Lao People's Democratic Republic
With an estimated per capita income of US$400 in 1997 the Lao People's Democratic Republic (Lao PDR) is one of the poorest and least developed countries in the East Asian region. Social indicators are among the worst in the region. Forty six percent of the population lives below the national poverty line (World Bank, 1999). The coverage of medical facilities and immunisation is low, and infant (96 per 1000) and maternal mortality rates (65 per 10 000) are still high.
Glutinous rice represents the main food in the Lao diet. The daily dietary energy supply per caput increased from 2030 kcal in 1968 to 2400 kcal in 1995. In 1999, rice provided 69% of the energy supply and 64% of the protein supply. Generally three meals are consumed per day, light meals or snacks are seldom consumed. A typical meal consists of rice complemented with small portions of vegetables, mainly green leafy vegetables and fish. Other common food items are roots, eggs, meat, poultry and various kinds of fruit. Food consumption patterns vary geographically and ethnically.
Almost all mothers breast-feed their children and almost half of the mothers continue breast-feeding for 20 to 23 months. However complementary food is introduced much too early: one fifth of the infants receive food, mainly rice, during the first month of life. The early introduction of rice may provoke intestinal disorders and contrasts with the late introduction of other nutritive foods: 70% of children aged 10 to 11 months receive only breast-milk and water. Only a small number of children receive complementary foods at the recommended age. Breast-feeding and weaning practices differ geographically and ethnically. Feeding pre-chewed or steamed rice to new-borns is a common feature among the Lao Loum and Khamu ethnic groups while the H'mong ethnic group shows more appropriate breast-feeding and weaning practices.
The National Health Survey in 2000 has found high prevalence rates of malnutrition among children: 40% of the children under 5 years of age were underweight, 41% were stunted and 15% wasted. Compared to surveys conducted earlier, the prevalence of underweight remained the same while the prevalence of stunting decreased and in contrast the prevalence of wasting increased.
In 2000, the prevalence of chronic energy deficiency (CED) among adults was alarmingly high (19%), even higher than reported during a previous survey in 1995 (14%).
Malnutrition among children as well as among adults is more prevalent in the Southern region compared to the Northern and Central ones.
The National Health Survey included data on micro-nutrient deficiencies. The total goitre rate (TGR) among school aged children was 9%. Clinical signs of Vitamin A deficiency were also prevalent. A study conducted in Vientiane Province found anaemia in 56% of females aged 15 to 45 years.
The increase in the prevalence of wasting among pre-school children and of CED among adults is alarming and requires immediate and well designed multi-sectoral interventions integrated into health, agriculture, education and overall socio-economic development.