Food and Nutrition Security Theory: Kwanele Siyabonga Simelane, MSC, PHD Student and Steve Worth, PHD
Food and Nutrition Security Theory: Kwanele Siyabonga Simelane, MSC, PHD Student and Steve Worth, PHD
Food and Nutrition Security Theory: Kwanele Siyabonga Simelane, MSC, PHD Student and Steve Worth, PHD
Abstract
Background: Food and nutrition insecurity continue to affect societies in both developed and
developing countries even in years of bounty harvest. This confirms that availability of food does not
automatically translate to food and nutrition security (FNS). Even when food is available it may not be
accessible to everyone who needs it, and sometimes available and accessible food may not provide all
the nutrients required to nourish the body to develop, grow, resist diseases, and meet ordinary
physiological demands. Sometimes, food is plenty and accessible but not acceptable or sustainable. All
such instances constitute potential food and (especially) nutrition insecurity.
Objective: We intend to establish a theoretical framework for investigating food and nutrition
security.
Method: This is a theoretical paper drawing on previous publications within the scope of food
security and nutrition security.
Results: The review found that it is imperative to consider carefully the definition of FNS to ensure
the two concepts (food security and nutrition security) are adequately and sufficiently addressed in the
implementation of food policies and strategies without sacrificing one concept over the other. This
balance can be achieved through a thorough needs assessment analysis following the livelihood and the
vulnerability approaches to FNS. The analysis should take into account the four conceptual dimensions
to FNS to holistically cover every aspect of FNS.
Conclusions: The information gathered from the analysis will help prioritize and focus food and
nutrition support efforts to the people who really need it, yielding impact measured in public health
indicators, education, productivity and the broader national/regional economy.
Keywords
food security, nutrition security, availability, accessibility, utilization, sustainability
Introduction
The purpose of this article is to explore the impor- 1
University of KwaZulu-Natal, Pietermaritzburg, South Africa
2
tance of integrating in practice food security and African Centre for Food Security, University of KwaZulu-
nutrition security without sacrificing one concept Natal, Pietermaritzburg, South Africa
over the other. To lay a base, a definition of food
Corresponding Author:
and nutrition security (FNS) is presented. It paints Kwanele Siyabonga Simelane, University of KwaZulu-Natal,
a clear picture of the factors to be considered Pietermaritzburg, South Africa.
when dealing with FNS issues. Specifically, 4 Email: [email protected]
368 Food and Nutrition Bulletin 41(3)
dimensions (categorical, socioeconomical, man- and should be viewed from at least 3 perspec-
agerial, and situational) of FNS are presented to tives: individual, household, and national/
provide context for understanding FNS theories. regional food security.2 These are vital distinc-
Much attention will be given on the key factors tions because it is entirely possible (as is often
to be considered during assessment, program the norm) for a nation or region to be considered
development, policy formulation, and provision “food secure” while simultaneously households
of food and nutrition support. The whole purpose and individuals within that nation or region expe-
of this is to unearth the tools required to rience food insecurity. Conversely, it is also pos-
implement strategies that focus on identifying, sible for individuals and households to be food
categorizing, and prioritizing responses to food secure when a nation or region is not, as is often
and nutrition insecurity and further develop sus- the case with highly inequitable economies.
tainability programs. In addition to unearthing Each of these pillars (in particular the first 3)
tools required, this article also seeks to explore are functions of the physical environment, social
the engagement of key stakeholders from environment, and policy environment. They
grassroots level to policy makers, and from directly influence FNS, particularly at the house-
household to regional level, based on the hold level.4 Factors such as extreme weather (eg,
knowledge and understanding acquired from floods and droughts), inadequate roads and trans-
the dimensions of FNS. port, social conflict, and ineffectual government
policy may limit the ability to produce, distribute,
Food and Nutrition Security and/or access food and the stability thereof. Such
vagaries affect not only current production and
Food and nutrition security can only be achieved
availability but often lead to the loss of produc-
when all people have, when needed, physical,
tive assets such as land, livestock, equipment, and
social, and economic access to adequate, safe
infrastructure, affecting individual households,
(free of contaminants), and nutritious food to
regions, and even whole nations. This loss of pro-
satisfy their dietary needs and choices for an
ductive capacity is not always easily regained and
active and healthy life. To establish a compre-
usually requires a considerable amount of time to
hensive definition of FNS, first requires a defi-
recover, potentially creating long-term challenges
nition of food: a substance one eats and/or drinks
to achieving FNS.
