Study Protocol: Interactive Dynamics of Coral Reef Fisheries and the Nutrition Transition in Kiribati

Abstract

The Kiribati 2019 Integrated Household Income and Expenditure Survey (Integrated HIES) embeds novel ecological and human health research into an ongoing social and economic survey infrastructure implemented by the Pacific Community in partnership with national governments. This study seeks to describe the health status of a large, nationally representative sample of a geographically and socially diverse I-Kiribati population through multiple clinical measurements and detailed socio-economic surveys, while also conducting supporting food systems research on ecological, social, and institutional drivers of change. The specific hypotheses within this research relate to access to seafood and the potential nutritional and health benefits of these foods. We conducted this research in 21 of the 23 inhabited islands of Kiribati, excluding the two inhabited islands—Kanton Islands in the Phoenix Islands group with a population of 41 persons (2020 census) and Banaba Island in the Gilbert Islands group with a population of 333 persons (2020 census)—and focusing exclusively on the remaining islands in the Gilbert and Line Islands groups. Within this sample, we focused our intensive human health and ecological research in 10 of the 21 selected islands to examine the relationship between ecological conditions, resource governance, food system dynamics, and dietary patterns. Ultimately, this research has created a baseline for future Integrated HIES assessments to simultaneously monitor change in ecological, social, economic, and human health conditions and how they co-vary over time.

Characterizing pathways of seafood access in small island developing states

“…), suggesting that consumption of local seafood cannot be assumed based on island or village level characteristics, or even household characteristics in isolation (e.g., wealth, household size). Across the nation, i-Kiribati people consume very high levels of seafood, approximating 63 kg/person/year ( 29 , 31 , 32 ). These high levels of seafood intake are of potential concern in exceeding toxic limits of mercury, yet can serve two very important roles in i-Kiribati diets: 1) supplying needed micronutrients like iron, zinc, calcium, and vitamin B 12 that may be inadequate in other parts of the diet; and 2) displacing the consumption of more harmful meats (e.g., spam, tinned corn beef, etc.)…”

“…These surveys were conducted across 21 islands and 111 villages ( Fig. 4 and SI Appendix , Tables S6 and S7 ), representing a total of 12,481 individuals (aged 0 to 88) ( 29 , 44 ). Primary respondents were those self-identified as the person in the household with the most knowledge about household spending and food consumption.…”

“…As part of the same sampling effort, a VRS was conducted in 109 of the 111 villages where the HIES was conducted. The VRS questionnaire was administered to village authorities, and respondents included elected village leaders (46), unimane/unaine (elders; 41), teachers (1), pastors (2), and others (5, 29 , 44 ). Informed consent was given for all human subject data, and the full study was Institutional Review Board approved under Protocol #18-0967, Committee on the Use of Human Subjects, Office of Human Research Administration at the Harvard T. H. Chan School of Public Health; for full details please see ref.…”

“…Informed consent was given for all human subject data, and the full study was Institutional Review Board approved under Protocol #18-0967, Committee on the Use of Human Subjects, Office of Human Research Administration at the Harvard T. H. Chan School of Public Health; for full details please see ref. 29 .…”

“…We base this study in the island nation of Kiribati, whose food system is characteristic of small island developing states that are strongly reliant on seafood resources, and threatened by both social [e.g., western market food proliferation; ( 26 )] and biophysical forces [e.g., climate change; ( 27 , 28 )]. We use a nationally representative household income and expenditure study (HIES) and village resource survey (VRS) ( 29 ) to define household-level indicators for each of the eight access mechanisms as well as metrics of household seafood consumption. We use a random forest model to determine which of the eight access mechanisms most frequently differentiate high from low seafood consumption households when considering the full population of i-Kiribati (the term for Kiribati nationals) households.…”