Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar

THE ALARMING FOOD INSECURITY SITUATION IN : ANALYSIS OF 13 STUDIES IN 6 PROVINCES WITHIN 2004-2006 AND ITS RELATIONSHIP WITH LIVELIHOOD SECURITY

Avita A. Usfar1 1SEAMEO-TROPMED Regional Center for Community Nutrition (RCCN), Universitas Indonesia (UI),

ABSTRAK

KETAHANAN PANGAN YANG MENGKHAWATIRKAN DI INDONESIA: ANALISA 13 PENELITIAN DI 6 PROVINSI TAHUN 2004-2006 DAN HUBUNGANNYA DENGAN KETAHANAN HIDUP

Pada kurun waktu 2004-2006, SEAMEO-TROPMED RCCN-UI telah melakukan 13 survei yang berhubungan dengan Ketahanan Pangan. Survei-survei tersebut mencakup 6 propinsi (Jakarta, , Jawa Timur, Nusa Tenggara Barat (NTB), Nusa Tenggara Timur (NTT) dan Tengah), mencakup 22 Kabupaten dan 9.038 rumah tangga. Sepuluh survei dilakukan di perdesaan. Tulisan ini bertujuan untuk melihat pola ketahanan pangan (Food Security), dari segi lokasi, waktu, kualitas, maupun hubungannya dengan status gizi dan ketahanan hidup (livelihood security). Berdasarkan analisa menurut lokasi, NTT memiliki proporsi rumahtangga rawan pangan lebih banyak (94%) dibandingkan propinsi lainnya (68-83%) baik dari segi rawan pangan dengan kelaparan, kelaparan tingkat sedang, maupun kelaparan tingkat parah. Kebanyakan rumah tangga rawan pangan di NTB termasuk kategori Kelaparan (rawan pangan 77%, rawan pangan dengan kelaparan 64%), namun kebanyakan rumahtangga rawan pangan di Jakarta termasuk tidak kelaparan (rawan pangan 83%, rawan pangan dengan kelaparan 19%). Di Jawa Timur, walaupun persentase rumahtangga rawan pangan sama, proporsi terbesarnya di kota (kota 25%, desa 19%). Sebaliknya, di NTT proporsi rumahtangga yang rawan pangan dengan kelaparan lebih besar di desa (kota 58%, desa 65%). Berdasarkan analisa waktu, ketahanan pangan rumah tangga di NTT dari 2004-2006 tetap tinggi (>93%) dan cenderung meningkat. Banyak rumah tangga turun dari kategori kelaparan tingkat sedang menjadi kelaparan tingkat parah setelah September 2005 (50%). Ketahanan rumah tangga di Sulawesi Tengah juga mengkhawatirkan, i.e. meningkatnya rumah tangga kurang pangan sebanyak 19% dalam kurun waktu satu tahun. Berdasarkan analisa dimensi, masalah ketahanan pangan terbesar adalah aksesibilitas, bukan ketersediaan. Berdasarkan analisa kualitas, walaupun lebih banyak varietas makanan (dietary diversity) terdapat di Jakarta/Surabaya dibanding NTT (99 dibanding 56), penduduk NTT secara rata-rata mengkonsumsi lebih banyak varietas makanan (Jakarta dan Surabaya 40, NTT 46). Beragam cara untuk bertahan hidup (coping strategies) ditemukan di daerah-daerah survei. Asosiasi antara ketahaan pangan dengan status gizi ditemukan di NTT (dengan stunting) dan NTB (dengan underweight); p<0.05. Variabel langsung (ketahanan ekonomi, ketahanan gizi) maupun variabel tidak langsung (ketahanan pendidikan, lingkungan perumahan, pangan, dan kesehatan) mempunyai peran pada ketahanan hidup rumahtangga di NTT maupun di Sulawesi Tengah.

