Article
209
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
Niraj Prakash JOSHI1 and Keshav Lall MAHARJAN2
1
Graduate Student, 2Professor
Graduate School for International Development and Cooperation,
Hiroshima University,
1-5-1 Kagamiyama, Higashi-Hiroshima, 739-8529, Japan
E-mail: nirajpjoshi@hotmail.com
Abstract
Realizing the importance of food self-sufficiency in achieving the household food security, this paper tried to
assess the food self-sufficiency situation in village areas of Nepal. Agriculture was the main source of livelihood
and Bahun/Chhetri was the dominant ethnic group. Involvement of households in agriculture was found declining
with the attainment of higher level of education resulting into higher concentration of illiterate and just literate
manpower in this sector. The major resource determining food self-sufficiency of households, land holding and
coverage of irrigation was higher among Bahun/Chhetri ethnic group and in Tarai ecological region. The better
irrigation coverage together with relatively high access to production resources led to the higher crop yield among
Bahun/Chhetri ethnic group and in Tarai. Thus, Tarai was experiencing surplus food crops production, which was
merely enough to fulfill the deficit of Hills and Mountain regions. Food self-sufficiency was achieved among 72%
of households in Tarai region while the figure of Mountain region was only 11%. Similarly, the highest proportion
(53%) of Bahun/Chhetri households achieved food self-sufficiency compared to mere 10% of Occupational caste
households. Together with small land holding and low productivity, production shift from food crops to cash crops
were also the major factors responsible for food self-insufficiency. Purchasing was the most dominant means to
fulfill the deficit food. About 20% of food self-insufficient households were unable to meet minimum level of food
security threshold income for deficit months. This constituted 10.2% of sample households, who were in chronic
food insecurity situation. The incidence of chronic food insecurity as well as poverty gap was the highest in
female-headed households, Mountain region, Occupational caste, daily wage laborers and small landholders.
Education received the highest priority for the cash income expenditure followed by food items and agriculture
promotion. This expenditure patterns show the positive indication to move towards food self-sufficiency and
ultimately to food security if provided with better off farm employment opportunities and better market for both
farm produces and essential inputs.
1. Introduction
Nepal is an agrarian country. Agriculture is the main source of livelihood for 65.7 % of its population. Agriculture
sector generates employment opportunity for majority of rural households contributing 38.3% of total gross
domestic product (MOAC, 2005a). In contrast to this huge dependency on agriculture, still 46 out of 75 districts in
Journal of International Development and Cooperation, Vol.13, No.1, 2007, pp. 209-230
210
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
the country are experiencing food deficit situation. Among these, 13 districts (out of 16) are from the Mountain
and 33 (out of 39) are from Hills (CBS, 2003a). However, due to surplus production in Tarai, the country in
overall is producing surplus food revealing the country to be self-sufficient in food production. (ProPublic, 2002
and MOAC, 2005b).
This signifies that the country is self-sufficient in food at macro level and has enough food to feed its all people.
At district level, however, 61.3 % of districts are facing food deficit situation. The case is similar at household
level as well. Only 39.8 % households in the country are self-sufficient in food production (CBS, 2003b). The rest
have to meet the food demand from the external sources. Borrowing and purchasing from the income earned
within district, outside district but within the county and outside country are the important means to fulfill the
household food demand (CBS, 2004).
Considering the notion of Sen (1981), food self-sufficiency is mainly related to production-based entitlement.
Besides production-based entitlement, one can also acquire food through trade, trade-based entitlement.
Borrowing and purchasing is the common form of trade-based entitlement in Nepal. Food self-sufficiency, a
production based entitlement to acquire food is regarded as a principal indicator of food security in developing
countries like Nepal where access of rural households to the food is limited due to inadequately developed
marketing channel (Osmani, 1998 and Thomson and Metz, 1998). Together with this limited non-farm
employment opportunities also justifies the importance of food self-sufficiency, study to understand the food
security situation. Thus, food self-sufficiency at household level in developing countries like Nepal resembles the
food security status of the households in greater extent. Food self-sufficiency, however, in the country is still
inconsistent and is fluctuating over time (Osmani, 1998 and MOAC, 2005b). More importantly the overall growth
rate of food production in the country has not kept in pace with population growth rate (Maharjan, 2003).
Therefore, understanding food self-insufficiency is considered to be critical to cope with the problem of food
insecurity (Alaimo et al. 1998). Together with food self-sufficiency, income level study of households dealing with
trade-based entitlement will also help to understand food security situation, particularly whose calorie
requirements are not met by the own farm production.
Thus, realizing the importance of food self-sufficiency in achieving the food security goal of the country the study
was intended to 1) assess the food self-sufficiency situation in village areas of the country, 2) analyze the effect
of various socioeconomic factors on food self-sufficiency at household level, and 3) analyze the reason for food
deficit and means to fulfill the deficit food. Together with this, the study also tried to relate the food-self
sufficiency with the income level of households to assess the food security situation. The study, therefore,
considered the production-based entitlement as the first step of analysis and trade-based entitlement as the second
step. Trade-based entitlement will be confined to those whose production entitlement is not sufficient to meet the
calorie requirement of households.
2. Means for securing food in rural Nepal
Agriculture sector in the country is still subsistence in nature making the people dependent on agriculture to meet
their daily needs, especially food (Maharjan and Khattri-Chhetri, 2005). The majority of farms in Nepal operate
mixed farming system integrating crop and livestock with the forest resources. Each of these components is
interdependent and well integrated with each other using products and by products of the other in an efficient way.
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
211
All these three components of farming in integration supply food, fuel, clothing, shelter, labor and other needs of
farmers (Majarjan, 2003). This procured goods specially foods are consumed directly. Others non-food items
including some surplus or even deficit foods (distress sell) are indirectly consumed by exchanging them with
various foods and or cash for meeting their food needs and other basic needs. This has been practiced in a
systematic way by sustainable management of locally available resources through community participation.
