Validation of household food insecurity access scale - Sri Lanka validation of HFIAS-SL

Background
Until recently, Sri Lanka did not have a validated instrument with which to assess household food insecurity. The objective of this study was to adapt and validate the Household Food Insecurity Access Scale, which has been developed and used by the United States Agency for International Development's Food and Nutrition Technical Assistance project, in Sri Lanka.

Methods
This tool, Household Food Insecurity Access Scale, consists of nine questions which were adapted to the local setting with input and approval from both local content experts and target community members. The adapted tool was pretested and identified as the Household Food Insecurity Access Scale-Sri Lanka (HFIAS-SL) and was used to assess the household foodinsecurity. One hundred and fifty households from different socio-economic levels were purposively identified and included in the sample. Wealth index and household per capita income were assessed as indicators of socio-economic status. Food intake was assessed using a food group frequency questionnaire.

Results
Cronbach's Alpha was 0.879 (95% CI: 0.847 - 0.906) and scale question response curves were parallel across the socio-economic strata of the households. The two extreme levels, 'food secure' and 'severely food insecure' households, showed a statistically significant dose-response relationship (P < 0.001) across wealth index and household per capita income strata. Daily consumption of food from animal sources and fruit had a statistically significant dose-response relationship (P < 0.001) with household food insecurity.

Conclusion
The Household Food Insecurity Access Scale-Sri Lanka is a valid tool to assess household food insecurity in Sri Lanka.

DOI: http://dx.doi.org/10.4038/jccpsl.v19i2.7580

Journal of the College of Community Physicians of Sri Lanka 2014 June 19(2): 17-28