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Articles

Household Food Insecurity Was Prevalent in Java during Indonesia’s Economic Crisis¹

Ministry of Health and Aged Care, Parliament House, Canberra, ACT, 2600, Australia and ^* Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301

²To whom correspondence should be addressed. E-mail: eaf1{at}cornell.edu.

	ABSTRACT

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

 
Valid assessment of household food security is important, particularly in rapidly changing circumstances such as the economic crisis that struck Indonesia in 1998. The Cornell-Radimer tool for measuring household food security has now been used in several social and economic settings. An adaptation of this tool was used in the context of the economic crisis of Java, Indonesia in June-August 1998 in a survey of 1423 mothers with children < 5 y old. Qualitative and quantitative data contributed to understanding food insecurity and provided evidence for some aspects of validity. The data showed substantial household food insecurity with 94.2% of households found to be uncertain or insecure about their food situation in the previous year. Of respondents, 11% reported losing weight in the previous year because of lack of food. Food security in Java was undoubtedly compromised by the economic crisis. These results suggest, on the basis of qualitative and quantitative understandings of food insecurity, that this tool provided a useful measure of the situation in Java in 1998. From this study and others done recently, such a tool or ones constructed using a similar approach have been found to be useful in various settings in which there is a need to understand and identify household food insecurity for purposes of estimating and monitoring prevalence and targeting of policies and programs. Further research to validate this approach in various settings is warranted.

KEY WORDS: • food security • household measures • Java • economic crisis • Indonesia

	INTRODUCTION

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

 
In 1997 and 1998, Indonesia was struck by a severe economic crisis (1) . Indonesia’s economic and social situation was also affected by El Niño–induced droughts, widespread forest fires and the end of President Suharto’s 32-y term in May 1998. The confluence of these circumstances brought a decade of strong economic growth and declining poverty rates to a dramatic end.

From early 1998, the government, popular press and international aid agencies expressed growing concerns about hunger and malnutrition throughout Indonesia. By May 1998, the price of food had increased 74% over prices a year before, and there were concerns about the overall supply of rice (2 ,3) . Data on food security at the household level, however, remained scant and largely anecdotal. Speculation about food supply and widespread concern for a subsequent increase in the prevalence of malnutrition were based almost entirely on price and supply indicators. Rapidly available and interpretable data on household-level food security, particularly from Java where it was predicted the crisis was hitting hardest, were clearly needed.

Food security, or insecurity, is a complex phenomenon whose dimensions may vary considerably in different contexts (4 –6) . Many currently used measures are distal from the actual experience of food insecurity and do not directly capture the important element of unsustainability or uncertainty (either of current or future food resources). Household decision-makers organize the limited resources at their disposal not only to minimize the short-term effects of not having enough to eat, but also to address the longer-term imperative of maintaining their productive resources or livelihood (5 ,6) . This subjective decision-making at the household and individual level about what constitutes access to "sufficient" food, or what should be done when there is insufficient food, must be included in a direct measure of food security. Finally, many existing measures are also costly to implement in terms of time and resources, introducing time lags and other barriers that limit their usefulness for both short- and long-term planning and particularly for emergency situations in which immediate targeting of food aid is needed.

Radimer et al. (7 ,8) developed a direct measure of food security and used it successfully in household surveys. Their work derived measurement items from statements about food insecurity that emerged from in-depth interviews with low-income women with children in rural New York. Items measuring food insecurity, which described the experience of food insecurity in the women’s own words, were developed and used in a 1988 survey (8) . Twelve of these items, which captured most of the food insecurity components and showed high reliability, were tested subsequently in a general population survey of households with children and were found to be valid and reliable (9 –12) .

The Cornell-Radimer measure was a key component of the U.S. Food Security Measure that was developed by a governmental interagency group (13) . The success of the U.S. national measure reinforced the potential for developing improved measures of household food security based on in-depth understanding of the experience of food insecurity (14) . Although the U.S. measure itself is probably not directly applicable to many developing countries, the approach used may well be (15) .

