Baseline Study of the Title II Development Food Assistance Program in Haiti Contract #: AID‐OAA‐M‐13‐00022 May 8, 2015 This publication was produced for review by the U.S. Agency for International Development. It was prepared by ICF International, Inc. Photo copyright Kendra Helmer/USAID https://www.flickr.com/photos/46658241@N06/5093680654/ The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government The Baseline Study of the Title II Development Food Assistance Program in Haiti was implemented by ICF International and its subcontractors, Institut Haïtien de l’Enfance (IHE), Centre d’appui au suivi et a l’evaluation (CASE) and Groupe de Support en Informatique et en Statistiques (GSIS), from January through August 2014. This study was made possible by the generous support of the American people through the Office of Food for Peace (FFP) of the U.S. Agency for International Development (USAID). Contents Abbreviations and Acronyms ....................................................................................................... iv Executive Summary ....................................................................................................................... v 1. Introduction ............................................................................................................................. 1 2. Methodology ............................................................................................................................ 2 2.1 Methods for Population-based Household Survey ..................................................................................... 2 A. Study Design and Objectives .................................................................................................................... 2 B. Sample Design .............................................................................................................................................. 2 C. Questionnaire .............................................................................................................................................. 4 D. Field Procedures .......................................................................................................................................... 5 E. Data Analysis ................................................................................................................................................ 8 2.2 Methods for Qualitative Study ........................................................................................................................ 9 A. Objectives, Design and Topical Focus Areas........................................................................................ 9 B. Site Selection .............................................................................................................................................. 10 C. Study Participants, Interviewing and Data Collection ...................................................................... 11 D. Data Preparation, Coding and Analysis................................................................................................ 12 2.3 Study Limitations and Issues Encountered.................................................................................................. 13 3. Overview of the Food Security Situation in Haiti .............................................................. 13 4. Findings .................................................................................................................................. 16 4.1 Characteristics of the Study Population ...................................................................................................... 16 4.2 Household Indicators ....................................................................................................................................... 17 A. Household Hunger Scale ......................................................................................................................... 17 B. Household Dietary Diversity Score ...................................................................................................... 19 C. Food Consumption Score ....................................................................................................................... 22 D. Household Poverty Levels ...................................................................................................................... 23 E. Household WASH Practices .................................................................................................................. 28 4.3 Women’s Health and Nutrition Indicators ................................................................................................ 31 A. Women’s Anthropometry ...................................................................................................................... 31 B. Women’s Dietary Diversity .................................................................................................................... 32 4.4 Children’s Health and Nutrition Indicators ................................................................................................ 35 A. Stunting and Underweight ....................................................................................................................... 35 B. Diarrhea and Oral Rehydration Therapy ............................................................................................ 38 C. Minimum Acceptable Diet....................................................................................................................... 40 D. Breastfeeding .............................................................................................................................................. 42 4.5 Gender Equality ................................................................................................................................................. 45 5. Summary of Key Findings ..................................................................................................... 47 Baseline Study of the Title II Development Food Assistance Program in Haiti i Annexes 1. Statement of Work for Baseline Study of Title II Development Food Assistance Programs in Haiti and Zimbabwe 2. Sampling Plan for Baseline Study of Title II Development Food Assistance Programs in Haiti and Zimbabwe 3. Household Survey Questionnaire in Haitian Créole 4. Household Survey Questionnaire Back-translated into English 5. Household Survey Indicator Definitions 6. Methods for Derivation of Poverty Indicators 7. Tabular Summary of Indicators 8. Multivariate Model Results 9. Qualitative Study Interview Guide in English 10. Qualitative Study Interview Guide in Haitian Créole 11. Tally Sheet of Qualitative Focus Group Discussions and Interviews 12. ATLAS.ti Code Book for Coding Focus Group Discussions and Interviews 13. Additional Tables for Indicator Analyses Baseline Study of the Title II Development Food Assistance Program in Haiti ii List of Tables Table 2.1 Sampled SDEs and Households for the Baseline Study .................................................................... 4 Table 2.2 Survey Response Rates ............................................................................................................................ 8 Table 2.3 Topical Focus Areas for the Qualitative Study ................................................................................ 11 Table 2.4 Geographical Focus Areas for the Qualitative Study...................................................................... 11 Table 4.1a Total Population in the Title II Program Area .................................................................................. 16 Table 4.1b Household Characteristics .................................................................................................................... 17 Table 4.2a Food for Peace Indicators – Household Hunger Score ................................................................ 18 Table 4.2b Food for Peace Indicators – Household Dietary Diversity Score .............................................. 20 Table 4.2c Program-specific Indicators – Food Consumption Score ............................................................ 22 Table 4.2d Food for Peace Indicators – Poverty by Gendered Household Type ........................................ 25 Table 4.2e Food for Peace Indicators – Water, Sanitation and Hygiene ....................................................... 29 Table 4.3a Food for Peace Indicators – Women’s Nutritional Status ............................................................ 32 Table 4.3b Food for Peace Indicators – Women’s Dietary Diversity ............................................................. 33 Table 4.4a Food for Peace Indicators – Children’s Nutritional Status ........................................................... 36 Table 4.4b Food for Peace Indicators – Children’s Diarrhea and ORT ......................................................... 39 Table 4.4c Food for Peace Indicators – Children’s Minimum Acceptable Diet ............................................ 41 Table 4.4d Food for Peace Indicators – Exclusive Breastfeeding ..................................................................... 42 Table 4.5 Program-specific Indicators – Agreement with Gender Equality ................................................ 46 Table 5 Summary and Comparison of Indicators