This integrated nature of farming, however, is changing rapidly. Cash income generation through the introduction
of cash crops including food crops at commercial level has become more and more prevalent nowadays. In recent
years, rapid population growth and degradation of the resource base especially land and forest is creating greater
hardship in procuring food from their own production (Adhikari and Bohle, 1999). In addition, the mounting
challenges of education, employment, health care, transportation and communication services in rural areas have
forced rural people to migrate in urban areas for an improved livelihoods (Bhandari, 2003). This led to the shift
from farm activities to non-farm activities. These non-farm activities within the region and beyond are both
agro-based as well as non-agrobased. Non-farm agrobased activities include food and agro processing and
marketing activities, and non-farm non-agrobased activities mainly includes involvement in service sectors, which
are private and governmental, business and laboring within the region and beyond (Maharjan, 2003).
Thus, kind and cash derived from farming with the management of resource available and the cash derived from
non-farming sector are the important means of procuring food in rural Nepal. Figure 1 reflects the basic
relationship among various components of Nepalese farm households and the way of procuring food. The figure
served as conceptual framework for this study.
3. Methodology
Twelve districts were selected through the stratified random sampling techniques representing each of the five
development regions and three ecological zones (Figure 2). The Village Development Committees (VDCs)
adjoining to the headquarters of the districts were selected for the study. These VDCs were purposively selected
to solicit the food securing means that people tend to choose beyond agriculture when they are self-insufficient
and there are seemingly more such opportunities in those VDCs. Thus, the study may have limitations in
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
212
representing the hinterland of the country. All the population of the sampled districts constituted the study
population for the research. Thus, for simplicity non-probability sampling techniques was used to select the
respondents. Forty respondents from different VDCs of each sampled district were randomly identified with the
help of District Agriculture Development Office together with the agriculture service centers and sub centers of
the respective districts and VDCs. However, the complete responses were received only from 430 respondents
(Table 1). The survey was conducted in the year 2003 using pre-tested structured questionnaires for collection of
primary data. These data were supplemented by the data and information obtained through observations, informal
group discussions and secondary sources, as well.
Table 1. Sample size and food balance of the sample districts by development regions
Districts
Sample size
Food balance
Negative
37
Ilam (Hill)
Negative
40
Eastern (n = 116)
Dhankuta (Hill)
Positve
39
Jhapa (Tarai)
Sindhuli (Hill)
29
Negative
Central (n = 57)
Sarlahi (Tarai)
28
Positive
Gulmi (Hill)
39
Negative
Western (n = 77)
Nawalparasi (Tarai)
38
Positive
Positive
39
Salyan (Hill)
Positve
29
Mid Western (n = 104)
Banke (Tarai)
Negative
36
Jumla (Mountain)
Kanchanpur (Tarai)
38
Positive
Far Western (n = 76)
Dadeldhura (Hill)
38
Positive
Total
430
Development Regions
Source: CBS, 2003a
Figure 2. Map of Nepal showing sample districts
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
213
Data on socioeconomic characteristics, food crops production, food self-sufficiency, perception on reasons for
food self-insufficiency, means to fulfill deficit food and preferred areas of expenditure of cash income were
collected. Results were summarized using descriptive statistics mainly frequency and cross tables.
Food self-sufficiency was measured through total calorie available for consumption to households from their own
farm production and requirement based on adult equivalent of respective households for a year. The major
food crops namely, rice, wheat, maize, millet, barley and potato were taken into consideration for the estimation of
calorie availability (CBS, 2003a). The basic standard calorie requirement of 2144 kcal/person/day in the Tarai and
2344 kcal/person/day in the Hills and Mountain based on CBS (2003a) was considered for the study. It is
estimated that 87.3% of this calorie is generally available from the food crops (Gautam, 1993). The food crops
requirement, thus, was estimated at 2046.3 kcal/person/day for Hills and Mountain, and 1871.7 kcal/person/day in
Tarai. Therefore, food self-sufficiency was calculated based on the food crops requirement and available from
self-production. Calculation of calorie available, requirement, balance and food self-sufficiency months was based
on equation 1, 2, 3 and 4, respectively.
Calorie available (CAi) = a1xpaddyi + a2maizei + a3wheati + a4milleti + a5barleyi + a6potatoi ----------- 1
Where,
CAi = Calorie available in ith household
x = Conversion factor from paddy to rice i.e. 0.6175
a1 = Calorie conversion factor of paddy i.e. 345 kcal per 100 gm
a2 = Calorie conversion factor of maize i.e. 342 kcal per 100 gm
a3 = Calorie conversion factor of wheat i.e. 346 kcal per 100 gm
a4 = Calorie conversion factor of millet i.e. 309 kcal per 100 gm
a5 = Calorie conversion factor of barley i.e. 336 kcal per 100 gm
a6 = Calorie conversion factor of potato i.e. 97 kcal per 100 gm
paddyi, maizei, wheati, milleti, barleyi and potatoi = Food crops produced in ith household
Calorie requirement (CRi) = (scr*0.873)*famsizei*365 ------ 2
Where,
CRi = Calorie requirement of ith household
scr = Standrard calorie requirement i.e. 2144 kcal/person/day in Tarai and 2344
kcal/person/day in Hills and Mountain
famsizei = Family size of ith household (adult equivalent)
Calorie balance (CBi) = CAi - CRi --------------- 3
Where,
CBi = Calorie balance of ith household
Food self-sufficiency is simply calculated dividing calorie available by monthly calorie requirement of the given
household (equation 4)
Food self-sufficiency months (FSSi) = CAi/(CR i/12) = (CAi/CR i)*12--------- 4
Where,
FSSi = Food self-sufficiency month of ith household
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
214
In this analysis, household with food crops calorie requirement fulfilled for 12 months or more were considered as
food secured. Those unable to meet their food crops calorie requirement were considered as food self-insufficient
households. In case of food self-insufficient households’ income was then taken as basis to assess their food
security status. For this, the minimum threshold income of Rs 300 per month per person at 1988/89 constant price
converted into the value at 2003 using yearly inflation rate of the country was taken into consideration to assess
the poverty (Koirala and Thapa, 1997 and IPRAD, 2005). Magnitude of poverty was assessed through head count
index and poverty gap index to consider both the number of poor people and depth of poverty (Ravallion, 1992).
Thus, it is considered as the combined measure of incidence of poverty and depth of poverty (equation 6). The
closer the value move towards 1 higher will be the depth of poverty.