To our knowledge, the Cornell-Radimer tool had not been used previously in a crisis- or emergency-related setting in a developing country. A study in Russia in 1993 found the measure to be useful in the context of a humanitarian relief operation (16) . In June 1998, an opportunity arose to add some additional items to a monitoring study to be conducted across Java in relation to a United Nations International Children’s Emergency Fund (UNICEF) child nutrition intervention. We designed a household food security study, incorporating an adapted version of the Cornell-Radimer measure, to address the following three research questions: 1) What are the features of the experience of food insecurity at the household level in Java, Indonesia? 2) Is the performance of a "Household Food Security Measurement Tool" (HFSMT), adapted from the Cornell-Radimer tool, consistent with two aspects of validity for categorizing households in Java? and 3) What was the status of household food security in Java in 1998 during the economic crisis?

	SUBJECTS AND METHODS

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

 
Data collection for the quantitative survey.

In May 1998, as a crisis-related intervention, the Government of Indonesia and UNICEF launched a program to provide a micronutrient-fortified, industrially prepared, weaning food at a subsidized price through village health posts in 245 selected villages in Java. This first trial phase was for a period of 3 mo during which a monitoring study of uptake and usage patterns was conducted. A set of questions on household food security, including nine items based on the Cornell-Radimer tool, was added to the survey questionnaire.

The villages included in the trial phase of the initiative were selected by UNICEF officials in consultation with the Indonesia Women’s Association, the Ministry of Health and local government authorities. Three districts in each of the three provinces of Java (West, Central and East Java) were nominated and villages were selected from within the nine selected districts. For the monitoring study, a single subdistrict from each of these districts was randomly selected. From each subdistrict, four villages were randomly selected, and from each village, two village health-posts, known locally as posyandus, were randomly selected. The research team obtained a list of all households registered at the village health-post with at least one child <5 y old. These lists were double-checked for completeness with the village midwife. From each list, 20 households were randomly selected and visited, and the mother or principal caregiver of the child was asked to respond to the survey. The mother or principal caregiver was approached at home and asked if they were willing to participate in a survey on the UNICEF weaning food intervention and on the general effects of the economic crisis on their household; only when this consent was given would the field worker and/or interviewer enter the home to commence questioning.

This selection process resulted in a maximum of 160 households from each subdistrict being interviewed. Thus, a maximum of 480 households per province and a maximum of 1440 households were included in the study.

In addition to the HFSMT items, 11 more traditional measures of household economic and food security were included. Respondents were asked about changes in household composition, employment, income, assets, food and general expenditures, and food stores in the past year. Change in assets was assessed by asking whether the family sold or mortgaged possessions such as jewelry, motorcycle or automobile in the last 6 mo, and whether this was normal. Pilot testing of both components of the survey was conducted in Central Java in June 1998. Full survey implementation was done from July to September 1998. UNICEF contracted locally based research institutions to do this.

Qualitative data collection.

Qualitative interviews were conducted in East Java in August 1998. Four in-depth interviews were done with mothers in their homes after the completion of the main quantitative survey tool by the local field worker. Two interviews were done in an outer urban, semi-industrial village 40 km from Surabaya (the provincial capital) and two were done in a rural village 60 km from Surabaya. These settings were selected to provide specific contrast in the economic environment; within each village, the households were selected to provide some contrast in their location relative to the posyandu (inner-village, close to posyandu vs. outer village, distant from posyandu). Because the interviews required additional time from the mothers/caregivers, the final selection was made according to their availability and willingness to participate. Three key-informant interviews were also completed with a village leader, a village midwife and with a local university professor and medical doctor who provided critical insights and explanations. The principal author (L.J.S.) conducted the interviews with the assistance of a translator. All interviews were taped and transcribed verbatim. The interviews were formatted for analysis by assigning line numbers to each text.

Significant segments of text were selected and compiled (17) . The main foci for this selection were the following: 1) how food problems were interrelated; 2) uncovering of patterns in the occurrence of events or different themes related to the food situation; and 3) whether identified themes differed in their relevance to the food situation. Each of the selected segments contained an informant’s idea or perception of the food situation (18) . Segments were grouped into categories of emergent themes. Some of the segments were grouped simultaneously under different but related themes. Themes were then evaluated for their relevance in addressing problems in the food situation. Validation was done through the following two distinct processes: 1) segment categorization was triangulated among three researchers; and 2) peer-examination was done for relevance of emerging themes (19 ,20) . Subsequently, themes were combined under broader and larger constructs focusing on their ability to elicit and illustrate the nature of the food problem.