Kata kunci: ketahanan pangan, rawan pangan, kelaparan, status gizi, keragaan pangan, ketahanan hidup

98 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar

INTRODUCTION The studies covered 6 provinces, 22 districts with a total of 9,016 households ood security refers to physical and (Table 1). Six studies were conducted in East economic access by all people, at all Nusa Tenggara (n=3,554), two in West Nusa times to sufficient, safe, and nutritious Tenggara (n=1,059), three in Central F Sulawesi (n=1,560), two in East food in order to meet their dietary needs and food preferences for an active and healthy (n=886), one in Banten province (n=944), life (1). Four aspects or dimensions of food and one in Jakarta (n=1,013). The districts security are: availability, accessibility, covered are as follows: Tengah Utara utilization, and sustainability. Availability (TTU), Belu, N. Jakarta, E. Jakarta, refers to adequate food at one’s disposal. Surabaya, Timor Tengah Selatan (TTS), Accessibility of food within the household Sampang, Bangkalan, Kota Tangerang, denotes that all individuals have sufficient Kabupaten Tangerang, Poso, Morowali, Tojo resources to obtain appropriate food. Una-Una, W. Lombok, C. Lombok, E. Utilization of food covers aspects related to Lombok, Sumbawa, Bima, E. , Kota the ability of human body to ingest and , Ende, and Timur. Seven metabolize food as well as food’s social role studies were part of a baseline survey, while of keeping family and community together. 4 others were endline surveys. Ten studies Sustainability refers to availability of food were conducted in rural areas, while three within a longer time period. Cases of others were either urban-rural or urban areas absolute food scarcity within a region happen only. less frequently today because of the more In evaluating the food security status of global access to food. Instead, problems of the households, all studies used the United food entitlement or command over food are State’s Food Security/Hunger Survey Module now more dominant. Assessment of food (FSSM) consisted of 16 questions (16). insecure households in Indonesia is currently Household’s responses were scored: “1” for approximated through measurement of poor affirmative response and “0” for negative households, such as those used by the response. The total score (range 0-18) were National Statistic Bureau (BPS) and the then categorized into four food security National Family Planning Bureau (BKKBN). status, namely Food secure (0-2), Food Livelihood security, on the other hand, insecure without hunger (3-7), Food insecure is a broader concept, involving sustainable, with moderate hunger (8-12), and Food adequate access to resources to meet basic insecure with severe hunger (13-18). Only needs. It comprises of the following one study in E. Java used the short form of determinants: education security, community the US-FSSM (6-questionnaires). participation, habitat security, food security, Information from qualitative assessment, i.e. and health security (2). Focus Group Discussion (FGD) and in-depth The paper analyzed thirteen studies interview were combined with the results of conducted by Seameo-Tropmed RCCN-UI in quantitative assessment to reveal a the period 2004 to 2006 (3-15). The comprehensive review of the food security objective is to analyze trend, if any, within the situation. Analysis of the food security various study places and time of data situation was also based on its dimensions, collection generated by the studies. namely availability, accessibility, utilization, Although the main objective of each of the and sustainability. Information on food intake thirteen studies may be different, similar food quality was assessed using dietary diversity and/or livelihood security aspects can be questionnaire (17). The questionnaire pulled out. consisted of a list of food items based on various food groupings. The total number of METHODOLOGY food items consumed would reflect the variety of consumption within household or per individual. It is assumed, the more variety