PG =
1 q = n ⎡ zi − yi ⎤
∑
n i =1 ⎢⎣ zi ⎥⎦
------------ 6
Where,
PG = Poverty gap
zi = Food security income threshold level for ith household (equation 7)
yi = Income of ith household
q = Total number of poor households
n = Number of poor households
------------- 7
zi = (12-FSSi)*I*FSi
Where,
FSi = Family size of ith household
I = Monthly minimum threshold income level per person (Rs. 895.1 at 2002/2003/ constant price)
4. Result and discussion
4.1 Socioeconomic characteristics
Majority (88.8%) of the sampled households were male headed (Table 2). Bahun/Chhetri (Indo Aryan origin) was
dominant ethnic group (79.3%) followed by Mongoloid (Tibeto Burman origin), Occupational caste (Damai, Kami,
Sarki, Kalwar, Pode, Muslim), and Newar (Indigenous). This clearly indicates that the Bahun/Chhetri was
widespread throughout the country, especially in the village areas adjacent to headquarters of district. This was
mainly due to better opportunities offered by nearby city areas like market and infrastructure accessibility with
low cost of living compared to urban areas. In addition, Bahun/Chhetri represents 87% of participation in state
bureaucracy (Pradhan and Shrestha, 2005). Dominancy of Bahun/Chhetri in state bureaucracy also led to high
concentration of these caste groups in vicinity of administrative centers. These caste/ethnic group notably
constitutes 80% of total migrants migrated most often from remote rural areas to relatively accessible rural and
urban areas (CBS, 2003a). Thus, distribution of caste/ethnicity reported in this study might not resemble the actual
distribution of caste/ethnicity in the country, where Bahun/Chhetri constitutes around 30% of total population
(CBS, 2004).
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
215
Table 2. Distribution of sampled households based on social characteristics
Attributes
Percentage
Frequency (n=430)
Household head
Male
382
88.8
Female
48
11.2
Caste/ethnicity
Bahun/Chhetri
341
79.3
Mongoloid
40
9.3
Newar
18
4.2
Occupational caste
31
7.2
Education
Illiterate
34
7.9
Non-formal and primary education
186
43.3
Secondary education
142
33.0
College education
68
15.8
Occupation
Agriculture
392
91.1
Business
15
3.5
Service
21
4.9
Daily wage
2
0.5
Family size-adult equivalent (Average family size = 5.8)
Small (<5)
174
40.5
Medium (5-10)
241
56.0
Large (>10)
15
3.5
Source: Field Survey, 2003
Education is crucial for adoption of any improved technology in agriculture, which ultimately aids to food
self-sufficiency. Most (43.3%) of the households were literate (able to read and write through non formal and
primary education). Similarly, 33% attended secondary education and 15.8% attended college education, whereas
7.9% were illiterate, unable to read and write (Table 2). Agriculture was most dominating occupation with 91.1%
of households engaged in it. This indicates that agriculture still remained important source of livelihood for
majority of the people in village areas of Nepal. Average family size, adult equivalent, was 5.8 persons per
household. Majority (56%) of households had 5-10 members in their family i.e. medium size family, followed by
small size family.
Medium size farm was the dominating one with holding between more than 0.5 to 2 ha. This medium size farm
constituted 73.9% of the households followed by small (15.6%), and large (10.5%) (Table 3). Average size of
holding was 1.17 ha per household, which is higher compared to national average of 0.8 ha (CBS, 2003b).
Irrigation is vital for agriculture, however 30% of households had land without any sort of irrigation. Though 70%
of farmers had access to irrigation facility, only 33.3% of the total land, however, was irrigated. Livestock ranging
from cattle to poultry i.e. buffalo, cattle, sheep, goat, and poultry were common for all households. Livestock
holding was, thus, calculated by livestock standard unit (LSU ), which help to aggregate the number of different
216
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
types of livestock into a standard one. The average livestock holding size was 5.27 LSU and 39.1% households
had greater than 0 to 5 LSU, whereas 20.7% of households did not hold any livestock.
Table 3. Distribution of sampled households based on economic characteristics
Attributes
Frequency (n=430)
Percentage
Land holding (Average landholding = 1.17 ha)
Small (<0.5 ha)
67
15.6
Medium (0.5-2 ha)
318
73.9
Large (>2 ha)
45
10.5
Irrigation accessibility
Accessible (Average holding = 0.39 ha)
301
70
Non-accessible (Average holding = 0.78 ha)
129
30
Livestock holding (Average LSU holding = 5.27 LSU)
No livestock
89
20.7
Above 0 - 5 LSU
168
39.1
Above 5 – 10 LSU
139
32.3
Above 10 LSU
34
7.9
Source: Field Survey, 2003
4.2 Education and occupation
Education is crucial for development of any sector. Bhattarai and Narayanamoorthy (2003) reported the largest
marginal positive impact of rural literacy on agricultural yield. The direct relationship of technical change and
agricultural yield led to this conclusion. Education facilitates adoption of improved technology, selection of
appropriated mix of crop and input, and timely application of these inputs including the farmers’ ability to
effectively process market, and price information and farm managerial decision.
In this study, involvement of respondents in agriculture was found declining with the attainment of higher
education. Table 4 clearly depicts that for illiterate people in villages, there were no other option than to depend on
agriculture and daily wage laboring. Out of 34 illiterate respondents 33 were engaged in agriculture composing
8.4% of agriculture dependent households. Similarly, high proportion of respondents who were literate (attained
non-formal or primary education) and attained secondary school education constituted 46.7% and 34.7% of
households dependent in agriculture, respectively. In contrast to this 10.2% of respondents involved in agriculture
attained college education. Service and business sector comprised the highest proportion (90.5% and 60%
respectively) of college education attained respondents. This resembles that the higher education level offers the
people with varieties of opportunities.
At the same time higher proportion (i.e. 58.8%) of college education attained respondents involved in agriculture
was reported mainly due to the limited off farm employment opportunities. However, almost all of them showed
little interest in agriculture and expressed their desire to quit this sector as soon as they find opportunity in service
sectors. Gylfason (2000) and Adhikari (2000) also reported negative relationship of the education attainment of the
youth and educated people with the involvement in agriculture, which they consider a serious concern for future
agriculture development. Therefore, FAO (2002) and FAO (2005) recommended for a successful policy of bringing
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
217
educated persons into agriculture to accelerate agricultural production. Sufficient incentives to attract educated
people in agriculture are thus important for development of this sector.
