1. H OUSEHOLD H UNGER S CALE (HHS) H OUSEHOLD H UNGER S CALE (HHS) Sentinel Site Training- Kabul, Afghanistan May 20 -22 2012 Aida Ndiaye Tools and Methodology Tools and Methodology

2. O VERVIEW Household Hunger Scale(HHS) HHS Tool HHS Methods HHS Scoring HHS Categories Exercises

3. H OUSEHOLD H UNGER S CALE measure of household food access captures insufficient food quantity, which includes food supply and intake and physical consequences index built around 3 questions representing varying degrees of food hunger experienced in a household by the number of times households have experienced hunger within the last 30 days- (perception) unique compared to other food insecurity indicators in that it has been developed and validated for cross-cultural use comparable, thus facilitates decision making

4. HHS T OOL questionnaire used to collect information on food consumption at the household level 3 questions from the Household Food Insecurity Access Scale (HFIAS) questionnaire items which showed internal validity for all data sets. questions inquire about: not having food to eat of any kind in the house because of lack of resources to get food; going to sleep at night hungry because there was not enough food; going a whole day and night without eating anything at all because there was not enough food.

5. HHS M ETHODS 4 weeks/1month recall careful linguistic adaptation required for choosing the most appropriate term to describe this exact time period. QuestionFrequencyCode Q1 In the past [4 weeks/30 days] was there ever no food to eat of any kind in your house because of lack of resources to get food? 0=Never 1 = Rarely /Sometimes (1-10 times) 2 = Often (more than 10 times) |___| Q2 In the past [4 weeks/30 days] did you or any household member go to sleep at night hungry because there was not enough food? |___| Q3 In the past [4 weeks/30 days] did you or any household member go a whole day and night without eating anything at all because there was not enough food? |___|

6. HHS S CORING four frequencies-of-occurrence options for scoring the HHS (with corresponding values) Never =0 Rarely/sometimes =1 often =2 HHS = response1+ response2 + response3: score ranges from 0 to 6 score is basis for categorizing households with respect to household hunger

7. HHS C ATEGORIES to tabulate the categorical HHS indicator, two different cut-off values (>1 and >3)

8. E XERCISES In household A, you have obtained the following scores on the HHS In what category of the hunger scale is household A? QuestionFrequencyCode Q1 In the past [4 weeks/30 days] was there ever no food to eat of any kind in your house because of lack of resources to get food? 0=Never 1 = Rarely /Sometimes (1-10 times) 2 = Often (more than 10 times) 1 Q2 In the past [4 weeks/30 days] did you or any household member go to sleep at night hungry because there was not enough food? 2 Q3 In the past [4 weeks/30 days] did you or any household member go a whole day and night without eating anything at all because there was not enough food? 0

9. E XERCISES In household B, you have obtained the following scores on the HHS In what category of the hunger scale is household B? QuestionFrequencyCode Q1 In the past [4 weeks/30 days] was there ever no food to eat of any kind in your house because of lack of resources to get food? 0=Never 1 = Rarely /Sometimes (1-10 times) 2 = Often (more than 10 times) 1 Q2 In the past [4 weeks/30 days] did you or any household member go to sleep at night hungry because there was not enough food? 0 Q3 In the past [4 weeks/30 days] did you or any household member go a whole day and night without eating anything at all because there was not enough food? 0

10. E XERCISES In household C, you have obtained the following scores on the HHS In what category of the hunger scale is household C? QuestionFrequencyCode Q1 In the past [4 weeks/30 days] was there ever no food to eat of any kind in your house because of lack of resources to get food? 0=Never 1 = Rarely /Sometimes (1-10 times) 2 = Often (more than 10 times) 2 Q2 In the past [4 weeks/30 days] did you or any household member go to sleep at night hungry because there was not enough food? 2 Q3 In the past [4 weeks/30 days] did you or any household member go a whole day and night without eating anything at all because there was not enough food? 1

11. E XERCISES In household D, you have obtained the following scores on the HHS In what category of the hunger scale is household D? QuestionFrequencyCode Q1 In the past [4 weeks/30 days] was there ever no food to eat of any kind in your house because of lack of resources to get food? 0=Never 1 = Rarely /Sometimes (1-10 times) 2 = Often (more than 10 times) 2 Q2 In the past [4 weeks/30 days] did you or any household member go to sleep at night hungry because there was not enough food? 2 Q3 In the past [4 weeks/30 days] did you or any household member go a whole day and night without eating anything at all because there was not enough food? 0

12. A NSWERS Household A: HHS Category=2 - Moderate hunger in the household Household B: HHS Category=1 - Little to no hunger in the household Household C: HHS Category=3 - Severe hunger in the household Household D: HHS Category=3 - Severe hunger in the household