The DHS Program User Forum
Discussions regarding The DHS Program data and results
Home » DHS-8 Questionnaire Review - Archived » Core questionnaire: Nutrition » Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets
Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16778] Fri, 01 March 2019 14:20 Go to next message
DataDENT is currently offline  DataDENT
Messages: 11
Registered: January 2019
Member
Women of reproductive age (WRA) are nutritionally vulnerable due to pregnancy, lactation, and cultural practices. For WRA, information is needed on the diversity of the diet, which is associated with micronutrient adequacy in resource poor settings, and the extent to which unhealthy food groups are consumed by WRA. We propose three indicators to capture dietary diversity of WRA.

1. Minimum dietary diversity for women (MDD-W)
Definition: Proportion of women 1549 years of age who consumed at least five out of ten defined food groups the previous day or night.

2. Percent of women of reproductive age who consumed sugar-sweetened beverages (SSB) in the previous day or night.
Definition: Proportion of women 15-49 years of age who consumed any sugar-sweetened beverages the previous day or night.

3. Percent of women of reproductive age who consumed "junk food" in the previous day or night.
Definition: Proportion of women 15-49 years of age who consumed any savory or fried snacks, or any sweets during the previous day or night.

Attached to this post is a completed submission form with full justification for the recommendation.

----------

This recommendation originated in the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), and coordinated by Data for Decisions to Expand Nutrition Transformation (DataDENT). The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.

This recommendation was authored by Megan Deitchler (FHI360/Intake Center for Dietary Assessment) and reviewed by Mary Arimond (Intake Center for Dietary Assessment), Terri Ballard (Independent Consultant), Anna Herforth (Independent Consultant/Ag2Nut Community of Practice lead), Alissa Pries (Helen Keller International (HKI)), Estefania Custodio (European Commission (EC)), Alexandra Tung (Food and Agriculture Organization of the United Nations (FAO)), Yves Martin Prevel (Institute of Research for Development), and Francois Kayitakire (EC).

This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 2 of 3 (high priority data need).

This recommendation is also endorsed by the EC, FAO, Countdown to 2030, Alive & Thrive, Global Alliance for Improved Nutrition (GAIN), the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

[Updated on: Fri, 01 March 2019 14:38]

Report message to a moderator

Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16840 is a reply to message #16778] Thu, 07 March 2019 15:17 Go to previous messageGo to next message
DHS QRE Administrator is currently offline  DHS QRE Administrator
Messages: 107
Registered: January 2019
Senior Member
Originally posted by Naveen Paudyal on March 7 as a report to the forum moderator. Moved as a reply to this post by the moderator.

I did not see women of adolescent age, 10-14 years covered in the MDD-W, where country has need for the information/ data related to adolescent age to move ahead with the adolescent nutrition programme and further measure the progress. Global momentum is also targeting women of adolescent age as well under new emerging programming. My report is on this context if it is possible to include adolescent module as well. I did not find appropriate theme area to discuss about it but has taken opportunity to discuss about it under MDD-W.


DHS QRE Administrator
The DHS Program
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16908 is a reply to message #16778] Wed, 13 March 2019 21:44 Go to previous messageGo to next message
SUN Movement MEAL Team
Messages: 9
Registered: March 2019
Member
MDD-W is a key nutrition indicator selected in the SUN Movement's MEAL Results Framework; however, we are currently unable to track it for a majority of SUN member countries due to the fact that these data are not yet being collected on a large scale, such as through the DHS or MICS surveys. We strongly recommend the inclusion of these questions.

The availability of the MDD-W as a validated proxy for micronutrient adequacy provides an opportunity for data on food groups collected for women to now be able to be used meaningfully for assessment, monitoring and tracking; for cross-country comparison, and to help monitor progress towards SDG targets in SUN countries.

Given the dramatic increase in overweight and obesity among women in SUN countries in recent years, we agree that monitoring the quality of diets of WRA is important.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16922 is a reply to message #16778] Thu, 14 March 2019 05:02 Go to previous messageGo to next message
Mauro Brero is currently offline  Mauro Brero
Messages: 12
Registered: March 2019
Member
UNICEF Tanzania Nutrition team concurs with all the indicators except that the wording should be changed from previous day or night to previous 24 hours. We also suggest to increase the age group to include early adolescence, i.e. 10-14 years old girls.

