How one community is addressing child malnutrition

While malnutrition is slow acting, persistent, and often not diagnosed, it leads to death and harm of children on a vast scale. Malnutrition has severe implications on a child’s physical and mental development.

Ministry of Health reports indicate that chronic malnutrition among children under-the-age-of-5 remains one of the biggest challenges in Lao PDR.

According to the 2011/12 Lao Social Indicators Surveys, child stunting and underweight levels continue to affect one in every three children below the age of five. In mountainous rural areas, the situation is worse.

Child malnutrition and underweight children are found in many villages where World Vision works.

Community health volunteers report that many parents do not understand the impact of malnutrition. They are unable to identify it and do know about the importance of eating nutritious food. Additionally, many families do not have enough food at home and do not know the best way to cook it for optimal nutritional value.

They are at further risk of disease due to poor sanitation and lack of access to clean water.

Research points out that children under two years old grow faster than at any other age, and are the most vulnerable to disease, wasting and stunting, however, they also respond best to immediate intervention.

In one community in Nhommalath District, a project called Happy Child by Community, is the answer to the rehabilitating malnourished children.

“My 2-year-old daughter was not healthy, I didn’t know how to take care of her and I worried I would not be able to raise her well because we do not have enough food for our family,” says 19-year-old Thom, a first-time mother.

In 2012, the World Vision Laos health team worked with this community, along with the Nutrition Center of the Ministry of Health and other local government offices, to promote behaviour change and empower caregivers to take responsibility for nutritional rehabilitation of their children. The project aims to tap into local wisdom for effectively treating and preventing malnutrition and spread the wisdom throughout the community.

“To implement this project, the community and families are engaged in finding the solution, implementing the activities by cooking nutritious food, providing better care, and using clean water for their children,” says Thipphaphone Panyanouvong, Health and Nutrition Manager of World Vision Lao.

Parents bring their children to participate in all the activities. It means addressing child malnutrition by using resources, knowledge and food that have in their village.

Thom is one of 33 mothers who bring their children to participate in the Happy Children by Community activities in Nhommalath. Each mother is asked to bring from home a food-item to share – frogs, morning glory, rice, cassava, spinach or coconuts – and then the instructors demonstrate and cook a nutritious meal for the children.

Mothers also learn about feeding babies, keeping their children healthy and how to play with children for their development.

The women and their children spend 12 days attending the course, and on the last day the children are weighed to assess their improvement. Normal programme standards expect children to gain at least 200 grams.

“Before, most mothers did not pay attention to their children’s health. They said, they did not wash their children’s hands before eating and they wore dirty clothes. They didn’t know the importance of the nutritious local food like vegetables, crabs and fish that they could find in their village,” shares Oulayvanh, the health officer of Nhommalat ADP.

Parents continue to practice what they learn and after two weeks World Vision staff and health workers follow-up to weigh the children again. If they are not gaining weight, the parents are asked to bring their children back to the programme for another 12 days.

“I think the 12-day course activities are beneficial to the health of children. Many child gained weight, and the parents are interested in attending the activity,” Oulayvanh says.

After the cooking activities, World Vision and district officers continue to work with families to create home gardens to ensure healthy vegetables are available to families and reduce the risk of child malnutrition.

The project also provides gardener’s tools, seeds and training skills on how to grow crops and look after crops.

“This garden not only made us have enough food to eat for the family, but we could make some income from it,” Thong adds, one of the mothers who took part in the group.

The project works in close cooperation with the local government.

“We followed up on monitoring and supported the families to cook nutritious food with fresh vegetables that are grown at home. In the first month, we saw children’s weight was increasing. In addition, we also used this opportunity to educate those mothers about hygiene and breastfeeding,” says Mrs. Sisay Haksamerchai, District Health Coordinator of Nhommalat health office.

"I am very happy to participate in this activity because I see that my daughter gained weight.  Before her weight was 8kg and now she is 10 kg,” says Thom proudly. “My hope is that my daughter is healthy and has a bright future.”