Improving child nutrition in Cambodia

FAO project teaches caregivers how to prepare nutritious meals using locally available foods

Key facts

In the last decade, Cambodia’s poverty rate has declined but malnutrition rates remain high, and complementary feeding practices continue to be poor. Annually, more than six thousand Cambodian children under the age of 5 years die as a result of maternal malnutrition, underweight and wasting, poor infant feeding practices or micronutrient deficiencies. For infants and children under the age of two, the consequences of undernutrition are particularly severe, often irreversible, and reach far into the future. Malnutrition, resulting in stunting of children, undermines human capital and economic productivity. To help fight the effects of poor nutrition, in 2011 FAO started a 42-month nutrition-sensitive agriculture project: ‘Improving Food Security and Market Linkages for Smallholders (MALIS) in Preah Vihear and Otdar Meanchey’ in northern Cambodia. The project focused on boosting food security by increasing the capacity of smallholder farmers to diversify production, enhance productivity and increase resilience, and improve their family feeding practices.

Nutrition education, a key component for a better diet
The nutrition education component of this project started in 2013 in 16 villages in Preah Vihear and 19 villages in Otdar Meanchey. 1 387 volunteer community nutrition promoters (CNPs) with infants and young children aged 6-18 months were trained on improved infant and young child feeding, hygiene and food safety practices.

Participatory cooking demonstrations were also held in collaboration with the Provincial Health Department, District Health Centres, Provincial Department of Women’s Affairs and NGOs: Malteser International and Farmer Livelihood Development in which caregivers learned how to prepare improved thick and multi-ingredient porridge (bobor khap krop kroeung) from locally available foods, and how to responsively feed their young children.

The final nutrition education sessions and graduation ceremonies took place in early 2014.

Improved complementary feeding plays a key role in the food and nutrition security of families
In order to improve the quality of the nutrition education intervention, the project focused on identifying enabling factors for caregiver behaviour change in relation to complementary feeding.

The results from a knowledge, attitude and practice study showed that most caregivers improved their hygiene practices, in particular washing hands with soap before cooking and feeding children. It was also noted that caregivers improved their knowledge on age-appropriate feeding and they felt that learning about better child feeding practices is important. Most caregivers interviewed prepared the enriched bobor 4 to 6 times per week and some caregivers even prepared it every day for their children. As a result of improved nutrition, children cried less, had healthier skin, less diarrhoea and gained weight.

To convince caregivers of the benefits of enriched bobor, FAO conducted a complementary feeding campaign in 35 villages during February - March 2014. A cooking demonstration and tasting of bobor by all villagers was followed by a one-week bobor distribution in which children aged 6-23 months were given bobor three times a day. Overall feedback from caregivers was positive and children liked the food.

The MALIS nutrition team also produced new training materials, designed nutrition education posters for facilitators and caregivers, developed nutrition modules for Farmer Field Schools, and created food availability calendars to promote the use of diverse foods during different seasons.

Success can only be maintained through constant follow up
Since the start of the project a total of 1 387 caregivers of infants and young children aged 6 - 18 months participated in nutrition education sessions, which took place in 99 villages.

The project demonstrated that locally available foods play an important role in improving the food and nutrition security of  household members in rural Cambodia, particularly for children through improved complementary feeding.

In order to measure the quality of the project, FAO receives regular feedback from caregivers and trainers and conducts follow-up home visits together with the implementing partners to reinforce nutrition education messages and to observe whether behavior change in villagers has occurred due to improved complementary feeding practices.

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