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Cambodia - Building Public-private partnerships, Malnutrition
The high incidence of child malnutrition in Cambodia is a critical development challenge. Poor nutrition in the 1,000 days from conception to the second birthday causes long-term damage to physical an... d cognitive development. Functional losses in this period can never be fully recovered. In addition to impacts on child health and mortality, malnutrition has adverse health and economic consequences that persist throughout the individual’s lifetime and can be handed down to harm the next generation. Chronic poor health and malnutrition stunt the growth of 40% of Cambodian children. Demographic surveys show 28% of children under 5 years of age underweight in 2005—and no improvement 5 years later. Indeed, severe malnutrition increased, with the incidence of wasting among children rising from 8.4% to 10.9% (Figure 3.23.9). The incidence of anemia was at epidemic proportions, affecting 55% of children under 5 in 2010. The World Health Organization estimated in 2011 that Cambodia loses $146 million in GDP each year from the impacts of vitamin and mineral deficiencies alone. While the full economic impact of malnutrition in the country has yet to be assessed, international evidence cited by the United Nations Development Assistance Framework suggests that a 1% decrease in adult stature translates into a 1.4% decrease in productivity. Risk factors for child malnutrition include poverty (although child malnutrition also affects higher-income families in Cambodia), lack of toilets, unsafe water supply, inadequate breast feeding, and poor maternal nutrition. The 2010 demographic survey found that 57% of Cambodian households had no toilet and therefore defecated in the open, 26% of infants under 6 months were not exclusively breastfed, and 44% of women suffered some degree of anemia. The good news is that addressing child malnutrition early can avoid long-term damage to health. Further, the solutions are highly cost- effective. The 2012 Copenhagen Consensus, a meeting of economists to establish cost-effective priorities to improve global welfare, found that fighting malnourishment should be the top priority and that the benefits in terms of improved health, schooling, and productivity would be significant.Note: Children under 5 years of age. Source: Cambodia Demographic and Health Surveys., Asian Development Outlook 2013 -Child malnutrition can be countered by• targeting social transfers, fortifying foods, and improving local food production to overcome seasonal food shortages and ensure food supplies of sufficient quantity, quality, and variety; • promoting breastfeeding and appropriate complementary feeding practices for young children; • improving pregnant women’s dietary intake through nutrition education and communication;• providing to women and children improved basic health services and micronutrient supplementation; and• reducing nutrient loss through improved hygiene, sanitation, parasite control, and food processing and storage.The key is to develop mechanisms to scale up existing and future small-scale pilot initiatives that are designed to address these issues, thereby converting them into a government-led, integrated package of interventions for better food security, nutrition, sanitation, and hygiene. This requires a program with active community participation and a concerted strategy to change parental behavior that hinders child nutrition. Malnutrition issues could be addressed under the umbrella of social protection, for example through cash transfers, or through innovative public-private partnerships.
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