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Ambassador Mussomeli helps to distribute fortified food items at a community awareness raising event in Kampot province.
Improving the Health of Cambodians through Food Fortification
Kampot Province
September 21, 2007
Insufficient micronutrient intake is a contributing factor to high morbidity and mortality rates among Cambodia’s women and children. Vitamin A, iron, and iodine have been proven to profoundly improve child survival, women's health, educational achievement, adult productivity, and overall resistance to illness. The U.S Agency for International Development (USAID), in collaboration with the Ministry of Health, UN agencies and local NGOs such as the Reproductive and Child Health Alliance (RACHA), has developed a number of innovative projects that address these issues, primarily by fortifying commonly consumed foods with combinations of vitamins and minerals missing or limited in the local diet and through national distribution of Vitamin A and iron supplements.
In Kampot Province there are three such projects. The first is fortification of salt with iodine; the second focuses on iron-fortified fish sauce; and the third are comedy performances in local communities to raise awareness about micronutrients and disseminate health information. U.S. Ambassador Joseph A. Mussomeli and USAID/Cambodia Mission Director Erin Soto recently traveled to Kampot to view some of these programs first hand.
Iron-fortified Fish Sauce
Iron deficiency anemia among women and children in Cambodia remains a serious public health problem. According to the Cambodia Demographic and Health Survey 2005, 47% of reproductive age women (15-49) and 57% of pregnant women are anemic. Additionally, 62% of children ages 6-59 months are anemic, a status which has only improved by 1% since 2000. Consequently, one of the Ministry of Health’s key strategies focuses on iron supplements for women, distributed both in Health Centers as well as through outreach activities in the community. This strategy, however, has had only limited success due to inadequate knowledge on the importance of iron among vulnerable populations and an irregular supply of iron tablets.
To overcome these challenges, USAID and RACHA developed an innovative program to fortify fish sauce with iron in collaboration with the largest and most popular fish sauce producer in Kampot province, Ngov Heng. The iron-fortified fish sauce program began as a pilot project in order to reduce anemia among vulnerable populations in a more sustainable way. The sales of iron-fortified fish sauce have increased significantly since it was introduced in 2005: from 32,000 liters in the last six months of 2005 to 459,400 liters in calendar year 2006. Due to its overwhelming success in Kampot, plans are currently being developed for distribution of iron-fortified fish sauce in other provinces.
Community awareness on nutrition and Vitamin A capsule distribution
USAID's micronutrient supplementation and food fortification programs have been successful because of effective community awareness and behavior change activities. USAID supports RACHA's community mobilization and awareness raising activities to encourage increased participation in micronutrient distribution programs and to promote greater consumption of micronutrient-rich/fortified food.
In order to disseminate health messages, RACHA works through Village Health Support Groups for health education, such as through comedy performances, in order to attract community attention to key health education messages. RACHA provides the support groups with training, and the groups travel around Kampot Province delivering health messages to 110 communities throughout the year. Each performance focuses on several related health issues. The performance observed during this visit focused on breastfeeding and Vitamin A as we approach Vitamin A distribution month in November.
Research shows that Vitamin A can prevent blindness and reduce infant and child mortality by as much as 23% by strengthening the immune system against common childhood killers such as diarrhea and measles. Vitamin A supplementation is one of 10 recommended and proven child survival interventions. USAID works with the Ministry of Health’s National Nutrition Program to promote increased access to and intake of Vitamin A, in addition to increased public awareness.
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