EVEN though Cambodia’s economy is expected to grow 6 percent this year – more children are smaller and thinner than they should be because they are not getting the nutrients they need, according to the results of the 2010 Cambodia Demographic and Health Survey preliminary report.

Published in March this year, the most alarming findings indicate that more children are now excessively thin or “wasted” between being newborn and just under five years old, or 59 months, than they were in 2005.

Stunting – children who are short in height for their age – is the result of not receiving adequate nutrition over an extended period and is often exacerbated by recurring illnesses, including diarrhea.

According to the survey, 40 percent of Cambodian children under five are short for their age and about one-third of those are severely stunted. Fourteen percent of all Cambodian children are considered severely stunted.

Poor nutrition during childhood has long-term negative effects on people’s entire lives and cost nations in healthcare costs and productivity. Malnutrition is the single largest cause of child death in the world.

United Nations Resident Coordinator Douglas Broderick says nutrition is a key issue facing Cambodia.

“The typical diet of the poorest people in Cambodia consists predominantly of rice and is lacking in key micronutrients and sufficient dietary diversity.” said Broderick.

“In addition, an average of 70 percent of daily income is spent on food – 85 percent for the poorest households. As food prices rise globally, improved nutrition and food security in Cambodia is an area of need, as evidenced by continuing high rates of stunting.”

The prevalence of underweight children in Cambodia remains at 28 percent – unimproved since 2005 – and the Cambodia Millennium Development Goal is to reduce underweight children to 19 percent.

In a “healthy” population, only 2.5 percent of children are underweight. The prevalence in Cambodia is more than 11 times higher.

What constitutes stunted is arrived at by comparing the results of a Cambodia-wide survey with standard weight-for-height charts. If children are more than two “standard deviations” below the median weight-for-height, they are considered wasted or thin.

On the bright side, child mortality has decreased over the last five years and mothers choosing to give birth at health centres has increased. Supplementation of micronutrients to pregnant women and children has also improved.

The 2010 CDHS survey found 11 percent of all Cambodian children were wasted and 28 percent of all children, or three in 10, are underweight. The “underweight” distinction measures if a child’s weight is appropriate for his or her age.

The survey was carried out by the National Institute of Statistics and the Directorate General for Health and was funded by the United States Agency for International Development, the UN Population Fund, the UN Children’s Fund, the Japan International Cooperation Agency and the Health Sector Support Program, Second Phase.

An entity called ICF Macro provided technical assistance to the project through the MEASURE Demographic and Health Surveys Program.

The data was collected between July 23, 2010, and January 20, 2011.

A total 15,557 households in provinces all over Cambodia were interviewed, including 19,237 women and 8,665 men.

According to the report, Cambodia’s population is mainly rural, with four in five Cambodians living in the countryside and 21 percent living in cities and towns. The survey found that 49 percent of women and 41 percent of men have attended some primary school without having gone on to secondary school.  

Half of the men and one-third of the women surveyed have attended secondary or higher education, while 16 percent of the women surveyed and 8 percent of the men reported they had never attended school.

The stated main objective of CDHS 2010 was to collect up-to-date information on the Cambodian population’s demography, family planning, maternal mortality, infant and child mortality and health related information including childhood diseases, children’s immunisation, breastfeeding, delivery antenatal care and HIV/AIDS, as well as measuring the occurrence of anemia over Cambodia’s population.

The Cambodian government is addressing these problems with a number of programmes in cooperation with NGOs through the Ministry of Health’s National Subcommittee on Food Fortification, which can authorise the use of a special NSCFF logo on products which are tested and validated as fortified.

Food fortification as a “public-private partnership” is recognised worldwide as an effective solution for malnutrition across a population and has the advantages of using existing food distribution systems (see inside stories on LyLy Food Industry and Men Sarun Flour Factory’s Mee Yeung Instant Noodles), and fortification is considered to be sustainable because industries and the public can bear the costs and perhaps most importantly, it doesn’t require behaviour change in the population, because people can continue to eat what they normally eat – only fortified.