Seasoning malnutrition away in Laotian children through a sustainable recipe

Nestled in flora-clad mountainous grandeur of Luang Prabang province in Lao PDR lies the Phonexay district. Draped in a dense thicket, the district perfectly camouflages a startling truth. As per a baseline survey conducted by World Vision, in 2022, stunting rates in children were reported high as 56% and 78% of the households (HHs) were facing moderate and severe food insecurity in Phonexay[1]. The effects climate change further triggered a food insecurity quandary.

In Lao PDR, approximately 70-80% of the population depend on agricultural sector for their livelihood[2]. According to World Bank, approximately 53.8 climate-related deaths per million population linked to lack of food availability in Lao PDR by 2050[3]. It is forecasted that the influence of climate change on temperature and rainfall patterns could depress local rice yields by around 5–20% by the 2040s, with losses typically larger on higher emissions pathways.

Similarly, the communities in Phonexay whose sole irregular income of USD 10 (200,000 Kip - 250,000 KIP per month) per month, comes from farming, working in field as manual labour and selling grass as fodder, found themselves rattled by this unique dimension of complexity that adversely affected not only their food bowl but the health and well-being of their children.

"Compared to when I was young the weather has changed drastically. It has become hotter and the rain is not balanced. Due to the changing climate, the season to grow rice has changed from what it used to be. It is now difficult to anticipate. When we grow rice in the season it should be grown, the rice crop dies. Our average income depends on the weather conditions. During the season of drought, the intensity of the drought directly impacts our produce. If the drought is severe our crop production is less. This affects our food consumption. We have less food to provide for our children and we are unable to send them to school. Climate change has severely impacted our lives, our ability to provide food for our families and the health of our children. In extreme rainy conditions the children are prone to catching cold and flu,"

says 25-year-old Chitta a mother of a five-year-old and four-month-old.

World Vision has implemented long-term sustainable solutions through integrated nutrition, livelihoods, climate change adaptation, and resilience programmes to address food security issues. This includes organising saving avenues for nutrition groups, climate-smart agriculture interventions, small animals raising like Chicken and fish, home/Kitchen gardening support and developing the local value chain development. 25 Village Disaster Management Committees, in Phonexay and Pakou, have been strengthened through trainings, hazard mapping and community planning (including village mapping, identifying where the village household is located, and identifying the risk area in the village).

“I am delighted with the start of the saving for transformation initiative in my village, In the past, I lacked knowledge on how to save money; I just kept the money at home which is not safe. Now I am a member of the S4T group, and I make monthly deposits to save money for when necessary, such as buying educational material food for my children. Besides the S4T group, I also joined the home gardening activity; I received training on how to make a home garden and compose fertilizer. I have learned how to prepare the soil and how to take care of my plants.  After the training, World Vision gave me the seeds and home gardening materials. Due to disasters like recurring floods or drought season cause by changes in climate it has been a challenge doing farming. But I am thrilled that after I got trainined to grow a home garden and seeds my children and family have access to more nutritious food. We don’t need to go to the forest in search for food. This saves time and I can stay home to take care of my children instead,” says 25-year-old Chitta.

To address the issue of malnutrition, World Vision through its integrated health and nutrition programme, in Phonexay and Pakou, built the capacity of 50 Health workers and Village Health volunteers in Infant and young child feeding (IYCF), Integrated Management of Acute Malnutrition (IMAM), Social Behaviour change communication (SBCC), Growth monitoring and promotion (GMP). In 25 villages, outreach clinics have been strengthened through training and equipment support. Equipment support includes weight machine for both child and adult, height meter for adults and height meter for babies. In total of 10 sets of outreach clinic equipment were provided to four sets for small hospitals in PakOu and six sets for small hospitals in Phonexay. 

Golden 1,000-day interventions including Time, and targeted Counselling (TTC) was rolled out benefiting, in total, 1550 children under 5 and 596 pregnant and lactating mothers in Phonexay and PakOu. TTC focuses on counselling pregnant women and mothers who have children under 2 years old with the aim to help them find contextual solutions to challenges they faces are mothers. Village health workers are trained to provide counselling to mothers through a storytelling method on issues of maternal and child health care. Mothers are taught the technique of cooking nutritious food with locally available produce. This includes rice, sweet potatoes, green leafy vegetables, protein like pork etc.

"Managing three children is not easy, especially when one child is disabled. When the children are hungry and in pain, the mother hurts too. As a mother our role is to take care of our children to the best of our abilities. We used to feed the child adult food but we learned that we need to be more intentional while making food for the children. It needs to have all the nutrients to keep the child healthy. Heathy nutritious food builds the child’s immunity. I started adding vegetables and meat with rice, making it a porridge that my children can swallow easily and they find it tasty. They really like the taste. Now I am more at peace and my children’s happiness makes me joyful. My desire for my children is for them to be healthy, well-educated and safe from sickness and abuse,"

says 30-years-old Boun, a mother of three who attends the World Vision’s Infant and young child feeding programme.  

Focusing on the most vulnerable children, especially in rural and remote areas, with ethnic communities, World Vision Lao PDR through the integrated health and nutrition programme provided 10,935 pregnant women, mothers, and care givers knowledge on nutrition and infectious diseases with the support of 649 village health volunteers trained by World Vision. 3,094 households were provided access to financial services through new Saving Groups. 3,726 households had improved access to clean water. 2,519 households were trained and resourced to practice climate-sensitive agriculture, including improved home gardening and small animal raising techniques.

"We see a difference in the health condition of our children, after attending programmes. My children and the children in our village are healthier. Earlier we struggled with frequent cases of stomach ache and fever, as going to the hospital which is more than an hour away was very challenging especially during rainy season with roads all washed away. We are happy now that the cases of sickness have reduced. When mothers gather for any training, it brings us closer to each other. We can share each other’s problems and collectively find solutions. Organisations like World Vision are important for us because they show us ways to improve our community life and ensure the health of mothers and children under five,"

says 26-year-old Nauk, a mother of two who attends the World Vision’s Infant and young child feeding programme.

Extra Notes:

As a result of climate change, Rainy seasons are predicted to bifurcate (wetter April, drier May, then increasing rainfall through October), so the main rainy season will have a later onset, shorter duration, and more intense rainfall events[4].  Rainfall with about 80% received during the rainy season (May-October) and 20% in the dry season (mid-October to April).  It has impacted overall agricultural productivity.