The number of children in the country who are stunted—leaving them physically smaller and mentally weaker than their properly nourished peers—dropped by 7 percent between 2010 and 2014, according to a nationwide survey released Tuesday.
Preliminary results of the Cambodian Demographic and Health Survey 2014, which included 15,825 households across the country, showed that 32.9 percent of children under 5 years old were stunted in 2014, down from 39.9 percent when the same survey was conducted in 2010.
Chreay Pom, director of the Rural Development Ministry’s department of rural health care, attributed the drop in stunting to a combination of improved nutrition and an increase in proper sanitation practices, such as hand-washing and the use of toilets.
“Stunting is caused by lack of food intake, but at the same time, poor sanitation plays an important role. Everywhere there is poor access to sanitation, there is a high proportion of stunting in children,” Mr. Pom said at an event at Phnom Penh’s InterContinental Hotel launching the survey.
“Poor sanitation causes diarrhea, pneumonia and other diseases, which affects the digestive system of a child and they cannot absorb the nutrients for their growth,” he said, adding that access to proper sanitation in rural areas has increased from 23 percent in 2008 to 38 percent in 2013.
“This means for example that people in rural areas are washing their hands and using latrines,” Mr. Pom said. Improvements in diets and agriculture practices have also played a key role, he added.
“Some programs have been designed to provide food supplements with micronutrients, adding for example iron to the fish sauce so it is more nutritious,” he said. “Agriculture also plays a role, because children need a greater variety of food to choose from. Before, there was a habit of the people to just eat rice.”
Despite the gains, malnutrition continues to be among the greatest threats to Cambodia’s children, Lao Sokharom, secretary-general of the Council for Agricultural and Rural Development (CARD), told some 200 government officials and health workers at Tuesday’s launch event.
Mr. Sokharom said that half of all deaths of children under 5 are caused by malnutrition. And for those malnourished children who make it to adulthood, the affliction “affects their mental and psychosocial development, and in turn, it affects the national economy.”
Ngy Chanphal, vice chairman of CARD, said that malnutrition was costing the country hundreds of millions of dollars per year, factoring in the number of children who never enter the workforce, the productivity of malnourished adults who do enter the workforce and the health care costs related to poor nourishment.
“If we do not improve nutrition, Cambodia’s economy will lose $400 million a year, equal to 1.5 to 2 percent of GDP,” he told the audience. “This is too big to lose, so if we do not do anything we will lose a lot of income.”
Despite the decrease in stunting across the country, the survey showed that the rate of stunting remains above 40 percent in four provinces: Kampong Chhnang, Kompong Speu, Preah Vihear and Stung Treng.
Frank Wiering, a senior researcher at the French research organization Institut de Rechere Pour le Developpement who worked on the survey, said that while stunting has steadily decreased, more severe malnutrition such as wasting—extreme weight loss—have not.
“If stunting goes down, chronic malnutrition goes down,” he said. “But acute malnutrition stays the same. A child with acute malnutrition can be tall but wasted, and wasting has not changed in the past four years, it is still 10 percent.”
One of the most startling findings in the survey, Mr. Wiering said, was the rate of wasting in Oddar Meanchey province.
“In Oddar Meanchey, there is 15 percent of acute malnutrition, which is a very high percentage, and 7 percent of the kids have severe acute malnutrition, which means that they need medical treatment immediately,” he said.
“That is really an emergency situation.”