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Percentage of Total Expenditures Spent on Food in HIV-affected Households

Export Indicator

The average percentage of total household expenditures that are spent on food in HIV-affected households. HIV-affected households are defined as households with people living with HIV (PLHIV), households with HIV-affected orphans and vulnerable children (
What it measures

The indicator measures the household’s vulnerability to food insecurity.
Households that spend a higher percentage of their income on food expenditures are
vulnerable to food insecurity because if their income falls or food prices rise—for example owing to a job loss, natural disaster, disease onset, or price policy reform—they will have
limited reserve for meeting their food needs. Conversely, households that spend a lower
percentage of their income on food are less vulnerable to disruptions of food access resulting
from falling incomes or rising food prices. Food produced at home or obtained through
bartering or gifts is included in the expenditure values.

Interpretation. The indicator is interpreted to measure the level of vulnerability to food
insecurity that exists in the program area from which measurements are taken. Because an
average value is used, the indicator does not measure changes in vulnerability to food security
at the household level. Rather, it measures the average vulnerability to food insecurity among
HIV-affected households in the program area.

Changes in the share of household expenditures spent on food measured by the indicator may
not be entirely attributable to program interventions. External conditions such as weather,
changes in the economic environment, conflict, or government policies may also influence
household expenditures. These factors need to be considered and accounted for when
interpreting results for the indicator.

Household expenditures are difficult to measure, and any indicator used to measure it will
include some degree of measurement error. The data collection methods proposed here,
however, follow established practice and should produce credible income estimates if
implemented properly.

Interpretation of the indicator should also take into consideration and make note of other
factors that may affect indicator values and changes in indicator values. For example, a
reduction in the percentage of food expenditures to total expenditures may reflect a food
shortage, and thus increased food insecurity, rather than an improvement in food security.

The definition of the indicator allows for cross-program comparisons. Situations may arise,
however, in which different programs use different methods to measure expenditures or draw
their expenditure estimates from different target populations (e.g., all households in the
program area vs. HIV-affected households in the program area). In such situations, any
differences in measurement methods or target population should be noted and their
implications for the interpretation of results explained. In all cases, interpretation of the
indicator should describe the target population and the data collection method used.

Uses. The information provided by the indicator can be used for a variety of purposes. At the
global level, it can be used by donors and international organizations to track the extent to
which efforts to reduce vulnerability to food insecurity among HIV-affected households are
effective, compare results achieved by different programs, and identify countries or regions
where greater efforts may be required. Similarly, national governments can use the indicator
to track the success of its policies or interventions and to prioritize needs within their countries.
Programs can use the information to assess the impact of their interventions, inform resource
allocation and program management, and report to donors.

Rationale
Numerator
Denominator
Calculation

Information to calculate the indicator comes from a survey administered to a representative
sample of HIV-affected households, or a broader set of households from which data are drawn
from those households identified to be HIV-affected. After data from households in a program
area are collected, the percentage of food expenditures to total expenditures is calculated for
each household. This information is used to calculate an average value for all households in the
sample. To obtain the individual household values for the indicator, the amount spent on food
is divided by the total amount spent. The average percentage is then calculated by adding
these household values together and dividing by the number of households that have
contributed values.

Method of measurement

The indicator is easily calculated using data obtained from
household expenditure surveys. Household expenditures are measured using estimates of
expenditure totals over the relevant reference period for food items, non-food items,
household durables, non-durables and other household expenditures based on the recall of a
household head. The relevant reference period for each expenditure category is determined by
the frequency of the expenditure (e.g., weekly, monthly, yearly). All expenditure values within
a household are then normalized to a single reference period. If possible, household
expenditures also include an estimate of ‘imputed expenditures’ as measured by the monetary
value of home produced and gifted food and non-food items.

Information to calculate the indicator comes from a survey administered to a representative
sample of HIV-affected households, or a broader set of households from which data are drawn
from those households identified to be HIV-affected. After data from households in a program
area are collected, the percentage of food expenditures to total expenditures is calculated for
each household. This information is used to calculate an average value for all households in the
sample. To obtain the individual household values for the indicator, the amount spent on food
is divided by the total amount spent. The average percentage is then calculated by adding
these household values together and dividing by the number of households that have
contributed values.