99 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar the food, the more quality the consumption. are categorized as with hunger (food Children <-2 SD Z-scores was categorized insecure 77%, with hunger 64%). The undernourished using anthropometric opposite with W. Nusa Tenggara, the food measurement (18, 19). Statistical calculation insecure households in Jakarta are mostly was analyzed using Statistical Program for without hunger (food insecure 83%, with Social Sciences version 11.5 (SPSS Inc., hunger 19%). The proportion of households Chicago, USA). with severe hunger in E. Nusa Tenggara is Topic of livelihood security was one-fifth (20%) of the total households, while discussed in two studies, in C. Sulawesi and in the other three provinces, the proportion is E. Nusa Tenggara. Livelihood security is less than 10%. Households in C. Sulawesi analyzed based on its two direct causes, and E. Java are better off in terms of its food namely economic security and nutritional security status. However, improvement in security. The underlying determinants are food accessibility is still needed, since more five factors, namely education security, than two-third is still categorized food community participation, habitat security, insecure (C. Sulawesi 75%, E. Java 68%). food security, and health security. Factors Comparing the three cities (Jakarta, affecting habitat security are shelter and Surabaya, Kupang)-Figure 2, Jakarta has the environment, while factors affecting health highest proportion of households that are security included mother and child care and food insecure and moderately insecure (food water and sanitation. insecure: Jakarta 83%, Surabaya 68%, Kupang 62%; moderate insecure: Jakarta RESULTS 30%, Surabaya 21%, Kupang 13%). In this section, food security results is Although Jakarta is the worse, proportion of presented based on location (pool provincial households with hunger is much greater data, urban and rural setting), time (trend (approximately double) in Kupang (Jakarta between 2004 and 2006), dimensions 19%, Surabaya 25%, and Kupang 58%). (availability, accessibility, sustainability, and Proportion of households with severe hunger utilization), quality, and its association with is relatively similar (Jakarta 7%, Surabaya nutritional status. Livelihood security aspects 4%, and Kupang 7%). will be discussed at the end. Comparing the rural areas (Figure 3), E. Nusa Tenggara has the worse number of Food security based on location food insecure, with hunger, moderate, and E. Nusa Tenggara has the highest severe insecurity (E. Nusa Tenggara 94%, proportion of food insecure households others 68-77%), followed by W. Nusa (94%), as well as those with hunger, Tenggara, C. Sulawesi, and E. Java. The moderate and severe hunger (Figure 1). severe cases in E. Nusa Tenggara are about Percentage of food insecure household in one-fifth, while in other places only less than the other four provinces (W. Nusa Tenggara, 10%. The trend result in the rural area is C. Sulawesi, and E. Java, and Jakarta) similar to that of the pool data. ranged from 68% - 83%. The proportion of Urban-rural differences can be seen households suffering food insecurity with from the studies conducted in E. Java and E. hunger is greater in East and W. Nusa Nusa Tenggara (E. Java urban=486, Tenggara (65% and 64% respectively) rural=400; E. Nusa Tenggara urban=117, compared with the other provinces, C. rural=3,437). In E. Java, the proportion of Sulawesi, E. Java and Jakarta, whose range food insecure households are comparable from 19% to 29%. Although the total number (both 68%), while in E. Nusa Tenggara, the of food insecure households in W. Nusa rural areas suffered more (urban 62%, rural Tenggara is lower than E. Nusa Tenggara, 94%) - note: the sample size for Kota proportion of having the insecurity with Kupang is considered low n=117. In E. Java, hunger is the same. Thus, most of the food although the percentage of food insecure insecure households in W. Nusa Tenggara households is the same, higher proportion of

