Introduction
Despite Cambodia’s remarkable economic growth and poverty reduction in the last two decades, the country still faces challenges related to malnourishment.
The problems of undernutrition are compounded by micronutrient deficiencies, overweight and obesity. Like many other low and middle income countries, Cambodia is in the process of transition in its population’s nutritional composition. The country is facing a twofold nutritional challenge, which is often referred to as the ‘double burden of malnutrition’. This is where undernutrition, described by wasting, stunting and micronutrient deficiencies, coexists with overnutrition and obesity, either in the life cycle of an individual and/or within a household, and across communities and regions (Nakphong and Beltran-Sanchez 2021; Popkin et al. 2020;
Uwira and Claasen 2020).
Poor maternal health, low birthweights, and undernutrition among children cause a high prevalence of child stunting and wasting in Cambodia (Wieringa et al. 2016, UNICEF 2021, DHS 2022). Hidden hunger in the form of micronutrient deficiencies, particularly iron, vitamin A, and iodine, is among the highest in Southeast Asia (UNICEF 2021). Coordination efforts and plans to address the prevalence of undernourishment in the country include several national policies and strategies such as the National Strategy for Food Security and Nutrition (2019-2023), National Policy on Infant and Young Child Feeding (revised 2018), and the Nutrition Technical Working Group of the Ministry of Health National Nutrition Programme.
The school feeding programme in Cambodia, which is run by the national government and the United Nations World Food Programme (WFP), has the potential to reduce the burden of diseases caused by micronutrient deficiencies. Providing fortified rice to schoolchildren can potentially be a cost-effective way of improving micronutrient deficiencies in young children. WFP and the Nutrition Improvement Department of the Ministry of Planning partnered with Virginia Tech University between 2022 and 2023 to evaluate the socioeconomic impact of providing fortified rice in Cambodian schools.
The analyses conducted by the researchers provide answers to three policy questions:
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Is providing fortified rice a cost-effective way of improving nutritional outcomes among schoolchildren?
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Does fortified rice in school meals reduce the burden of disease?
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What are the economic benefits and the return on investment of serving fortified rice in Cambodian schools?