Data collection method. Data to measure the indicator are collected directly from members of
HIV-affected households using a formal survey instrument. Or if the survey is carried out
among a sample of all households, only the households determined to be HIV-affected are
included when calculating the indicator. Data collection is expected to occur primarily at the
homestead. Where resource or logistical constraints or stigma do not allow collection of data
at the homestead, data may be collected from clients at facility-based HIV delivery sites, at
community service delivery points, or through other locations.
Economists and national statistical agencies often
attempt to measure household expenditures using
very long and detailed expenditure modules
including dozens of disaggregated expenditure
categories. This approach, however, is infeasible for
most development programs. As an alternative,
programs may use an abbreviated set of expenditure
categories capturing the largest and most common
household expenditures at higher levels of
aggregation. While this approach probably yields
less accurate expenditure estimates, it compensates
with substantially increased feasibility. Academic
researchers also frequently use this approach. An
example of this approach is shown below. This is
only one example, and several alternative
approaches may also be used.Over the past 7 days
approximately how much have you spent for each of
the following items?
Purchased
Home
Produced
Or Received As
Gift
1. Food and non-alcoholic beverages (e.g., meat,
vegetables, fruits, dairy, grains, legumes,
starches, water, juice, soda, etc.)

2. Alcoholic beverages and tobacco

Over the past 30 days, approximately, how much
have you spent for each of the following items? Purchased
Home
Produced
Or Received As
Gift
1. Payment for housing (, rent, maintenance and
repair, water, electrical power, fuel)
2. Non-Durable and Personal Goods (e.g.,
toiletries, personal grooming, handbags, travel
bags, newspapers and magazines)

3. Transport and Communication (e.g., tires, tubes,
taxi/bus fares, mobile phone airtime, fuel)
4. Health and Medical Care (e.g., consultations,
medicines, hospital/clinic charges)
5. Supporting relative/friends, religious donations,
6. Other (e.g., entertainment, laundry, barber and
beauty shops, domestic servants, hotels and
other lodging)

Over the past 12 months, approximately, how
much have you spent for each of the following
items?
Purchased
Home
Produced
Or Received As
Gift
1. Clothing and Footwear
2. Furniture, Furnishing, etc.
3. Household Appliances and Equipment (e.g.,
refrigerator, iron, stove, TV, radio, cassette,
bicycle, motorcycle, computers, mobile phone,
jewelry, watches)

4. Glass/Table Ware, Utensils, etc. (e.g., basins,
plates, tumblers, buckets, enamel and metallic
utensils)

5. Education (e.g., school fees, boarding and
lodging, uniforms, books, supplies)
6. Livestock
7. Other (funerals, bride price, festivals/events)
8. Land

Because the average values for the program area are used for this indicator, it is not necessary
to collect data from a panel of the same households over time, although a panel of households
is also acceptable. If at all possible, the data should be collected from a representative sample
of HIV-affected households in the program area. If a representative sample is not possible, then
the implications for the results in terms of bias, accuracy, and other factors should be explicitly
acknowledged. In all cases, programs should also report the sample size and how the sample
was constructed. The size of the sample will also affect the precision with which the indicator
values reflect the status of the larger population of HIV-affected households.

Frequency of measurement and reporting. While household expenditures are expected to
fluctuate less over the course of the year than actual household income, they too can show
significant temporal variation. Significant and permanent changes in household expenditures,
moreover, can take years to emerge. Additionally, information on household expenditures can
be time and resource intensive to collect. For these reasons, it is recommended that the
collection of household expenditure data takes place no more than once every 12 months and
that it take place at the same time of the year to account for seasonal differences in
expenditures.

Disaggregation. Because the indicator measures the average share of expenditures that are
spent on food, disaggregation at the individual level is not possible. Programs may choose to
disaggregate the indicator based on categories that are relevant to their target groups and
services, such as type of household, geographic region, or type of intervention. In this case, the sample of HIV-affected households may need to be stratified by the relevant disaggregation
categories.

Measurement frequency

Annual

Disaggregation
Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

Strengths: The primary strength of the indicator is that it is measured via a widely-used method
for measuring household expenditures and the share of these expenditures going toward food.
The practice of measuring household expenditures with household surveys is well-established
and enjoys a high level of credibility among national governments, multi-lateral agencies,
donors, and other program stakeholders.

It may be possible, moreover, to integrate the indicator into Household Expenditure Surveys,
Core Welfare Indicators Questionnaires (CWIQs), or other multipurpose surveys administered
by national statistical agencies or other research institutions, which are common in developing
countries. Alternatively, it may be possible to calculate the indicator with data in existing
national or regional data bases. The popularity of expenditure modules in national and regional
surveys increases the opportunities for piggybacking the measurement of the indicator on
other data collection efforts. However, this approach requires identifying which households are
HIV-affected, which may be challenging unless such questions are part of the survey.

