Press release: The Government, EU and UNICEF launch the National Information Platforms for Nutrition in Laos

Vientiane, 5 October 2018 – The Vice Minister of Planning and Investment, H.E Dr. Kikeo Chanthaboury, launched today the National Information Platforms for Nutrition (NIPN) which aims at strengthening information systems for nutrition to prevent malnutrition and its consequences. This is an international initiative of the European Union with support from the United Kingdom Department for International development (DFID) and the Bill and Melinda Gates Foundation to be implemented in the Lao PDR by UNICEF. 

This nutrition information system will generate quality data, perform analyses, track progress and use the information for policy development, contributing to expanding and scaling up effective programmes, and allocating more public funding for nutrition activities. Thanks to this information platform children will benefit from better results.  

“The establishment and use of the NIPN initiative will help the Lao PDR to strengthen national capacity to manage and analyse information and data from all sectors which have an influence on nutrition, to track progress, and to disseminate and use information to better inform the policies and strategic decisions that prevent undernutrition and its consequences,” H.E Dr. Chanthaboury said at the launch event.

The overall goal of NIPN is to contribute to the global reduction of stunting (chronic undernutrition) in alignment with the World Health Assembly 2025 targets. Particularly, this initiative will strengthen capacities in the Lao PDR to monitor progress towards under nutrition reduction, contributing to implement more cost-effective and evidence-based policies.

According to the Lao Social Indicator Survey (LSIS-II, 2017), stunting has decreased from 44 per cent in LSIS-I to 33 per cent. Despite this positive downward trend, significant disparities remain across the 18 provinces. Between 2015 (Lao Child Anthropometric Assessment Survey) and 2017, a slight but not significant decrease has occurred in the prevalence of children under 5 years of age who suffer from wasting or acute malnutrition (low weight for height) from 9.6 per cent to 9.0 per cent.

“Strengthening the multi-sectoral approach to combat all forms of malnutrition is also dependent on the availability of nutrition information and related systems. It is an essential step to establish a national information platform that has the capabilities to generate information for policy dialogue and debate and that will contribute significantly to how nutrition programmes can be improved to meet changing conditions and the future context,” stated H.E Mr. Leo Faber, Ambassador of the European Union to the Lao PDR.  

Comprehensive data generated from the NIPN will be the basis for the National Nutrition Committee’s Annual Progress Report on the implementation of the National Nutrition Strategy to 2025 and Plan of Action to 2020 (NNSPA) and monitoring and reporting of the 8th National Socio-economic Development Plan, Sustainable Development Goals and Scaling Up Nutrition movement, monitoring. This will also provide significant information for monitoring and reporting of SDGs.

“The information collected through NIPN will feed into the annual National Nutrition Forums, Round Table Meetings and review meetings. With this system in place, we will be able to maximize the analysis and interpretation of existing information and data on nutrition to understand better the factors that influence it,” explained Octavian Bivol, UNICEF Representative, Lao PDR.

This NIPN initiative will be an integral part of the Government nutrition programme, which is supported and implemented jointly by EU Delegation and UNICEF in the context of their Partnership for Improved Nutrition in the Lao PDR in support of the National Nutrition Strategy to 2025 and Plan of Action 2016-2020. The NIPN project will be implemented by the Ministry of Planning and Investment and the National Economic Research Institute (NIER) with support from related line ministries and partners over a 4-year period from 2018 – 2021.

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About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children in Lao PDR, visit http://www.unicef.org/laos

Follow us on Facebook, Twitter, YouTube and at www.unicef.org         

About the European Union

The European Union and our member states is the biggest provider of Official Development Assistance as well as humanitarian aid in the world. We work on reducing poverty; ensuring sustainable development; promoting democracy, peace and security in the world. 

For more information about us, visit http://europa.eu/

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For more information, please contact:

Maria Fernandez, UNICEF Lao PDR, (+856) 2055519681, mfernandez@unicef.org

Tabongphet Phouthavong, UNCEF Lao PDR, (+856) 2096888890, tphouthavong@unicef.org

Thongvone SOSAMPHAN, Press and Information Officer, EU Delegation in Laos, (+856) 20 52826193, Thongvone.SOSAMPHAN@eeas.europa.eu

Giving children the right start in life

By Mike Saycon

Loulli has just woken up from her nap, eager to play with her older sister and cousins. At eight months, she is full of energy and easily responds to her playmates’ clowning around with a giggle, and tries to stand on her feet. But just three months ago, her story was very different.

