Feeding of Fresh or Reheated Foods

Outcome

% of children aged [specify: 6-23 or 6-59] months for whom all cooked meals given during the previous day and night were prepared within two hours of feeding or reheated until hot

Cooked food can become contaminated when it is kept at room temperature for too long. Preparing food shortly before feeding or thoroughly reheating previously prepared food can help reduce this risk. This indicator measures whether cooked foods given to young children followed these practices. It measures one aspect of food hygiene and does not show whether the food was microbiologically safe.

Collect the following data from a representative sample of children aged 6–23 or 6-59 months by interviewing, for each child, the caregiver who knows most about the meals the child consumed:

1) Ask whether yesterday was a special day, such as a religious festival or celebration, when meal preparation or consumption was unusual. Record this information, but do not stop data collection or exclude the observation from the indicator calculation.

2) Ask the caregiver about all cooked meals that the child consumed during the previous day and night. If the child did not consume any cooked meal during the previous day and night, record ‘no cooked meal consumed’, do not ask Q1–Q3, and exclude the child from the indicator calculation. For each meal the child consumed, enquire:

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

Q1: When was this meal prepared?

A1:

1) Within two hours before the child ate it

2) More than two hours before the child ate it

3) Does not know

If the previous answer is 'More than two hours before the child ate it', ask:

Q2: Before the child ate this meal, was it reheated or served without reheating?

A2: __

1) Reheated

2) Served without reheating

3) Does not know

 

If the previous answer is 'Reheated', ask:

 

Q3: When you reheated the meal, was it just warmed or heated until hot?

A3:

1) Just warmed

2) Heated until hot

3) Does not know

3) For each child, classify each cooked meal as meeting the indicator criterion if it was prepared no more than two hours before feeding or, if prepared earlier, was reheated until hot. A child meets the indicator criterion only if every cooked meal consumed during the recall period met this criterion. If the respondent answers ‘does not know’ to any question needed to determine whether a meal met the criterion, classify the child’s result as ‘unknown’ and exclude it from the indicator calculation, unless another meal clearly did not meet the criterion, in which case classify the child as not meeting the indicator.

4) To calculate the indicator's value, divide the number of children who met the criterion by the number of surveyed children who consumed at least one cooked meal and whose result could be classified as either meeting or not meeting the criterion. Exclude children who consumed no cooked meal and children whose result was classified as ‘unknown’. Multiply the result by 100.

This data can be disaggregated by the type and age of caregiver and child age. If relevant and feasible, also by household wealth category, geographic area and project exposure.

1) The assessment of reheating is based on the caregiver’s description of the meal as ‘hot’ rather than ‘warm’; it does not measure the actual temperature or confirm that the meal was reheated thoroughly. As the indicator is based on caregiver recall, responses may also be influenced by recall and knowledge of recommended practices.

 

2) The two-hour criterion is intended for food kept at room temperature. Where refrigeration or safe hot holding is commonly used, adapt the questions so that safely stored food is not automatically classified as poor practice.

 

3) If more detailed programme monitoring is useful, you can also calculate the percentage of cooked meals that met the criterion.

Also consider using the following indicators:

• Minimum Dietary Diversity - Children (complements food hygiene with a measure of the nutritional diversity of foods consumed and uses the same previous-day recall period)

• Handwashing Facilities With Soap and Water (measures an important enabling condition for hygienic food preparation and child feeding)