RTCCD has been dedicated to combating child malnutrition since its establishment. Our nutritionist and primary healthcare specialist helped launch the project-based Poverty Alleviation and Nutrition Program (PANP) run by the Save the Children US since 1994. The organization then participated in the evaluation of PANP implemented by Save the Children US, Save the Children Japan and Plan International. RTCCD has also worked to identify the main problems in the diets and feeding practices of children less than two years of age and the social, economic, and cultural factors that influence these feeding practices. To accomplish this, a variety of tools for data collection were applied, including demographic surveys; 24-h dietary recall of child intake; market surveys; observations of mother-caregiver interactions during feeding; semi-structured interviews with mothers, caregivers, and local authorities; and food exercises by seasons. These techniques were applied in two assessments done in Phu Tho province (for 18 months) and in Quang Tri province (a cross-sectional study).
RTCCD recently published an article analyzing the factors that attribute to child malnutrition in Vietnam and how those factors have changed over time. The article was presented at the National Institute of Nutrition, where the findings and implications were discussed and accepted by nutrition specialists across the country. Based on the theoretical framework developed, the research was put into action via an intervention project developed in 2007. The project pilots a model that is aimed at influencing the behavioral practices of young couples and adolescents towards to achieve more hygienic food preparation and richer food intake. Other activities recently conducted by RTCCD to further combat child malnutrition in Vietnam include the following:
Opinion Leader Research on infant and young child feeding policies in Vietnam: 2010
RTCCD was contracted by the GMMB in Washington D.C. to conduct a policy-oriented study which aims to collate enough information to encourage the creation of policies and practices that will support families in implementing optimal infant and young child feeding practices. Interviews with policy makers and key health leaders will be conducted in early 2010. Download report summary in English.
A study on childhood poisoning: Risks and causes: 2006-2007
Acute poisoning is considered one of the most common injuries among children in Vietnam. The recent outbreaks of food poisoning among both children and adults concerned the general public and implied that Vietnam’s food security management is questionable. Responding to the most pressing needs of the public, RTCCD, in collaboration with UNICEF and the Vietnam Administration of Preventive Medicine, conducted a study in Thua Thien Hue and Dong Thap from October 2006 to January 2007. The aims of the study were to critically assess the routine information system for childhood poisoning, to describe the circumstances of childhood poisoning, to identify the causes and risk factors associated with childhood poisoning, and to provide recommendations for childhood poisoning prevention.
The findings indicated that the reported data from the routine information system only reflected 48% of childhood poisoning burden in the community. The reasons were that the routine information system only reported the in-patient cases at the hospitals and did not cover the outpatients or the poisoned children who were treated either at home or by private doctors. Children aged less than 2 years of age were primariliy exposed to unintentional poisoning at home; children aged 2-5 years were reported to have been unintentionally poisoned from sources in a wider environment such as at home, at their neighbours’, or at kindergartens; and school children suffered unintentional or intentional poisoning from sources either at home, at school, in the community, in the forest, in the park, or in an area away from home. Food poisoning was the major cause of childhood poisoning, followed by chemical poisoning, drug poisoning, and venomous bites. To prevent childhood poisoning, the study recommended that the monitoring and controlling system on childhood poisoning should be upgraded and strengthened. The improvement of public awareness is needed and the childhood poisoning has to be put onto the agenda of the national program. Download report summary in English and Vietnamese.
The study findings and recommendations have been raised for discussion in the section of Paediatrics in the Mekong Health Congress in Vientiane, Lao PDR 24th-29th January 2010.
An assessment of the situation and the causes of anaemia in pregnant women and children 6-30 months old in Dakrong and Huong Hoa districts, Quang Tri province: 2003
This study was conducted in all communes of the Dakrong and Huong Hoa districts of Quang Tri province in 2004. It aimed to identify behavioural factors attributing to anaemia in pregnant women belonging to the ethnic minority Van Kieu. It surveyed 400 women in a cross-sectional study using 24 hour-recall of pregnant women, a food intake frequency questionnaire, blood tests, anthropometric measurements and market surveys.
The study found that the prevalence of anaemia was 50%, and the prevalence of severe anaemia was 3.5%. The mean haemoglobin in pregnant women was 107.6 g/L after adjustment for smoking and gestational age. The main factors associated with a high prevalence of anaemia included being in the third trimester of pregnancy, having given birth four or more times, and having reported health problems during the last 12 months , and clinical reasons for the high prevalence of anaemia were low MUAC and low iron intake. The factors associated with severe anaemia were being in the third trimester of pregnancy and height <145 cm. The women’s daily dietary intakes were low in iron and dominated by rice (97%), and very low in energy and other micronutrients. Hookworm infection was very high (69%). The prevalence of anaemia in children was 44.3%. Children who were suffering from malnutrition, lived in poor families, and whose mother’s were less educated were at higher risk of being anaemic. Similarly to pregnant women, poor iron intake and micronutrient were the main reasons for anaemia in children.
In short, the high prevalence of anaemia in these pregnant women and children living in a disadvantaged ethnic minority community in Quang Tri can be attributed to low dietary intakes of energy and micronutrients, combined with a high prevalence of hookworm infection and poor socio-economic conditions. Download report summary in Vietnamese.
Improving breast feeding and complementary feeding practices using a positive deviance approach in Vietnam: 1999-2001
Positive deviance (PD) refers to a phenomenon that exists in many resource-poor communes, that is, the findings that a few individuals and families employ uncommon, beneficial practices that allow them and their children to have better health as compared to their similarly impoverished neighbours. These PD behaviours are likely to be affordable, acceptable, and sustainable by the wider community because their peers are already practicing them. With financial support from the USAID LINKAGES project, RTCCD, Save the Children Federation (SC/US) and Emory University conducted a rigorous evaluation of a large-scale implementation of the PD approach to better understand “why and how PD works”. This was a prospective, longitudinal, randomized evaluation of one phase of SC/US’s Community Empowerment and Nutrition Program (CENP) in northern Vietnam. The evaluation lasted from 1999 to 2001. Based on findings of the evaluation, a revision of the CENP model was suggested and henceforth applied. A journal with 12 articles was published in the Food and Nutrition Bulletin, volume 23, number 4, December 2002. Nowadays in Vietnam CENP has been changed, providing similar impacts but using fewer financial resources and less time in comparison to its original model.
Poverty Alleviation and Nutrition Program: 2000
In the late 1990s, most health programs directed by Plan International were focused on reducing the malnutrition rate in Vietnam. With a strong background in nutrition and health systems research, RTCCD conducted the final project evaluation in Quang Tri province where PLAN International implemented a 2-year project aimed at decreasing malnutrition using a positive deviance approach. The evaluation was conducted from June to September 2000.
Integrated Child Nutrition Project in Thanh Hoa: Baseline Survey and Final Project Evaluation: 1998
In 1998, Save the Children Japan in collaboration with the Vinh Loc district People’s Committee implemented an integrated child nutrition project in five communes. RTCCD conducted both the baseline survey and final project evaluation of the project.