100 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar having it with hunger is greater in urban area food insecure with hunger in E. Java, on the (urban 25%, rural 19%). In E. Nusa other hand, is relatively stable between Tenggara on the other hand, the proportion October 2004 and August 2005 (Figure 6). of those having food insecurity with hunger is slightly greater in rural area (urban 58%, Food security based on dimensions rural 65%). Food availability is less problematic in Condition between local (non-uprooted) all areas/provinces. Mothers admitted that and ex-refugee (uprooted) households was food is sufficient in terms of its variety in the compared in four studies (two in E. Nusa market. Food prices were also considered Tenggara and two in C. Sulawesi). One affordable. Common food sources varied: E. study in each location found statistical Java, mostly (85%) from the market, E. Nusa significant difference in the condition of the Tenggara mainly from own garden and field, two different households, whereby the and C. Sulawesi mostly (58%) from small condition of the ex-refugee was worse (E. kiosk around the neighborhood area. The Nusa Tenggara p-value=p<0.001; C. following specific conditions were true in E. Sulawesi p-value=p<0.05). Nusa Tenggara: the availability of animal The SEAMEO study results are protein and vegetables throughout the whole basically correspond to the results of national year, the availability of plant protein during food insecurity and mapping planting season only (Sept-Feb), and the produced by the Ministry of Agriculture and less availability of water in August through WFP, in which East and West Nusa November. Tenggara are among the prioritized areas for Overall, the problems lied in intervention (Table 2). accessibility to food. Mothers mostly had no problem in providing vegetables and fruits, Food security across time because they relied heavily on garden or From five studies in three districts of E. field. However, provision of animal and plant Nusa Tenggara (Timor Tengah Utara-TTU, protein was more problematic. The Timor Tengah Selatan-TTS, and Belu) ownership of productive asset, land, and between September 2004 and February poultry was highest in E. Nusa Tenggara 2006 (Figure 4), the followings were compared to E. Java and C. Sulawesi observed: (a) the trend of food insecurity (productive asset >85%, land >62%, poultry among the households is relatively the same 73%). Recipient of food aid was highest in (remains very high >93%), (b) The trend of C. Sulawesi (81%). The situation is more food insecurity with hunger as well as food prevalent in refugees/ex-refugees/uprooted insecurity with severe hunger increased, (c) households (true in all three provinces). Households with hunger increased from 66% Although farm land and water were in September 2004 to 90% in February 2006, available and accessible throughout the (d) More households fell from moderately whole year, presence of food difficulties was hunger into severe hunger after September still found. Thus, sustainability of food was a 2005 (increase from 12% to 62% or 50% threat. In E. Java and E. Nusa Tenggara increase). more than 81% felt the difficulties. Paddy The food insecurity situation in C. stock lasted only for 3-4 months after Sulawesi is alarming (Figure 5). All the harvest. Staple food shortages were felt in indicators of food insecurity (i.e. proportion of all three provinces (E. Java, E. Nusa food insecure households, proportion with Tenggara, and C. Sulawesi). Unsustainable hunger, moderately hunger, and severely animal and plant protein were experienced in hunger) increased in trend from the period E. Java and E. Nusa Tenggara, and February 2005 to February 2006. Number of vegetables in E. Nusa Tenggara. Drought households suffered from food insecurity and less working opportunity were increased by 19% within one year period. recognized as problems in E. Java and E. The trend of food insecure as well as the Nusa Tenggara (e.g. disease, insect, infertile

101 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar land in E. Nusa Tenggara). Economic cook whatever food available, purchase problem, psychological worriness were cheaper or low quality food, consume lower- mentioned by people in E. Java and E. Nusa valued food, consumed seeds, decrease Tenggara. The predictors of food insecurity food expenditure, find wild food, skip meals, in E. Nusa Tenggara were income, socio- reduce portion size, self-process the food), economic condition, and supply of food, Immediate access to food (i.e. borrow food while in C. Sulawesi, they were parent’s from the neighbor or family, receive food education and income security. aid), Immediate access to cash (i.e. borrow money from the neighbor or family, sell Food security based on food quality assets including small and large assets, sell (Dietary diversity) farm animals including small and medium Data on dietary diversity from five size animals, agriculture/forest production, studies, two in urban and three in rural sell jewelry, and draw money from savings). provinces i.e. Jakarta, Surabaya, E. Nusa Drastic steps (i.e. in-country migration, child Tenggara, C. Sulawesi, and Banten were labor, and working overseas) as the last available for analysis, which included two measure of coping strategies, was found quantitative and two qualitative information. very rare in E. Nusa Tenggara. The lack of Two studies (i.e. Jakarta, Surabaya, and E. coping action in one province does not mean Nusa Tenggara) classified the dietary that the particular coping action is not diversity questionnaire into six food present in that province. Since the objective groupings, namely carbohydrate, animal of the studies varied, coping aspects may not protein, plant protein, vegetables, fruits, and be well explored, as the case of working others. Although, more food items is overseas in W. Nusa Tenggara. identified from the Jakarta and Surabaya compared with the E. Nusa Tenggara study Association of food security and (99 and 56 respectively), the E. Nusa nutritional status Tenggaran consumed, on average, more Six studies presented association variety of food (Jakarta 40 (min 7, max 64), between food security and/or its related Surabaya 40 (min 13, max 57), and E. Nusa factors with nutritional status of mothers and/ Tenggara 46 (min 4, max 65)). In E. Nusa or children. From the three provinces (E. Tenggara, no statistical difference was found Nusa Tenggara, W. Nusa Tenggara, C. between ex-refugee and local community Sulawesi, two showed statistical significant households in terms of their food variety. association, i.e. E. Nusa Tenggara (n=928) Carbohydrate source food, vegetables and W. Nusa Tenggara (n=819). The and fruits are commonly consumed in E. association in E. Nusa Tenggara (p-value Nusa Tenggara. However, households that <0.05) was with stunting while in W. Nusa could not provide animal or plant protein Tenggara (p-value <0.05) with underweight. were also presence. The adults tended to In E. Nusa Tenggara, households with eat more maize, while the children were hunger have shorter children (lower HAZ) but given more rice. Meat was rarely consumed. not lighter (no difference in WAZ and WHZ), Those who consumed fish every day was showing the chronic food insecurity situation only 8-24%. of the area.