Once these larger constructs were established, and their interrelations triangulated among researchers, a conceptual model of the overall food situation was created. In composing this model, the different constructs, the linkages among them and the directionality of their logical progression were evaluated according to their ability to depict the data.

Analysis of the quantitative survey.

Households were categorized according to the conceptual meaning of the survey items, creating a range of household food security categories, following an approach similar to that of Radimer et al. (8) and the U.S. Measure (13) . This approach recognizes that each item has an inherent meaning and is indicative of a degree of severity relative to other items. The five categories created were as follows: 1) food security; 2) uncertainty about food; 3) insecurity for family; 4) insecurity for adults; and 5) severe insecurity for children or adults.

Two aspects of the validity of the HFSMT were assessed following Frongillo (12) . First, to assess whether the performance of the HFSMT was consistent with understanding of food insecurity, the patterns of responses across the items (i.e., the percentage of affirmative responses) between the 1988 New York survey (8) and the Indonesian survey were compared using Pearson’s correlation and also graphically. If the relative severity of the items was similar in each of the three surveys, we expected that the correlation of the percentage of affirmative responses across the items between surveys would be high, and that the curves from the percentage of affirmative responses across the items would be parallel. All but item 5 in the Indonesian survey (Table 1 ) were used in the New York survey. The patterns of responses across the items in the Indonesia study were also compared with a survey done in Québec (21) . All but item 9 in the Indonesian survey were used in the Québec survey. These two surveys were chosen for comparison because the prevalence of affirmative responses to items in those samples was similar in magnitude to that of the Indonesian sample, thereby making it easier to judge whether the percentages of affirmative responses across the items produced parallel curves. All three surveys had intentionally oversampled people at risk of food insecurity. The other surveys with data available have item-response patterns similar to the New York and Québec surveys, but with lower prevalence of food insecurity (12) .

A test for linear trend was done using linear regression (weighted by the sample size) to assess the association of the household food security categorization with each criterion measure that was expressed as a percentage. A linear contrast implemented through a one-way ANOVA was used to assess the association of the household food security categorization with each criterion measure that was in rupiah.

	RESULTS

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

 
A total of 1423 of the targeted 1440 households completed surveys. The 17 nonreturns were explained by the inability of the field workers to find a suitable respondent at a selected household in the time available. Returns by province were as follows: West Java, 475/480; Central Java, 469/480; and East Java, 479/480. Because of missing data, the analytic sample size was 1356.

Features of food insecurity in Java

The understanding expressed in the qualitative interview data revolves around two constructs as depicted in Figure 1 . These constructs, "food insecurity" and "management processes," have arisen in previous research (5 ,8 ,22 ,23) . The relationship found between the constructs "food insecurity" and "management processes" at the household and individual level is represented with a two-way arrow. This emphasizes that in times of plenty, as in times of crisis, families and individuals rely on self-derived strategies to access food. The situation of potential food insecurity adds to the daily challenges of providing adequate as well as acceptable food and meals. Analysis also revealed specific constituents of these constructs such as compromised diet, decreased food intake, changes in food stores, selling and borrowing practices as well as storing and substituting food.

View larger version (25K): [in this window] [in a new window]   Figure 1. Features of food insecurity in Java, Indonesia in 1998 from the analysis of the qualitative data.

    Experience of food insecurity. As expressed in the interview data, the concept of food insecurity was found to be meaningful in Java. It was expressed by respondents through descriptions of decreased food intake, compromised diet and changes in household food stores.

    Decreased food intake. When confronted with an economic and social environment that limits or changes access to food, respondents made compromising changes to their diet. Altering meal patterns was one such expression that came out in the data. Respondents spoke of adults "reducing food frequency " and children "reducing the number of snacks." A decrease in the frequency of food consumption was expressed more directly than a decrease in quantity of food intake, although both were noted to be occurring.

