the
who were food insecure had less diverse diets as mea- fact that governmental and non-governmental agencies
sured by the Food Consumption Score. often publish their HCES findings in the grey literature,
In LMIC, it has been argued that if quantitative indicators particularly websites. We acknowledge that grey literature
of food insecurity could be developed using data that are may be a valuable source of information; however, the
routinely collected for the purpose of determining living primary purpose of the current review was to determine
standards measures, such as HCES, this would be advan- the robustness of methods used to assess food security
tageous to government agencies and non-governmental using HCES using peer-reviewed literature.
organizations, which often have scarce resources to meet
their information needs(33). A quantitative, objective Conclusion
method to assess food insecurity would be a valuable
resource for the purpose of food and nutrition monitoring The present scoping review has identified HCES that are
and surveillance. With the development of qualitative routinely conducted in LMIC are a potentially valuable
assessment tools and their incorporation into HCES-based source of information to assess food security and parti-
surveys we may also begin to see a change in the way that cularly the access dimension of food security. As shown, a
food security is regularly measured and monitored. range of quantitative and qualitative methods as well as
Regardless of the method chosen to assess food security proxy measures have been used to determine food
using HCES data, clarity is needed regarding the criteria security status of households. However, use of standar-
used to inform the choice of proxy measure to allow dised measures as described above, as well as adaptation
greater consistency across surveys in future research. of measures from developed countries and greater clarity
Evidently, HCES data are able to be utilised in a number describing the methods, including the associated
of ways to assess food security through both quantitative assumptions and limitations, are needed to allow com-
and qualitative means. An additional indicator to measure parisons between countries in the context of assessing
food availability using HBS from European countries was progress towards the SDG. These measures can be used to
also identified. The DAFNE databank has used such sur- inform the effectiveness of food policy interventions to
veys to calculate the mean food availability as grams per alleviate poverty, malnutrition and hunger.
person per day for various European countries(53). Results
from these studies have also shown that HCES can provide
useful information on the nutritional status at household Acknowledgements
and individual levels, as well as dietary patterns and their
impact on overall health(14). Although this indicator has Financial support: The authors gratefully acknowledge
provided relevant nutrition information in high-income funding support from the University of Wollongong’s Global
countries, none of the cited studies in LMIC that met our Challenge programme and the Australian Centre for

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 Assessing food security using HCES: a review 2209
International Agriculture Research (ACIAR) Project ‘Fish in 13. Naska A, Berg MA, Cuadrado C et al. (2009) Food balance
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