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*This page is currently under construction* The Cost of the Diet (CotD) is an innovative method and software developed by Save the Children UK to estimate the amount and combination of locally available foods that are needed to provide a typical family or individual with a diet that meets their average needs for energy and their recommended intakes of protein, fat and micronutrients. The method was developed as a response to research undertaken by Save the Children which demonstrated that the impact of traditional nutrition education programmes has been limited because of the economic constraints facing many households in low-income countries. The tool aims to answer the following questions: 1. What is the minimum cost of foods that meet the nutrient needs of a typical household? 2. Can a nutritious diet be achieved by people using locally available foods? 3. Is this diet affordable? 4. If not, what could be done?
Photo: Sri Budiatmi shops with her daughter in Sulawesi, Indonesia
A Cost of the Diet assessment follows a logical process from identifying the food security and nutrition problem, collecting and analysing data, through to report writing, including recommendations and conclusions.
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This figure gives an overview of the tasks and information required for a Cost of the Diet assessment.The Cost of the Diet Practitioner’s Guide explains each of these steps in more detail. The timeframe for a Cost of the Diet assessment will depend upon the length of data collection. Use the following timeframe as a rough guide:
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Assessment Leader:
This individual commissions an assessment based on an understanding of why and where it is needed as a result of knowledge of the local environment and its effects on food production, diet, nutrition and livelihoods. The Assessment Leader typically works in the field of food security and/or nutrition.
CoTD Practitioner:
This individual can also be the Assessment Leader (same person), but may be a hired consultant or a senior member of staff. The Practitioner trains the data collectors, oversees data collection, analyses the data and writes the final report. Depending on the knowledge and capacity of the agency or country office commissioning the assessment, the Practitioner maybe required to provide support planning the assessment, such as defining the objectives and the scope of the study. It is recommended that assessments be conducted by certified Cost of Diet Practitioners. This will ensure that the data are collected, analysed and reported to a consistent standard.
Data Collectors:
These individuals will be hired locally from the specific assessment area and will speak the local language. Data Collectors collect the market survey data, and conduct interviews and focus group discussions.
Assessment Administrator:
This individual organises the recruitment of Data Collectors and makes practical arrangements for data collection. The Assessment Administrator should be based in and have a very good knowledge of the assessment area. If the assessment is being conducted in an area new to the agency, it may be necessary to identify and seek support from a local partner organisation. Duties include, but are not limited to, the following:
Assessment level
Cost of the Diet assessments are designed to be undertaken in an area with similar livelihoods and market access. Livelihood zones, as defined using the process outlined in the Household Economy Analysis (HEA Analysis), are the most common way to define an assessment area for a CotD assessment, though administrative units have also been used.
Food List
Before data collection begins, a detailed list of all foods (local, imported, grown and wild) available at any time during the year is compiled. This list is used as the basis for the market survey and interview questionnaire
Market Survey
Before data collection begins, a detailed list of all foods (local, imported, grown and wild) available at any time during the year is compiled. This list is used as the basis for the market survey and interview questionnaire
Food Group Discussions
Focus group discussions (FGD) are conducted in 4 villages in order to create a nutritious diet that considers typical dietary habits. Each FGD should consist of 8 participants; 2 from each wealth group identified by the HEA. All participants should be those responsible for preparing food for the household. The interview questionnaire is based upon the food list generated before and during the market survey and aims to determine how often foods are consumed when they are in season. Questions are based on observations from the market data, comments from traders and responses to the questionnaire. Information is collected on key staples, household food production, ‘normal’ consumption patterns, cultural taboos and wild foods consumed.
Constraints
Applied constraints are intended to reflect typical dietary patterns rather than economic constraints, as Cost of the Diet is a tool used to illustrate a diet that could be achieved if economic limits were removed.
Cost of the Diet software uses the collected data to generate hypothetical diets using a combination of foods that will enable a family to meet their energy and nutrient requirements, as recommended by the World Health Organisation and the Food and Agriculture Organisation, at the lowest possible cost.
