Download pdf - ILSI SEA Region Seminar on Maternal, Infant and Young ...ilsisea-region.org/wp-content/uploads/sites/21/2017/08/Session-1... · seminar on maternal, infant and young child nutrition,

S E M I N A R O N M A T E R N A L , I N F A N T A N D Y O U N G C H I L D N U T R I T I O N ,

J U L Y 2 4 - 2 5 , 2 0 1 7

H O L I D A Y I N N S U K H U M V I T , B A N G K O K , T H A I L A N D ,

Maternal Dietary Intake and Nutritional Status in

Cambodia

CHEA Mary, MD, MHID, MSc

Trend in Maternal Mortality Ratio in Cambodia

437

472 461

206

170

140

0

50

100

150

200

250

300

350

400

450

500

CDHS 2000 CDHS 2005 CDHS 2008 CDHS 2010 CDHS 2014 MDG Target

2015

BMI Status Among Women age 15-49

Anemia among women 15-49

•Forty-nine percent of women had received iron/folate supplements in the six-

week period following the delivery.

•94 percent of PW reported that they had taken iron tablets and 76 percent

indicated that they took the supplements for 90 days or more as recommended.

ILSI SEA Region Seminar on Maternal, Infant and Young Child Nutrition, July 24, 2017, Bangkok, Thailand

Anemia and Iron Status in Mothers (15-49)

Source: CDHS 2014

Intestinal and Parasite Infection in women age 15-49

Source: CDHS 2014

72 percent of women age 15-49 took deworming medication

during their most recent pregnancy

Type of hemoglobin among mothers by residence

Source: CDHS 2014

% of Vitamin A, B12, B9, and D and Calcium Deficiency among Women age 15-49

Source: CDHS 2014


Urinary iodine excretion in mothers (15-49) and children

Source: CDHS 2014

69% of women living in households with iodized salt

Mean one-day household food intake and percent of total food intake: Cambodia,

2011

Baseline Assessment of Diet and

Nutrition in Cambodia 2012

Percent distribution of calories from carbohydrates, fats and protein



Macronutrient distribution in the Cambodian

diet




Mean intake and proportion of household & individual that met the RDA : Cambodia, 2011



Energy and nutrient intake & the proportion that met the RDA: Cambodia, 2011†



Micronutrients (Vitamins)

Micronutri-ents

Vitamins

Non-pregnant, Non-lactating women

Pregnant and Lactating women

Adolescents (15-19 yo)

Adults (19-49 yo)


Adults (19-49 yo)

Vitamin A NA NA NA NA

Folate NA NA NA NA

Vitamin D NA NA NA NA

Micronutrients (Minerals)

Micronutri-ents

Minerals

Non-pregnant, Non-lactating women

Pregnant women


Adults (19-49 yo)

Iron (mg) NA NA 14.13 mg

Calcium NA NA NA

Iodine NA NA NA

Zinc NA NA NA




Dietary Supplement

Micronutr-ients

Minerals

Non-pregnant, Non-lactating women (15-49yo)

Pregnant and Lactating women

(15-49yo)

Pregnant W Lactating W

IFA 90 tablets: -Received: 94% -Took: 76% (CDHS 2014)

42 tablets : 49% (CDHS 2014)

WIF 1 tablet/day (CDHS 2014)

Vitamin A NA NA NA NA

Folate NA NA NA NA

Vitamin D NA NA NA NA

Energy and nutrient intake by age group with pregnant women: Cambodia, 2011

Requirement for protein was met by 80 % of the pregnant women. Energy was met by

a little over one-fifth (23 %). A low proportion of the pregnant women met their RDA for

iron at about 16 %.



Nutrition interventions for women 15-49

� Strengthening and promoting the use of antenatal and

postnatal care package that includes nutrition counseling and

promotion & distribution of IFA and deworming

� Promotion of weight gain and dietary intake during pregnancy

and lactation

� Scaling up weekly iron/folic acid for women of reproductive

age and exploring possibility of using social marketing to

promote the supplement

� Nutrition Education

� Universal salt iodization/mandatory iodization of salt

� Food fortification- Fish & Soy Sauce Fortified with Iron

Summary of key issues in Cambodia

• Generally nutrition status and micronutrient deficiency of women aged 15-49 is improving; but wasting, overweight, anemia, VDD and Vitamin B 9 deficiency is still a public health concern.

• Limited resources and dietary data constitutes to the main

challenge for the successful implementation to reduce micronutrient deficiency and promote maternal and child health

• Food Fortification stays at lower rank

• Difficult to scale up national wide for some innovative supplementation programmes such as distribution of WIF


Lessons Learnt

• Community-based nutrition intervention strategies allow community participation and empowering.

• To strengthen integrated intervention for anaemia

prevention and control • More research is needed to collect data on dietary

and nutrient intake for assessing adequacy of nutrient intake and develop policy/guidelines and recommendations

• Enhance monitoring system
