Health Staff Help Families Make Big Changes

“I’m not going to do hard work and I’m going to eat more!” Just 10 weeks after her first nutrition counseling training, Nurse Minda was already seeing the positive results of her new skills.

Health care workers in Laos, like Minda, have been emphasizing the importance of breastfeeding, diverse diets, rest and good hygiene for pregnant women for many years but poor nutrition-sensitive behaviors remain widespread. Despite a record of rapid economic growth in Laos, the country currently suffers some of the highest rates of child and maternal mortality and malnutrition in Southeast Asia. Malnutrition is the single largest underlying cause of child mortality in Laos, contributing to almost 60% of all child deaths. Undernourished children have an increased risk of mortality, more illness, delayed development and poorer school performance.

(Midwives and nurses role play counseling scenarios during training to hone their skills.)

In 2017, USAID, the Government of Laos, and Save the Children, began working together to improve the quality of nutrition services provided at local health centers and hospitals in Khammouane and Savanakhet provinces through the USAID Nurture project, funded by the United States Agency for International Development. Initial research found that people were aware of good nutritional practices but felt unable to make changes. The research also uncovered that health care workers were frustrated by their inability to convince families to improve their behaviors.

USAID Nurture worked with the Lao Ministry of Health to develop a National Social and Behavior Change Communication plan that reflected the research findings tailored to the local communities. USAID Nurture partnered with the Ministry of Health’s Center for Information and Education for Health to develop a new in-service training program to enable staff to use the key elements in the plan that were related to the training program. The three-module skill building course enables health staff to provide practical, targeted counseling for the 1,000 days (from conception to age 2) window of opportunity for lasting nutrition. Health care workers learn key counseling competencies they can apply in all areas of their work and learn how to help clients choose effective but doable actions that have large payoffs.

“Before I would talk a long time,” said Minda, “But this time I used what I learned to find the most critical nutrition issue for the mom. We discussed it and made a plan together.” When women return for follow up visits, Minda sees them keeping to their plans and staying healthier throughout their pregnancies.

 The U.S. Agency for International Development sponsored “Nurture” (USAID Nurture) project focuses on improving the nutritional status of women and children to reduce child stunting in targeted areas of Laos. This three-year project works to improve community and household nutrition, water, sanitation and hygiene practices.

Despite strong economic growth, Laos still experiences some of the highest rates of child and maternal mortality and malnutrition in Southeast Asia. Lao children remain some of Asia’s most undernourished with national rates of stunting (low height for age) at 44 percent and 27 percent of children are underweight. The project uses two strategies applied primarily through community-based health workers and local village authorities.