Coping strategies for food insecurity Livelihood security Information on coping strategies was Two studies, namely in E. Nusa available for six studies in three provinces, Tenggara and C. Sulawesi, focused on namely E. Java, E. Nusa T and C. Sulawesi. livelihood security. The studies compared Common coping strategies included actions two types of households, namely the belonging to four of the five coping uprooted (ex-refugee/refugee) and the non- categories, namely Income generation (i.e. uprooted (local). The potential factors seek additional work), Diet alteration (i.e. affecting livelihood security was derived from

102 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar variables that were found to be statistically places where food insecurity is increasing, as significant different between the two types of the case in C. Sulawesi. The prevention of household. Both the direct causes (economic transitory (seasonal) food insecurity is very & nutrition security) as well as four of the five important: i.e. (a) Agriculture prediction underlying determinants (educational, (land, weather, climate) can be optimalized habitat, food, and health security) by using modern technologies; (b) Focus presumably had effect on livelihood security should be made not only on food availability, (Figure 7). The other underlying determinant, but also on water availability; (c) The usage community participation, seemed did not of the short (6 questionnaire) USFSSM have effect on livelihood security in E. Nusa questionnaire to quickly assess households Tenggara. In C. Sulawesi this aspect was not food security situation can be field tried. The analyzed. role of education (training, extension) is vital, Household type (nuclear/extended), e.g. the difference between sufficient vs. type of income (routine/non-routine), nutritious food. The importance of food ownership of home appliances (i.e. quality should not be ignored (aside from television, VCD/DVD player, bicycle, cooking focusing on the increase of food quantity). stove), and ownership of non-productive National institutions should share their asset that is related to saving and capital, are findings on methods and results that could noted as variables for economic security. help quick identification of food insecure For nutrition security aspect, weight-for- households and individuals, as well as height (WHZ) index is important in E. Nusa remedies. Last but not least, we should move Tenggara, while weight-for-age (WAZ) and on toward satisfying our livelihood security. height-for-age (HAZ) is important in C. The following serves as limitation of the Sulawesi. paper: (a) Some studies indirectly assessed Education of parents (both mother and food security status of the unfortunate/poor father), food intake of mothers (i.e. energy, households due to interventions purposes, protein, zinc) and children (i.e. protein), the thus results may be over-estimated and not practice of taking sick children to represent the general population; (b) The professional health workers (i.e. midwife, USFSSM questionnaire was adapted to local Puskesmas), and acute respiratory infection languages and situation in some studies, in children were indicators specifically thus it was not direct translation of the important for C. Sulawesi. Transportation to original version. The original questionnaire the school and to the market (i.e. type of was developed to evaluate food security vehicle used, distance, cost), malaria, status of people who mainly purchase their immunization i.e. DPT and polio, care-giving food. In Indonesian setting, the questionnaire practices, water supply facilities, and must accommodate village subsistence ownership of the house were particularly farmers, e.g. alteration of the word important for E. Nusa Tenggara. Common “purchasing” to “supplying” food. The result indicators for both studies were: latrine of studies using USFSSM questionnaire was facilities (ownership and availability) and tested against coping strategies sought by housing condition (i.e. type of roof and Indonesian urban and rural households in six lighting). provinces (n=3,704) and the result was synergetic (20). DISCUSSIONS The following should be considered in CONCLUSIONS our challenge to overcome food insecurity. Considerable food insecurity condition We have to target the underlying cause of was found in all study areas. East and West undernutrition, which is poverty, as in the Nusa Tenggara suffered from chronic and case of chronic food insecurity in E. Nusa higher degree of food insecurity. The Tenggara. Both short and medium term increasing tendency of household suffering remedies should be worked out, especially in from food insecurity is alarming, whereby

