The Lao People’s Democratic Republic (PDR) has one of the highest rates of stunting in children under 5 years in Southeast Asia; nationally, the prevalence is 44 percent and as high as 60 percent in some rural districts ^(1,2).

People experiencing malnutrition face complex and diverse needs, including but not limited to access to diverse foods and adequate health care, it is an issue requiring a multi-sector response and partnerships across Water, Agriculture, Sanitation and Hygiene (WASH), business, government and others. It involves the activities of a wide range of groups and government bodies working together to achieve results.

Burnet is leading the health component in landmark multisector response in Southern Laos, funded by the European Union. This Action will be implemented over 48 months by a consortium of partners including World Vision (lead), Agronomes et Vétérinaires Sans Frontières (AVSF), Green Community Development Association (GCDA) and the Burnet Institute (BI). This is an integrated, multi-sectoral project in line with the Government of Lao PDR’s (GoL) convergence approach, the National Nutrition Strategy and Plan of Action (NNSAP) (2016-2020), and the European Union’s (EUs) Joint Indicative Programming Document for Lao PDR (2016-2020).

The overall objective of the action is to create supportive conditions for enhanced household nutrition.

This will be achieved through the following specific objectives:

• Improved access to and availability of sufficient and/or diverse foods year round;
• Improved dietary and care practices among Women of Reproductive Age (WRA) (15-45 years ) and CU5 (Burnet Inputs all fall within Outcome 2)
• Reduced incidence of selected Water, Sanitation and Hygiene (WASH) related diseases/illnesses linked to undernutrition;
• Improved gender equitable relations at the HH level, particularly in decision-making and distribution of workload; and 5) Strengthened multi-sector coordination and support for nutrition.

Implementation will target 12 districts across Savannakhet: Saravane: and Attapeu.

Burnet will deliver the health component, and activities include:

1. Conduct qualitative research into harmful food restrictions, taboos and other traditional practices contributing to poor nutrition outcomes.
2. Medical Supply Management: Train health facilities to improve procurement, monitoring, storage & management systems for contraceptives, dietary & therapeutic supplements, Micro-Nutrient Powder (MNP), deworming & other medications linked to the treatment of selected illnesses/diseases liked to malnutrition.
3. Integrated management of childhood illnesses (IMCI): Train health actors in the prevention & treatment of selected illnesses/diseases linked to nutrition including diarrhoea, malaria, dengue fever and Acute Respiratory Infections (ARI).
4. Severe Acute Malnutrition and Moderate Acute Malnutrition (SAM/MAM): Train health actors in the identification, referral, treatment and/or community-based management of Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM).
5. Sexual and reproductive health (SRH): Train health actors on sexual and reproductive health.

Burnet’s qualitative research will inform other inputs, including adapting WV’s Community Change for Social Action approach and curriculum for the purposes of culturally appropriate alternatives to harmful food restrictions, taboos and other traditional practices through facilitated interpersonal dialogue. This will be used in the implementation of “Nutrition Groups” formed by the project, to contribute to the outcome that Mothers & Caregivers have the knowledge and skills to care for their families and adapt culturally appropriate alternatives to harmful food practices, restrictions, food & other traditional practices.

Activities will be delivered to target audiences as modules which include:

• Refresher training: deliver refresher training to health actors on key components related to modules.
  
• Counselling skills development: integrate revision of key aspects of each content area with practical exercises that illustrate how to engage with parents, how to come turn learning into locally relevant conversations
  
• Creating demand: promote linkage of the community actors with the health staff so that all have a common understanding of basic facts and of a way of creating demand for appropriate healthcare within communities (not relevant for medical supply management module)
  

^{1 Ministry of Health and Lao Statistics Bureau. Lao PDR, Social Indicator Survey 2011-12. Vientiane 2012.
2 Government of Lao PDR. Report on Implementation of the Brussels Programme of Action for the Least Developed Countries (2001-2010). 2010}

Timeline

September 2017 to September 2021