to support life and body development.1 Thus, for
this article, food excludes water (even though it
is essential to life) and commodities such as Food availability. Availability is defined by Riely
alcohol and medicines. Secondly, it is useful to et al5 as the physical existence of (potentially
consider the dimensions of FNS, of which, con- obtainable) food, either from own farm produce
ceptually, according to Gross et al,2 there are 4: or purchased from off-farm (eg, from markets). It
categorical, socio-organizational, managerial, is evident from this definition that, particularly in
and situation-related. the case of own production, land and the other
means of production such as funds, workforce,
knowledge and skills are important components
Discussions of the Dimensions of of availability and, therefore, of food security.
FNS Food availability at national level is a combina-
tion of commercial production, household pro-
Categorical Dimension duction, food imports, international donations,
The categorical dimension of food security most and domestic food stocks. Most commonly, food
commonly has 4 pillars: availability, access, uti- availability refers to food at household or regional
lization, and stability.1,3 To achieve FNS, each of levels. It is rarely considered at individual level.
these 4 pillars must be satisfied at all times with- Food availability at these latter 3 levels are part
out neglecting one in favor of the others. Thus, it of, and are influenced by, the national availability
is essential to explore each pillar. Each pillar can of food. However, as noted earlier, it is possible
Simelane and Worth 369
Availability
Accessibility
Utilization
plex, and it is often difficult to distinguish
between household and national or regional food Nutrition
Status
availability. Of course, availability of food on its
own does not translate to FNS because it repre-
sents only potentially accessible food in a society.
Determining that food is available does not neces-
sarily confirm whether individual households or
Stability
individuals within households can actually
access, use, and utilize the food.
Figure 1. The relationship among the categorical
Food accessibility. Accessibility is a state of house- elements of framework of food and nutrition security.4
holds and individuals within households having
sufficient means and/or resources to obtain the
food required for a nutritiously complete diet— culture and education levels) regarding what food
in this instance, the food is taken to be available.4 to buy, the methods of preparation and, of partic-
Access to food has 2 fundamental aspects ular importance, about who in the household con-
“physical accessibility” and “financial sumes what food and when—with an eye on fair
accessibility.” Accessibility is determined by distribution.7
availability of recourses such as capital (to pay
for the food), human mobility (to physically Stability/sustainability. Stability/sustainability
obtain the food), and knowledge (to enable deci- refers to the time frame over which FNS is being
sions about accessing the food). This suggests considered.4 There is always a prevailing possibil-
that adequate access to food cannot only be deter- ity, that at any time, food security could be lost or
mined by households being able to produce food gained.8 This suggests that, even if one’s food con-
but also having the ability to get to and purchase sumption is optimum today, one may still be food
food from the market. Thus, even when a house- and/or nutrition insecure if access to the correct
hold is able to produce food, its ability to generate food cannot be sustained as long as it is needed.
income is pivotal to achieve food and nutrition Specifically, intermittent access to (correct) food
accessibility. Simply put, food accessibility is associated with compromised nutritional status.
ensures people are able to acquire food, both phy- Therefore, to sustain FNS, stresses and shocks
sically and economically, through various means such as climatic conditions, conflicts borne of
which include growing, purchasing, gifts, food unstable political environment, and economic
aid, and bartering or trading.5 attributes (eg, unemployment, rising food prices)
need to be managed as they may have an impact
Food utilization. Food utilization is defined as the (directly or indirectly) on FNS status.6 Hence, the
ability of a person’s body to assimilate nutrients need to put in place means to stabilize all the fac-
in consumed food. Optimum calorie and nutrient tors that impact on ensuring the stability of FNS.
