If women of childbearing age do not achieve the so-called "Minimum Dietary Diversity for Women" (MDD-W), this often has devastating consequences for the development of children during and after pregnancy. Hence Johanniter and Khmer Community Development (KCD) implement a four-years project to improve nutrition in local communities with worrying MDD-W results.
A low MDD-W in women of childbearing age and pregnant and breastfeeding women increases the risk of miscarriage, premature birth and low birth weight. It can also lead to long-term health problems. In the districts of Kandal province in Cambodia, Johanniter and its partner organisation Khmer Community Development (KCD) found in 2017, that only one in four women reached MDD-W. Poor sanitation practices worsened the situation. With the financial support of the German Federal Ministry for Economic Cooperation and Development (BMZ), a project has been implemented since then, which aims to face this deficiency by the end of 2021.
After half of the project duration, the first important steps have been implemented. One of these is the training of 85 multipliers who provide information in the target communities. They are mostly composed of teachers, young members of the Peace Clubs, members of the Village Health Support Groups (VHSG), local authorities or village elders. They teach, for example, nutritional rules in relation to newborn and small children, which are immensely important especially in the first 1000 days. Furthermore, they pass on knowledge in the area of hygiene. "Changing behaviour patterns that have existed for decades is a slow process," recognizes Nicole Kockmann, Johanniter project coordinator. It is therefore important that people from the communities take up new methods and pass them on. This way, new knowledge does not remain abstract, but is applied within the families.
Cheng Soveth is one of those key individuals. She has been involved since the project started in 2018 and has attended KCD-supported training sessions. She now visits households in the village of Prek Chrey to train them about nutrition or techniques such as compost fertilizers for the home garden. "I have learned a lot by participating in the various trainings and capacity building provided by KCD," she says. "The more I get involved, the more I learn.
Ms. Cheng is also a model farmer in the project and grows various vegetables in her own garden such as mushrooms, lettuce, cucumbers, cauliflower and bitter pumpkin. This garden helps to feed her family and reduce costs. "My husband and the whole family are sensitized to nutrition and hygiene," she says. She shares these insights with her community and becomes an important mosaic piece of the project to improve the overall situation for more than 8,600 people.
What is the “Minimum Dietary Diversity-Women” (MDD-W)?
It is an indicator of whether or not women 15-49 years of age have consumed at least five out of ten defined food groups the previous day or night. The proportion of women 15–49 years of age who reach this minimum in a population reflects one important dimension of diet quality. Even though the indicator is measured by asking questions of individual women, it is a population-level indicator, i.e. it is designed to provide information about micronutrient adequacy of groups of women. The indicator was developed by The Food and Agriculture Organization of the United Nations (FAO).
The 10 food groups that comprise the MDD-W indicator are:
1. Grains, white roots and tubers, and plantains
2. Pulses (beans, peas and lentils)
3. Nuts and seeds
5. Meat, poultry and fish
7. Dark green leafy vegetables
8. Other vitamin A-rich fruits and vegetables
9. Other vegetables
10. Other fruits