Table 4. Education occupation cross tabulation
Occupation
Education
Agriculture Business
Service
Illiterate
33 (8.4)
Non-formal and primary education
183 (46.7)
2 (13.3)
Secondary education
136 (34.7)
4 (26.7)
2 (9.5)
College education
40 (10.2)
9 (60)
19 (90.5)
Total
392 (100)
15 (100)
21 (100)
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
Daily wage
1 (50)
1 (50)
2 (100)
Total
34 (7.9)
186 (43.3)
142 (33)
68 (15.8)
430 (100)
4.3 Resource Distribution
Mainly land, livestock and labor were important farm resources. Regarding land distribution, Bahun/Chhetri had
the highest average landholding of 1.24 ha per household. This ethnic group also comprised the highest proportion
of respondents (75.7%) having access to irrigation (Table 5). In contrast to this, with the average holding of 0.87 ha,
only 38.7% of farmers from Occupational caste had access to some sort of irrigation. Remaining 61.3% of them
were completely devoid of irrigation, which is crucial for agriculture. Regarding the land distribution under
irrigation availability, only 33.3% of land was irrigated. This proportion was the highest in case of Bahun/Chhetri
with 56.5% of their land under irrigation, followed by Newar (42.5%), Mongoloid (33%) and Occupational caste
with the lowest of 24.1%. Similar was the case for livestock holding. In case of family size distribution, however,
Occupational caste had the largest family size, but with low level of holding and education they were either
engaged in off farm activities like daily wage labor or engaged in agriculture as agricultural labor.
Attributes
Table 5. Resource distribution among different ethnic groups
Caste/ethnicity
Bahun/Chhetri
Newar
Mongoloid
Freq
%
Ave
Freq
%
Ave
Freq
%
Ave
Landholding (ha)
Irrigated
258
Non irrigated
83
Total
341
277
LSU holding
Family size
75.7
24.3
100
81.2
0.7
0.54
1.24
5.5
6.8
10
8
18
12
55.6
44.4
100
66.7
0.4
0.54
0.94
4.6
5.4
16
24
40
33
40
60
100
82.5
Source: Field Survey, 2003
Freq = Frequency, % = Percentage, Ave = Average land holding (ha)/per household
0.3
0.61
0.91
4.7
5.7
Occupational caste
Freq
%
Ave
12
19
31
19
38.7
61.3
100
61.3
0.21
0.66
0.87
3.7
7.0
218
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
4.4 Food crops production and requirement
The main food crops of the country rice, maize, wheat, barley, millet and potato were taken into consideration to
assess the food self-sufficiency situation of households (CBS, 2003a). In overall, rice supplied 49% of calorie
available from food crops followed by maize (25.9%), wheat (17.7%), potato (3.9%), millet (2.1%) and barley
(1.4%) (Table 6). The share of rice to calorie available from food crops was the highest in Tarai and the lowest in
Mountain. Almost 61% of the total calorie available was supplied by rice in Tarai. Proportion of rice to total
calorie available in Mountain was 33.8%, which seems higher compared to 16% reported in CBS (2003a). The
present study confined to only one district i.e. Jumla of Mountain, which is well-known for high altitude rice
cultivation may be reason behind the result. In contrast to this, share of potato to total calorie available to
households was the highest in Mountain and the lowest in Tarai. This shows the importance of potato in Mountain.
Potato contributed 13.5% of total food crops calorie supplied to households in Mountain compared to 1.1% in
Tarai.
Table 6. Calorie supplied from food crops produced in each ecological zone
Sources of calorie supplied (Million calorie)
Total
Ecological
Calorie
zones
Rice
Maize Wheat Millet Barley Potato
available
Mountain
45.6
14.7
17.2
14.2
24.9
18.2
134.91
% share of crop
33.8
10.9
12.7
10.6
18.5
13.5
100.0
Hills
294.6
267.8
148.7
24.1
0.3
44.0
779.52
% share of crop
37.8
34.3
19.1
3.1
0.04
5.6
100.0
Tarai
557.3
191.2
158.3
10.0
916.8
% share of crop
60.8
20.9
17.3
1.1
100.0
Overall
897.5
473.7
324.2
38.3
25.2
72.2
1831.23
% share of crop
49
25.9
17.7
2.1
1.4
3.9
100
Source: Field Survey, 2003
Regarding food balance Mountain and Hills were suffering food deficit in terms of calorie requirement and
availability. Tarai, on the other hand, had fairly surplus calories, sufficient enough to meet the deficit of Hills and
Mountain. Mountain was suffering negative balance of 39 persons, which constituted around 18% of sample
population (Table 7). This was also equivalent to around 18% deficit of total food crops calorie requirement. The
proportion of negative balance in Hills was little bit lower with 13.1% deficit. This negative balance of Mountain
and Hills was fairly covered by 25.1% surplus of Tarai. Therefore, in overall there was only 3% surplus in calorie
available for consumption
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
Table 7. Food balance in each ecological zone
Total Calorie
Total Calorie available
Balance
Ecological
requirement
for consumption
(in Million
zones
(in Million
(in Million kCal)
kCal)
kCal)
Mountain
134.9
163.8
-28.9
Hills
779.5
896.8
-117.3
Tarai
916.8
732.9
183.8
Overall
1831.2
1793.6
37.6
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage of sample population
219
Balance in
adult
equivalent
-39 (17.6)
-157 (13.1)
270 (25.1)
74 (3.0)
4.5 Yield of food crops
Yield of all the food crops was found slightly higher compared to national average except potato. The highest yield
was reported in Tarai for each of the food crop with the overall yield of 3.2 ton per hectare (Table 8). Better access
to infrastructure like road, irrigation, credit, agriculture extension service and timely availability of essential inputs
like fertilizers and pesticides might have resulted in relatively higher yield of food crops in Tarai. In contrast to
this, lack of irrigation facility and transportation facility hindering timely availability of essential inputs and other
factors might have resulted into lowest yield in Mountain region of the country. Newar and Bahun/Chhetri with
better access to these inputs were able to get the highest level of yield. Occupational caste, on other hand, had the
lowest overall food crops yield.