consumption by a person is an outcome of good As shown in Figure 1, the ultimate aim of food
care and dietary habits, food preparation, variety security is nutrition security. It also highlights the
of the diet, and intrahousehold distribution of consequential relationship among the 3 pillars—
food. Combined with good biological utilization availability, accessibility, and utilization. Utiliza-
of food consumed, all of these factors determine tion is possible only if food is accessible, which is
the nutritional status of individuals.6 Another ele- possible only if food is available. Stability of each
ment of utilization is the socioeconomic aspects of the 3 pillars is critical. To achieve nutrition
of food including knowledge, habits, and security, availability of the correct food must be
decision-making (which are greatly affected by stable, access to that food must be stable, and
370 Food and Nutrition Bulletin 41(3)
Table 1. Examples of Varying Instruments to Assess Food and Nutrition Security Situation at Different Social
Levels.2
Macro Precipitation record, Vulnerability Analysis Demographic and Global Information Early
food balance sheet and Mapping Health Surveys Warning System
Meso Food market survey Food Focus Group District Health Anthropometric Survey in
Discussion Survey Children
Micro Agricultural production Intra-household Immunization Chart Weighing Chart of
plan Food Frequency Pregnant Women
Questionnaire
utilization of that food must be stable. The stabi- At the macro-level, food availability (at least
lity of food availability is self-evident. The stabi- in terms of coarse grains) can be determined
lity of access implies that the physical and through the amount of rain recorded to predict
monetary means to access food is stable. And the yield. Food balance sheets can also provide data
stability of utilization suggests, at the very least, on food availability at national level. The Vulner-
stability of the health of the body to assimilate the ability Analysis and Mapping intervention helps
required nutrition and the consistency of prepara- analyze the vulnerability to food insecurity of
tion of food to ensure it consistently delivers the target populations, which speaks to the accessi-
required nutrition. Further, the complex nature of bility and relates to food availability. The com-
stability of each of the 3 pillars and the dynamic mon survey periodically done in countries,
relationship among the 4 pillars suggest that FNS Demographic and Health Survey, provides health
is not the responsibility of just one entity or data for national policy formulation which
agency but requires coordination and collabora- informs utilization. The Global Information Early
tive efforts from various stakeholders and role- Warning System, developed by Food and Agri-
players in the whole food system to ensure FNS culture Organization, gathers information rele-
at all level. vant to short-term food insecurity which
corresponds to the stability pillar.
Socio-Organizational Dimension At the meso level, food market surveys give
information on the availability of food. Surveys
The elements of the socio-organizational dimen- such as food focus group discussions provide data
sion of FNS are macro-, meso- and micro- on accessibility of food, especially for popula-
perspectives, which can, respectively, be defined4 tions at risk of malnutrition. Health outcomes that
as follows: reflect food utilization can be traced through dis-
trict health surveys.
Macro: Encompasses world, regional, and
At the microlevel, several instruments exist.
national food and nutrition status;
Agricultural production plans, intrahousehold
Meso: Focuses on community (province/
food frequency questionnaires and interviews,
city; district/town; village) food and
immunization surveys, and anthropometric mea-
nutrition status; and
surements of pregnant women and children under
Micro: Centers on the household/family and
5 can be used to assess the availability, accessi-
individual food and nutrition status.
bility, and utilization of food and its stability.2
As shown in Table 1, the categorical elements
of FNS are applicable to all of the levels of the
socio-organizational dimensions. However, the
Managerial Dimension
significance of each element varies with each The third dimension of FNS is the managerial
level. For example, instruments to assess FNS at dimension. Alshuniaber9 argues that “food secu-
different social levels vary. rity governance is a complex issue.” He suggests
Simelane and Worth 371
Free Provision of
(Group) Credits
Commodities (Food, Tools / Inputs-for
Nutrients, Medicine, work
etc.)
