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Titre : Measuring nutrition : Comparing different nutritional assessment tools and analyzing intra-household inequality in rural Kenya.

Auteur : Fongar, Andrea

Université de soutenance : Georg-August-Universität Göttingen

Grade : Ph.D. in the International Ph.D. Program for Agricultural Sciences in Goettingen (IPAG) 2018

Résumé partiel
Good and improved nutrition is an essential driver of human development, a platform for progress in health and equality. But in spite of notable improvements in achieving global nutrition goals, the malnutrition and food security situation has worsened, especially in Sub-Saharan Africa. Underweight, micronutrient deficiencies and overweight/obesity are contributing factors to the multiple burdens of malnutrition globally. Worldwide, more than 800 million people remain undernourished and 2 billion people suffer from micronutrient deficiencies, caused by imbalanced diets. Stunted growth affects one out of four children, and 52 million children under the age of five are affected by acute malnutrition. At the same time, the global nutrition landscape recognizes a significant upward trend in the prevalence of overweight and obesity of adults, and children. Especially, low- and middle-income countries experience high rates of underweight, micronutrient deficiencies and overweight or obesity. Malnutrition affects one in three people directly and many even suffer from several deficiencies simultaneously. Kenya in particular, reports a substantial increase in overweight and obesity rates, while levels of undernutrition remain high. Moreover, intra-household inequality of malnutrition describes a situation where family members face different nutritional deficiencies within the same household. The identification of poor diets is especially important, as poor diets are one contributor to the global burden of malnutrition and an indicator of food insecurity. Therefore, it is important and necessary to keenly assess how nutrition is measured. Against this background, this dissertation presents two essays dealing with nutrition measurements. In the first essay, we investigate the association of results from different nutritional assessment tools for the same households and individuals. In the second essay, we identify different ways to define the double burden of malnutrition at household and individual level in rural Kenya. To measure nutrition, a wide set of assessment methods and indicators exist. Various tools measure and describe malnutrition and food insecurity, ranging from various food production and consumption based indicators up to anthropometric measurements and individual health outcomes. Each of the tools has a somewhat different focus and interpretation, but with the common aim to measure how well people are nourished. A positive correlation between the different indicators would be expected, but is that really true ? Empirical evidence is limited, as many existing studies eventually rely on one approach, or a small set of indicators to display food and nutrition security and malnutrition. Therefore, relatively little is known about how closely results match when different assessment tools are used in the same context. The first essay of this dissertation directly addressed this question by comparing results from different assessment tools for the same households and individuals.

Mots clés : measuring nutrition ; nutritional assessment ; intra-household inequality ; rural Kenya ; dietary diversity ; double burden of malnutrition

Présentation

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