Feasibility and sustainability of dietary surveillance, Bosnia and Herzegovina

Abstract

National dietary surveillance systems are necessary for monitoring people’s intake of foods and nutrients associated with health and disease, and for implementing national and global dietary goals. However, these systems do not exist in many low- and middleincome countries. The development of a model of dietary surveillance for Bosnia and Herzegovina, described here, provides insights into the feasibility and sustainability of dietary surveillance systems in resource-constrained settings and illustrates the challenges involved. In 2016, a year-long dietary survey was initiated in collaboration with the country’s Institute for Statistics using a subsample of households that participated in the 2015 national Household Budget Survey. Interviewers collected lifestyle, anthropometric and health data and participants answered two 24-hour dietary recall questionnaires. The survey included a representative sample of 853 participants and was performed efficiently by a small team of highly motivated, well-trained staff. Conducting a high-quality dietary survey was found to be feasible despite constrained resources. In addition, the ability to link dietary intake and regular household survey data provided an effective way of associating dietary variables with socioeconomic determinants of health. This dietary survey, the first conducted by an official institution in Bosnia and Herzegovina, represents an important starting point for building a sustainable nutritional surveillance system for the country. The cost-effective, low-burden approach to dietary surveillance described here could be applied in other low- and middleincome countries, many of which already carry out regular economic surveys.