    Compromised diet. Changes occurred in the diet revealing compromises made in households in response to a change in economic circumstances. Some of the changes consisted of choosing less preferred and/or lesser quality foods. These compromises were expressed as being divergent from the cultural norms and expectations for diet. For example, food items such as rice, fish and meat were favored foods, and better quality grades of these items are preferred when affordable and available. When not available or affordable, tempeh or tofu was an acceptable substitute for fish and meat. However, eating corn or cassava instead of rice, even lesser quality rice, was identified as being a culturally compromised diet: "because the philosophy in Indonesia is you are not eating if you are not eating rice." As it was experienced by respondents, when a household substitutes cassava or a snack food such as sweet potato for rice, the diet becomes less acceptable in quality and certainly less comfortable given cultural preferences and expectations.

    Changes in food stores. Food stores were found to have varied since the crisis, but it was not clear whether stores were actually increased or decreased. Changes in food stores were expressed mainly as changes made in storing practices. Respondents spoke of making efforts to store food whenever possible. In rural areas, for example, "many people used to sell all the rice they cultivated and buy back as needed, but now ... many people start to keep their rice and especially their cassava." In times of difficulty "I have to be smart. I try my best ... to save even a little for the day ... for the lean day."

    Management processes. Respondents needed and relied on management systems and processes to maintain and organize a level of household food security, whether normal or compromised. Some household management processes were found to relate to general household management practices, whereas other processes related more specifically to food.

Respondents elaborated on traditional management processes. The management skills of families, as well as the allocation of responsibility of household management, such as "the wife managing the budget," were mentioned as part of the usual processes. In times of difficulty, the option of selling assets and borrowing are considered to be ways of managing the household and seemed to be an inherent part of these management processes.

    Household and general issues: selling assets and borrowing money or food. Part of a household’s management process in the face of food insecurity is the practice of selling assets and borrowing food, money or other assets. Selling appeared to be more acceptable than borrowing, which appeared to carry some stigma and was mostly spoken of indirectly. Borrowing was apparently more commonly done by destitute people: "the shame of it depends on status." The practice of selling assets such as selling jewelry and machinery occurred, and generally preceded the practice of borrowing money or food from family, friends, shops or lenders.

"In this kind of crisis situation the community has a habit of selling things. The community would reduce food consumption before they borrow money."

    Specific to food: storing. Storing food was expressed as a common practice in the management processes. The storing of food was described, although it seemed to be more commonly practiced in rural compared with urban areas. For example, one respondent spoke about the practice of storing cassava on rooftops and that this was an indicator to others in the village of a household’s food situation. Respondents reported that in times of difficulty, food storing practices changed.

    Specific to food: substituting. The substituting of preferred food commodities in different meals was described by respondents, particularly in relation to staples that could be substituted by other commodities of lesser price and/or nutritional quality, and of differing cultural preference. In a time of stress or crisis, it was explained that foods, mainly staples, were altered in a specific order of preference and quality. Rice, for example, was "substituted with low cost rice ... and mixed with an [alternative] energy source food like maize." Practices such as mixing corn with rice or eating more tempeh and tofu compared with fish or meat, were described as a management process in a food insecurity context. As one respondent reported, in a later step, "the frequency of food consumption will be reduced and mostly we’ll eat staples and change from rice to cassava."

Aspects of validity of the Household Food Security Measurement Tool (HFSMT)

The percentage of households giving affirmative responses for each of the items in the survey is presented in Table 1 . For each item, the order of severity of the items is exactly as expected based on their conceptual meaning, i.e., a declining number of affirmative responses as descriptions move from less to greater severity in household food security.

The correlation across the items between the percentage of affirmative responses for the 1988 New York (8) and the Indonesian surveys was 0.85, indicating a high degree of correspondence in the pattern of responses. That is, the order of severity of the items was highly similar for the two surveys. The correlation for the Québec (21) and Indonesian surveys was also high (0.89). The correlation between the New York and Québec surveys was similar (0.93). Figure 2 compares the results of these three surveys graphically. The high correspondence among the responses to the surveys is readily seen because the curves for the percentages of affirmative responses are reasonably parallel. It is also apparent that the Indonesian sample, in comparison with the two others, had a somewhat higher percentage of affirmative responses to items 1, 2 and 3 than expected, given the responses to other items. These results from the correlation and graphical analysis indicate that the relative severity of the items was similar in the three surveys.