Attributes
Ecological zones
Mountain
Hills
Tarai
Caste/ethnicity
Bahun/Chhetri
Newar
Mongoloid
Occupational caste
Overall
Source: Field Survey, 2003
Table 8. Yield of food crops (ton/ha)
Crops
Rice
Maize
Wheat
Millet
Barley
Potato
Overall
2.1
2.8
3.4
2.2
2.0
2.3
1.8
1.7
2.0
1.6
1.6
-
1.3
1.5
-
5.8
8.4
9.4
2.1
3.0
3.2
3.0
2.8
2.8
2.6
3.0
2.1
2.3
2.0
1.9
2.1
1.9
2.0
1.7
1.7
1.9
1.6
1.9
1.4
1.7
1.6
1.4
1.3
1.2
1.3
8.8
7.8
7.5
6.4
8.3
3.0
3.2
2.9
2.6
2.9
4.6 Food self-sufficiency situation
Food self-sufficiency is one of the important determinants of food security and can be used to assess the food
security situation in household level. Household is said to be food secured when it has access to the food needed for
a healthy life for all its members, and when it is not at undue risk of losing such access due to poor production, high
food price, inadequate wages, and or inadequate access to market (ACC/SCN, 1991). Thus, food self-sufficiency in
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Niraj Prakash JOSHI and Keshav Lall MAHARJAN
household level in case of developing countries where access of rural households to food is limited due to
inadequately developed marketing channels is the best determinant of food security (Thomson and Metz, 1998).
Rice, wheat, maize and potato were the major food crops grown in the country. Besides, millet and barley were also
grown in some extent in the country, especially in Hills and Mountain. Food self-sufficiency was measured based on
production of the food crops in own farm that is available for consumption to meet the standard calorie requirement.
On an average the food self-sufficiency of 12.5 months was recorded (Table 9). Food self-sufficiency situation was
found poor among 4.4% of households having food self-sufficient for less than 3 months. Farmers’ interest towards
cash crop in Eastern Development Region and small size of land holding in Far Western Development Region
contributed to food self-insufficiency in farm households. Similarly, small landholding with relatively low
proportion of land under irrigation on the part of Occupational caste resulted this situation.
Central Development Region showed the strong position in terms of household food self-sufficiency with 73.7%
of households producing enough food. Mid Western Development Region, on the other hand, showed the awful
situation; only 31.7% were able to produce sufficient food. Ecologically, Tarai showed the best position, where
72.1% were able to produce sufficient food. In contrast to this, only 11.1% households in Mountain region was
able to produce sufficient food to meet the household calorie requirement.
With the higher land holding under irrigation and small family size almost 50% of Newar households were food
self-sufficient for more than equal to 12 months. Similarly, 53.4% of Bahun/Chhetri were able to produce food
crops sufficient for more than 12 months in their own farm. The figure was the lowest in case of Occupational
caste. Only 9.7% of households from Occupational caste were able to produce food crops sufficient for more than
equal to 12 months.
Relating food self-sufficiency with education, about 61% of household heads having secondary and college
education met household calorie requirements from their own farm. This was mainly due to their better
understanding of knowledge and adoption of modern agriculture. While only around 39% of households head that
were illiterate and just literate were able to produce sufficient foods.
Though agriculture was the main occupation for 392 sample households (i.e. 92.1%) only 50.2% among them
were able to produce enough food to meet food crop calorie requirement of households. Households involved in
business and service were also able to derive food in their land either through renting out land or through
involvement of some member in agriculture. All large farmers having more than 2 hectares of land were able to
meet their household food crops calorie requirement. In case of small farmer however, only 4.5% of them were
able to produce sufficient food for more than equal to 12 months.
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
221
Table 9. Cross tabulation of food self-sufficiency with various social factors.
Food self-sufficiency
Attributes
<3 months 3-6 months >6-9 months >9- <12 months ≥ 12 months
19 (4.4)
50 (11.6)
68 (15.8)
84 (19.6)
209 (48.6)
Overall
Development Regions (Average food self-sufficiency months = 12.51)
9 (7.8)
21 (18.1)
11 (9.5)
15 (12.9)
60 (51.7)
Eastern
2 (3.5)
6 (10.5)
7 (12.3)
42 (73.7)
Central
5 (6.5)
10 (13.0)
20 (26.0)
42 (54.5)
Western
1 (1.0)
9 (8.7)
31 (29.8)
30 (28.8)
33 (31.7)
Mid Western
9 (11.8)
13 (17.1)
10 (13.2)
12 (15.8)
32 (42.1)
Far Western
Ecological zones
2 (5.6)
19 (52.8)
11 (30.6)
4 (11.1)
Mountain
14
(6.3)
42
(18.9)
37
(16.7)
48
(21.6)
81
(36.5)
Hills
5 (2.9)
6 (3.5)
12 (7.0)
25 (14.5)
124 (72.1)
Tarai
Caste/ehnicity
13 (3.8)
35 (10.3)
44 (12.9)
67 (19.6)
182 (53.4)
Bahuns/Chhetris
1 (5.5)
4 (22.3)
3 (16.7)
1 (5.5)
9 (50.0)
Newar
3 (7.5)
12 (30.0)
10 (25.0)
15 (37.5)
Mongoloid
5 (16.1)
8 (25.8)
9 (29.0)
6 (19.4)
3 (9.7)
Occupational caste
Education
3 (8.8)
6 (17.6)
5 (14.7)
9 (26.5)
11 (32.4)
Illiterate
11 (5.9)
26 (14.0)
35 (18.8)
38 (20.4)
76 (40.9)
Non-formal and
4 (2.8)
14 (9.9)
18 (12.7)
27 (19.0)
79 (55.6)
Secondary education
1 (1.5)
4 (5.9)
10 (14.7)
10 (14.7)
43 (63.2)
College
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
Total
430 (100)
116 (100)
57 (100)
77 (100)
104 (100)
76 (100)
36 (100)
222 (100)
172 (100)
341 (100)
18 (100)
40 (100)
31 (100)
34 (100)
186 (100)
142 (100)
68 (100)
Table 10. Cross tabulation of food self-sufficiency with various economic factors
Food self-sufficiency
<3 months
3-6 months
>6-9 months
>9- <12 months
≥ 12 months
Total
Agriculture
18 (4.6)
43 (11.0)
61 (15.6)
73 (18.6)
197 (50.2)
392 (100)
Business
1 (6.6)
3 (20.0)
4 (26.7)
4 (26.7)
3 (20.0)
15 (100)
Service
-
3 (14.3)
3 (14.3)
6 (28.6)
9 (42.9)
21 (100)
Daily wage
-
1 (50.0)
-
1 (50.0)
-
2 (100)
Attributes
Occupation
Land holding
(Average land holding = 1.17 ha)
Small (<0.5 ha)
Medium (0.5-2 ha)
Large (>2 ha)
18 (26.9)
29 (43.3)
12 (17.9)
5 (7.4)
3 (4.5)
67 (100)
1 (0.3)
21 (6.6)
56 (17.6)
79 (24.9)
161 (50.6)
318 (100)
-
-
-
-
45 (100)
45 (100)
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
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Niraj Prakash JOSHI and Keshav Lall MAHARJAN
4.7 Reasons for food self-insufficiency
Small size of land holding (43.9%) followed by low yield (38.9%), land rented out (14.9%) and production shift
from food crops to cash crops were perceived as the major factor responsible for food self-insufficiency (Table 11).
