The aim of this assessment is to better understand how people in Attapeu Province living in rice production areas use aquatic resources in their livelihood strategies. An important aspect of the study is the nutritional role of aquatic resources in the diets of rural households, including poorer groups and those with special needs such as pregnant and lactating women and children less than five years of age. The three principal issues addressed by this assessment are:
the nutritional value of living aquatic resources;
food security strategies at provincial, district and household levels;
potential opportunities, constraints and threats to nutritional security that relate to water management and the environment.
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The Dialogue on Water Food and the Environment aims to have the following impacts:
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Country health information profile The country’s health situation is characterized by low life expectancy, high mortality rates and a high birth rate. The major causes of child mortality and morbidity are communicable diseases, notably malaria, acute respiratory infections, measles and diarrhoeal diseases. The incidence, severity, and outcome of these diseases are influenced by aggravating factors such as inadequate nutrition, lack of clean water, poor sanitation and limited access to health care. Only seven percent of pregnant women deliver in a hospital or clinic under the supervision of qualified staff. The main direct causes of maternal deaths are postpartum haemorrhage, postpartum sepsis, eclampsia, obstructed labour, complications during termination and infectious diseases. Important risk factors include early and later pregnancies and short intervals between births, aggravated by hard work during pregnancy and inadequate nutrition, which often results in anaemia. The health sector is generally under-financed and foreign aid is very important.
The European Union, the Japan International Cooperation Agency (JICA),
the United Nations Development Programme (UNDP), the United Nations Children’s
Fund (UNICEF), WHO and 72 non-governmental organizations are contributing
to health sector development in the Lao People’s Democratic Republic. |
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Population |
Maternal mortality ratio |
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Total: |
5 403 000 |
per 100 000 live births: |
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0-14: |
2 361 010 |
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>65: |
179 826 |
Infant mortality ratio |
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per 1 000 live births: |
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Fertility Rate |
5.00 |
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Life Expectancy |
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Crude birth rate |
in years (1999): Men 51 |
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per 1 000: 37.00 (2000) |
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Per cent of population |
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Crude death rate |
adequate sanitation Urban: 84 |
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per 1 000 live births: 13.00 (2000) |
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Diet and nutrition are key factors affecting health, food security and poverty. Health and poverty alleviation are basic themes of Dialogue activities and are also high priorities for national and local development in Lao PDR. An understanding of diet and nutrition are particularly important for vulnerable groups such as poor households and those with special needs such as pregnant and lactating women and children less than five years of age.
‘Nutritional status’ is the result of the interaction of a number of variables, which are shown in Figure 1. This conceptual framework was used as the basis for understanding the links between health and nutrition and aquatic resources. In this framework, the aquatic resource base is the source from which food is acquired and is expressed in terms of variety and certainty of acquisition, frequency, quantity and quality.
Figure 1. Linking aquatic resources to nutritional status
‘Food behaviour’ (the acquisition and use of food) is influenced by community and household variables such as family economics, social structure and organization, markets and cultural beliefs. The interaction of food acquisition and food behaviour under the influence of community and household variables determines nutritional status. The result of this interaction is individual health. Poor health can limit an individual’s ability to acquire food and for the body to use it efficiently once consumed.
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Protein-energy malnutrition Protein-energy malnutrition (PEM) is by far the most lethal form of malnutrition. Children are its most visible victims. Malnutrition, “the silent emergency,” is an accomplice in at least half of the 10.4 million child deaths each year. Micronutrient deficiencies Called micronutrients because they are needed in only miniscule amounts, these substances are the ‘magic wands’ that enable the body to produce enzymes, hormones and other substances essential for proper growth and development. As tiny as the amounts are, the consequences of their absence are severe. Iodine, vitamin A and iron are most important in global public health terms; their lack represents a major threat to the health and development of populations the world over, particularly to preschool children and pregnant women in low-income countries. Infant and young child feeding practices Nutrition and nurturing during the first three years are both crucial for lifelong health and well-being. In infancy, no gift is more precious than breastfeeding; yet barely one in three infants is exclusively breastfed during the first four months of life. From: World Health Organization - Nutrition for Health and Development.htm (updated 4 July 2003) |