103 Gizi Indon 2007, 30(2):98-111 The alarming food insecurity Avita A. Usfar accessibility to food is the most restricted 4. Fransisca DO, Roshita A, and variable. Food insecurity can, but not Purnomosari L. Household Food ultimately, lead to undernourishment, but Security, Nutrition & Health Status in definitely one of the determinants of Belu and Timur Tengah Utara District, livelihood security. : Baseline survey. SEAMEO TROPMED RCCN and ACKNOWLEDGMENTS Catholic Relief Services. 2006. I would like to express sincere thanks to 5. Pangaribuan RV and Purwestri RC. our partners, namely Care International Food Security Survey at Poso and Tojo Indonesia, Catholic Relief Service, World Una Una Districts, : Vision International, World Food Programme, Situation between Refugee and Local and Neys-van Hoogstraten Foundation, for households. SEAMEO RCCN-UI and their trust and collaboration. I recognize the Care International Indonesia. 2005 hard work of my nine other colleagues, as 6. Pangaribuan RV and Purwestri RC. Principal Investigator or Co-Principal Household Food Security, Health and Investigators in these studies, who have Nutrition Survey in Selected Sub-district, produced outstanding reports: Dwi Nastiti Poso and Tojo Una Una Districts: An Iswarawanti, Lupi Purnomosari, Maria evaluation of MUTIARA project. Wijaya-Erhardt, Nia N. Wirawan, Ratna C. SEAMEO RCCN-UI and Care Purwestri, Rosnani Pangaribuan, Siti International Indonesia. 2005 Muslimatun, Tina Rosalina, Umi Fahmida, Yulianti Wibowo; as well as all the Field 7. Pangaribuan RV and Purwestri RC. coordinators, Field supervisors, and other Household Food Security, Health and SEAMEO staff who helped with data entry, Nutrition Survey at Kupang and TTU cleaning, transcription, logistic and other Districts: An evaluation of PENA helpful work. project. SEAMEO RCCN-UI and Care International Indonesia. 2005. REFERENCES 8. Pangaribuan RV and Wibowo Y. 1. Food and Agriculture Organization. Household Livelihood Security Survey in Proceedings Measurement and Poso, Morowali and Tojo Una Una Assessment of Food Deprivation and Districs, Central Sulawesi Province: A Undernutrition. International Scientific baseline survey for PULIH project. Symposium, Rome 26-28, 2002. SEAMEO RCCN-UI and Care International Indonesia. 2006. 2. Frankenberger TR & McCaston MK. The Household Livelihood Security 9. Rosalina T. Determination of Food Concept. Food, Nutrition, and Poverty Status in Rural West Lombok Agriculture 22. 1998. Based on Mother’s Food Expenditure ftp://ftp.fao.org/docrep/fao/X0051t/X005 Equivalency Assessed by Dietary 1t05.pdf. Recall: Verified with household food security and nutritional status. MSc 3. Fahmida U and Muslimatun S. Rapid thesis. Faculty of Medicine University of Nutritional Assessment among Children Indonesia, Post Graduate Program, 6-59 Months and Women of Study Program in Nutrition. 2005. Reproductive Age in and East Nusa Tenggara 10. Usfar AA and Fahmida U. Food Provinces. World Food Programme- Security Survey at Kabupaten Belu and Indonesia, Humanitarian Aid Timor Tengah Utara (TTU): Department of the European Comparison between local and ex- Commission (ECHO), and SEAMEO refugee households. SEAMEO RCCN- RCCN-UI. 2005. UI and Care International Indonesia. 2004.

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