Friday, November 4, 2016

Nutrition Efforts to Build Brighter Futures for Mothers and Babies

By Noémi de Verneuil and Arnaud Laillou

Nanja and Niag answer the data collector’s questions
©UNICEF Cambodia/2016/Verneuil

Ratanakiri and Phnom Penh, Cambodia, November 2016 – It is early morning in Ka Lay 2 village and 28-year-old Nanja arrives at the meeting point with her husband Niag and their three-month-old boy Syna.

The baby, their third child, looks healthy and energetic and looks at everything around him. Nanja is here to do a follow-up on her health and that of her baby. The visit is part of the project called ‘Sokapheap Knhom’, which means “my health” in Khmer.

This project is an innovative joint development involving UNICEF, IRD (Institut de Recherche pour le Développement or French Research Institute for Development) and the Cambodian Government’s Department of Fisheries.

They are collectively involved in a study of more than 4,000 children and pregnant women in Kratie, Ratanakiri and Phnom Penh provinces which involves monitoring their health, nutrition and water/sanitation access. From this study, UNICEF with its local partners will adjust programmes to improve the survival rate and development of children.

Like other families in the village, Nanja and Niag decided to take part in the project three months ago. Niag said: “We don’t lose our time. I don’t know how to explain it. All I can say is that it is good for the health of my wife and my family.

“I was worried that my wife could be at risk when she would deliver. After we get into this project, I was less worried for my wife”.

Nanja was screened three months ago when she was still pregnant. Based on the measurements of her weight, height and mid-upper arm circumference (MUAC), she was found to be undernourished, with a MUAC of less than 23 centimetres.

As part of the project, she received a stock of food snack supplements to help her gain some weight.

Project researcher Aleth Som said: “Nanja was malnourished when we met her for the first step of our study in Ratanakiri.

“And we found that lots of pregnant women are malnourished in the targeted areas in the three provinces (over 20 per cent). The food snack supplement was adapted for pregnant women with certain needs, it is very rich in vital nutrients and has been developed specifically to fit with local eating habits.”

Made from fish, rice, beans and other micronutrients, the snacks are a complementary food for pregnant women like Nanja. She said: “It is delicious. The taste is sweet and not too fishy.”

A data collector holds a packed of the Num Trey (fish snack). One double pack contains 20 wafers
©UNICEF Cambodia/2016/Verneuil

Today, her baby is screened by the team to ensure that the episode of malnutrition accounted during pregnancy didn’t impact negatively on him.

He weighed 3kg at birth and is 5.3 kg now and his nutritional measurements are also normal for a baby of his age.

“When I see the baby growing-up, I feel very happy,’’ said his father Niag.

Thanks to the follow-up on her weight and MUAC size, the team is able to provide good advice to Nanja and encourage her to keep taking strong nutrients like the fish snack supplements which can provide sufficient energy to put on weight while she is breastfeeding her baby.

A data collector measures the mid-upper arm circumference of Nanja’s baby boy Syna ©UNICEF Cambodia/2016/Verneuil

For other women, maintaining good health and nutrition status during and after pregnancy is an even bigger challenge.

Romas Vy, from the Charay ethnic group, is 19 years-old and she gave birth one and a half months ago to an underweight baby that requires close monitoring.

Because of her nutrition status, the team leader also gave her the fish snacks during her pregnancy.

Unlike Nanja, Romas didn’t use this intake on a regular basis as recommended as she found it challenging.

“Being pregnant is difficult; I was working in the field to grow cassava and needed to clean and wash in the house, but I felt always tired and needed to rest a lot and couldn’t eat that much.”
She said: “The taste was not my favourite and therefore I don’t eat it always, even if it helps me to have more energy.

Researcher Ahlet Som, (left) and the village health worker (right) discuss health issues with Romas Vy (centre)
©UNICEF Cambodia/2016/Verneuil

 Even living in an urban area in Chey Chomnas, in Banlung district does not protect against malnutrition. Tavy, 24, is pregnant for the first time. She was also found to be undernourished and was given the fish snack supplements.

“I went to take part in the project because lots of people say it’s good, including the chief of my village. Every month I go to the health centre.

“They give me advice to eat more vegetables. But I went to see the project Sokapheap Knhom and they explained to me that I was malnourished, so they gave me the fish snack supplements.” 

Tavy is encouraged by her husband and mother-in-law to eat the snacks almost every day.

“I like the num trey and it makes me thirsty and so I drink more water. I think there are a lot of vitamins in it so I take it because it is good for my health.

“Before I didn’t have an appetite, but after taking it, I had more of an appetite.”

The birth of Tavy’s child is scheduled in two weeks. She is planning to take the food supplements for two weeks to have more energy before delivery and is also considering taking the snacks after giving birth.

Tavy (left) answers researcher Ahlet Som’s questions at her home in Banlung district. 
 ©UNICEF Cambodia/2016/Verneuil

Thanks to the support of several UNICEF national committees – including those of Australia, Canada, Hong Kong, and South Korea – the Sokapheap Knhom project has been able to engage over 5,000 households in the three provinces of Kratie, Ratanakiri and Phnom Penh.

This approach has enabled thousands of pregnant women gain access to quality health care, and nutrition and hygiene advice and services which is providing a better start in life for those yet to be born.

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