High levels of childhood malnutrition present a staggering, yet avoidable, loss of human and economic potential for Lao PDR. Childhood stunting is associated with poor health, delayed child development, underperformance in school, and eventually reduced employment opportunities, and thus contributes to keeping communities in poverty. Nationally, stunting affects over one third of all children under the age of five. Current rates of maternal and child malnutrition represent a loss of human capital potential costing Lao PDR an estimated 2.4% of Gross Domestic Product annually. A child born in Lao PDR today is only 45% as productive as she would be if she enjoyed complete education and full health.
Given the strong association between childhood stunting, poverty, and economic growth, investing in the early years, especially reducing malnutrition, is a key priority. The World Bank has developed a multisectoral long-term strategy to support the Lao government to address malnutrition, aligned with the 8th National Socio-Economic Development Plan (2016-2020) and the National Nutrition Strategy to 2025.
International experience, based on evidence from other countries that have made progress reducing stunting, suggests that to address childhood stunting effectively, a series of coordinated policies and programs are needed to address the immediate, underlying, and basic causes of malnutrition, focusing on the critical first 1,000 days of life.
Several ongoing and upcoming World Bank operations will come together to support an innovative multi-sectoral and long-term nutrition convergence approach. Projects will target the same households in the same geographic areas and will initially be implemented in 12 districts in Xieng Khouang, Houaphan, Phongsaly, and Oudomxay provinces, which suffer from stunting levels above 40%.
Effective implementation of a multi-sectoral approach will require strong leadership, guidance, and ownership at central, provincial, and district levels, as well as continuous monitoring and evaluation of its effectiveness in Lao PDR. Several ministries, including Health, Agriculture and Forestry, Education and Sports, and Public Works and Transport will be responsible for implementation, with coordination support from the Ministry of Planning and Investment.
Existing portfolio and areas of intervention for improved nutrition (2018-2022)
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