Kabalo Bereket Yohannes, Gebreyesus Seifu Hagos, Loha Eskindir, Lindtjørn Bernt
1School of Public Health, Wolaita Sodo University, PO Box 126, Wolaita Sodo, Ethiopia.
2School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
BMC Nutr. 2019 Nov 20;5:54. doi: 10.1186/s40795-019-0323-6. eCollection 2019.
Seasonality poses a considerable food security challenge in Ethiopia. Yet, measuring seasonal variations in food insecurity, particularly the dimension of food access, lacks an adequately validated tool. We therefore evaluated the performance of an adapted Household Food Insecurity Access Scale (HFIAS) to estimate seasonal variations in food insecurity (FI) among subsistence villagers in Ethiopia.
We employed a cohort study design using a panel of four repeated measurements taken in June, September, and December in the year 2017, and in March 2018. The study recruited 473 villagers from the drought-affected Wolaita area in southwest Ethiopia. The performance of the HFIAS was evaluated via internal consistency (Chronbach's alpha values) and criterion validation techniques. The set of criteria include: parallelism between affirmative responses to FI questions and wealth strata; dose-response relationship between FI and dietary intake; and also FI severity and household wealth status.
This study revealed that the HFIAS had satisfactory performance in four repeated measurements. The likelihood of affirmative responses to questions about FI decreased with ascending wealth quintiles. We observed an inverse dose-response relationship between FI and wealth status, and between FI and household dietary diversity.
The HFIAS showed an acceptable potential for measuring seasonal variations in FI in the study area. Our findings complement efforts to evaluate the scale's applicability in various settings, in order to promote cross-culture monitoring and comparisons. However, it required a careful adaption for contextual and cultural sensitivities.
季节性对埃塞俄比亚的粮食安全构成了重大挑战。然而，衡量粮食不安全状况的季节性变化，尤其是粮食获取这一方面，缺乏经过充分验证的工具。因此，我们评估了一种经过调整的家庭粮食不安全获取量表（HFIAS）在估计埃塞俄比亚自给自足村民粮食不安全（FI）季节性变化方面的表现。
我们采用队列研究设计，在2017年6月、9月、12月以及2018年3月进行了四轮重复测量。该研究从埃塞俄比亚西南部受干旱影响的沃莱塔地区招募了473名村民。通过内部一致性（克朗巴赫α值）和标准验证技术对HFIAS的表现进行了评估。标准包括：对FI问题的肯定回答与财富阶层之间的平行关系；FI与饮食摄入量之间的剂量反应关系；以及FI严重程度与家庭财富状况。
本研究表明，HFIAS在四轮重复测量中表现令人满意。对FI问题的肯定回答可能性随着财富五分位数的上升而降低。我们观察到FI与财富状况之间以及FI与家庭饮食多样性之间存在反向剂量反应关系。
HFIAS在测量研究区域FI的季节性变化方面显示出可接受的潜力。我们的研究结果补充了评估该量表在各种环境中适用性的努力，以促进跨文化监测和比较。然而，需要针对背景和文化敏感性进行仔细调整。
