Improving dietary diversity and quality through systems innovation: a pilot study from Vietnam

In the third of her blog reports, Jessica Raneri, Nutrition Programme Specialist, explains some of the challenges in gathering baseline data in the Mai Son district in Son La Province, Vietnam.

This is part of research under the CGIAR Humidtropics Research Program to assess local food biodiversity and identify opportunities for improving diet quality and diversity. The focus is on women of child-bearing age and children between 12-23 months – an age group part of the critical 1000 day window for child development and the stage where they are able to consume a more diverse diet. As such, it is from this age group that biodiversity can have an effect on the diet.

Jessica Raneri reports:

In August and November of 2014, the project moved to gathering baseline data from 400 households in four rural and farming communes of Mai Son district in Son La Province. This stage is to identify the current availability, access and utilization of on and off farm agricultural biodiversity, as well as nutrition knowledge and practices.

The study was carried out in two periods – once in August and again in November – which are the rainy pre-harvest and the dry, post-harvest seasons. This duplication is to capture differences in seasonal food availability and consumption at these times. But between the two surveys, the differences I saw first-hand were certainly not just the seasonality of the foods.

In August, heavy rains fell almost every day. This makes for difficult navigation in the field. Motorbikes were struggling up steep and muddy hills to reach remote villages, and after exceptionally heavy rainfall, some villages were not accessible at all. One morning I even had to ride on a buffalo to get to a village! During this time, the rolling mountainous hillsides were never-ending fields of green as the harvest season for maize was approaching. Mostly, the hills were covered with intensified maize production which is used for animal feed, often with rice paddy or sugar cane being produced on the flatter areas.

In November when I returned, the rains had stopped and the maize harvest completed. The landscape was completely transformed. Where the maize fields once stood – now there was a never ending panorama of black and brown empty fields spotted with the odd dry, brown maize stalk left forgotten to rot. At least now it was much easier to navigate the roads and reach some of the villages that were inaccessible during August and I did not have to look to the local buffaloes to get around.

One of the biggest challenges in this phase of the study was training the enumerators on 24hr recall methods.* 12 recent graduates were trained on the 24hr methodology and 22 learned how to administer quantitative questionnaires as part of plans to strengthen local capacity in these skills. Perhaps one of the most difficult parts was trying to get even measurements in the measuring cups and jugs whilst in the farming households. For example, the traditional houses of the Thai Minority group are made out of bamboo and on high stilts. The floors are often uneven, and so enumerators had to find innovative ways to find a flat surface to get an accurate measurement of food quantities, for example, using stools or boxes.

Immediately apparent was the extent of ready-to-eat processed snack foods in the rural communities. The only market-like shops in some communities would sell one or two types of fresh vegetables, tofu and maybe some meat. All other foods being sold were processed snack foods. While some seemed to be nutritious from the packages, such as a popular instant rice porridge showing a diversity of different beans and vegetables on the packet, closer inspection showed very little vegetable content – in this case only 5.2% of the ingredients. Instead these foods are high in fat and in salt and often make a large contribution to a child’s daily diet.

A household survey was administered to each head of the household, to get a full inventory of the species that households cultivate, collect and catch from the wild with details on how these species are used (sale in the market, consumed as part of their diet, used as fertilizer or building materials on farm). Gender disaggregated data were also collected, with questions about who makes decision about and who manages different plots and species that the household uses.

Focus group discussions also helped identify which species are prioritized by the community, as well as to better understand the local food system and gender opportunities or barriers. The participants became really excited and active in the focus groups, as they were asked to talk about the foods they have available and how people in the community like to eat them and how.
Time was spent at the commune health office, talking with the staff to understand what nutrition services they offered. It was interesting that the level of nutrition extension varied so greatly between the different communes, with some communities organizing cooking demonstrations a few times a year and others not doing anything at all.

Again we were lucky enough to share many a meal with the households we were visiting often with ingredients that came directly from their farms. Vietnamese food is incredibly fresh and very tasty – often served with mounds of coriander and lemon, it’s the perfect break to a busy day. Farmers were happy to show us how to prepare some of the dishes (like the pork and wild green leaf rolls).

Data from the study is currently being analyzed with reports expected to be completed by April and used to help decide what approaches to take in the next stage of the project.

Read Jessica’s other blogs about this research:

Part 1 : Assessing the nutrition potential of diverse local foods in Vietnam

Part 2 : Bringing together best methods to assess food quality and dietary intake in Vietnam

Part 4 : Putting nutrition data to work in the community

Part 5: Joining the diversity club – how village health workers in Vietnam are putting nutrition back on the menu

Part 6: Spicing it up to increase vitamin A consumption in Vietnam

 

For more information, please contact Jessica Raneri

Take a look at Jessica's photos from Vietnam

*Bioversity International and Healthbridge engaged in a post-graduate programme with the Son La medical school.

This work is part of the CGIAR Humidtropics Research Program, Bioversity International is leading the Nutrition cluster in the Global Cross-cutting Flagship under which this study will pilot a participatory methodology in Vietnam.

Photo: Research team joined by local Vietnamese guides go from village to village to collect baseline data. Credit: Bioversity International/J.Raneri