It would also be relevant in this section of the questionnaire to add an indicator about physical activity among women, as reduced physical activity has been identified in Tanzania (but also globally) among the drivers of increased overweight and obesity.

These indicators will be used to track progress on impact of maternal nutrition interventions and to further inform planning and programming to improve those interventions.

UNICEF Tanzania Nutrition team.

[Updated on: Thu, 14 March 2019 05:06]

Report message to a moderator

Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16938 is a reply to message #16778] Thu, 14 March 2019 06:40 Go to previous messageGo to next message
Geeta Verma is currently offline  Geeta Verma
Messages: 5
Registered: March 2019
Member
I support these indicators and feel that the time for recall be 24 hours. I too advocate inclusion of early adolescence age group 10-14 years for these indicators.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16973 is a reply to message #16778] Thu, 14 March 2019 15:05 Go to previous messageGo to next message
jruelbergeron is currently offline  jruelbergeron
Messages: 8
Registered: March 2019
Member
The Global Financing Facility (GFF) Secretariat endorses the recommendations made in this document (DataDENT).
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16981 is a reply to message #16973] Thu, 14 March 2019 17:31 Go to previous messageGo to next message
Olutayo
Messages: 12
Registered: March 2019
Member
Nigeria, like many other low and middle income countries, has a high burden of malnutrition. The DHS is considered the authoritative source for the prevalence of nutrition outcomes as well as many nutrition determinants. However, nutrition determinants data focus on disease, care for women and children, access to sanitary environments and health services. The DHS has included limited information about food-based nutrition determinants. This has been a huge gap since all of food, care and health must be addressed to improve nutrition. If we do not have a full picture of where the problem lies, we cannot provide adequate solutions. Recognizing this, relevant government ministries, FAO and other nutrition stakeholders in Nigeria successfully advocated for the inclusion of MDD-W in the Nigeria DHS-7. The purposes of including MDD-W in Nigeria included:
1. Obtain indication of micronutrient adequacy of women's diet in Nigeria for
•Prioritizing scale-up and targeting of existing and new nutrition interventions
•Improving design and implementation of micronutrient deficiency control programmes
2. Provide periodic information about food-based nutrition indicators for
•Monitoring changes in nutrition determinants
•Assessing impact of nutrition-sensitive actions
It would be quite useful indeed if MDD-W becomes a core nutrition indicator in DHS so that the data is available for all subsequent survey years and other countries. I therefore endorse the recommendation to include this indicator


Olutayo Adeyemi
Nutrition Capacity Strengthening Officer
FAO Nigeria

[Updated on: Thu, 14 March 2019 17:32]