View larger version (19K): [in this window] [in a new window]   Figure 2. Comparison of the percentages of affirmative responses for items from the Indonesian household food security measurement tool (solid line) with the corresponding items from two other surveys from New York (dotted line) and Québec (dashed line) having a similar prevalence of food insecurity.

	DISCUSSION

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

The items that were tested in the field for the survey were taken from the Cornell-Radimer set (9) . Feedback from the field workers who conducted the field tests led to several modifications to the set of items. The most important feedback was that related to the use of the word "hunger." Field workers reported that this word was highly sensitive and embarrassing to respondents and that questions including it were unlikely to elicit a true response; thus, questions using this term were excluded. Field workers also reported being uncomfortable with the repetitive nature of the items because they felt it conveyed a mistrust of the previous answer given by the respondent. We eliminated three items and reworded questions to make the remaining items seem less similar to each other.

The term "balanced meals" from Cornell-Radimer did not translate well and confused respondents and field workers. After much discussion, it was decided to use the word "healthy" as an alternative. The relative severity of this item was about as expected.

Although formal cognitive testing (26) of the items was not done after their adaptation from the Cornell-Radimer tool, the process for developing the items helped to ensure that the items would be understood and interpreted as intended. Furthermore, there was no indication from the qualitative interviews that the wording of the items was not understood or interpreted as intended.

The high degree of correspondence in the pattern of responses within surveys is comparable to that observed previously among surveys using the Cornell-Radimer measure in North America (12) . This result indicates that the performance of the HFSMT in Java, Indonesia was consistent with that expected from the understanding of food insecurity. The relative severity of the items was similar to that previously established in other settings.

The categorization of households to food security status by the HFSMT was associated with income, expenditures and food stores in the direction expected if the HFSMT is an accurate measure of household food insecurity. These associations are similar to those previously reported as part of establishing the validity of the Cornell-Radimer measure (9) and the U.S. national measure (13) . We believe that the recall of household expenditure levels (i.e., the recollection of general and food-specific household expenditures at present and 1 y ago) was reliable and probably somewhat conservative. The range of increases in monthly household food expenditures recorded across the five household food security groups was 44–63%. Data from urban and rural areas in Java and South Sulawesi showed that the price increases between July 1997 and November 1998 averaged 225% for rice, 200% for oil, 190% for sugar and 200% for beef (24) . The official Indonesian consumer price index for foodstuffs ranged from 29% in January 1998 to 138% in September 1998 (27) . In interviews, we found that this sort of information was always readily recalled and there appeared to be little doubt or debate among respondents on the information provided.

Although limited in its scope, the supporting qualitative work greatly enhanced our capacity to interpret and use the HFSMT data. As with any work in a cross-cultural setting, the opportunity to probe and check responses and understandings is important to ensuring data validity and to adding interpretive value to the presentation of results. The few mentions of hunger outcomes, children lethargic and adult weight loss, in the results are indicative of this. These manifestations of hunger and food insecurity were not actively questioned in the interviews but emerged spontaneously. Had time and resources permitted, we believe further questioning along these lines could have revealed much more about the nature and outcomes of food insecurity at this time. Although not necessarily adding value for targeting and monitoring of food delivery and related interventions, such data might be useful for designing further interventions such as for employment, education and health care.

The conceptual model (Fig. 1) includes changes in food stores based on qualitative and quantitative data. However, we were not able to distinguish in the qualitative data whether these changes were increases or decreases or both. Both would be understandable in times of stress, and we believe both might have existed. The quantitative data indicate that decreases did occur (Table 3) . Which particular management process a household adopts might depend on how food is normally obtained, i.e., purchased from market vs. self-grown; thus, without further data and understanding, we must just simply recognize the reports of change in normal practice as indicative of food insecurity.

The results presented provide evidence for three criteria for validity for a measurement tool (12) , i.e., grounded understanding of food insecurity, performance of the measurement tool that is consistent with the understanding of food insecurity and accuracy. More information about the performance of the measurement tool would be helpful. In particular, further qualitative research would enhance our understanding of food insecurity, and further quantitative research comparing the HFSMT with other criteria would be useful for demonstrating accuracy. In addition, an extensive investigation of all of the factors that might affect household food security and its measurement, including rural/urban differences, was beyond the scope of this paper, but would be valuable.

