Ernährungssituation in Nord-Laos [Elektronische Ressource] : Determinanten der Unterernährung und Veränderungen nach vier Jahren intensiver Interventionen / eingereicht von Silvia Kaufmann

Sujets

• Social work

Informations

• Publié par: justus-liebig-universitat_giessen
• Publié le: 01 janvier 2008
• Nombre de lectures: 24
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Justus-Liebig-Universität Giessen
Fachbereich Agrarwissenschaften,
Ökotrophologie und Umweltmanagement
Institut für Ernährungswissenschaft





Dissertation


Ernährungssituation in Nord-Laos –
Determinanten der Unterernährung und Veränderungen
nach vier Jahren intensiver Interventionen



Eingereicht von:

Dipl. oec. troph. Silvia Kaufmann

aus Alsfeld



Betreut von:

Prof. Dr. Claus Leitzmann

Giessen, Oktober 2008




iiJustus Liebig University Giessen
Faculty of Agricultural Science, Nutritional Science and
Environmental Management
Institute of Nutritional Sciences





Dissertation


The nutrition situation in Northern Laos –
determinants of malnutrition and changes after four years of
intensive interventions



Submitted by:

Dipl. oec. troph. Silvia Kaufmann

Alsfeld



Supervised by:

Prof. Dr. Claus Leitzmann

Giessen, October 2008




iiiTable of contents

List of tables .............................................................................................................vi

List of figures...........................................................................................................iix

List of abbreviations .................................................................................................x

1 Introduction.............................................................................................1
1.1 Subject and objectives of the study ..........................................................1
1.2 Conceptual framework of malnutrition ......................................................3
1.2.1 Introduction to the framework .................................................................. 3
1.2.2 The different levels of the framework – content and indicators................ 6
1.3 The global nutrition and food situation and trends..................................16
1.4 Food and nutrition security assistance within the German
Development Co-operation.....................................................................22
1.5 The situation in Lao People’s Democratic Republic................................23
1.6 The Lao-German Integrated Food Security Programme Nalae and
Sing district, Northern Laos ....................................................................29

2 Methodology .........................................................................................31
2.1 Sample size calculation and procedure of data collection ......................31
2.2 Methods of data collection......................................................................34
2.3 Anthropometric assessment ...................................................................39
2.4 Qualitative information and secondary data............................................43
2.5 Statistical analysis ..................................................................................44

3 Results...................................................................................................46
3.1 Outcome level46
3.1.1 Nutritional status of children and mothers.............................................. 46
3.1.2 Child mortality........................................................................................ 53
3.2 Direct causes..........................................................................................56
3.2.1 Family’s food intake............................................................................... 56
3.2.2 Infant and young child feeding............................................................... 62
3.2.3 Health status 71
3.3 Indirect causes .......................................................................................77
3.3.1 Access and use of health services ........................................................ 77
3.3.2 Water, sanitation and hygiene 86
3.3.3 Food security and livelihood .................................................................. 92
3.4 Basic causes ........................................................................................108
3.4.1 Education..............................................................................................108
3.4.2 Social status of women.........................................................................113
3.4.3 Accessibility of the location...................................................................118
3.4.4 Basic causes and nutritional status (multifactorial analysis) .................121

4 Discussion and conclusions .............................................................125
4.1 Outcome level.......................................................................................125
4.2 Direct causes132
4.2.1 Family’s food intake..............................................................................132
4.2.2 Infant and young child feeding practices ..............................................139
4.2.3 Health status.........................................................................................143
4.3 Indirect causes .....................................................................................146
iv4.3.1 Access and use of health services .......................................................146
4.3.2 Water, sanitation and hygiene ..............................................................148
4.3.3 Food security and livelihood .................................................................150
4.4 Basic causes ........................................................................................161
4.5 Determinants of malnutrition – multi-factorial analysis..........................167
4.6 Overall conclusions ..............................................................................171

Summary .............................................................................................................173

Zusammenfassung................................................................................................177

Literature181

Annex .............................................................................................................200



v
List of tables

Table 1: Global and regional trends in chronic malnutrition from 1980 to
2005 .....................................................................................................16
Table 2: Sample size calculation....................................................................... 32
Table 3: Number of households, mothers and children studied by district in
1997 and 2001 .....................................................................................32
Table 4: Demographic information by district in 1997 and 2001........................ 33
Table 5: Comparison of death and mortality rate, Nalae district 38
Table 6: Degree of malnutrition in children........................................................ 41
Table 7: Classification of severity of malnutrition within a population by
prevalence rates of children under 5 years.......................................... 41
Table 8: Degree of chronic energy deficiency in adults..................................... 42
Table 9: Chronic malnutrition by district in 1997 and 2001................................ 46
Table 10: Acute malnutrition by1997 and 2001 ................................... 49
Table 11: Underweight by district in ............................................ 50
Table 12: Prevalence of malnutrition by sex and district in 1997 and 2001......... 50
Table 13: Malnutrition of mothers by grade in 1997 and 2001 ............................ 51
Table 14: Malnutrition of mothers by age in 1997................................................ 52
Table 15: Mothers and children’s nutritional status in 1997................................. 52
Table 16: Prevalence of anaemia by district in 1997 and 2001 ........................... 53
1Table 17: Child death by age and district in 1997 .............................................. 53
Table 18: Infant and child death rate by district in 1997 and 200) ....................... 54
Table 19: Evolution of mortality rates in Nalae district from 1997 to 2001........... 54
Table 20: Number of meals, snacks and nutritional status in 1997 ..................... 57
Table 21: Number of food items and nutritional status by source in 1997 ........... 62
Table 22: Initiation of breastfeeding in 1997........................................................ 63
Table 23: Type of first feeding by district in 1997 ................................................ 63
Table 24: Time of first introduction of complementary food by district in 1997 .... 64
Table 25: Age of first introduction of plant and animal products by
district in 1997 ......................................................................................65
Table 26: Accessibility of location and introduction of complementary
food in 1997..........................................................................................65
Table 2