Explore the vast range of titles available.

Background/Objectives: Multiple micronutrient supplements (MMS) are more effective in improving maternal and birth outcomes compared to iron and folic acid (IFA) supplementation during pregnancy. High adherence to MMS is critical to achieving all the anticipated health benefits. Therefore, to ensure successful program implementation of transitioning to MMS in Cambodia, implementation research has been prioritized. The objective of this study was to assess the relevance, acceptability, utility and short-term, exploratory adherence outcomes of three behavioral interventions designed to support adherence to daily MMS intake and to promote healthy pregnancy practices. Methods: This mixed-methods study, conducted in four provinces in Cambodia, involved 12 focus group discussions (FGD) with 36 pregnant women who were exposed to three distinct behavioral interventions (family support, a tracking calendar, and educational videos). FGDs were held after three weeks of exposure to each intervention. Data was analyzed using a COM-B model, with inductive codes added to capture emerging themes. Results: Family support emerged as the most preferred and perceived as the most effective intervention, with participants consistently valuing the presence, encouragement, and practical assistance offered by husbands and other close family members. The second most preferred were educational videos, which were perceived to effectively convey key messages in an engaging, relatable way, overcoming literacy barriers. Finally, the calendar supported habit formation and appealed to first-time mothers but posed challenges for low-literacy users. Across interventions, findings reflect participants’ perceived effectiveness and preferences rather than comparative efficacy. Conclusions: This study provided insights into Cambodian women’s preferences and experiences with three distinct interventions designed to improve adherence over a short-term, 3-week exposure period per intervention. An integrated, multilevel approach that combines family-focused, educational, and system-level strategies is recommended for further piloting and scale-up, with longer-term studies needed to assess comparative efficacy for adherence and health outcomes.

ObjectivesLimited research has been conducted on the maternal and child health situation of garment factory workers in Cambodia. This qualitative study investigated the health-seeking behaviours for maternal and infant care of female garment factory workers in Kampong Tralach district, Cambodia.MethodsWe conducted 54 in-depth interviews, six focus group discussions and observed two factories. Participants were pregnant women and mothers of infants who have worked in factories, young women currently working in factories, caregivers of children, village leaders, healthcare workers, and factory managers. Deductive and inductive thematic analysis was performed.ResultsThe women were accessing regular antenatal and facility-based delivery care. Most factory managers provided maternity leave, and some also provided leave for regular antenatal (ANC) visits. Women often returned to work 2 months post-delivery and this triggered the cessation of exclusive breastfeeding. Feeding was also compromised for the 6–12 months old children as carers, delayed the introduction of complementary feeds. Factories were equipped with childcare and breastfeeding spaces, however these were not used due to both feasibility issues and distrust of factory management. Instead, grandmothers were the preferred childcare providers.Conclusions for PracticeCurrent factory policies regarding ANC, maternity leave and childcare provisions are context insensitive to rural workers who live far from the workplace to avail themselves of mandated ANC leave or breastfeeding breaks. Our study suggest that the increasing number of young women working in garment factories is compromising the early nutrition of their children, with a reduction in exclusive breastfeeding and inadequate complementary feeding.

The caregiver–child interaction during mealtime, which refers to responsive feeding (RF), influences child's dietary intake. In Cambodia, given the level of malnutrition, getting better knowledge of RF among young children is essential, but to do so, using an appropriate assessment tool is necessary. We aim to develop and to validate a measurement tool to assess RF in two different situations (before and after an intervention) among children 6–23 months old. This research is part of a larger trial assessing the impact of nutrition education combined or not with the provision of complementary foods on child nutritional status. The “Opportunistic Observation Form” from the Process for the Promotion of Child Feeding package was used to collect data on RF through direct observations of child's meal episodes. Data were used to define an initial scale composed of four constructs and 15 indicators. Confirmatory factor analyses (CFA) and Hancock and Mueller's H reliability indices were computed to assess the validity and reliability of the scale. The final tool was applied to baseline and endline data. At baseline, the sample included 243 pairs and, at endline, 248 pairs. The final scale included two latent constructs (RF and active feeding) that comprise three indicators for active feeding and five for RF. Criteria for fit indices of CFA were met for both constructs though better at baseline. Reliability coefficients were above 0.80 for each construct at baseline and endline. This research proposes a scale that could be used to assess active feeding and RF. Further validation is warranted in different contexts.

Background: In Cambodia, stunting and wasting affect, respectively, 32% and 10% of children 0–59 months while 55% are anemic. Our research aims to assess the efficiency of two local foods combined with nutritional education and counseling (CEN) activities as compared to CEN alone on improving child nutritional status and dietary intake. Methods: A cluster-randomized controlled trial was conducted in Soth Nikum area over a six-month period among children 6–23 months (n = 360) assigned to receive either moringa +CEN, cricket +CEN or CEN alone. Anthropometric measurements were performed and hemoglobin and ferritin levels assessed. Results: Overall, no significant increase in the mean length/height-for-age z-score was observed, although a small increase of the weight-for-length/height was noted in intervention groups. Hemoglobin and ferritin mean values increased in all groups. The degree of satisfaction of energy, proteins, iron, and zinc requirements improved in all groups, but to a greater extent in the intervention groups and more children were healthy. Conclusion: Our research shows no significant impact of the provision of two local foods combined with CEN on the improvement of child nutritional status as compared to CEN alone. However, children consuming them better fulfilled their energy, iron, and zinc requirements and were healthier.

