Diet quality - an indicator for monitoring the contribution of investment projects to good nutrition

By Marian Odenigbo, IFAD Senior Technical Specialist, Nutrition

Investment projects on agriculture and rural development are increasingly focusing on improving the nutritional status of project beneficiaries. This has led to the project implementation going beyond the context of food security - the access and availability of food commodities to improved diet quality and nutrition outcomes. In IFAD, we have documented reports on influence of project interventions and testimonies on the improvement of diet quality from farmers and beneficiaries involved in varied interventions (such as natural resource management; crop productivity; livestock; fisheries; rural marketing; value chain; and climate-smart agriculture).

Mrs Xantonnon, a farmer and beneficiary of Smallholder Productivity Promotion Programme in Zambia, believes her life has been changed significantly since the programme was launched. She said “at the start of the project life cycle, we had an unstable market where the food prices were high and unstable, but now we can see more production and market stability thanks to the project. I and other community members can boldly speak about changes in our diet and the reduction of hunger in our households.”

IFAD is increasingly, supporting projects and programmes in promoting the consumption of quality food and diet for good nutrition. The quality of dietary intake has a significant impact on the nutritional status of rural poor farming households.

Diet quality encompasses the consumption of safe, nutritious and diverse food commodities. In nutrition-sensitive projects, the focus is mainly to contribute and facilitate food safety, production of nutrient rich food varieties and consumption of diversified diets.

Projects could assess and measure the contribution of nutrition–sensitive interventions on the beneficiaries’ nutrition outcomes with the use of dietary diversity indicators. There is a wide range of different indicators on dietary diversity such as Household Dietary Diversity Score; Minimum Dietary Diversity for women; Minimum Dietary Diversity for Children.

Minimum Dietary Diversity for women (MDD-W) is a diet quality indicator and a global indicator used at individual level and associated with micronutrient adequacy of diets. This indicator is different from the dietary diversity indicator at household level that measures food access and dietary consumption pattern of the entire household members and is used to represent the household’s socioeconomic level.

The IFAD Mapping of Nutrition-Sensitive Interventions in East and Southern Africa (2016) provided an insight on the data collection for dietary diversity at household verses individual levels. The findings of this mapping revealed a higher proportion of women and children groups with poor dietary diversity as compared to the household level.

Priority on dietary diversity for women

Why should a project assess the dietary diversity of women rather than men? 
  • Women and, in particular women of reproductive age (15-49 years) are vulnerable to micronutrient deficiencies due to their physiological higher demand as compared to adult men. 
  • Women can be disadvantaged in intra-household distribution of nutritious foods and diets in the resource-poor settings - the primary targets for IFAD operations. 
  • Dietary diversity promotes micronutrient adequacy before pregnancy and during pregnancy to lactation for improved maternal nutrition and child health predominantly during the critical first 1,000-days of life. 
Given the IFAD corporate priority on nutrition and in reaching the most vulnerable groups, MMD-W indicator is considered feasible and meaningful for monitoring the impact of IFAD investment projects on nutrition through the impact pathway of increasing food group diversity in family diets and among the nutritionally at risk groups. The IFAD Results and Impact Management system (RIMS) has included MMD-W as one of the core indicators at outcome level for monitoring improved nutrition of projects beneficiaries.

Measuring dietary diversity

Dietary diversity is a measure of diet quality and a simple indicator that calculates the number of different food groups consumed over a given period. Different lists of food groups are used to compute dietary diversity scores at the household level; for women of reproductive age (15-49 years); and for children (6-23 months).
  • Household Dietary Diversity (HDD) is computed with 12 food groups 
  • Minimum Dietary Diversity for women (MDD-W) is computed with 10 food groups 
  • Minimum Dietary Diversity for Children (MDD-C) is computed with 8 food groups 
The reference for good dietary intake at household level is an intake of ≥5 food groups out of the 12 groups outlined for HDD indicator. For women of reproductive age, the reference for good dietary intake is ≥5 food groups out of the 10 groups outlined for MDD-W indicator. The reference for good dietary intake among children is ≥5 food groups out of the 8 groups outlined for MDD-C indicator.

Examples of the food items contained in each group