Food-for-Work Extension
Services
Cash-for-work
Training &
Upgrading
Program-Related
Institution Building
Program Type
Fig. 3 Importance of Implementation Tools at Meso Level in Different Stages of Food
Figure 3. Importance of implementation tools at meso level in different stages of food and nutrition security.2
including credit programs, extension services, nomenclature uses the term “food and nutrition
training, and institution-building. All of these tar- security.” This helps ensure that nutrition is not
get building sustainability and resilience to rein- lost in theory, policy, or practice. Nutrition secu-
force FNS and the human and institutional rity is defined14 as a state when a person has a
capacity that supports it. nutritionally adequate diet, the food consumed is
“bioavailable” for the body to perform ade-
quately in maintaining various physiological
Nutrition Security processes including growth, resisting or recover-
Dating from the early 1970s, food security was ing from disease, pregnancy, breastfeeding, and
conceptualized primarily as sufficiency of food physical activities. Additionally, Wall15 posits
on a global scale. The 1974 World Food Confer- that nutrition security encompasses physical,
ence defined food security as the “availability at economic, and social access to a balanced diet,
all times of adequate world food supplies of basic safe drinking water, environmental hygiene, pri-
foodstuffs to sustain a steady expansion of food mary health care, and primary education. As
consumption and to offset fluctuations in produc- seen, nutrition security involves both food and
tion and prices.”11 It was not until the 1990s that nonfood attributes. Hence, while water, for
the concept of nutrition security was included in example, may not be considered food in the def-
the definition. Despite the passage of more than 2 inition of food security, it is a vital part of nutri-
decades, nutrition is not implicit in discussions, tion security. Further, these definitions suggest
policy, or practice of food security. Thus, current that nutrition (and food) security is, in part,
Simelane and Worth 373
dependent on health services, healthy environ- that income, socioeconomic status, and food
ment, and care practices 16 and that nutrition prices significantly influence FNS and should,
security can only be realized when there is thus, be taken into account when considering FNS
secure access to an appropriately nutritious diet and insecurity.
in a healthy environment (including clean water In the quest to improve their economies
and sanitation and no pollution) together with through agriculture, governments often promote
adequate health care services for all members cash crop (as opposed to food crop) farming.
of the household. Thus, the difference between However, undernutrition is significantly greater
nutrition security and food security is that nutri- in regions that primarily produce cash crops.20
tion security demands access to essential nutri- Lack of nutrition leads to decreased productivity
ents, not just calories as is most often the case levels among adults and poor performance of
when food security is considered. scholars. Further, undernutrition often passes
A review by Hwalla et al17 argued that nutri- from one generation to another. When undernu-
tion is an integral component of food security and trition is not dealt with, children will grow into
should be embedded within all 4 of its dimen- malnourished adults and their children will expe-
sions: availability, access, utilization, and stabi- rience similar problems. This affects not only
lity. The review highlighted that the availability, families but also the overall local economy.21 In
accessibility, utilization, and stability of both 2016, 155 million children were reported stunted,
macro- and micronutrients should be incorpo- which implies that these children will fail to
rated into all 4 dimensions of food security as achieve their genetic potential and will not realize
applied to analysis, policy, and programming.
their full developmental ability and will suffer,
Thus, it can be argued that if one is not nutrition-
among other things, cognitive deficits and dimin-
ally secure, one is not food secure.
ished economic opportunities. 22 Specifically,
With regard to food availability, improvement
Black et al23 highlighted that stunting happens
in the quality and quantity of nutrients within
early in a child’s life—within the first 1000 days
foods can be made to achieve nutrition security.
(between conception and 24 months of age)—
For instance, staple foods can be fortified with b-
causing permanent damage to brain development.
carotene to improve its nutritional composition to
This has educational, income, and productivity
alleviate a vitamin A deficiency in a population.
Government policies can be structured to support implications throughout the life of the individ-
such fortification programs17 and other processes ual—from childhood through to senior adulthood.
that support the improvement of the nutritional The human cost of undernutrition is devastat-
value of food. ing, impacting negatively and significantly on the
most vulnerable in the developing world. Under-
nutrition in developing countries causes popula-
Importance of Nutrition Security in Food tions to suffer from deficiencies of one or more
Security micronutrients and, in addition to retarded and
Nutrition security and food security are intercon- limited development, can also lead to child
nected and must be dealt with simultaneously.18 deaths.23 Malnutrition is the main contributor to
Diet quality is an important factor of the FNS of a child morbidity and mortality worldwide.24
society. It is determined by food availability, Another substantial nutrition-related concern
access, utilization, and affordability at national, is the concurrent burden of obesity among adults
household, and individual level and by the nutri- and children, and stunting among children, occur-
tional quality of the available and accessible food. ring in developing countries. This occurs mainly
Within this dual context, it is understood that poor among those of low-income and middle-income
diet quality is often linked with compromised status.22 It is unfortunate that the poor are the
socioeconomic status. 19 Further, food price ones who suffer the most by this double burden,
increases (which affect accessibility) lead to diets which predisposes them to health risks and eco-
lower in micronutrients.20 Hence, it can be argued nomic shocks.
