La inseguridad alimentaria es un fenómeno que afecta a millones de hogares en América Latina. Herramientas válidas y confiables para su medición son esenciales para la mejor focalización de los programas abocados a este problema. La Escala Latinoamericana y del Caribe de Seguridad Alimentaria (ELCSA) ha sido propuesta como instrumento regional y fue recientemente aplicada en Colombia, Guatemala y México. Este estudio evalúa las características psicométricas del instrumento y estima el grado de similitud entre esas mediciones. Inicialmente, se determinó que 15 ítems tuvieron contenidos equivalentes en los tres países. Al aplicarle el modelo matemático de Rasch, ELCSA mostró buen ajuste a ese modelo y un comportamiento consistente con el marco conceptual subyacente. Sin embargo, entre Guatemala y México se detectaron diferencias mayores a 1,0 lógitos en cuatro ítems, de los cuales uno solo presentó una diferencia cercana a 2 lógitos. Al omitir este ítem de subsiguientes análisis se atenuaron las diferencias en los otros ítems. Variaciones en el lenguaje, así como en el diseño de las muestras analizadas explicarían en parte los resultados de este estudio. A pesar de las diferencias detectadas, ELCSA parece medir de manera similar la experiencia de los hogares que confrontan situaciones de inseguridad alimentaria.Palabras Clave: ineguridad alimentaria, medición, Rasch, américa latina. PSYCHOMETRIC CHARACTERISTICS OF THE FOOD SECURITY SCALE (ELCSA) APPLIED IN COLOMBIA, GUATEMALA Y MÉXICOFood insecurity is a phenomenon affecting millions of households in Latin America. Valid and reliable tools are essential to improve targeting of programs addressing this issue. The Latin American and Caribbean Food Security Scale (ELCSA) has been proposed as a regional instrument and was recently applied in Colombia, Guatemala and México. This study assesses the psychometric characteristics of this tool and estimates the degree of similarity between these measures. Initially, it was determined that 15 items had equivalent content matter across the three countries. After applying the mathematical model Rasch to ELCSA, this tool showed good adjustment to the model, and a performance consistent with the underlying conceptual framework. Nevertheless, between Guatemala and Mexico differences greater than 1.0 logits were detected in 4 of the items, one of which showed a difference close to 2 logits. Removing this item from subsequent analyses lessened the differences among the other items. Variations in the language used, as well as different sample designs might partly explain the results of this study. Despite the differences detected here, ELCSA appears to measure the experience of the households confronting food insecurity in similar manner.

Background Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them. Methods Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (n = 25), grandmothers (n = 11), and healthcare providers (n = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers. Results Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow. Conclusions There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.

This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

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The Puerto Rican/Latino community in Hartford, Connecticut suffers disproportionately from a wide variety of nutrition-related problems, including food insecurity, insufficient consumption of fruits and vegetables, high rates of obesity, diabetes and other chronic diseases, and low breastfeeding rates. The Hispanic Health Council (HHC) has since its inception worked to address these problems, and has developed a highly effective model that integrates the utilization of its key strategies of research, service and advocacy.