Smallholding of land with limited access to irrigation resulting into lower yield was the major problem causing the
deficit food crops production in own farm among majority (71.5%) of the Occupational caste. Though the yield
was highest for Bahun/Chhetri, 44.7% of Bahun/Chhetri producing insufficient food in their farm perceived low
yield as the main reason for deficit food crops production followed by small holding (35.2%) and production shift
from food crops to cash crops. This was mainly because they believe that they can increase production by
increasing the yield through better management of irrigation and modern inputs rather than increasing land
holding.
Low yield was severe problem in Mountain region where 59.4% of respondents perceived it to be factor
responsible for deficit food production in own farm, which was also reflected by the figures in Table 8. The
proportion of farmers perceiving low yield as responsible factor for this was 39.0% and 25.0% in Hills and Tarai,
respectively. Production shift from food crops to other crops like vegetable, fruits, and spices including land
rented-out to explore off-farm income put threats on self-food sufficiency. This trend was higher in Tarai. About
27% of the respondents in Tarai perceived this kind of production shift to be responsible for declined food
production in own farm. The figure for Hills was 17.7%. In contrast to this, none of the respondents from
Mountain perceived this to be factor responsible for food self-insufficiency. This is mainly due to limited access to
infrastructure and off-farm income opportunities in these regions (Table 11).
Table 11. Reasons for food self-insufficiency for food self-insufficient households
Reason for food self-insufficiency
Production shift
Attributes
Total
Small land
Land
Low yield
from food crops
holding
rented out
to other crops
Caste/ethnicity
Bahun/Chhetri
71 (44.7)
56 (35.2)
3 (1.9)
29 (18.2)
159 (100)
Newar
1 (11.1)
7 (77.8)
1 (11.1)
9 (100)
Mongoloid
6 (24.0)
14 (56.0)
1 (4.0)
4 (16.0)
25 (100)
Occupational caste
8 (28.5)
20 (71.5)
28 (100)
Ecological zones
Mountain
19 (59.4)
13 (40.6)
32 (100)
Hills
55 (39.0)
61 (43.3)
2 (1.4)
23 (16.3)
141 (100)
Tarai
12 (25.0)
23 (47.9)
3 (6.3)
10 (20.8)
48 (100)
Overall
86 (38.9)
97 (43.9)
5 (2.3)
33 (14.9)
221 (100)
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
The major crops replacing food crops were cardamom, tea, vegetables, and ginger in Ilam. In Dhankuta
cardamom, ginger, vegetables and citrus were found to be responsible for replacement of major food crops. Tea,
vegetables, ginger, sugarcane, areca nut and banana are the major crops that were replacing the food crops in
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
223
Jhapa. Similarly, ginger and citrus in Sindhuli and, turmeric, vegetable, and sugarcane in Sarlahi were replacing
major food crops. Coffee and ginger in Gulmi; and, vegetable, sugarcane and banana in Nawalparasi were the
main crops replacing food crops. Ginger and vegetable in Salyan, vegetables and banana in Banke and, vegetable
and apple in Jumla were replacing major food crops. In Kanchanpur, vegetable and banana and in Dadeldhura,
vegetable and ginger were replacing these food crops. The shift in cultivation in cash crops from food crops
created threats to self-sufficiency with increasing dependency in market. However, increased dependency of
households on market for acquiring food tends to be less well off in terms of food security than those who had
achieved food self-sufficiency (Osmani, 1998). The replacement of food crops by these cash crops was mainly due
to low return from food crops. These cash crops had a better market and higher returns compared to food crops.
4.8 Resolving food self-insufficiency
Purchasing from market by the income derived from various off-farm and on-farm activities was the only mean to
fulfill the deficit food for 93.8% of food self-insufficient households (Table 12). Similarly, borrowing, which was
either paid by working or paid at the time of harvesting was another important means to fulfill deficit food for
3.6% of food self-insufficient households.
Table 12. Means to fulfill deficit food for food self-insufficient households
Means to fulfill deficit food
Attributes
Total
Purchasing Food for work
Borrowing
Caste/ethnicity
Bahun/Chhetri
149 (93.8)
5 (3.1)
5 (3.1)
159 (100)
Newar
8 (88.9)
1 (11.1)
9 (100)
Mongoloid
25 (100.0)
25 (100)
Occupational caste
24 (85.8)
2 (7.1)
2 (7.1)
28 (100)
Ecological zones
Mountain
22 (68.7)
7 (21.9)
Hills
138 (97.9)
Tarai
46 (95.8)
Overall
206 (93.2)
7 (3.2)
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
3 (9.4)
3 (2.1)
2 (4.2)
8 (3.6)
32 (100)
141 (100)
48 (100)
221 (100)
Market dependency on Mountain was found low compared to Hills and Tarai. More than 95% of food
self-insufficient households in Hills and Tarai met their deficit food by purchasing compared to 68.7% in
Mountain. Jumla was the district in the Mountain where the food for work program was running and 7 out of 34
food self-insufficient households were procuring deficit food by participating in the program. Borrowing was
another important means for 9.4% of food self-insufficient household in Mountain to procure deficit food.
