ILSI SEA Region Seminar on Maternal, Infant and Young ...ilsisea- on maternal, infant and young child nutrition, july 24-25, 2017 holiday inn sukhumvit, bangkok, thailand, ... anemia among women 15-49

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  • 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

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

  • 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

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

    Macronutrient distribution in the Cambodian

    diet

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

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

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

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

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

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

    Micronutrients (Vitamins)

    Micronutri-ents

    Vitamins

    Non-pregnant, Non-lactating women

    Pregnant and Lactating women

    Adolescents (15-19 yo)

    Adults (19-49 yo)

    Adolescents (15-19 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

    Adolescents (15-19 yo)

    Adults (19-49 yo)

    Iron (mg) NA NA 14.13 mg

    Calcium NA NA NA

    Iodine NA NA NA

    Zinc NA NA NA

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

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

  • 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 %.

    Baseline Assessment of Diet and

    Nutrition in Cambodia 2012

    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

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

  • 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

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

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