National Nutrition Strategy and Plan of Action 2010-2015.

The overall Vision of the present National Nutrition Strategy is a prosperous country free from malnutrition, food insecurity, and poverty. Its Mission is to establish effective overall mechanisms through which policies, strategies, programmes, and activities can be identified, prioritized, coordinated, implemented, monitored, and evaluated for the attainment of nutrition and food security in Lao PDR.
The Strategic Framework is outlined in Chapter 4. There are three main Strategic Directions: 1) Address immediate causes; 2) Address underlying causes; 3) Address basic causes. Strategic Direction 2 addresses underlying causes dealing with ways in which sufficient quantities of nutritionally adequate food can be made available and accessible at the right places, at the right times and in the right forms throughout the country. One of the four strategic objectives relating to this Direction is to increase and diversify domestic food production. To achieve this objective activities related to increasing and stabilizing domestic production (including home food production) are suggested, as well as policies and programmes regarding imports and exports, food reserves and the management of food distribution channels.Another main issue is to improve the access to nutritious food. Even if food is available, people often lack access to it and thus cannot utilize it to improve or maintain their nutritional status. The barriers to access are often physical such as isolation and poor transport facilities. They can also be socio-economic ones, especially inadequate income. To improve this, the following action areas have been identified: a) Improve physical access to food; b) Improve economic access to food; c) Improving immediate access to food by chronically vulnerable groups; d) Improve women’s access to food and other resources. Many factors can hinder the proper utilization of food even if it is available and accessible. Therefore, there shall be put into place interventions emphasizing the strong need to impart knowledge and to encourage appropriate practical action through health and nutrition education, as well as through influencing cultural practices. Also improved access to safe water and sanitation facilities, hygiene behaviour and household water treatment and safe storage and improved access to Nutrition and Health Services shall be promoted.
It is suggested that immediate causes are in general a function of individual behaviour and circumstances, underlying causes are mostly associated with household and community behaviour and circumstances. Basic causes are mainly due to problems at the national level. The most significant underlying cause of food unavailability in Laos is the low level of domestic production of food items in view of high risks in the agricultural sector. The main causes of this include: small size of land holdings; prevalent absence of secure land tenure; high percentage of cropping area that is dependent on often erratic rainfall in the wet season, with little possibility of dry season cultivation; proneness to natural disasters brought by climate change, including flooding, landslides, drought, etc; lack of affordable good quality inputs such as fertilizers, seed and tools and machinery; inadequate agro-processing and storage technologies to reduce post-harvest losses; lack of appropriate agricultural marketing infrastructure and services; and insufficient knowledge and skills that decrease productivity and impose food security risks.
Throughout the Strategy addresses the particular rights of the most vulnerable groups consisting of school age children, children under five, women in general and in particular pregnant and lactating women, individuals living with hiv, in transition or in emergency.
In Chapter 3 under Guiding Principles it is stressed that geographical focus of interventions shall be on the poorest districts and geographic areas with high absolute and high relative numbers of vulnerable and disadvantaged groups (including ethnic minorities, groups living in remote upland areas, groups that have been relocated /resettled).
The Strategy provides for short-term interventions including a rapid institutionalisation of nutrition, a solid base lining of the relevant coverage and outcome indicators, continuous implementation and progress monitoring and evaluation, natural resource management, and disaster preparedness, as well as for long-term strategies with a view to sustainable growth. In the text it is stated: “Special programmes are required to ensure immediate as well as long-term access to food by the chronically poor, food insecure and nutritionally deficient households”. As a corollary of this the implementation shall take place in three time periods: i) Short-term: Implementation over the next 2 years (2010 – 2012); ii) Mid-term: Implementation over the next 5 years (2010 – 2015); iii) Long-term: Implementation over the next 10 years (2010 – 2020.
Chapter 4 highlights, inter alia, that promoting gender equality in accessing resources (including intra-household food distribution) and opportunities is an important component of the NNS, and attention will be paid to ensuring that women have improved access to resources and are treated fairly when resources are allocated. Areas of focus in this regard include land entitlement, credit provision, entrepreneurship and income generating opportunities, and education. This is important in the field of nutrition and food security (NFS) as studies have shown that most incremental income obtained by women is spent on food and other needs of the family.
Environmental sustainability is one of the Guiding Principles of the Strategy and it shall be ensured that all interventions strike a balance between the nutritional status and food security of the country and the long-term environmental sustainability. Control for adverse impacts on nutrition from other development sectors.
One of the Guiding Principles in Chapter 3 is the promotion of good governance underlining the following aspects: Transparency: Provide full transparency on roles and responsibilities as well as on progress, input, output, and outcome; Accountability: Define strategies that are discrete, concrete, measurable, and have clear responsibilities; Harmonization: Vertical and horizontal integration as well as convergence of multistakeholder actions will guide planning, implementation and monitoring and evaluation.
The institutional mechanism that provides high-level leadership shall include the most senior representation from all relevant parties. The concerned institutions, such as Ministries, inter-ministerial bodies and organizations, agencies, other stakeholders, shall act as the high-level reporting and decision making body, take policy and major strategic decision, and ensure full commitment from all relevant stakeholders.
To ensure a solid planning process, guide implementation and measure outcomes and impact, a solid base lining in terms of a National Survey on the key indicators shall be put in place. Such a survey should take place also midway the implementation road map and at the end. In addition, a National Monitoring and Evaluation (NME) system shall be activated which shall build on existing information systems.
The text consists of 5 Chapters as follows: Introduction (1); Nutrition and Food Situation in Lao PDR (2); Vision, Mission, Overall Goal and Guiding Principles (3); Core Strategies (4); Resource Mobilization, Implementation, and Monitoring and Evaluation (5).