4.9 Income and food self-insufficiency
As purchasing was the main source to fulfill household food demand, cash income was the best way to assess the
food security status of any household. A World Bank recognized Rs. 300 per month per person at the 1988/89
constant prices as the threshold income for food security (Koirala and Thapa, 1997). This threshold income for
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Niraj Prakash JOSHI and Keshav Lall MAHARJAN
food security for the year 2003 using yearly inflation rate of the country reached to Rs 895.14 per month per
person (IPRAD, 2005).
The minimum food security threshold income level for household varied according to the food self-sufficiency
period and family size. Almost 20% of the food self-insufficient households were unable to meet the food security
threshold income level in overall (Table 13). Proportion was the highest in Mountain where 25% of food
self-insufficient households were unable to meet this requirement followed by Hill (22%). Lack of
commercialization in agriculture in Mountain with low yield and limited off farm employment opportunities were
the major determining factors for this. Similarly, small size of land holding, very limited irrigation access resulting
into low food crop yield, together with lack of skill that limits the off-farm income opportunity on daily wage
laboring with minimum wage rate resulted into 28.6% of respondent from Occupational caste unable to meet
minimum food security income threshold level. All the respondents involved in business and service were able to
Table 13. Food security threshold income attainment among food self-insufficient households
Ability to meet minimum level of food
security threshold income
Attributes
Total
Able
Household head
Male
160 (82.5)
Female
17 (63.0)
Ecological zones
Mountain
24 (75.0)
Hills
110 (78.0)
Tarai
43 (89.6)
Caste/ethnicity
Bahun/Chhetri
127 (79.9)
Newar
9 (100)
Mongoloid
21 (84.0)
Occupational caste
20 (71.4)
Occupation
Agriculture
152 (77.9)
Business
12 (100)
Service
12 (100)
Daily wage
1(50)
Category of household based on land holding
Small
48 (75.0)
Medium
129 (82.2)
Large
Overall
177 (80.1)
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage
Unable
34 (17.5)
10 (37.0)
194 (100)
27 (100)
8 (25.0)
31 (22.0)
5 (10.4)
32 (100)
141 (100)
48 (100)
32 (20.1)
4 (16.0)
8 (28.6)
159 (100)
9 (100)
25 (100)
28 (100)
43 (22.1)
1 (50)
195 (100)
12 (100)
12 (100)
2 (100)
16 (25.0)
28 (17.8)
44 (19.9)
64 (100)
157 (100)
221 (100)
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
225
Table 14. Food insecurity incidence and poverty gap in relation to the total sample
Attributes
Sample size
Food insecurity incidence
Poverty gap index
Household head
Male
384
34 (8.9)
0.33
Female
48
10 (20.8)
0.47
Ecological zones
Mountain
36
8 (22.2)
0.60
Hills
222
31 (14.0)
0.43
Tarai
172
5 (2.9)
0.39
Caste/ethnicity
Bahun/Chhetri
341
32 (9.4)
0.42
Newar
18
Mongoloid
40
4 (10.0)
0.41
Occupational caste
31
8 (25.8)
0.59
Occupation
Agriculture
392
43 (11.0)
0.43
Business
15
Service
21
Daily wage
2
1 (50.0)
0.63
Land holding category
Small
67
16 (23.9)
0.47
Medium
318
28 (8.8)
0.40
Large
45
Overall
430
44 (10.2)
0.45
Source: Field Survey, 2003
Note: Figures in parentheses indicate percentage of sample size
meet the income threshold level to meet the deficit food. However, 22.1% and 50% of food self-insufficient
households involved in agriculture and daily wage laboring were unable to meet the food security income
threshold level. Higher proportions of small farmers were unable to meet their income threshold level compared to
medium size farmers.
In overall, 10.2% of the households were unable to meet the household calorie requirement from their own food
crops production as well as income threshold to fulfill the deficit food, i.e. they were chronically food insecure
(Table 14). Almost 21% of the female-headed households were chronically food insecure. Similarly, low level of
holdings together with very less access to infrastructure like road, irrigation and limited off farm opportunities led
to high incidence of chronic food insecurity in Mountain. In case of caste/ethnicity the highest proportion (25.8%)
of households from Occupational caste were suffering chronic food insecurity. They were followed by mongoloid.
Newars with better explored off farm opportunities were able to meet the income threshold level. Cent percent of
the respondents involved in service and business were food secured through combination of own farm production
as well as cash income. Whereas, 11% of the household involved in agriculture and 50% of household involved
in daily wage laboring were unable to meet the food security level even through the combination of own farm
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
226
production and cash income. Approximately 24% of households from small landholding category were under
chronic food insecurity. Whereas all of the farmer under large land holding category were food secured.
Poverty gap index, the combined measures of incidence of poverty and depth of poverty, was higher in the
household headed by the female (Table 14). Similarly small land holding and lack of transportation resulting into
very confined market access coupled with low yield and lack of off-farm income opportunity resulted to higher
poverty gap in Mountain. Occupational caste getting low social privileges in terms of land holding, LSU holding,
irrigation access had the higher depth of poverty. Newar with better exploration of off-farm opportunity, however,
were found to meet the minimum income threshold to fulfill the family calorie requirement. Also the households
involved in business and service were able to secure food security in combination with self-food production and
income. Whereas the households involved in daily wage laboring had the highest poverty gap index of 0.63 i.e.
able to earn only 37% of income necessary to fulfill the deficit calorie requirement. Food self-insufficient small
farmers were able to meet only 53% of their income threshold to fulfill deficit calorie and of medium farmers were
able to meet 60% of the threshold. In overall, poverty gap index of 0.45 indicated that the food self-insufficient
households were able to earn only 55% of total food security threshold income.
4.10 Expenditure preference
Food, education, agriculture promotion, health, and religious and cultural ceremony were major areas of cash
income expenditure. Ranking of these areas with indexing showed that education was the area, which got the
highest priority for expenditure followed by food, agriculture promotion, and health (Table 15). These areas
influence food security in positive direction (Smith, 1998). Thus, this trend of expenditure signifies households
moving towards sustainable level of food security resulted by the improved knowledge on agriculture brought by
the higher level of education. In addition, the higher level of education provides the possibilities of better off farm
opportunity resulting into higher level of income thereby increases the access to food. Similarly, expenditure
preference of cash income in agriculture promotion activities like investments on improved seed, fertilizer,
pesticides, mechanization, improved breeds, concentrate to feed animal, etc. help to increase the household food
production as well as the total income.
