RESUMEN
Tackling nutrition insecurity remains a critical challenge in developing countries. In the predominantly rain-fed and smallholder-based farming systems of Ethiopia, production diversity and livelihood strategies of the farm households vary across geographic areas. However, the effects of household socioeconomic characteristics, production diversity, and household incomes on nutrition profiles in distinct settings have been inadequately understood. Therefore, this study was undertaken to examine the association of farming system type, sources of income, and household wealth status with household nutrition profiles in three remote locations such as Mennisa, Welmel Tiqa, and Agam Wuha that represent root crops-based farming, maize-based semi-pastoral farming, and teff-based cereal farming systems, respectively. A combination of qualitative and quantitative data collection techniques was employed. A multistage sampling procedure was used to select a total of 265 smallholder households for the structured survey interviews. Standard statistical tests and Tobit regression analyses were performed after determining the wealth category of each household. Results revealed a diversity of income sources used by each of the farm households with average values of 9 in Mennisa, 10 in Agam Wuha, and 11 in Welmel Tiqa, with the contributions of each income source varying by household wealth category and location. As expected, expenditures on food significantly exceeded those on non-food categories for poor households and vice versa for rich wealth households. The average total food variety score (FVS) for Welmel Tiqa was twice that for Agam Wuha, confirming the need for site-specific nutrition profile assessments. Despite the observed differences in household nutrition profiles among wealth categories and locations, the apparent intakes of vitamin A, vitamin B12, vitamin D, and calcium were consistently below the population-level estimated average requirements across all locations. The number of adequately consumed nutrients by farm households was negatively associated with family size, age of household heads, livestock holdings, wealth categories, and irrigation use, and positively associated with crop production diversity, income diversity, and FVS. The negative association between irrigation use and nutrition security was likely due to the focus on producing crops with a high market value on land under irrigation, coupled with ineffective allocation of generated income for enhancing household nutritional outcomes. Therefore, programs that include irrigated agriculture investments should consider adopting a more integrated nutrition-sensitive interventions, including consideration of locally adapted nutritious crops, such as orange-flesh sweet potato, to address critical deficiency of Vitamin A, nutrition training coupled with development of recipes and cooking demonstrations, and marketing and promotion for nutritious crops.
RESUMEN
Early identification of inadequate intake of nutrients from a person's diet is usually crucial to prevent the development of micronutrient malnutrition. However, there is no single dietary assessment tool for Ethiopia that can assess the nutrient intake of a person from the type of food she or he consumed with a given amount. Therefore, the Calculator for Inadequate Micronutrient Intake (CIMI) application was adapted in consideration of food and nutrition contexts in Ethiopia and validated for its suitability to compute nutrient intake and identify nutrient intake inadequacy. For this, a 24-h recall quantitative dietary data of children aged 12-23 months (n = 781) and lactating mothers (n = 1086) were collected between February 15 and 30, 2017, from rural Genta Afeshum district, Tigray region, Ethiopia. An individual nutrient intake was estimated by calculating using CIMI-Ethiopia and also by NutriSurvey (NS) software for comparison. The average (mean and median) intake of energy and most nutrients and the prevalence of inadequacy calculated by the two software for the children aged 12-23 months and lactating mothers were comparable, except that of the vitamin A. The correlation coefficients for the intake results calculated by CIMI-Ethiopia and NS were between 0.85 and 0.97 for the children and between 0.5 and 0.96 for the lactating mothers' group. Most of the mean intake differences calculated by the two methods were within the acceptable limits, except for the vitamins A, D, and B12 in the Bland-Altman plots. CIMI-Ethiopia is very sensitive to identifying energy, protein, and selected micronutrients inadequacy included in this study, both for the lactating mothers (84.1%-100%) and 12-23-month-old children (77.6%-100%) group. Our results showed that CIMI-Ethiopia estimates the energy and nutrient intake, and can be also used as a screening tool to identify energy, protein, and selected micronutrients inadequacy from an individual woman's and child's diet in rural Tigray, Ethiopia.