374 Food and Nutrition Bulletin 41(3)
There is need to pay attention to risk factors threats such as negative natural or economic
that seem to threaten food security at any point in trends and crises and can maintain or enhance its
time as they increase the probability of vulner- capabilities and assets without compromising the
ability. For instance, at the household level, a livelihoods of others.32
main risk factor is health that can present in the A livelihoods approach focuses on people
form of illness, disability, and/or injuries. and tries to analyze the diversity of (poor) peo-
Another risk factor can be life cycle-related (old ple’s livelihoods in totality giving particular
age, death). Social-related risk factors include attention to the interrelationship between
those which can arise due to inequitable food community-level activities, broader policy, and
distribution among households in a society or institutional frameworks. “Sustainability” covers
among household members within individual economic, environmental, institutional, and
households. Economic-related risk factors may social parameters. Thus, adopting a livelihood
manifest due to unemployment and harvest fail- approach requires focusing on the people’s way
ure.26 These risk factors exacerbate food and of life and factors influencing their ways of
nutrition insecurity by decreasing food produc- living and dynamic lifestyle patterns. The
tion (availability), diminishing income and other approach efficiently exposes gaps and possible
assets (access), escalating debt (stability), and points of action.12
decreasing recommended consumption of macro- One of the most basic livelihood activities is
and micronutrients (utilization) as a consequence food production which can be a main source of
of the other risk factors. food availability and access, especially for rural
One of the main merits of the vulnerability households. Also important is the capacity of
approach in analyzing food insecurity is that it
households to buy food in the market which is a
is dynamic and progressive in that it focuses not
determinant of food access; purchasing capacity
only on the immediate outcome but also scans for
rests mainly on the household’s means to gener-
possible future incidents. In this way, the
ate income.
approach is applied ex ante (based on forecasts
Food and nutrition security is supported by
rather than actual results) rather than ex post
livelihoods in a way that households get access
(based on events that have occurred). The second
to resources and assets in their dwellings in order
advantage is that the vulnerability approach is
to satisfy their needs. Livelihood analysis of
cast in a stochastic (randomly determined) frame-
households and individuals starts with investigat-
work and can, therefore, fully consider the uncer-
tainties associated with future FNS, such as the ing the 5 livelihood assets—physical, financial,
role of external shocks and the strategies that natural, social, and human capital—present in the
households, communities, and institutions can assessed area. Then identifying the range of live-
adopt in order to minimize the likelihood of neg- lihood strategies into which people translate
ative outcomes.30 assets follows. Therefore, a successful livelihood
strategy is seen in the outcome of achieved
FNS.33 In brief, FNS is a fundamental goal of all
Sustainable Livelihoods Approach livelihood strategies.
The sustainable livelihoods approach was devel- In addition, the focus of FNS and livelihood
oped to understand the context in which house- approaches is on the household FNS elements of
holds pursue livelihoods and food needs. It the underlying agencies of malnutrition, examin-
examines the assets available to develop liveli- ing the availability, quality, and use components
hood strategies and investigates the influence of related to household FNS. The vulnerability
macro-level policy and institutions on assets and aspect is incorporated into livelihood assets and
strategies. Livelihoods comprise the capabilities, strategies and also into FNS.33 The integration of
material and social assets, and activities required the 3 concepts results in a conceptual overlap;
for a means of living.31 A livelihood is sustain- hence, they should be treated inseparably during
able when an individual or household can adapt to an FNS analysis.
