Search Titles Subjects Organizations. Data were obtained during a recent UNlCEF-supported consultancy, the objective of which was to assess young child nutrition and household food security as a prerequisite for recommending appropriate community-based primary health care and information system interventions. The data were collected through published and unpublished documents, observations of Lao PDR medical and health facilities, rural schools, and villages, and interviews with Laotian nutrition and health specialists. The findings show that house-hold food security rests unstably on a risk-diffusion strategy and women's participation.

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Search Titles Subjects Organizations. Data were obtained during a recent UNlCEF-supported consultancy, the objective of which was to assess young child nutrition and household food security as a prerequisite for recommending appropriate community-based primary health care and information system interventions. The data were collected through published and unpublished documents, observations of Lao PDR medical and health facilities, rural schools, and villages, and interviews with Laotian nutrition and health specialists.

The findings show that house-hold food security rests unstably on a risk-diffusion strategy and women's participation. A number of nutrition disorders are also prevalent. Control strategies require both long- and short-term actions focusing on assessment, advocacy, planning, training, appropriate model development, and communication for food and nutrition. Editor's note While the Food and Nutrition Bulletin does not usually publish surveys of individual countries, so little information is available on nutrition and health in the countries of former Indochina that this account by a very competent team of investigators from Thailand is, of general interest.

It examines a wide range of nutrition and related health issues and highlights the importance of essential health research to understand problems and devise local solutions. Introduction As the nations of Indochina open their doors to peace and political stability, the national and international health and medical forces are challenged to strengthen basic health services for their populations. In the case of the Lao People's Democratic Republic Lao PDR , one major problem area addressed through cooperative efforts between international development agencies, the Lao government, and foreign universities is food and nutrition.

This review was a prerequisite to developing appropriate community-based primary health care interventions and proposals to improve the nation's health information base and monitoring systems. This paper synthesizes the team's major findings in five areas: household food security' the current nutrition situation with respect to specific disorders and their magnitudes and trends, food and nutrition policy and activities, priority studies and the government's operational objectives for , and strategies for the development of short-term and long-term approaches to dealing with the problems.

Methodology and outcome The mission adopted a practical operating research pattern involving four main phases. First, documentary research was carried out entailing the collection of existing materials e. Second, the team conducted observations of the Mahosot. Special attention was given to visiting schools. The team tried to assess current health care services, household food security strategies, food and nutrition practices. Third, the team conducted informal interviews with nutrition and health specialists and middle- to high-level government officials in order to evaluate the extent, effectiveness, and needs of existing national food and nutrition policies.

Emphasis was also placed on identifying potential short-term and longer-term intervention strategies and their requirements. These were then examined in relation to the statistics on specific food and nutrition disorders and household food security issues.

A report with recommendations was prepared. The report also serves as a guideline for the Lao Ministry of Public Health and Social Welfare in identifying existing health and nutrition infrastructure problems. Iargely mountainous country with an area of , square kilometers.

The agriculture and livestock sectors alone could potentially assume food security for the country. The nation's small population 3. The majority of the emigres were qualified professionals.

The female and male life expectancies are The infant mortality rate is high 1 4 per 1, live births in but on the decline per 1, in and per 1, in [1]. The same holds for the under-five mortality rate, which decreased from per 1, in to per 1, in The mortality and morbidity patterns, moreover, are those of a less developed country in the first stage of the epidemiological transition.

Malaria, acute respiratory infections, and diarrhoeal diseases are the top three causes of mortality among infants and small children. The causes of morbidity are the same, but in the following order of magnitude: acute respiratory infections, diarrhoeal diseases. Other preventable infectious diseases remain uncontrolled, and there is room for improvement in the expanded programme of immunization since coverage rates of DPT3.

Health service development has low levels of health financing. There is also a bias towards curative care. In the curative sector comprising largely drugs and medical supplies received Household food security Food security has many different definitions, yet at a basic level it is primarily concerned with household microeconomics.

Special attention here is paid to household food security issues - namely food availability, acquisition or entitlement, food consumption, and the role of gender for each. Household food availability The Lao PDR household economy is largely dependent on agriculture for food production, especially livestock and rice. Buffalo and cattle are primarily used as draft animals rather than as a common food source.

They are considered depositories of family wealth which can be readily liquidated to purchase needed domestic items and additional food. While swine and poultry are present in all villages, they are raised using non-labour-intensive methods which often include allowing the animals to forage. Rice production is the fundamental component of the farming system, and all other production activities constitute secondary hut crucial elements. The estimated annual paddy unmilled rice requirement is kg per person.

The proven production of rice is approximately 1. Erratic climatic conditions commonly cause production shortfalls. An inefficient distribution and market system also causes local deficits due to poor transportation and management. Semi-migratory swidden farmers, particularly among the Lao Soung and Lao Theung, usually do not produce enough rice for their own needs. Consequently, they cultivate crops with short maturation periods to provide food before the rice harvest and in times of need.