At five months, Loulli was getting recurrent fevers, and her mother Khamvilay started to worry she weighed less than the other children in the neighbourhood. After bouts of fever and lack of appetite, Loulli was diagnosed with Moderate Acute Malnutrition (MAM) at the Xepone District Hospital.

“She was really healthy and growing taller,” – or so she thought – “but had little appetite whether for breastmilk or for other food,” Khamvilay says; adding she had little to worry about since she was breastfeeding her. She simply attributed Loulli’s low weight to her poor appetite.

After the MAM diagnosis, Khamvilay doubled her effort to breastfeed her daughter, and introduced into her diet rice porridge mixed with mashed vegetables, and SuperKid [a mix of vitamins and minerals added to food to prevent micronutrient deficiencies], provided by UNICEF to local health centres.

Along with advice on feeding Loulli, doctors and nurses at Xephone Hospital monitored Khamvilay’s health to be sure she was also healthy – especially because while pregnant she had repeated fevers and allergy attacks. She initially suspected her daughter’s condition was caused by her inability to produce enough milk or the little girl’s poor appetite, but Maternal and Child Health staff assured her this was not entirely the problem, and could be addressed with proper complementary feeding.

Now that Loulli is well on the way to recovery, she has gained 1.3 kilograms in just three months, growing from 5.8 kg to 7.3 kg now. “Still slow compared with other children,” says Somsanouk, MCH nurse who attended to Loulli at the clinic, “but I am confident she is on a steady recovery – especially with the way she responds to stimuli around her environment, and her level of energy.”

If left untreated, Loulli could have suffered in the long run – including irreversible effects on brain development, weak health and immunity making her susceptible to infections and diseases, poor performance in school, and less productivity as an adult. Even worse, close to half of the deaths among children aged below five globally are linked to malnutrition. Summing these up, economists across the world estimate malnutrition’s economic impact to any society as a 3 per cent loss in annual GDP. In Laos, the cost of undernutrition in terms of loss in economic productivity is $197 million annually – or around 2.4 per cent of its national GDP.

Khamvilay now vows to continue breastfeeding Loulli, although she says she may have to stop when her daughter reaches 18 months, still below the recommended two-year threshold, because she will have to return to her job as a secondary school teacher. Somsanouk reminds her to continue breastfeeding, especially if Loulli still has the appetite for it, to ensure her optimal health and growth.

For working mothers like Khamvilay, there are ways to go around this: she can either take advantage of the Government policy of an hour-break to return home and feed Loulli, or she can express milk in advance and keep this in the freezer or cold storage facility at home – or even in her office.

* * *

For mothers like Aht, however, who toil in the farms every day in a remote village, this is a challenge. A mother of a three-year-old and seven-month twin boys, she has to juggle working in the field all day, caring for her boys, and breastfeeding her twins.

But because she does not have any form of maternity leave, most of the time she has to leave her boys at home with her mother-in-law, feeding the young twins with rice porridge, tenderised meat, and vegetables while she works. Only when she’s home can she breastfeed them.

“One of the twins is frequently sick, and I don’t understand what medicine the health workers give. So I just try to breastfeed them as much as I can,” she says. The boy has slowly recovered, but she still worries he’s a little smaller than his twin brother.

Although she goes to the village health centre for post-natal care, family planning advice and regular tests, the distance and amount of time she spends on the journey is time lost from work. Going is also not a decision she solely makes: as practised in her ethnic community, her husband and mother-in-law hold influence on her choice to go or whether she has the need to.

As a result, there is wide disparity in access to maternal and child health care. Only half of the women in poor villages are able to visit health centres and seek care and services for their and their children’s health, including immunisation, advice on better infant feeding, natal care or contraceptives, when those who live in urban centres and have a higher level of education do.

Prevailing social norms also hinder poor mothers from seeking safe childbirth. Fueang, head of the Lao Women’s Union in Naluang Noy village for nearly 30 years now, says “many still give birth at home or don’t seek care at clinics because they live far away, are too poor to travel or have no means of transport, or simply choose to remain working in the fields.”

