Key strategies to further reduce stunting in Southeast Asia: lessons from the ASEAN countries workshop.
BACKGROUND
To further reduce stunting in Southeast Asia, a rapidly changing region, its main causes need to be identified.


OBJECTIVE
Assess the relationship between different causes of stunting and stunting prevalence over time in Southeast Asia.


METHODS
Review trends in mortality, stunting, economic development, and access to nutritious foods over time and among different subgroups in Southeast Asian countries.


RESULTS
Between 1990-2011, mortality among under-five children declined from 69/1,000 to 29/1,000 live births. Although disease reduction, one of two direct causes of stunting, has played an important role which should be maintained, improvement in meeting nutrient requirements, the other direct cause, is necessary to reduce stunting further. This requires dietary diversity, which is affected by rapidly changing factors: economic development; urbanization, giving greater access to larger variety of foods, including processed and fortified foods; parental education; and modernizing food systems, with increased distance between food producers and consumers. Wealthier consumers are increasingly able to access a more nutritious diet, while poorer consumers need support to improve access, and may also still need better hygiene and sanitation.


CONCLUSIONS
In order to accelerate stunting reduction in Southeast Asia, availability and access to nutritious foods should be increased by collaboration between private and public sectors, and the Association of Southeast Asian Nations (ASEAN) can play a facilitating role. The private sector can produce and market nutritious foods, while the public sector sets standards, promotes healthy food choices, and ensures access to nutritious foods for the poorest, e.g, through social safety net programs.
World Food Programme, Rome, Italy.
Martin W
MW
Bloem
Saskia
S
de Pee
Le Thi
le T
Hop
Nguyen Cong
NC
Khan
Arnaud
A
Laillou
Minarto
Regina
R
Moench-Pfanner
Damayanti
D
Soekarjo
Soekirman
J Antonio
JA
Solon
Chan
C
Theary
Emorn
E
Wasantwisut
D001210:Asia, Southeastern / Q000453:epidemiology; D046688:Child Mortality; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet; D005502:Food / Q000191:economics; D063427:Food Quality; D005527:Food, Fortified; D006130:Growth Disorders / Q000453:epidemiology / Q000517:prevention & control*; D006266:Health Education; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D044342:Malnutrition / Q000517:prevention & control; D009751:Nutritional Requirements; D010290:Parents / Q000193:education