A house in Dak Lak province (Photo: VNA)Hanoi (VNS/VNA) - The health ofchildren in Vietnam has recorded considerable improvements in recent years.However, these improvements disproportionately tend to occur in delta regionswith better economic condition, while children in remote areas with a highconcentration of ethnic minority groups continue to lag behind.
A study conducted between 2010 and 2015 by the National Institute of Nutrition(NIN), under the Ministry of Health, showed the ratio of underweight children(five-year-old or younger) has decreased from 17.5 percent to 14.1 percent,while the ratio of stunted children dropped from 29.3 to 24.6 percent. In 2016,the national rates were 13.8 and 24.3 percent, respectively.
However, in a number of areas with high concentrations of ethnic minorityresidents, such as the northern mountain region and Central Highlands,undernourishment continues to plague children, with one third suffering fromstunted growth or underweight, nearly double the rate in delta regions,according to Prof. Tran Thanh Do from the NIN. In the six to 23-month period,the children in minority areas do not enjoy a full five food group diet andiron-rich food like red meat, he added.
The lack of clean water is also a major issue. According to Save the Childrenin Vietnam (SC), the northern mountainous Yen Bai province showed an alarmingrate of stunted growth children at 69 percent (2016 figure). The organisationalso noted that women here do not usually wash hands before and after preparingmeals for children, leading to high worm infection rates (40.52 percent), andmost water samples collected were deemed impure.
These figures point to a likely correlation between the rate of malnourishmentand other detrimental elements like water quality, worm infections, andpollution.
According to Prof. Nguyen Thanh Tuan from the Alive&Thrive project of thenon-profit human development organisation FHI 360, the high rate ofundernourishment in these areas can be attributed to poor nurturing practices.The organisation’s latest project in 11 provinces showed that the exclusivebreastfeeding rate amongst ethnic people remains too low (4-33 percent), andthe rate of children enjoying appropriate diets in mountainous region hoversaround half of those in flatlands (the former’s 33-52 percent against thelatter’s 75 percent).
"Generally speaking, the reasons are due to low awareness amongst ethnicminority mothers and a severe lack of food security," Tuan told VietnamNews Agency.
Differing practices among ethnic minority groups are also a problem. Forexample, Thai and Muong people have poor diets and incomplete meals, while Tayand Nung people generally wean children off breastmilk too early, according toTuan.
NIN says the undernourishment and less than ideal physical health amongstethnic minority groups will pose “long-term consequences” to the nationalworkforce, and impede poverty reduction and economic development efforts inalready underdeveloped areas. Therefore, the health ministry together withinternational organisations have implemented several programmes to help reducechild undernourishment and stunted growth, with more attention paid to ethnicgroups. However, changing ingrained customs is not so easy.
Undernourishment in the northern mountainous province of Lao Cai isparticularly high.
UNICEF (United Nations Children’s Fund) is therefore providing funding for theprovince to improve infant and young child feeding (IYCF) in Ban Pho commune (BacHa district) and Thao Chu Phin commune (Si Ma Cai district). The projectcovered 6,000 children, 700 of whom were found suffering from acutemalnutrition. The underweight children were treated with nutritional productsand an 85.5 percent success rate was reported, each gaining an average of0.5-5kg after 6-12 weeks of treatment. However, the rest could not follow thenutrition regime or failed to show any improvements.
Thanks to the project, the rate of undernourishment in 5-year-old children andyounger has decreased by 5 percent compared to pre-intervention figure, and therate of women knowing when to supplement child’s diet with food besidesbreastmilk has gone up by 20 percent. Furthermore, the rate of exclusivebreastfeeding in the first six months after birth has jumped 30 percent, andthe rate of childbirth with medical intervention by health workers is up 10 percent.More importantly, the project has helped local mothers realise how to make bestuse of locally available food.
On a larger scale, to reduce food insecurity and undernourishment in thenorthern region (Lao Cai, Lai Chau and Ha Giang provinces), NIN launched athree-year project in November 2015 to build a supply chain of products in linewith NIN’s nutrition standards. So far, an estimated 1,500 children from six to24 months old and young mothers in nine targeted communes have benefitted fromsafe and nutritious food made from locally available ingredients, including afactory-produced porridge (rich in iron and zinc) and vegetable powder. Theproject also trains local nutritionists to help women accept and use productsfrom these newly built factories.
Ass. Prof. Dr Truong Tuyet Mai, deputy head of NIN, said the institute istrying to address undernourishment by focusing efforts on the critical “1,000golden days,” or the first 100-day window starting from pregnancy to thechild’s second birthday, as the nutrition during this period has “profoundimpacts” on children’s health and cognitive development.
Dao Lan Huong, senior health specialist from World Bank Vietnam, recommendedthe country identify the root causes of malnutrition and devise appropriatestrategies. The Vietnamese authorities also need to facilitate public access tosafe and nutritious diets as well as clean water and find ways to reduce thework burden for women.-VNA
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