The Food Consumption Score (FCS), a food frequency indicator developed by the World Food Programme (WFP) that aims to capture both diet quantity and quality of household food consumption, has been validated only against calorie intake in a limited number of rather small countries. This article examines the potential of FCS to capture variation in diet quantity and quality using the 2004/5 Household Consumption and Expenditure Survey (HCES) conducted in the DRC. In addition to quantifying the strength of association between FCS and a series of benchmark variables, a set of nutrient-consistent regional adequacy levels is proposed as an alternative to the standard WFP’s cut-off in identifying food insecure households. We point out several key issues. First, for a country the size of the DRC, but possibly in other settings too, it is necessary to adopt a geographically disaggregated approach to account for regional diversity in food systems and resulting diets. Second, FCS can indeed capture qualitative aspects of food consumption in addition to quantitative ones. Third, increasing the number of food groups, removing their associated weights or truncating their food group score does not structurally improve FCS’s correlation with the benchmark variables. Fourth, the WFP’s threshold is only weakly consistent in terms of nutrient adequacy, marginally relevant to each of the country’s regions and markedly less sensitive and specific compared to the set of nutrient-consistent regional thresholds, which we propose based on the empirical relation between FCS and the mean adequacy ratio (MAR). Lastly, despite several methodological challenges, this work demonstrates the potential use of HCES to conduct this sort of food security validation exercises.
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To avoid conceptual confusion with one of the ROC statistics mentioned above, we refer here to the principle of ‘relevancy’ instead ‘specificity’ – the latter being more commonly used in the poverty literature.
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The authors are grateful to Claudia AH POE, William OLANDER and Ollo SIB for providing material and data related to the Food Consumption Score methodology and to Jef LEROY, John ULIMWENGU and Josee RANDRIAMAMONJY for their insightful comments and assistance with data analysis. The authors also wish to thank the editor of this journal and two anonymous referees. Despite these acknowledgements, all errors remain the authors’ sole responsibility.
Conflict of interest
The authors declare that they have no conflict of interest with any organisation or individual.
Appendix: FCS module used by WFP in the DRC
Appendix: FCS module used by WFP in the DRC
1.1 SCORE DE CONSOMMATION ALIMENTAIRE
Il s’agit ici des aliments consommés au cours des 7 derniers jours
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Marivoet, W., Becquey, E. & Van Campenhout, B. How well does the Food Consumption Score capture diet quantity, quality and adequacy across regions in the Democratic Republic of the Congo (DRC)?. Food Sec. 11, 1029–1049 (2019). https://doi.org/10.1007/s12571-019-00958-3