Household food access remains a concern among primarily agricultural households in lower- and middle-income countries. We examined the associations among domains representing livelihood assets (human capital, social capital, natural capital, physical capital and financial capital) and household food access.

Cross-sectional survey (two questionnaires) on livelihood assets.

Metropolitan Pillaro, Ecuador; Cochabamba, Bolivia; and Huancayo, Peru.

Households (n 570) involved in small-scale agricultural production in 2008.

Food access, defined as the number of months of adequate food provisioning in the previous year, was relatively good; 41 % of the respondents indicated to have had no difficulty in obtaining food for their household in the past year. Using bivariate analysis, key livelihood assets indicators associated with better household food access were identified as: age of household survey respondent (P = 0·05), participation in agricultural associations (P = 0·09), church membership (P = 0·08), area of irrigated land (P = 0·08), housing material (P = 0·06), space within the household residence (P = 0·02) and satisfaction with health status (P = 0·02). In path models both direct and indirect effects were observed, underscoring the complexity of the relationships between livelihood assets and household food access. Paths significantly associated with better household food access included: better housing conditions (P = 0·01), more space within the household residence (P = 0·001) and greater satisfaction with health status (P = 0·001).

Multiple factors were associated with household food access in these peri-urban agricultural households. Food security intervention programmes focusing on food access need to deal with both agricultural factors and determinants of health to bolster household food security in challenging lower- and middle-income country contexts.

To provide an overview of the household dietary diversity score and the food consumption score, two indicators used for food security assessment and surveillance, and compare their performance in food security assessments in three countries.

Cross-sectional cluster sampling design using an interview-administered structured questionnaire on household food security, including household-level food group consumption measured over 1 d and 7 d.

Survey data are from Burkina Faso, Lao People’s Democratic Republic (Lao PDR) and northern Uganda.

Households in Burkina Faso (n 3640), Lao PDR (n 3913) and northern Uganda (n 1956).

Spearman’s correlation coefficients between the scores were 0·73 in Burkina Faso, 0·65 in Lao PDR and 0·53 in northern Uganda. Prevalence-adjusted kappa coefficients showed substantial strength of agreement in two countries. The proportion of agreement between the two scores ranged from 85 % in Lao PDR to 65 % in northern Uganda. Dietary profiles based on food group consumption using score tertiles were comparable. Rankings of the most food-insecure areas within a country corresponded well in northern Uganda and Burkina Faso but not in Lao PDR. Both indicators showed moderate correlations with other proxy measures of food security.

The comparative study highlights the similarities and differences between the food consumption and household dietary diversity scores. Similar classification of the most food-insecure areas within sub-national levels was obtained. The choice of indicator for food security assessment and surveillance will vary depending on user needs.