Further research to validate this approach to the measurement of household food security in various settings is warranted. Nevertheless, with a study design and setting that allows for rapid, in situ, analysis of the data, we believe this tool would be highly suitable for measuring the extent of household food insecurity and for targeting related interventions. Although any household-level survey will necessarily be labor- and time-intensive because of the need to move from household to household, the measure used in this study is quick to apply in the household setting and, even with a few supporting questions, should take less than 10 min to administer. Moreover, it does not require a physical presence in the home to check food stores or other conditions and could potentially be applied in the workplace or other community setting, thus increasing efficiency. Supporting questions might seek to identify and target at-risk households through socioeconomic characteristics such as the nature of income and employment, household structure, and perhaps some indirect measures of income or changes in income.

Consistent with the findings of other studies that have been reported, our work reveals a situation of food insecurity across Java during the later part of 1998. Although there has been an emerging consensus that the effects of the crisis were not uniform and that the groups affected were heterogeneous (1 ,25 ,28) , the indication of at least some degree of food insecurity across the three provinces of Java suggests that there was widespread concern and risk. Further analysis, or rapid resurveying using the HFSMT, could be useful for further identifying intra- and interprovincial variations including rural/urban differences and for monitoring the ongoing and persistent food security effects of Indonesia’s crisis.

	ACKNOWLEDGMENTS

 
The authors thank the agencies that provided support and, in particular, Vivian Krause from UNICEF. Helen Keller International, Jakarta, conducted the survey work in Central Java in collaboration with the University of Diponegoro in Semarang and managed data entry for all three provinces. Their role is acknowledged; in particular, we thank Mayang Sari for her work and support. Data collection was done by the School of Nutrition Assistants in East Java for which we thank especially Benny Soegianto and Ibu Ria and by the National Institute of Health Research and Development in West Java for which we thank Soewarta Kosen. Tarun Biswas at Cornell University assisted with both the qualitative and quantitative analysis. Wendy Wolfe at Cornell University provided valuable comments on an earlier draft.

	FOOTNOTES

 
¹ Supported by the National Institutes of Health (Training Grant HD 07331), the Cornell Institute for International Food, Agriculture and Development and United Nations International Children’s Emergency Fund, Indonesia.

Manuscript received March 14, 2001. Initial review completed May 2, 2001. Revision accepted July 17, 2001.

	LITERATURE CITED

TOP ABSTRACT INTRODUCTION SUBJECTS AND METHODS RESULTS DISCUSSION LITERATURE CITED

 

1. ACC/SCN (2000) Fourth Report of the World Nutrition Situation 2000 ACC/SCN in collaboration with IFPRI Geneva, Switzerland .

2. The Economist Intelligence Unit (1998) EIU Country Report Indonesia, 4th quarter 1998:1998 The Economist Intelligence Unit Limited London, UK. .

3. World Bank (1998) Notes from a Briefing to Donor Agencies 1998 Jakarta Indonesia. .

4. Riely F., Mock N., Cogill B., Bailey L. & Kenefick E. (1997) Food Security Indicators and Framework for Use in the Monitoring and Evaluation of Food Aid Programs 1997 Food Security and Nutrition Monitoring (IMPACT) Project for the U.S. Agency for International Development, Arlington, VA. .

5. Maxwell S. (1996) Food security: a post-modern perspective. Food Policy 21:155-170.

6. Maxwell S. & Frankenberger T. (1992) Household food security: concepts, indicators, measurements. A technical review 1992 UNICEF New York, NY and IFAD, Rome, Italy. .

7. Radimer K. L., Olson C. M. & Campbell C. C. (1992) Development of indicators to assess hunger. J. Nutr. 120(suppl.):1544S-1548S.

8. Radimer K. L., Olson C. M., Greene J. C., Campbell C. C. & Habicht J.-P. (1992) Understanding hunger and developing indicators to assess it in women and children. J. Nutr. Educ. 24:36S-45S.

