Conservation and the Environment
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Nutrition
Although frequently carried out separately, the information from nutrition surveys and HEA is complementary. Most obviously, HEA tells us about the ability of different wealth groups to cover their minimum food energy needs. However, energy is only one component of the diet, and food insecurity is only one of three underlying causes of malnutrition, the others being poor childcare and an unhealthy environment. Decision-makers seeking to use both HEA and nutrition data may reasonably ask the following questions:
- What can HEA tell us about dietary quality?
- What can HEA tell us about the causes of malnutrition?
- What can HEA tell us about the risk of malnutrition in the future?
Dietary quality
HEA is best suited to assessing the adequacy of access to macro-nutrients (energy, protein and fat). An analysis of the types of food consumed can also give some indication of dietary diversity, but a detailed assessment of micro-nutrient intake is beyond the scope of a conventional HEA. This is because many vitamins and minerals are provided in relatively small quantities of certain foodstuffs, and HEA’s quantification is not precise enough to capture this reliably. On the other hand, HEA can indicate whether or not certain types of food are present in the diet - this can prompt further investigation into the risks of specific micro-nutrient deficiencies.
Causes of malnutrition
HEA assessments can tell us whether food insecurity is a likely cause of high rates of malnutrition in a population. Where household food access falls significantly below 100% of minimum calorie requirements, malnutrition is very likely to occur. Linking HEA and nutrition survey data is easier if (a) wealth group data are collected during the nutrition survey and (b) nutrition survey data are analyzed by livelihood zone. HEA can provide useful clues about poor health and caring practices, e.g. it can tell us whether poverty is hindering access to healthcare or good hygiene (via data on health, soap and water expenditures), whether or not a balanced diet is affordable, and whether the seasonal workload of mothers is likely to disrupt childcare.
Future risks of malnutrition
One of HEA's main strengths is that it is a predictive tool. Where a significant food deficit is expected, we can usually say with confidence that - in the absence of an external intervention - malnutrition rates will rise. More precise prediction is difficult because of the multiple causes of malnutrition. When analyzing an expected deficit, it is important to bear in mind the following:
The size of the deficit - while a 10% deficit may not cause malnutrition, a 25% deficit is a major cause for concern.
- The timing of the deficit - a 17% deficit spread evenly throughout the year will have very different effects to a 100% deficit concentrated into just two months (even though the annual deficit is the same in both cases).
- Harmful coping strategies (usually excluded from the HEA outcome analysis) may be used before food consumption is reduced, significantly delaying the appearance of malnutrition.
Summarized from the Practitioners' Guide to HEA, FEG Consulting, RHVP, and SC-UK