In many cases, home gardening operates as a supplementary food production system which can, in times of surplus, provide an additional source of income.

In all three major ethnic categories, women assume major household economic roles, including vegetable growing, small-scale production. Household food acquisition or entitlement Carbohydrate requirements in Lao households are met by rice and other supplementary staples.

Maize and root crops are used mainly for animal feed. Requirements for protein, especially animal protein, usually cannot be met through farming alone. Natural foods such as fish, snails, small game e. Men also hunt regularly during the post-harvest period for household consumption and to provide a substantial source of income among poor families. Currently, pressures on game animals and forest encroachment are strong and widespread.

Internal trade in locally obtained food products via cash or barter systems is also more frequent in many lowland Lao Loum villages, but very little intra-village trade is conducted among the other ethnic groups [6].

In rural areas, markets are the means for obtaining small necessities e. The use of markets as a major source of food supplies is constrained by poor transportation, limited food industries, the time required to travel to the nearest market, and restricted purchasing power. Food consumption Presently, systematic data on household food consumption patterns are rare and largely confined to people living in Vientiane Prefecture [X].

The estimated Since the Lao eat a large variety of foods, their chance of consuming an adequately balanced diet is high, especially among adults. Unfortunately no nutrition survey exists providing quantitative and qualitative information on the dietary intakes of household members in different seasons and among different ethnic groups. Prepared supplementary weaning foods are unavailable.

The practice of introducing semi-solid foods e. Food taboos, such as withholding food during certain periods e. While gender differences appear to be insignificant, surveys have shown that girls tended to be marginally better off nutritionally than boys [9].

It may be that girls have better access to food since they often help their mothers with cooking. Thus, children's food security issues may not be food availability or household acquisition, but food habits, family distribution, and the multiple roles of women in the family.

The food and nutrition situation: Problems and magnitudes The effects of household food security issues are most clearly reflected in the nation's food and nutrition status. As with any quantitative assessment for the Lao PDR, however, the food and nutrition situation presented here must be considered very carefully, since information systems are only rudimentarily developed and there are no institutionalized nutrition surveys.

Even where nutrition status data are available, explicit statements of definitions, criteria, cut-off points, and the like are frequently varied and sometimes even missing. Nonetheless, data from a few prior nutrition surveys. Low birth weight The prevalence of low birth weight LBW reflects infant and maternal nutrition status.

In Kripps collected data on urban newborns and reported a mean birth weight of 3. A recalculation from these data, assuming a normal distribution. Protein-energy malnutrition in preschoolers Three major nutrition-status surveys have been conducted among Lao preschool children months of age.

Assessments of nutrition status depend of course on the indicator and cut-off point used. Recent small-scale surveys in three provinces by the Save the Children Fund UK have shown limited improvement in this situation. Children more than one year old who were being weaned constituted the most vulnerable group.

Micronutrient deficiencies Iodine deficiency Iodine deficiency disorders are a major nutrition problem in the Lao PDR. Their spectrum ranges from mere cosmetic annoyance to a conspicuous grade-lV goitre, and even severe mental retardation.

Vitamin A deficiency Although up to the present there have been no vitamin A studies in the Lao PDR utilizing objective methodologies serum retinol, relative dose response, impression cytology, dark adaptation to determine the extent of the problem, there are some indications of vitamin A deficiency. The present evaluation team also found several blind children at Mahosot Hospital. From interviews with their parents and attending physicians, it appears that vitamin A deficiency is most likely the cause of their affliction.

Children who are undergoing weaning are most vulnerable, since vegetables are not included in the diet of children under two years of age. Vitamin B 1 thiamine and B 2 , riboflavin deficiencies The magnitude of problems related to thiamine and riboflavin deficiency is unclear.

More systematic and scientific evidence is needed. The consultant team also discovered 10 students Chaitanee District, Vientiane Prefecture. Over the past two years Vientiane hospitals have reported that several patients have died of unexplained causes. Others with the same symptoms, however, quickly recovered after receiving vitamin B1 treatment. Some villagers in Ban Huachieng are also familiar with the sudden unexplained nocturnal death syndrome SUNDS which strikes young, physically active males.

They even use the same term as in north-east Thailand - lai tai - which literally means "sleep death. Nutritional anaemia or iron deficiency The nature and extent of nutritional anaemia has yet to be determined. Doctors in the maternal and child health clinic at Mahosot Hospital confirmed this rate and the importance of iron deficiency anaemia among pregnant and lactating women.

Bladder stones Bladder stones are a major problem in Thailand and other countries of the region. They are caused by several nutrition factors, including 1 the early introduction of weaning foods, especially premasticated glutinous rice, which leads to less breast milk intake or water content; 2 inadequate phosphate intake, usually accompanied by high protein sources; and 3 high oxalate content from vegetables in the diet.



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