9. Kendall A., Olson C. M. & Frongillo E. A., Jr (1995) Validation of the Radimer/Cornell measures of hunger and food insecurity. J. Nutr. 125:2793-2801.

10. Kendall A., Olson C. M., Frongillo E. A., Jr & Kepple A. (1994) Validation of the Radimer/Cornell Hunger and Food Insecurity Measures: Final Project Report 1994 Division of Nutritional Sciences, Cornell University Ithaca, NY. .

11. Frongillo E. A., Jr, Rauschenbach B. S., Olson C. M., Kendall A. & Colmenares A. G. (1997) Questionnaire-based measures are valid for the identification of households with hunger and food insecurity. J. Nutr. 127(suppl.):699S-705S.

12. Frongillo E. A., Jr (1999) Validation of measures of food insecurity and hunger. J. Nutr. 129(suppl.):506S-509S.

13. Hamilton W. L., Cook J. T., Thompson W. W., Buron L. F., Frongillo E. A., Jr., Olson C. M. & Wehler C. A. (1997) Household Food Security in the United States in 1995: Technical Report of the Food Security Measurement Project 1997 U.S. Department of Agriculture Food and Consumer Service, Office of Analysis and Evaluation and Abt Associates Washington, DC .

14. Eilerts G. S. (1999) Food Security Measurement in the United States: New Ideas for Third-World Assessments? Food Insecurity and Vulnerability Information and Mapping Systems 1999 Food and Agricultural Organization, United Nations New York, NY. .

15. Wolfe W. S. & Frongillo E. A., Jr (2001) Building household food security measurement tools from the ground up. Food Nutr. Bull. 22:5-12.

16. Welch K. J., Mock N. & Netrebenko O. (1998) Measuring hunger in the Russian Federation using the Radimer/Cornell hunger scale. Bull. WHO 76:143-148.[Medline]

17. Miles B. M. & Huberman A. M. (1994) Qualitative Data Analysis: An Expanded Sourcebook 1994 Sage Thousand Oaks, CA. .

18. Tesch R. (1990) Qualitative Research: Analysis Types and Software Tools 1990 Falmer Press New York, NY. .

19. Lincoln Y. S. & Guba E. A. (1985) Naturalistic Inquiry 1985 Sage Beverly Hills, CA. .

20. Krefting L. (1991) Rigor in qualitative research: the assessment of trustworthiness. Am. J. Occup. Ther. 45:214-222.[Medline]

21. Hamelin A.-M., Habicht J.-P. & Beaudry M. (1999) Food insecurity: consequences for the household and broader social implications. J. Nutr. 129(suppl.):525S-528S.

22. Maxwell D. (1996) Measuring food insecurity: the frequency and severity of "coping strategies.". Food Policy 21:291-303.

23. Maxwell D., Ahiadeke C., Levin C., Armar-Klemesu M., Zakariah S. & Lamptey G. M. (1999) Alternative food-security indicators: revisiting the frequency and severity of ‘coping strategies.’. Food Policy 24:411-429.

24. Helen Keller International (1999) Indonesia’s Crisis: A Comparison of Its Impact on Nutrition and Health in Urban and Rural Populations 1999 Jakarta Indonesia. .

25. Frankenberg E., Thomas D. & Beegle K. (1999) The Real Costs of Indonesia’s Economic Crisis: Preliminary Findings from the Indonesia Family Life Surveys 1999 Labor and Population Program, RAND, Working Paper Series 99–04 Santa Monica, CA. .

26. Alaimo K., Olson C. M. & Frongillo E. A., Jr (1999) The importance of cognitive testing for survey items: an example from food security questionnaires. J. Nutr. Educ. 31:269-275.

27. World Bank (2000) Indonesia: Macroeconomic Update. http://wbln0018.worldbank.org/eap/eap.nst/Attachments/EA+quarterly+update+2000, (accessed March 20, 2000) 2000.

28. Poppele J., Sumarto S. & Pritchett L. (1999) Social Impacts of the Indonesian Crisis: New Data and Policy Implications. A Report of the Social Monitoring and Early Response Unit (SMERU) 1999 Jakarta Indonesia. .

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