Report message to a moderator

Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #16997 is a reply to message #16981] Fri, 15 March 2019 02:16 Go to previous messageGo to next message
katherinek is currently offline  katherinek
Messages: 1
Registered: March 2019
Member
MDD-W is one of the key food security indicators and used to advocate for nutrition sensitive programming. Mercy Corps would support this indicator as a way leverage policy and raise awareness to government about the emerging issue of the double-burden of malnutrition.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17025 is a reply to message #16778] Fri, 15 March 2019 07:05 Go to previous messageGo to next message
Paula Kawiche is currently offline  Paula Kawiche
Messages: 9
Registered: March 2019
Member
I indorse these questions
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17038 is a reply to message #16778] Fri, 15 March 2019 07:59 Go to previous messageGo to next message
aperry is currently offline  aperry
Messages: 9
Registered: March 2019
Member
The DFID Nutrition Policy team strongly endorses this proposal - given the contribution this would make to enabling effective targeting of investments and monitoring of progress to improve the diets of women.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17048 is a reply to message #16840] Fri, 15 March 2019 08:40 Go to previous messageGo to next message
Haika Martin is currently offline  Haika Martin
Messages: 2
Registered: March 2019
Member
I endorse the suggestion made but should also include adolescents so age should start at 10yrs
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17050 is a reply to message #17048] Fri, 15 March 2019 08:51 Go to previous messageGo to next message
Katalambula is currently offline  Katalambula
Messages: 1
Registered: March 2019
Member
Dietary diversity is a useful indicator of nutrients intake. It is very important to know nutrients intake of this group. I endorse this recommendations.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17051 is a reply to message #16778] Fri, 15 March 2019 08:53 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
Messages: 11
Registered: April 2014
Member
I fully endorse the proposed new indicators of diet diversity and diet quality proposed. They are critically important to better understand not only whether women's diets include enough diversity, but also whether they include diet components that put them at risk of overweight, obesity and NCDs.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17099 is a reply to message #16778] Fri, 15 March 2019 13:18 Go to previous messageGo to next message
Rolf Klemm is currently offline  Rolf Klemm
Messages: 7
Registered: March 2019
Member
Helen Keller endorses the proposed new indicators of dietary diversity and diet quality for women of reproductive age. Information obtained from these indicators will help assess and track the diversity of women's diets as well as provide important information on the consumption of foods that may increase their risk of diabetes, obesity and other diet-related chronic diseases.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17124 is a reply to message #16778] Fri, 15 March 2019 14:28 Go to previous messageGo to next message
salayon is currently offline  salayon
Messages: 7
Registered: January 2019
Member
I fully endorse these recommendations. I can see value in having these data not just for monitoring progress in improving the diets of women. When paired with the data from the IYCF MDD, it can be very valuable to help program planners understand where there are gaps in food group consumption between mothers and their children. Identifying foods consumed by mothers, but not fed to their young children can help us identify "easy wins" for promoting specific food groups to increase diet diversity among young children.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17159 is a reply to message #16778] Fri, 15 March 2019 15:18 Go to previous messageGo to next message
PATH is currently offline  PATH
Messages: 8
Registered: March 2019
Member
We support the reinstatement of the minimum dietary diversity for women indicator.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17172 is a reply to message #16778] Fri, 15 March 2019 15:27 Go to previous messageGo to next message
1000 Days is currently offline  1000 Days
Messages: 10
Registered: March 2019
Member
1,000 Days is the leading non-profit organization working in the U.S. and around the world to improve nutrition and ensure women and children have the healthiest first 1,000 days.
We support the three proposed indicators and echo the importance of adolescent nutrition raised by DHS QRE Administrator. Reproductive age is a crucial period for nutrition, but so is adolescence, as experts often define it as "second window of opportunity" (after the first 1000-days) for growth and development. Better understanding women's diets will more comprehensively assess whether women are getting the nutrition they need and will be immensely important to our advocacy to improve women's nutrition.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17326 is a reply to message #17172] Fri, 15 March 2019 17:40 Go to previous messageGo to next message
ktripp is currently offline  ktripp
Messages: 6
Registered: March 2019
Member
Abt Associates endorses the proposal to include these indicators and also the proposal to include adolescents from aged 10yrs. Definitions of sugar sweetened beverages and junk food need to be fleshed out and context specific. Suggest rewording "sugar sweetened beverages" for "sweet drinks and drinks with sugar added". This is due to recent experiences in school based surveys in Ghana where the term beverages and sugar sweetened wasn't well understood. Additionally, many adolescents were adding sugar to drinks already considered sweetened or even to plain water for "energy"
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17339 is a reply to message #16778] Fri, 15 March 2019 17:51 Go to previous messageGo to next message
Erin Milner is currently offline  Erin Milner
Messages: 9
Registered: February 2019
Member
USAID supports this recommendation.
Re: Minimum Dietary Diversity for Women (MDD-W) and Unhealthy Diets [message #17416 is a reply to message #16778] Fri, 15 March 2019 23:28 Go to previous message
Judy Canahuati is currently offline  Judy Canahuati
Messages: 9
Registered: March 2019
Member
La Leche League International supports this recommendation
Previous Topic: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months
Next Topic: Coverage of Nutritional Interventions during Antenatal Care (ANC)
Goto Forum:
  


Current Time: Thu Dec 12 20:15:10 Eastern Standard Time 2019