17 Aug Those that address food insecurity through poverty reduction methods and community- and agriculture-based interventions to increase dietary variety may be more appropriate and cost-effective in the long-term

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Nutritional problems in Cambodia include severe food insecurity for about 14% of the population, poor dietary quality, and high food expenses, with over 70% of household income going towards food (United States Agency for International Development [USAID], 2021). Over 14% of the population qualifies as undernourished, and 32% of children have stunted growth, while child wasting and maternal undernutrition and anemia are also concerns; rural populations are more affected compared to urban populations (USAID, 2021). Further, the combined trend of female adolescent underweight and malnutrition with increasing adolescent pregnancy presents even greater risk to newborns and children for malnutrition and stunted growth (USAID, 2021). Thus, target groups for addressing malnutrition in Cambodia include rural populations and adolescent girls. Among children, key micronutrient deficiencies include anemia (iron, folate, B12), zinc, and vitamin A (Anderson, et al., 2008); however, additional research has found that a significant portion of anemia cases among Cambodian women and children may be related to non-nutritional factors, such as hookworm infection (Wieringa, et al., 2016). Methods to assess nutrient deficiencies and malnourishment in a population include anthropometric measurements, such as height, weight, skin-fold thickness, head circumference, as well as bloodwork and a comprehensive history and physical of selected members of the community (Shrivastava, et al., 2014). Agencies for surveillance, as well as sources of secondary data include health facilities, schools, and feeding centers (Tuffrey & Hall, 2016).

Fortifying foods and supplementing micronutrients are common methods of addressing malnutrition and micronutrient deficiencies. “These strategies do not, however, address the primary cause of poor micronutrient status, inadequate dietary intake because of food insecurity, and may not be the most acceptable, accessible, or appropriate strategies for rural and/or ultra-poor households” (Berti, et al., 2014). Supplementation and fortification may be acceptable temporary strategies, but are disparate and potentially uncoordinated when only addressing single micronutrient deficiencies. Those that address food insecurity through poverty reduction methods and community- and agriculture-based interventions to increase dietary variety may be more appropriate and cost-effective in the long-term (Berti, et al., 2014).