In Kampong Speu province, a health worker measures a student's mid-upper arm circumference in order to quickly determine if she is malnourished.
Photo Courtesy of PATH/Chivoan Heng
There are currently five million undernourished Cambodian citizens. A study released in December 2013 by the Council for Agricultural and Rural Development (CARD), WFP and UNICEF reveals that malnutrition costs between US$250 million and US$400 million annually or 1.5% to 2.5% of Cambodia’s total annual Gross Domestic Product.
Edith Heines, Deputy Country Director of WFP Cambodia, sat down with us to share her thoughts on malnutrition in Cambodia.
What is malnutrition and why is it so important to prevent it?
When a person is not getting enough food or not getting the right sort of food, adequate health care and a healthy environment, malnutrition is just around the corner. Malnutrition takes many forms depending on what nutrients are missing in the diet, for how long and at what age. It can even be getting too much food that takes the form of obesity which many people struggle with around the world. Major drivers of poor nutrition are inadequate complementary feeding practices, poor hygiene and high prevalence of diseases, including diarrhea.
However, in Cambodia, the biggest challenge is stunting or chronic malnutrition which is a growth failure in a child caused by an insufficient intake of essential nutrients in early childhood. During the first 1,000 days of life, between conception and the age of two, children are growing the essential building blocks of their adult life. The best example is the brain. Eighty percent of brain development happens during these critical first two years.
Without the right nutrition during early childhood, a child’s physical and mental development is compromised irreversibly. The body cannot fully develop, cognitive ability is diminished and there is a higher risk for disease and mortality. Not only are these effects irreversible after the age of 2, they are passed on from mother to child, impacting the next generation.
But malnutrition in Cambodia is not just about early childhood. Although they may not be visible to the naked eye, Cambodia has high rates of essential vitamins and mineral deficiencies. WHO ranks micronutrient deficiencies among the top 10 leading causes of death globally.
WFP Cambodia Deputy Country Director Edith Heines being interviewed.
Photo: WFP Cambodia/Somealea Ngay
What is the impact of malnutrition in Cambodia?
Malnutrition in Cambodia is a top public health concern and is a cause in approximately one third of child deaths. Cambodia has a staggering 40% of stunted children according to the latest Cambodian Demographic and Health Survey (CDHS 2010). This is the only health indicator that hasn’t improved over recent years and is worse than most countries in the same income group.
The consequences of malnutrition are severe: it is one of the key underlying causes of child mortality and morbidity in Cambodia, not to mention the longer term consequences on cognitive and physical growth, diminished learning capacity and ultimately lower work performance, productivity and earnings.
Malnutrition has a significant economic cost. The Cost of Malnutrition study indicates that losses due to malnutrition in Cambodia cost between $250 and US$400 million annually, representing 1.5 to 2.5% of its GDP. The Asian Development Bank (ADB) estimates that Cambodia loses over US$134 million in GPD per annum to vitamin and mineral deficiencies alone.
Therefore, interventions in malnutrition prevention need to be seen as an investment in the people of a country, particularly for those who are trapped in poverty. By ensuring people have the right types and quantities of food to ensure a healthy diet, especially pregnant and breast-feeding women, and children, a nation is doing its utmost to ensure a stronger and more productive society and nation for the future.
Why is malnutrition so widespread in Cambodia?
Access to appropriate nutrients remains a major challenge in Cambodia. Several studies have been done on the topic, and showing that access to adequate quantities of micronutrients, such as iron, calcium and zinc, for instance, is not possible through a local, affordable diet. This is especially the case for the poorest part of the population, especially in food insecure, rural areas where access to proper water and sanitation as well as health care is sparse.
Proper nutrition is also about knowledge. While breastfeeding is the best source of nutrition for children in the early stages of life, not all Cambodian women breastfeed exclusively during the first six months of the baby’s life. Many children older than six months get too little or not the right complementary food because parents lack knowledge or cannot afford nutritious food. Hidden hunger in the form of micronutrient deficiency remains a major challenge across all levels of society.
How does WFP work to address childhood malnutrition?
Reducing stunting levels is about providing the right food at the right time while ensuring adequate health care and a healthy environment. WFP Cambodia raises awareness on hygiene and basic health and nutrition practices, stressing the importance of breast-feeding and good complementary foods for young children. We work with partners to advocate for appropriate nutrition practices and inform national policy by supporting operational research such as the Cost of Malnutrition study.
Combined with awareness raising on diet quality and better care behaviors, micronutrient interventions – supplements and fortification designed to increase nutrient intake – offer the most effective investment that could be made, with massive benefits for a tiny price tag.
WFP is currently working on the first locally-produced ready-to-eat fortified supplement in Cambodia. The product is in its testing phase and will be made available for distribution to poor food insecure households in the future, possibly through social protection channels. In the long-run, we would like to work with private sector partners to establish a sustainable distribution model ensuring nation-wide market availability through social marketing.
Download a copy of the report here.