Abstract
Seventy-five percent of Vietnam’s ethnic minorities live in 45 of the country’s 63 provinces, which are in the country’s northern mountain and central highlands regions. Vietnam’s hills and forested highlands have influenced its demographics and the extent and persistence of its inequity in poverty, health, and nutrition. Because malnutrition in early life significantly affects the physical and mental development of children, addressing malnutrition is fundamental to the development of Vietnam’s human capital. Economic development of the nation depends on the strength, resilience, and intelligence of its workforce. Governments dedicate millions of dollars annually to health and education, recognizing that individual losses in productivity may run as high as 10 percent of lifetime earnings and that as much as 11 percent of GDP could be lost each year in Asia and Africa due to undernutrition. The ethnic minority groups living mainly in the northern midlands and in the mountainous and central highlands regions are consistently more undernourished than the Kinh majority. Despite decreases in stunting, the prevalence of stunting among ethnic minority children is still twice that in the Kinh ethnic group. There has been an overall decline in wasting of 1.7 percent between 2000 and 2011, although only the richest quintile showed a significant reduction (3.4 percent). These data, along with an overall decrease in the prevalence of wasting and stunting, indicate an increase in nutrition inequality between 2000 and 2011. Moreover, it is noteworthy that the ethnic minority groups constitute most of the undernourished populations in most of the 10 provinces with the highest rates of stunting among children under 5 years old. This analytical report describes the very high rates of malnutrition among ethnic minority populations in Vietnam. It assesses the determinants and causes, using a causal framework and systems analysis; reviews current commitments and policies directed at reducing disparities in malnutrition; examines implementation of nutrition-specific and nutrition-sensitive interventions, particularly those that require multisectoral coordination and collaboration; draws conclusions based on the analysis; and recommends how policies and programs can be strengthened to reduce inequities and fulfill the economic potential of all ethnic groups.
Highlights
Despite achieving remarkable national improvements in poverty and nutrition outcomes, Vietnam lacks the uniform gains that would solve its growing ethnic inequities, especially those related to nutrition
This is a problem that is persisting but worsening and acting as a marker of inequities in nutrition and health care that affect ethnic minority women and children. The longer it persists, the more questions it raises for the government about the full extent of its achievements in other areas and the more questions it raises among ethnic minority families about their place in society
Deficiencies in the nutrition and health of Vietnam’s ethnic minorities and their generally lower levels of education, lack of skills in the national language, and inability to migrate to jobs in urban centers have further hindered their ability to narrow the inequities, despite multiple government programs aimed at improving their health and nutrition and reducing their poverty
Summary
Boxes 1.1 Why tackling stunting is important for Vietnam 18 2.1 Why is tackling anemia so important for women and children in Vietnam? 28 2.2 Zinc and preterm births 30 5.1 Malnutrition and vaccinations 97 7.1 Peru’s success story in reducing chronic undernutrition (stunting) 123 7.2 Nutrition-specific interventions with evidence of effectiveness recommended in Lancet nutrition series 128. Boxes 1.1 Why tackling stunting is important for Vietnam 18 2.1 Why is tackling anemia so important for women and children in Vietnam? 28 2.2 Zinc and preterm births 30 5.1 Malnutrition and vaccinations 97 7.1 Peru’s success story in reducing chronic undernutrition (stunting) 123 7.2 Nutrition-specific interventions with evidence of effectiveness recommended in Lancet nutrition series 128.
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