Evaluation of a rapid field tool for assessing household diet quality in Mozambique

The Nutrition Section of the Mozambican Ministry of Health recently implemented a low-cost, rapid field tool for assessing the quality of household diets. Such tools can play an important part in targeting development assistance in countries where resources are scarce. This paper evaluates how well the tool performs at describing household dietary intakes in northern Mozambique and explores ways to improve it. The food-group classification and scoring system that form the core of the tool were applied to household data (n = 1,140) collected in a previous quantitative diet study in Nampula and Cabo Delgado Provinces. Using mean intakes as a criterion, the diet assessment tool performed well on all nutrients studied, except vitamin A. Those classified by the tool into the top group of diet quality had the highest mean intakes of energy, protein, and iron as well as the highest mean scores on the Mozambican Diet Quality Index, whereas those classified in the bottom group had the lowest intakes. Sensitivity rates for the diet assessment tool could be substantially improved by raising the cutoff point for an acceptable diet from the current threshold of 20 points to 23 points. Regression analysis was used to suggest other possible improvements. Such improvements were only marginal and do not justify field implementation, given the added complexity in classifying and scoring. This paper provides evidence that, with some minor changes, the Ministry of Health diet assessment method can be a useful tool in describing the dietary situation of groups of Mozambican households. Since this tool is both inexpensive and simple to use, there may be interest in adapting it for use in other low-income countries. A series of steps for doing so is outlined at the end of this paper.