While she has seen progress in the number of women in ethnic groups giving birth in health centres and seeking advice on nutrition – “they feel the centres are clean and have trained staff,” she says – common beliefs still prevail. One of this is supplementing breastmilk too soon because they feel they are not producing enough milk or their lactation is delayed. “They panic when their babies cry so they feed them with rice, cereals, or infant formula. They stick to this notion because they were taught or fed by their own mothers this way,” she laments.

Fueang raises this issue at local council meetings, reminding mothers to breastfeed their newborns, seek maternal and child care regularly, and be conscious of what they feed them. With an increasing number of health centres in villages, she has become an active advocate in changing many long-held notions, especially among ethnic groups.

So apart from the calls to Government to invest more in the facilities and health centres especially in remote areas, and increase the number of health workers – equally important is keeping mothers informed of the services that are available to them, and changing the attitudes that prevent them from providing proper nutrition to their newborns.

Aht is lucky as she is one of only 25 per cent of rural women to give birth in a health facility assisted by a health worker and to get the services to somehow monitor her and her twins’ health. But there is a long way to go to close this divide. After all, optimal health and development is not only every child’s fundamental right, it is the moral responsibility of everyone in the community, including the local government, health workers, and families. 

Photo stories: better health, better life

By Mike Saycon

Xaiathon works all day – at home and in the field – and still finds time to breast feed her youngest son and play with her sons. Living an hour from her rice field, and even farther from the town centre, means a challenge to juggle her role at home and in following through her and her children’s health checks. Still, the boys are healthy, she says – and she and her husband are trying to have a baby girl.

Vilayphone and her husband Sonephet regularly take their five-month old son Konkham to the village health centre in Dongsavanh for his dose of vaccines and monitoring his weight. They want to keep him healthy and strong.

Lii, who was already married at age 15, comes to the health clinic in Dongsavanh Village to see her nurse, Keolammone, who makes sure she is healthy and ready to give birth in four months’ time. Lii works in the farm with her husband, but she has decided to stop working for now, to make sure she and her baby will remain healthy.

At only age 24, Chansamone works at the Phonxai Village health centre with the few other, servicing women and children from 10 villages and 21 sub-villages. She also does the works of being both a nurse and a midwife. The logo on her uniform says ‘Safe Mother, Safe Baby’.

Patients arrive at the district hospital in Xepon, Savannakhet, for their health checks, on their farm tractor – which is the only common mode of transport in rural areas. For many families who do not own any or cannot afford to hire one, they simply forgo their health checks, including immunisation doses for their children, and instead work at their farms. © UNICEF Laos/2018/Mike Saycon 

The ripple-effect of child educated

Mike Saycon

Kamla’s older sister, who takes care of their younger brother while their parents work at the farm, walks him to school. Many of the children’s parents are farmers, and on non-school days they help out along with their friends and neighbours. 

Kamla and his classmates return to their CBSR centre – from their 20-minute outdoor learning activities between their lessons. As many of their friends are from nearby houses, they have many children to play with during their games; especially those younger children who are not yet in the CBSR, or the older ones who are on their summer break from primary school.

  

Between their learning activities, children play various games as a group or with the other village children outside their classroom. Many of the outdoor games that they play as a class are designed to reinforce the lessons they had just learned, thus allowing for a more holistic learning experience.

Kham, village facilitator in Cho Tai village in Ta Oi, Saravan Province, believes in the importance of school readiness for children that he brings along his son Dao to join the classes as well. “I am always very happy when the children in my class are all in attendance, and it motivates me even more to make their lessons as fun and as interesting for them – so they want to keep on learning,” he says.

 

Kamla and his friends at the CBSR centre, on the more serious parts of their lessons – writing the alphabet and comparing notes. The CBSR is one of the interventions that UNICEF supports to increase the readiness of children to enter and stay on in primary school; in order for them to be competent and sufficiently skilled to finish through all levels of the formal education system and be employed later.

                                        

 

Literacy and numeracy modules in CBSRs are integrated with musical and games elements to keep the young pupils interested, giving the classrooms a fun vibe. The big groups of 30+ children can be challenging to manage for one or two village facilitators; hence by giving the children some form of entertainment while learning their lessons along with it, they are able to reinforce their lessons well.

Learning activities at the CBSR centre are designed to be as interactive as possible, to enhance the ability of the young learners in responding to stimuli such as colours, images and numbers; and allow them to engage actively with both their facilitators and peers. Pictured here is Kone who motivates his pupils to volunteer for a show-and-tell session with their peers.