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OPINION

Better nutrition, better future

Annette Dixon, Mark Gooding, Penny Richards

Phnom Penh Post

August 24, 2012

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Cambodia’s GDP growth averaged 8.2 % between 2000-2010, becoming the 15th fastest growing economy of the world, according to the World Bank. The country’s economic performance remains strong – 6.9% in 2011 – driven by robust expansion of exports, private investment and consumption. 

This is a remarkable achievement for the Cambodian people, who have worked hard to overcome conflict and fragility. During the same period, maternal mortality has dropped by over half and child mortality by almost two thirds, already exceeding Millennium Development Goal (MDG) targets.

Despite these impressive accomplishments, malnutrition remains a serious problem. Nearly 40% of Cambodian children under the age of five are short for their age, according to the 2010 Cambodia Demographic and Health Survey – one of the highest rates in the region.  Twenty-eight percent of children in the same age group are underweight, 10.9% of which are dangerously thin and 55% anemic.

Why should we be concerned? Malnutrition has irreversible effects on health and human development. The first 1000 days, starting with pregnancy up to a child’s second birthday, are considered a critical “window of opportunity” when poor nutrition can result in stunted growth, diminished immune response, impaired intellectual ability, poor school performance and lower economic productivity. Early life malnutrition is also associated with increased risk of diabetes, cardiovascular disease, and other non communicable diseases later in life.

This means that the economic costs of malnutrition are substantial and need to be addressed to sustain Cambodia’s future economic growth. It is estimated that individual productivity losses are approximately 10% of lifetime earnings. Vitamin and mineral deficiencies alone cost Cambodia over US$140 million each year.

The Royal Government of Cambodia (RGC) recognises the challenge. In May of this year, the government convened a National Seminar on Food Security and Nutrition to strengthen the national response and has taken significant steps toward improving nutrition.  However, tackling nutrition requires a multi-sectoral approach,  including improved maternal and child care practices, and more equitable access to clean water, sanitation, and health services. This is a challenge for many governments.

This is why it is important for civil society, donors and other partners to work with Cambodia, engaging the principles of development effectiveness.  The World Bank and bilateral partners such as Australia and the United Kingdom’s Department for International Development (DfID) can contribute by mobilizing global knowledge and resources to ensure that the full spectrum of development work ranging from health, water and sanitation to gender will have a positive impact on nutrition.

Open Quotes

This means that the economic costs of malnutrition are substantial and need to be addressed to sustain Cambodia’s future economic growth. It is estimated that individual productivity losses are approximately 10% of lifetime earnings. Vitamin and mineral deficiencies alone cost Cambodia over US$140 million each year. Close Quotes

From experience, we know that well designed cash transfer programmes can encourage poor pregnant women and children to use health services, including nutrition programmes. Specific community driven development programs have also helped reduced stunting. In agriculture, priority can be given to policies that provide diverse diets for women and children.  

In Cambodia, Australia (AusAID), DfID, UNICEF, and the World Bank provide pooled financing for the Royal Government’s Second Health Sector Support Programme, which includes support for vitamin A distribution and communication campaigns to promote improved child feeding practices. 

But more can be done.

Nutrition is considered one of the most cost effective investments in development, with very high returns in the form of better school outcomes, higher work productivity, and improved health. It is also the critical multiplier goal, offering a strong opportunity for preventive action;  improved nutrition will contribute to every other goal, with positive implications for child mortality, maternal health, cognition, and poverty.  

On the closing day of the Olympics, UK Prime Minister David Cameron and Brazilian Vice-President Michel Temer hosted a summit to urge the world to take decisive action to address the problem of maternal and child malnutrition and transform lives. They said:  “It is only by acting together in genuine partnership that we can identify and implement collective responses and produce concrete results to tackle malnutrition.”

It is time for action. The international community, working in partnership with government and civil society, can rise to the challenge facing the children of Cambodia. The UK has made a global commitment to reach 20 million children under five and pregnant women with nutrition programs by 2015, and the UK’s ongoing support to Cambodia’s health sector programme will contribute to that.  Australia, already a major contributor to the health sector, has committed to further increase its support for maternal and child health in Cambodia.  The World Bank, a development institution representing 188 member countries whose mission is to eradicate poverty, stands ready to work with development partners to fulfill a collective responsibility to help Cambodians end malnutrition.