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Undernutrition is particularly widespread among ethnic minority children in Vietnam, with stunting ratesamong the highest in the world, according to a new report launched today by the World Bank and Vietnam’s National Institute of Nutrition.

Vietnam: Ethnic Minority Children are Disproportionately Undernourished
“Persistent Malnutrition in Ethnic Minority Communities of Vietnam: Issues and Options or Policy and Interventions” finds that 1 in 3 children of ethnic minorities in Vietnam suffer from stunting,while 1 in 5 are underweight.To address this, the report calls for a tailored and innovative approach that takes into account the unique geographical and cultural challenges facing this group.
“Despite Vietnam’s impressive progress in reducingthe overall rate of undernutrition over the past two decades, ethnic minority children still lag behind, and the disparity is widening,” said Ousmane Dione, World Bank Country Director for Vietnam. “The next phase of efforts on undernutrition should be more targeted, concentrating on the provinces with the highest burdens, to create a breakthrough.”
Because the window of opportunity for adequate nutrition for optimal health and physical and cognitive development is short, spanning the first 1,000 days of life, any undernutrition occurring during this period can lead to extensive and largely irreversible damage to physical growth and brain development. The report stresses that interventions to improve nutritional outcomes must focus on this age group and women of child bearing age. 
The report notes that among ethnic minorities, only 39 percent of children aged 6-23 months received a nutritionally adequate diet.Meanwhile, just 32.7 percent of mothers aged 15-49 made prenatal care visits whereby they were provided with essential vitamins and minerals,and nutrition counseling. 
The report stresses that cultural norms play a significant role. Early marriage and adolescent pregnancy are still common among ethnic minority women, with 23.9 percent starting child-bearing between the age of 15 and 19. Equally important is the reluctanceofmany members of communities toparticipate in preventive and curative health services. 
Ultimately, child undernutrition is rooted in poverty. Ethnic minority groups in Vietnam, which made up 14 percent of the country’s population but accounted for 73 percent of the poor in 2016. 
The report proposeskey steps that Vietnam can take to improve nutritional outcomes for ethnic minority children:
Build a strong and more coordinated partnership for nutritionwithhigh-level government leadership and a well-functioning coordination among stakeholders.
Secure adequate financing for nutrition.Adequate funding should beallocated to programs with the greatest evidence of effectiveness. Provinceswith the highest burdens of malnutrition should have access to fast-track or direct funding schemes.
Implement at scale well-proven direct nutrition interventions. Identify and scale up the delivery of a comprehensive package of high-impact, household-level interventions during the first 1,000 days from pregnancy to infancy, coupled with culturally sensitive social behavioral change and communicationactivities. 
Address the underlying determinants of undernutrition through multisectoral approaches. Formally recognize tackling undernutrition as a priority in the National Target Program. Expand access to package of adolescent, maternal, and child health services. Increase the access of ethnic minorities populations to improved water, sanitation, and hygiene. Encourage and incentivize girl students to enroll in and complete upper secondary schools. Expand the cash transfer program to effectively target and reach the poorest ethnic minority families with pregnant women, infants, and young children during the critical 1,000-day window of opportunity.

DIEP NGUYEN