Limitations, or constraints, may be used to reflect typical household food consumption patterns. For example, specifying that a particular food is eaten three times a day, every day. In this way, the software can identify a diet that is more realistic in terms of the frequency with which foods are eaten.
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Hypothetical Diets
The software can estimate the cost of four hypothetical diets:
1. Energy-only diet: Meets specified needs for energy only
2. Macronutrient diet: Meets specified needs for energy, fat and protein only
3. Nutritious diet: Meets specified needs for all nutrients at lowest cost
4. Food habits, nutritious diet: Meets specified needs for all nutrients at lowest cost using typically consumed local foods
Individual or Household Output
The software produces the following outputs for each of the four diets. For an individual or household:
Food Output
The software produces the following outputs for each of the four diets. For each food selected by the software:
Software capabilities
Cost of the Diet software can:
‘What if’ Models
‘What if?’ models may be generated in Cost of the Diet, for specific individuals or households as a whole, to determine the potential effect of:
… on the cost, quality, composition and affordability of a nutritious diet.
Cost of the Diet examples:
2017 · Save the Children
Situated in the North-West of Kenya, Turkana is one of the poorest regions of the country and affected by persistently high rates of malnutrition. Persistently high rates of... View Full Abstract
2022 · Save the Children International
Situated in the southwestern region of Nigeria, Oyo state has the highest prevalence (34.5 percent) of stunting among children under five; and two out of three children have... View Full Abstract
The Cost of the Diet (CotD) is predominantly used as a a programme design and advocacy tool to inform discussions on food, dietary diversity, nutrition and livelihoods.
As the software can calculate the cost of a nutritious diet for up to 6 seasons, the results can offer a unique perspective on seasonal changes in the price and availability of foods, identifying periods where households may be vulnerable to high food prices which affect their ability to afford a nutritious diet. This offers an insight for nutrition and health programme managers to assess when nutrition and food security interventions may have the greatest impact.
CotD foods can help to understand and identify:
CotD information can be used to:
Example: In Burera district, Rwanda, avocado was identified as a cheap but rich source of energy, fat, vitamin C, soluble B group vitamins, folic acid and copper. Alternatively, yoghurt was identified as the cheapest source of vitamin B12, meeting 96% of total needs for the family and calcium providing 80% of the total need for the family.
Diet Affordability
Estimating the affordability of the diets by wealth group using HEA income and expenditure data can be used to identify those most at risk of insufficient economic access to a nutritious diet and, thus, most in need of food security and/or nutrition interventions.
Cash Transfers
This vital diet affordability data can also be used to estimate the size of cash transfers for social protection programmes intended to have an impact on nutrition. For example, a Cost of the Diet analysis in Lindi district, Tanzania, found that families in the poorest wealth group could not afford a nutritious diet, estimating that 115% of their total income would be needed to meet their energy and nutrient requirements.
One of the most innovative aspects of the CotD software is that potential interventions can be modelled to estimate their impact on improving the quality and the affordability of the diet. These results can be used to inform and influence nutrition and food security policies and programmes and contribute to both advocacy processes and debates at local, national and global levels.
Example: A CotD analysis in Pakistan found that iron and zinc requirements could not be met by local foods for a 9-11 month old child. The impact of giving this child a sachet of micronutrient sprinkles twice a year for 30 days, six months apart on the quality of the diet was modelled. The software estimated that all the nutrient requirements for the child could be met and the cost of the diet could be reduced by 60% as a result of this intervention.
Early Warning Indicators
Regular CotD assessments can be used help understand changes in food and nutrition insecurity in particular contexts and can act as early warning indicators within food security and nutrition early warning systems.
A CotD analysis is most useful when chronic undernutrition and micronutrient deficiencies have been identified as nutritional problems and when the availability or affordability of nutritious foods are likely to be among the underlying causes.
Using CotD
4 resources
This guide aims to provide a Cost of the Diet practitioner with the information required to run a full Cost of the Diet assessment.
These guidelines and the Cost of the Diet software are free to use and can be downloaded here.
A French version of this guide and the Cost of the Diet reporting guidelines are available on request by contacting cotd@savethechildren.org.uk.
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