1. NUTRITIONAL STATUS OF CHILDREN, DIVERSITY OF FOOD CONSUMPTION AND ETHNICITY IN LAOS NAFRI POLICY BRIEF, No 17/2014 POLICY THINK TANK 9/10/20151

2. Outline of Presentation Introduction Objective Methodology Main Findings Policy Recommendations Policy Implications 9/10/20152

3. Introduction Globally, nutritional status among children has increased in the last decade with better awareness. Nutritional status is linked to economic growth and development. Efforts to reduce poor nutritional status in a number of developing countries, including Lao PDR, have yielded limited results. – 44 per cent are stunted (too short for their age). – 6 per cent are wasted (too thin for their height) – 27 per cent are underweight (too light for their age) (Source: LSIS, 2011) 9/10/20153

4. Objectives This study examines the determinants of nutritional status of children less than five years in Lao PDR. Specifically, the study investigates: – Examine a causal link between consumption of diversified diet, household food availability/source and malnutrition; – Explore the underlying factors that drives the difference in prevalence of malnutrition across ethnic groups; – Investigate the effect of mothers’ education and malnutrition; and – Explore potential relationship between household’s agricultural land holdings on nutritional status of children. 9/10/20154

5. Measurement Key Variables Malnutrition measured using anthropometric indicates Height-for-age; Weight-for-height and Weight-for-age Food items used in the construction of an index for food diversity include: breast milk, infant formula, yoghurt, semi-solid food, juice/juice drink, porridge and vitamin or mineral supplements. Cultural practices were captured using the main ethnic groups in Lao PDR, namely, Lao-Tai, Khmu, Hmong and others. Mother’s education measured as highest formal level of education ascertained. 9/10/20155

6. Data and Analytical Procedure The 2011 LSIS data that has a nationally representative sample of 11,096 children was the main dataset used for this study – Data was collected from approximately 20,000 households Ordinary Least Squares (OLS) Regression as well as Instrumental Variable (IV) estimations were used to achieve the first three objectives of the study. Descriptive analysis was employed in exploring the possible link between household's agriculture land holds and malnutrition 9/10/20156

7. Main findings Children who consume five or more food items have lower malnutrition rates compared to those who consume either one or two food items. 9/10/20157

8. Main findings (Cont.) 9/10/20158

9. Main findings (Cont.) Food diversity in five out of the six estimations indicates a positive relationship with nutritional status. That is, consumption of diversified diet leads to an improvement in the weight-for-age and height-for-age of children less than five years. Using a single food item as a measure of food consumption shows either an inconsistent or counterintuitive relationship with nutritional status. The study finds that rearing of livestock is one of the channels that promote the consumption of a diversified basket of food. 9/10/20159

10. Main findings (Cont.) Hmong ethnic groups have better weight-for-height nutritional status compared to their Lao Tai counterparts, but in terms of height-for-age (Findings from Table 1), Hmong children are worse off than Lao Tai. – this study argues that the differences in resources and food consumption behavior across the ethnic groups is potentially accounting for the differences in prevalence of malnutrition 9/10/201510

11. Main findings (Cont.) Mother’s education, is statistically significant and positive in two of the six estimation cases. Partly supports the expectation that mother’s education contributes to better nutritional status of children. Worth noting is that estimating the effect of mother’s education only, on malnutrition of children, consistently, shows a significant sign. 9/10/201511

12. Main findings (Cont.) Nutritional status of children in households that possess large parcels of agriculture land is better than their counterparts in households with small land holdings. – Effect of land on malnutrition has to take into account other factors such as type of land, slope and quality (fertility) of land. – Also the analysis should be conditioned on other factors such as household income, food consumption characteristics and parental education. 9/10/201512

13. Policy recommendations Campaign for the consumption of diversified foods rather than a single or a couple of food items should be initiated. To ensure the consumption of diversified food items, rearing of livestock has to be promoted. The consumption of diversified food and rearing of farm animals should be accompanied with adequate education on the nutritional contents of different food items and requisite cooking practices. The malnutrition interventions should take into consideration differences across ethnic groups for specific nutritional outcomes. 9/10/201513

14. Policy implications Repackaging of Multi-sectoral FNS  Implementation of multi-sectoral FNS asserted from a scientific and country context view point  Momentum is ripe and therefore revising the multi- sectoral FNS to include consumption of diversified diet is feasible.  Implementing the multi-sectoral FNS considering the differences and potential causes of the prevalence of malnutrition across ethnic groups will scale-up the pace of reduction. 9/10/201514

15. THANK YOU 9/10/201515