Caste/ethnicity
Bahun/Chhetri
Newar
Mongoloid
Occupational caste
Overall
Table 15. Expenditure preference
Preference ranking
Agriculture
Health
Food Education
promotion
II
I
III
IV
III
I
II
IV
II
I
III
IV
I
II
III
IV
II
I
III
IV
Source: Field Survey, 2003
Religious and
cultural ceremony
V
V
V
V
V
Assessment of Food Self-Sufficiency and Food Security Situation in Nepal
227
5. Conclusion
The study showed that agriculture was predominant economic activity, and Bahun/Chhetri were predominant
ethnic group in village areas in the periphery of administrative centers-headquarters. Majority of households had
medium level of family size, land holding and livestock holding. Resource distribution specially land holding,
irrigation availability to those lands, livestock holding differed according to caste/ethnicity. Bahun/Chhetri had the
highest level of resource possession while the Occupational caste had the lowest. Higher proportion of household
from Central Development Region was able to produce more than enough food to meet the household demand. In
case of Ecological zone, Tarai was able to do that. Most of households having irrigation, higher land and higher
livestock holding were able to produce sufficient food in their own farm.
Low yields, small size of land holding and production shift from food crops to other crops were the main reasons
for insufficient food production in own farm. Low yield was the major hindering factor to achieve food
self-sufficiency, especially in Mountain and Hills. Not only this but also lengthened crop-growing periods
relatively affecting mountain regions in terms of food production potentials, and high energy and food need due to
cold climate were the important reasons. Production shift from food crops to other crops though had negative
impact on food self-sufficiency, the increased income from those crops guaranteed access to the food items.
Purchasing from market, borrowing paid either by agricultural labor or at the time of harvest, and involvement of
food for work program helped to raise the possibility to meet the food demand. When this was not met, only
option left to them was to either cut their meal or borrow grains within the village or use the edible forest foods or
migrate in other area in search of better opportunity both in terms of income and access to food.
Due to low agricultural yield and limited opportunity for off farm income activities higher proportion of
respondent from Mountain and Occupational caste was unable to meet minimum income threshold for food
security. All the households involved in business and services were managed to meet calorie requirement through
the combination of own farm produce and income. However, around 10% of household involved in agriculture
was unable to meet the income threshold level for food deficit months, i.e. they were suffering chronic food
insecurity. Poverty gap index revealed the higher depth of poverty among the household headed by female.
Poverty gap was the highest in the Mountain and among Occupational caste as well among the daily wage laborer.
Depth of poverty was found negatively associated with farm category based on land holding and livestock holding.
Poverty gap was decreasing with the higher land holding. High preference for expenditure of cash income in
education, followed by food items, agriculture promotion and health shows the positive indication to move
towards food self-sufficiency and ultimately to food security.
The study indicated that with the low level of infrastructure development for marketing process coupled with low
level of self-sufficiency Hills and Mountain seek the special attention to deal with the problem of food insecurity.
Thus, yield increasing strategy in one hand helps to achieve food self-sufficiency, while on the other hand, focus
on crops with high market value or better exposure to off farm activities to the people of Mountain and Hills
focusing on deprived group help to increase access to food through increased income. In the mean time market
access to both farm produce and essential input must be smoothen.
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2007.2.23 受理
Endnotes
Village, which is also synonymously used, as rural areas are usually defined as the areas that do not fall under the category of urban area.
However, there is no commonly accepted definition of urban area. This can be often defined only in terms of other labels like urban centers,
major cities, administrative centers or municipalities. Thus, for the study purpose, urban areas are defined as the headquarters of respective
districts, which is also an important administrative center. Headquarters in Nepal may not necessarily be Municipality. Vicinity of
headquarters was regarded as village areas for this study. All of these areas fall under VDC, the lower tier of administrative division in the
country.
To implement the concept the regional development that was introduced in 1972, the country is divided into 5 development regions
(Second highest tier of administrative division) from east to west (Eastern, Central, Western, Mid Western and Far Western Development
Regions) and development policies are implemented according to these administrative divisions
Based on physical diversity, the country is divided into three broad physiographic areas; Mountain, Hills and Tarai. All three regions
extend from east to west parallels to each other as continuous ecological belts.
Mountain ranges from 4,877 to 8,848 m above mean sea
level and covers 35% of country’s geographic areas. The region is very rugged and only about 2% of land is cultivable. The region is
sparsely populated due to high altitude and cold climate and comprises a mere 7.3% of total population. Hills with the range of 610 to 4877
m above mean sea level constitutes 42% of total land area of Nepal and 44% of total population. Only about 10% of land in Hills is
cultivable. Tarai is a plain area with the altitude ranging from 60 to 610 m above mean sea level. Though it constitutes only 23% of total
land area it is home for 48.7% of total population. Around 40% of land area is under cultivation in Tarai. Tarai region is granary of Nepal.
Adult equivalent is aggregate measure of family size that standardize consumption unit within the household taking account age and sex
of household members (Appendix 1)
LSU is aggregates of different types of livestock kept at household in standard unit calculated using following equivalent; 1 buffalo = 1
cattle, 1 sheep and goat = 0.33 cattle and 1 poultry = 0.1 cattle (CBS, 2003b)
230
Niraj Prakash JOSHI and Keshav Lall MAHARJAN
Appendix 1. Conversion factor to compute adult equivalents
Adult equivalence
Adult equivalence
Age group
Age group
Male
Female
Male
Female
Under 1 Year
0.33
0.33
1-1.99
0.46
0.46
12-13.99
0.96
0.84
2-2.99
0.54
0.54
14-15.99
1.06
0.86
3-4.99
0.62
0.62
16-17.99
1.14
0.86
4-6.99
0.74
0.70
18-29.99
1.04
0.80
7-9.99
0.84
0.82
30-59.99
1.00
0.82
10-11.99
0.88
0.78
60 and over
0.84
0.74
Source: Gamba, P. (2005) as per World Health Organization