Background: Child undernutrition is of public concern in Cambodia. An understanding of factors influencing child nutritional status is essential to design programs that will reduce undernutrition. Using the UNICEF conceptual framework of causes of malnutrition, our research investigates the relationship between nutritional status of children aged 6–23 months and its immediate and underlying determinants. Methods: Baseline data from a cluster-randomized controlled trial aiming to assess the impact of the promotion of optimal feeding practices combined or not with the provision of local foods among 360 children 6–23 months of age were used. Anthropometry and biochemical measurements were performed at baseline. Data on each determinant of undernutrition were collected through interviews and direct observations. Results: Our results show that the degree of satisfaction of proteins and zinc requirements as well as the access to improved water sources and sanitation were positively associated with length-for-age, while having a better health status and a higher degree of satisfaction of energy, protein, zinc, and iron requirements were associated to an improved weight-for-length. Only child health status was associated to ferritin. Conclusion: Our results reiterate the importance of improving child diet and health status, but also the access to a healthy environment to ensure an optimal nutritional status.

Background and objectives: According to the UNICEF framework on the determinants of malnutrition, immediate causes of poor child nutritional status are inadequate dietary intake and poor health status which are, in turn, determined by access to food, to care to health (underlying determinants). To help at improving impact of nutrition programme, a better understanding of causes of malnutrition is essential especially in areas where malnutrition affects a significant proportion of young children. In Cambodia, stunting and wasting affect 32% and 10% of children below five years of age respectively. In Siem Reap province, these proportions are at 36% and 10%. The objective of this study is to assess the relationship between child nutritional status and its immediate and underlying determinants among a population of Cambodian young children. Methods: Data of a current clinical trial investigating the impact of consumption and promotion of local foods on child nutritional status will be further analysed to respond to the aforementioned objective. The clinical study is a cluster-randomized controlled trial among children 6-23 months old (n=360) living in 14 randomly selected villages. Data on nutritional (anthropometry, haemoglobin, ferritin) and health status (c-reactive protein, intestinal parasites in faeces, occurrence of illnesses), dietary intake (24-hour recalls), food and health practices, household food security, access to health and socioeconomics have been collected at baseline and will be collected at endline. Anthropometry data were analysed using WHO Anthro. Dietary intake are currently assessed using Nutrific software. Household food security (HFI) will be assessed using the HFI Scale. The adequacy of dietary practices will be estimated using WHO indicators. Scores will be developed to assess health practices and health and responsive feeding. Descriptive analyses will be used to assess differences in nutritional status and correlations will be performed to test for association between nutrition status and its determinants. Regressions will be used to identify predictors of nutritional status. Results: Data are currently analysed since baseline study has been finalized in February. Preliminary results on nutritional status reveal lower rates of undernutrition than expected: 19,5% stunting and 7,9% wasting. Moreover 7 out of 10 children (n=375) had a haemoglobin value below 11g/dl.

Background and objectives: In Cambodia, stunting and wasting affect 32% and 10% of children below five years of age respectively. In Siem Reap province, these proportions are even higher, 36% and 10%. Poor infant and young child feeding (IYCF) practices have constantly been reported as the cornerstone of young child nutritional status and development. In Siem Reap, breastfeeding practices are encouraging as 65% of children 0-5 months are exclusively breastfed. Nevertheless, only 36% of children 6-23 months do benefit from the three recommended IYCF practices. The objective of our research was to assess the impact of a higher consumption and promotion of micronutrient-rich local foods on child nutritional status, dietary intake and practices. Methods: The research is currently ongoing in Sotnikum district area, Southern part of the country. This is a cluster-randomized controlled trial among children 6-23 months old living in 14 villages (cluster) randomly selected and assigned to each treatment group namely: cricket + nutrition education (NE), Moringa oleifera + NE and NE only. The number of villages intends to get a sample size of 120 per group in order to detect a mean improvement of 1 g/ dl of hemoglobin level between baseline and after 6 months of implementation and to take into account a 10% drop-out. Cricket and Moringa are given daily to children. Quantities of each food aimed to add at least 2 mg of iron to their daily diet. Data on nutritional (anthropometry, haemoglobin and ferritin) and health status (c-protein, presence of intestinal parasites in faeces, occurrence of illnesses), dietary intake, food and health practices, household food security and socioeconomics have been collected at baseline and will be collected at endline. On a weekly basis, data on dietary intake, health status, food and health practices including food compliance and responsive feeding are gathered. Results: At the end of July 2017, the endline study will assess the impact of the consumption and promotion of local foods on child nutrition outcomes. Conclusions: To come.