Internal validity and reliability of experience-based household food insecurity scales in Indian settings

Background: Experience-based household food insecurity (HFI) scales are not included in large-scale Indian surveys. There is limited evidence on which experience-based HFI scale or questions within a scale are most relevant for India. Between 01 June and 31 August 2015, we reviewed 19 published and unpublished studies, conducted in India between January 2000 and June 2015, which used experience-based HFI scales. As part of this exercise, internal validity and reliability of the scale used in these studies was examined, field experiences of 31 researchers who used experience-based HFI scales in India were gathered and psychometric tests were conducted where raw data were available. Results: Out of the 19 studies reviewed, HFI prevalence varied depending on the type of experience-based HFI scale used. Internal reliability across scales ranged between 0.75 and 0.94; however certain items ('balanced meal', 'preferred food', 'worried food would run out') had poor in-fit and out-fit statistics. To improve this, the following is suggested, based on review and experience of researchers: (1) cognitive testing of quality of diet items; (2) avoiding child-referenced items; (3) rigorous training of enumerators; (4) addition of 'how often' to avoid overestimation of food-insecure conditions; (5) splitting the cut and skip meal item and (6) using a standardized set of questions for aiding comparison of construct validity across scales. Conclusions: An evidence-based policy dialogue is needed in India for contextualizing and harmonizing the experience-based HFI scales across multiple surveys to aid comparability over time, and support policy decision making

Partnering with women collectives for delivering essential women\u2019s nutrition interventions in tribal areas of eastern India: a scoping study

Background: We examined the feasibility of engaging women collectives in delivering a package of women\u2019s nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Methods: Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women\u2019s nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women\u2019s nutrition services/behaviour promotion. Results: Limited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women\u2019s nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services. Conclusions: Women SHGs (with tier 2 and tier 3) can become direct grantees for strengthening coverage of women\u2019s nutrition interventions in these tribal districts/pockets, provided they are capacitated, supervised and given safe guards against exploitation and violence

Partnering with women collectives for delivering essential women’s nutrition interventions in tribal areas of eastern India: a scoping study

Abstract Background We examined the feasibility of engaging women collectives in delivering a package of women’s nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Methods Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women’s nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women’s nutrition services/behaviour promotion. Results Limited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women’s nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services. Conclusions Women SHGs (with tier 2 and tier 3) can become direct grantees for strengthening coverage of women’s nutrition interventions in these tribal districts/pockets, provided they are capacitated, supervised and given safe guards against exploitation and violence