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At a glance: Lao People's Democratic Republic

In Lao PDR, a UNICEF-supported workshop helps health workers tackle malnutrition

© UNICEF EAPRO/2012/Kandel
A 3-year-old boy watches a malnutrition screening process in Lao PDR.

By Janine Kandel

SEKONG PROVINCE, Lao People’s Democratic Republic, 11 June 2012 – Nearly 40 local nurses and doctors have gathered at the Health Department in Sekong, a rural province in southern Lao PDR.

As part of an effort to combat malnutrition, they are attending a week-long workshop organized by the Lao Ministry of Health and UNICEF, with financial support from the European Union

Child malnutrition among the poor and remote

Dr. Wonkaeo Phonesivisay, a medical doctor at the Darkcheung District Hospital in Sekong Province, was among the participants.

He sees about 30 patients per day at the hospital. Almost half of them are under age 5 and are suffering from infectious respiratory diseases such as pneumonia or bronchitis.

© UNICEF EAPRO/2012/Kandel
Dr. Wonkaeo Phonesivisay (right) listens to a presentation on the diagnosis of malnutrition during a UNICEF-supported workshop.

“Very often, my child patients are malnourished,” Dr. Phonesivisay said. “The malnutrition negatively affects their immune system and overall health status so they contract more severe forms of pneumonia or other common diseases.”

His patients live in remote and poor areas, where parents often must travel for two days to bring their children to the hospital. Many belong to the Thaliang ethnic group and speak Thaliang, a language that is not widely understood. Many caretakers’ level of education is low, and many parents do not have sufficient information about proper child health and nutrition. They traditionally give birth at home, missing out on the health and nutrition counseling provided in health facilities.

“Children do not get enough of the essential body-building food groups,” Dr. Phonevisay said. “They lack protein, minerals and vitamins. This is largely because they grow up in mountainous areas with a scarcity of food. To buy fish, fruit and vegetables, parents have to go to a market. For most of them, this means travelling for up to 60 km on rough roads with inadequate transportation."

Community-based management of acute malnutrition

At the workshop, Dr. Phonesivisay learned how to diagnose acute malnutrition in children under age 5 by measuring their mid-upper arm circumference. A coloured tape measure instantly diagnoses acute malnutrition: the green portion of the tape indicates a child is healthy, the yellow part indicates moderate acute malnutrition, and the red part indicates that a child is severely malnourished. The process is quick, painless and cost-effective.

© UNICEF EAPRO/2012/Kandel
The green portion of a mid-upper arm circumference tape indicates this 4-year old a normal and healthy weight.

Sekong Province has some of the worst malnutrition rates in the country. More than 60 per cent of children under 5 in the province are stunted and nearly half are underweight. The rural, mountainous terrain makes it one of the most remote and inaccessible areas of the country.

Until now, Dr. Phonevisay has been able to do little to improve the nutritional status of the area’s severely malnourished children other than refer parents to the hospital and offer feeding advice.

But under the joint Maternal and Young Child Nutrition Security Initiative, implemented by the Lao Ministry of Health with support from UNICEF and European Union, public health facilities in Sekong will receive ‘eeZeepaste Nut’, a ready-to-use therapeutic food. Severely malnourished children who consume the paste can recover quickly, often between six and eight weeks. The paste has already reached the central warehouse in Sekong Province and will be distributed to health centres, hospitals and clinics in coming weeks.

With the availability of eeZeepaste Nut, Dr. Phonevisay believes the rates of severe malnutrition in children under 5 will decrease significantly.

“The paste is an easy way for mothers and caretakers to feed their children all the nutrients they need,” he said.

The provision of therapeutic foods to the severely malnourished is only one component of the joint initiative to reduce malnutrition in Lao PDR’s children. Promoting positive nutrition practices, increasing the intake of vitamins and minerals, improving food security, reducing poverty, and improving water and sanitation are also key components in reducing undernutrition, particularly stunting and anemia in young children.



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