376 Food and Nutrition Bulletin 41(3)
Nutrition Status
INDIVIDUAL
Access to food;
Food Food availability; Food Stability; Poverty,
Economy Domestic Weather Purchasing
NATIONAL, SUBNATIONAL, &
Socio-
economic, Population, Education, Micro economy including foreign
trade, Policies and laws, Natural resources endowment,
Vulnerability
Political,
Cultural Basic services, Market conditions, Technology, Climate,
Institutional, & Civil strife, Households characteristics, livelihood systems,
context
Figure 4. The Food and Agricultural Organization-Vulnerability Information and Mapping Systems (FAO-FIVIMS)
framework.12
The Overall Conceptual Saharan Africa. And, finally, indicators that are
Framework for FNS useful for on-going program monitoring purposes
may not be appropriate in the context of an
As the discussion thus far suggests, measuring impact evaluation.” Thus, one of the great chal-
FNS is complex. It is difficult, if not impossible, lenges of measuring, monitoring, and intervening
to observe FNS outcomes directly. The study by in FNS is establishing a common framework of
Aurino,34 as noted by Riely et al,5 stated that indicators to capture both the dynamics of FNS
“Food security indicators for food-supported and the multiple contextual variations in which
maternal and child health programs, for example, FNS must be addressed.34 Figure 4 presents the
might be quite different from those which are Food Insecurity and Vulnerability Information
appropriate for food-for-work programs. Simi- and Mapping Systems (FIVIMS) framework.12
larly, food security indicators that are appropriate It addresses food insecurity and vulnerability
in the humid tropics of Latin America may have across 3 fronts: collective (including national,
little validity in the semi-arid areas of sub- subnational, and community levels), households,
Simelane and Worth 377
and individuals. Some of the key elements of the and the environment) is limited or compromised
framework are discussed below. in its ability to utilize the food, then the individ-
ual cannot be food secure.
Socioeconomic, political, institutional, The FIVIMS framework clearly shows the lin-
cultural, and natural environment issues kages and interactions of key factors contributing
to an individual’s nutritional status. And while
This part of the diagram (residing under
food security is often reviewed from grander per-
national, subnational, and community level)
spectives, in the end, food security is about the
depicts the underlying factors in the food econ-
nutritional status of each individual in a societal
omy that affect the FNS availability, access, and
setting. Thus, exploring the challenges of food
stability pillars. These include population, the
security must embrace—in addition to the well-
macro-economy, technology, climate, livelihood
established 4 pillars—the factors affecting,
systems, and market conditions. These factors
directly and indirectly, the nutritional status of
also have direct and indirect impacts on
individuals.
household-level activities and processes includ-
ing livelihoods, food access, care practices, and
health and sanitation. Together these elements Conclusion
create the overall “vulnerability context” of
A filled stomach is not enough. The food a person
households.
eats should be complete and safe, balanced (con-
Food consumption and utilization at the taining all required nutrients), and available and
individual level accessible for as long as it is needed. Food and
nutrition security is possible only when the 4 pil-
Ultimately, as seen in Figure 4, food security is lars (availability, accessibility, usability, and sus-
essentially a matter of the nutritional status of tainability) are in place. Thus, a person is
individuals. The mapping highlights the fact all considered food and nutrition secure only when
of these processes affect the nutritional status of the food consumed is nutritionally adequate and
individuals by affecting food consumption and assimilated by the body to nourish itself for
utilization of food by the body. Specifically, indi- development, growth, resist diseases, and meet
vidual nutrition security is affected by food ordinary physiological demands of work and life.
access and care practices at household level. Understanding the different dimensions and
Because an individual’s food consumption is reli- approaches to FNS helps enable the provision of
ant on access to food at household and higher efficient and effective food and nutrition support.
levels, it is, in effect, determined by poverty/ This understanding also draws attention to the
income, buying power, transfers of income, mar- fact that not only do many players form part of
ket infrastructure, and quality of transport. The the FNS network, they must work coherently in
care practices that affect consumption encom- collaboration.
pass allocation of food within households, cul- Where FNS is achieved, sustainable liveli-
tural beliefs and practices, and understanding of hood in households thrives, health improves,
nutrition and food preparation. Specifically, the education improves, and the economy thrives.
health status of an individual determines the effi- But the reverse is also true. Where livelihoods
ciency and effectiveness of the body to utilize thrive, FNS is possible and sustainable. When
(assimilate) food, and health status is dependent livelihoods are vulnerable, household FNS is
on the overall health and sanitation conditions. also vulnerable. Thus, FNS analysis must always
As the diagram depicts, these conditions are give priority in assessing vulnerability in the
directly influenced by the vulnerability context context of sustainable livelihood in order to
prevailing at the collective levels. It is thus identify and classify populations at risk, to esti-
argued that, even where appropriate foods are mate the extent of vulnerability, and to deter-
stably available and accessible, if the body (par- mine kind of response be it relief, community
ticularly because of external factors in society development, sustainable systems development,
378 Food and Nutrition Bulletin 41(3)
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