Reproductive and Child Health Alliance

Phnom Penh, Cambodia

Reproductive and Child Health Alliance

Phnom Penh, Cambodia
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Jack S.J.,World Health Organization | Jack S.J.,University of Otago | Ou K.,National Maternal and Child Health Center | Chea M.,National Maternal and Child Health Center | And 17 more authors.
Archives of Pediatrics and Adolescent Medicine | Year: 2012

Objective: To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants. Design: Cluster-randomized effectiveness study. Setting: Cambodian rural health district. Participants: Among 3112 infants aged 6 months, a random subsample (n=1350) was surveyed at baseline and 6-month intervals to age 24 months. Intervention: Daily micronutrient Sprinkles along-side IYCF education vs IYCF education alone for 6months from ages 6 to 11 months. Main Outcome Measures: Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry. Results: Anemia prevalence (hemoglobin level <11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P=.001), and the prevalence of moderate anemia (hemoglobin level <10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; P<.001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6- 29.1; P<.001) and 11.6% (95% CI, 2.6-17.9; P=.02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 μg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26- 5.42; P=.03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time. Conclusions: Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period. Trial Registration: anzctr.org.au Identifier: ACTRN12608000069358. ©2012 American Medical Association. All rights reserved.


Theary C.,Reproductive and Child Health Alliance
Food and nutrition bulletin | Year: 2013

The prevalence of micronutrient deficiencies in Cambodia is among the highest in Southeast Asia. Fortification of staple foods and condiments is considered to be one of the most cost-effective strategies for addressing micronutrient deficiencies at the population level. The Government of Cambodia has recognized the importance of food fortification as one strategy for improving the nutrition security of its population. This paper describes efforts under way in Cambodia for the fortification of fish sauce, soy sauce, and vegetable oil. Data were compiled from a stability test of Cambodian fish sauces fortified with sodium iron ethylenediaminetetraacetate (NaFeEDTA); analysis of fortified vegetable oils in the Cambodian market; a Knowledge, Attitudes, and Practices (KAP) study of fortified products; and food fortification program monitoring documents. At different levels of fortification of fish sauce with NaFeEDTA, sedimentation and precipitation were observed. This was taken into consideration in the government-issued standards for the fortification of fish sauce. All major brands of vegetable oil found in markets at the village and provincial levels are imported, and most are nonfortified. Fish sauce, soy sauce, and vegetable oil are widely consumed throughout Cambodia and are readily available in provincial and village markets. Together with an effective regulatory monitoring system, the government can guarantee that these commodities, whether locally produced or imported, are adequately fortified. A communications campaign would be worthwhile, once fortified commodities are available, as the KAP study found that Cambodians had a positive perception of fortified sauces.


Laillou A.,United Nations Children's Fund | Pfanner S.,Reproductive and Child Health Alliance | Chan T.,Reproductive and Child Health Alliance | Chea C.,National Sub Committee of Food Fortification | And 4 more authors.
Nutrients | Year: 2016

Fortification of fish and soy sauces is a cost-effective strategy to deliver and increase iron intake in the Cambodian diet, as both are widely consumed by the entire population. In order to qualify as fortified sauces recognized by international regulations, iron content must be between 230 and 460 mg/L, whilst nitrogen and salt should contain no less than 10 g/L and 200 g/L respectively. This survey aims to analyze the progress of the fortification program. Through a better understanding of its obstacles and successes, the paper will then consider approaches to strengthen the program. Two hundred and fifty two samples were collected from 186 plants and 66 markets in various provinces. They were then analyzed for iron, nitrogen and salt content. The study demonstrates that 74% of fortified fish and soy sauces comply with Cambodian regulations on iron content. 87% and 53.6% of the collected samples do not have adequate level of nitrogen and salt content, respectively. The paper will discuss additional efforts that need to be implemented to ensure the sustainability of the project, including the need to: (i) comply with International Codex; (ii) adopt mandatory legislation; and (iii) ensure enforcement. © 2016 by the authors; licensee MDPI, Basel, Switzerland.


PubMed | Reproductive and Child Health Alliance
Type: Journal Article | Journal: Food and nutrition bulletin | Year: 2013

The prevalence of micronutrient deficiencies in Cambodia is among the highest in Southeast Asia. Fortification of staple foods and condiments is considered to be one of the most cost-effective strategies for addressing micronutrient deficiencies at the population level. The Government of Cambodia has recognized the importance of food fortification as one strategy for improving the nutrition security of its population.This paper describes efforts under way in Cambodia for the fortification of fish sauce, soy sauce, and vegetable oil.Data were compiled from a stability test of Cambodian fish sauces fortified with sodium iron ethylenediaminetetraacetate (NaFeEDTA); analysis of fortified vegetable oils in the Cambodian market; a Knowledge, Attitudes, and Practices (KAP) study of fortified products; and food fortification program monitoring documents.At different levels of fortification of fish sauce with NaFeEDTA, sedimentation and precipitation were observed. This was taken into consideration in the government-issued standards for the fortification of fish sauce. All major brands of vegetable oil found in markets at the village and provincial levels are imported, and most are nonfortified.Fish sauce, soy sauce, and vegetable oil are widely consumed throughout Cambodia and are readily available in provincial and village markets. Together with an effective regulatory monitoring system, the government can guarantee that these commodities, whether locally produced or imported, are adequately fortified. A communications campaign would be worthwhile, once fortified commodities are available, as the KAP study found that Cambodians had a positive perception of fortified sauces.

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