Feeding of Fresh or Reheated Foods

Existing research* shows that food which is not consumed within a short time after preparation has increasing levels of bacterial contamination, exposing children to a higher risk of diarrheal diseases and environmental enteropathy (both being reported among the main causes of undernutrition). This indicator therefore measures the proportion of mothers who during the previous day gave their child either freshly prepared or reheated food only.

Collect the following data by conducting individual interviews with a representative sample of mothers of children aged 6-23/59 months:

1)  Ask whether yesterday was a special day (religious festival or celebration) when an unusually varied or limited diet was eaten - if so, do not proceed with collecting dietary data as it is likely that they will not reflect typical food preparation practices.

2) List all meals that the child aged 6-23/59 months consumed the previous day in the Recording Meals Form (see below).

3) For each meal, ask the following questions (included in the Recording Meals Form - see below).

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: When did you prepare this meal?

A1: __

1) less than two hours before the child ate it

2) more than two hours before the child ate it

(ask the following question only if the previous answer is “more than two hours”)

Q2: Before you gave the food to your child, did you reheat it or did you provide it as it was?

A2: reheated / provided as it was

(ask the following question only if the previous answer is “reheated”)

Q3: How much did you warm up the food? Did you reheat it just a little bit so that the child can eat it immediately? Or did you reheat it to being very hot so you had to wait for it to cool down before giving it to the child?

A3: reheated to being warm / reheated to being very hot

4) As a next step, record on the tablet or paper questionnaire whether all the meals the child ate were either prepared less than two hours before eating or reheated to being very hot. It is sufficient to have two answers:

  i) meals were prepared less than two hours before eating OR were reheated to being very hot

  ii) meals were prepared more than two hours before eating and were not reheated to being very hot

Meals were prepared in a recommended way if they were either 1) prepared less than two hours before the child ate them or 2) reheated to (almost) boiling.

To calculate the indicator’s value, divide the number of mothers who prepared the meals in the recommended way by the total number of interviewed mothers who during the previous day and night served any type of meal to their child. Multiply the result by 100 to convert it to a percentage.

1) There are many other practices needed to ensure that the child meals are prepared in a safe way, such as protecting the food from flies, washing hands before cooking, washing the food before preparation or using quality ingredients. This indicator measures only one aspect of food safety. One of its limitations is that we can never know whether the freshly prepared food was really safe and whether the food was reheated to a sufficient extent. Despite these shortcomings, it is an important part of preventative interventions.

2) If your survey measures children’s dietary diversity, you can easily integrate the collection of dietary diversity data with additional questions on how the meals were prepared.

3) This indicator tells the % of mothers who prepared for the child in the recommended way. If you want to get more detailed data, consider also calculating the % of child's meals prepared in the recommended way. This will require knowing: 1) the total number of provided child's meals (by all surveyed mothers); and 2) the total number of meals that were prepared in the recommended way. Both types of data can be extracted from the Recording Meals Form (access below).

* examples of available research from: Zambia and Bangladesh