Another strength of this indicator is that there has been extensive experience using household
expenditure indicators in field settings. For example, the World Bank has collected household
expenditure data in 32 countries through its living standards measurement survey (LSMS).
Indicators measuring the share of household expenditures going to food have been used in
programs in various settings.

A final strength of the indicator is that it has general relevance across contexts and cultures.
Research indicates that many poor and vulnerable households in developing countries
(including both urban and rural households) are net purchasers of food. Thus household
vulnerability to income disruptions and/or food price increases appears to be a widespread
determinant of food security in developing countries.

Weaknesses: The principal weakness of the indicator is the challenge involved in collecting
accurate data on household expenditures. This challenge stems from two related sources. The
first is the challenge involved in capturing accurate estimates of household expenditures. The
second challenge is related to the financial and technical demands of capturing household-level
information.

The use of simplified expenditure survey modules is one way to address the challenges related
to data collection, although the tradeoff is a likely loss in accuracy. Producing accurate numeric
estimates of household expenditures is less critical with this indicator given that it measures the
percentage of food expenditures to total expenditures and not specific numeric values of actual
food or household expenditures, provided that the abbreviated expenditure model includes the
household’s primary expenditure categories.

If a country has existing national or regional data bases with expenditure modules, programs
can determine the most important expenditure categories by consulting the existing data bases as well as determining the extent to which the program’s abbreviated expenditure modules
produce results at variance with the more detailed expenditure modules.

With regard to the second challenge, data collection from individual households can be costly,
time intensive, and technically challenging making it a potentially significant burden for many
programs. In some situations, moreover, stigma may pose a challenge to data collection. This
challenge, however, exists for all indicators measured at the household level. If the program is
already doing household surveys for other purposes, the marginal cost for adding an
expenditure module to the survey is relatively moderate. In certain circumstances, programs
may be able to reduce the costs and burden of data collection by collecting expenditure data
from clients at facility-based HIV delivery sites or at community service delivery points, or by
piggybacking on regional or national household expenditure surveys.

Another weakness of the indicator is that it may be challenging to identify HIV-affected
households. If questions about HIV are not already part of the household survey used to collect
expenditure data, such questions could possibly be added, though there may be sensitivities to
asking such questions through household surveys. Alternatively, if programs already have
information about which households in a program area are HIV-affected, this information could
be used.

A final weakness is that results measured using random samples in each survey round (as
opposed to a panel of households) do not allow programs to measure and track changes in the
structure of household expenditures among specific HIV-affected households over time.
Rather, the results only allow programs to reach conclusions about average, or general,
changes over time. This approach does not allow the same type of in-depth analysis of factors
driving observed changes at the household level that would be possible with a panel survey.
The loss in analytical power may be accepted as a necessary trade-off to increase the practical
feasibility of the indicator.

Resources required:
The primary resources required to use this indicator are those associated with carrying out a
household survey: enumerators, training, transportation, survey forms. As discussed above, in
some cases household expenditure data may already be collected through existing household
surveys, in which case additional resources would not be required for data collection. Staff
time will also be needed for compilation and analysis of the data, as well as training of staff in
analysis. In cases where household surveys are already being conducted but expenditure data
are not already being collected, adding survey questions on expenditures will require
information on which expenditure categories to include and prices, as well as training in the
questions and in analysis. In some cases household expenditure data will be available, but
information about which households are HIV-affected will not be readily available. In such
cases, resources will be needed to collect information about HIV among households (e.g.,
adding questions to the household survey, or collecting additional data); or if program
information about HIV-affected households exists and can be matched with household
expenditure data, staff time will be needed to match these datasets.

Further information

Deaton, Angus and Margaret Grosh. “Chapter 17: Consumption.” Designing Household Survey
Questionnaires for Developing Countries: Lessons from Ten Years of LSMS Experience. Margaret
Grosh and Paul Glewwe, eds. World Bank, 1998.

Morris, Saul, Calogero Carletto, John Hoddinott, and Luc J. M. Christiaensen. Validity of Rapid
Estimates of Household Wealth and Income for Health Surveys in Rural Africa. FCND Discussion
Paper No. 72. Washington D.C.: International Food Policy Research Institute, 1999.

Smith, Lisa C., and Ali Subandoro. Measuring Food Security Using Household Expenditure
Surveys. Food Security in Practice technical guide series. Washington, D.C.: International Food
Policy Research Institute, 2007.