Factors associated with child malnutrition in mountainous ethnic minority communities in Lao PDR

Glob Health Action. 2020 Jul;13(sup2):1785736. doi: 10.1080/16549716.2020.1785736.

Abstract

Background: Although in many low- and middle-income countries undernutrition is steadily decreasing, nutritional challenges persist in remote communities, such as those in mountainous areas of Lao PDR. Isolated, with limited access to food and to health care and other public services, local diets are low in both quantity and diversity. Data needed to guide policy and planning are lacking.

Objectives: The study aimed to identify the extent of malnutrition and associated factors among children aged 12-47 months in remote mountainous communities in Lao PDR.

Methods: A cross-sectional survey was conducted in Nong district, Savannakhet province, covering 173 households, involving heads of households, mothers and their children aged 12-47 months.

Results: The prevalence of undernutrition was very high among the 173 children studied: 72.8% were stunted, 50.3% underweight and 10.4% wasted. Key factors showing significant positive associations with nutritional status were assets (mobile phone or electric rice mill), collection of non-timber forest products, and household dietary diversity. Negative associations were found with experience of malaria and consuming high amounts of white roots and tubers. Immediate causes of malnutrition were prevalent; half the children had insufficient consumption of all micro- and macronutrients. Diseases were highly prevalent; 30% had recently experienced fever. The households in these villages were quite homogeneous. All scored high on causes of malnutrition; 90% of households experienced food insecurity, nearly all lived below the poverty line, and almost two-thirds of household heads and nearly all mothers had had no education.

Conclusion: This study identified multiple factors influencing child malnutrition, including low household food diversity, food insecurity, and poor feeding practices among ethnic minority people living in a difficult environment with limited resources. Child undernutrition in these poor communities is complex. Interventions are needed in different sectors, including agricultural production, knowledge on feeding and health services.

Keywords: LEARN: Sexual Reproductive Health, ANC and Nutrition; Malnutrition; dietary diversity; stunting; wasting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child Nutrition Disorders / epidemiology*
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethnicity / statistics & numerical data*
  • Female
  • Food Supply / statistics & numerical data*
  • Humans
  • Infant
  • Laos / epidemiology
  • Male
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Mothers / statistics & numerical data*
  • Nutritional Status*
  • Prevalence
  • Rural Population / statistics & numerical data*
  • Socioeconomic Factors
  • Young Adult

Grants and funding

This research was funded by NWO-WOTRO Science for Global Development from the Dutch Ministry of Foreign Affairs under the Nutrition Sensitive Agriculture project in Lao PDR and Vietnam and by the European Union LEARN Project, grant DCI-SANTE/2014/342-306.s.