A Cross‐Sectional Study in Rural Areas of Myanmar: The Impacts of Dietary Behaviors and Nutrition Intervention on 6‐ to 72‐Month‐Old Children
Authors: Zhao Ai , Gao Hongchong , Win Naing Naing , Zhang Yumei 
Published: November 2023

Background

Myanmar is the largest country in Southeast Asia geographically, with over 50 years of internal conflicts. Over half of the children suffer from malnutrition and face a higher risk of morbidity and mortality. However dietary behaviors in this area are seldom reported and its effects on child's health are still unknown.

Objectives

The objectives of this study were: 1) to explore the possible dietary behaviors that might be associated with malnutrition, and 2) to assess the health effects of the nutrition promotion program.

Methods

Nine villages in the mountainous peripheral areas of Kachin, Shan, and Kokang were selected using convenience sampling. A nutrition promotion program by Health Poverty Action (HPA) was conducted in these areas half a year ago, and nutrition packages (FERROVIT, MEGA, Thailand: containing ferrous fumarate, folic acid and vitamin B12) and relief food (rice) were assigned to the head of the village or village doctors, then assigned to the target families according to personal experience. For assessment, a cluster sampling method was used for household selection and 141 children aged 6 to 72 months old participated in this study and provided the blood samples. A food frequency questionnaire was used to obtain data on dietary behaviors. Illness and nutrition related symptoms in the past three months were obtained from local medical records and caregivers' recall. Hemoglobin concentration, blood trace elements and anthropometric indicators were measured. The study was conducted in compliance with the Declaration of Helsinki and approved by local government. Written consent was obtained from all the primary caregivers.

Results

Significant insufficient intake of food was found in the studied children. In total, 58.3% of children consumed eggs less than once a week and for meat 25.0% of children consumed it less than once a week. In weaned children, 72.4% consumed dairy products less than once a week. The intake frequencies of eggs, meat and dairy products were all positively associated with the height‐for‐age Z score and hemoglobin levels. Children with a higher frequency of egg intake were more likely to have a lower chance of diarrhea and fever. Children with a higher meat intake were more likely to have a lower rate of fever. There were no associations between food intake frequencies and blood trace elements' levels. For the nutrition promotion program, the coverage rate of the nutrition package and relief food in studied children was 37.5% and 4.7% respectively and more were assigned to children under 24 months old. The hemoglobin of children who received or did not receive nutrition package was 91.8±21.4 g/L and 104.1±16.2 g/L respectively. Meanwhile, a lower blood iron level and a higher occurrence of fever were found in children who received the nutrition package.

Conclusion

Children in the mountainous peripheral areas of Myanmar still face a threat of food shortage and this contributes to malnutrition. Assign nutrients package by villages head can general cover the target malnourished population. However, the health effects were limited, partly because of the limited intervention time and partly due to a lack of constant following up and assessment.

Support or Funding Information

Supported by Health Poverty Action Eastern Asia Programme Office