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Vietnam has successfully reduced population stunting, but ethnic minority groups are being systematically left behind, limiting progress on national reductions. This mixed methods study aims to understand how policy drivers of stunting reduction differ between ethnic majority and minority communities. We used decomposition analysis to explain key determinants of stunting change between 2000 and 2010; and framework analysis to qualitatively assess changes in policy, actors and narratives that have underpinned these over decades. Our analysis shows that stunting reductions are associated with increased household wealth (accounting for 61% of change), improved access to specific health services (16%), and changes in level of maternal education (12%). Despite multiple actors involved in change and a large set of policies designed to address inequities, many among Vietnam’s defined ethnic minority groups are not finding themselves able to effectively engage with central government plans for their communities, and central policies often do not consider their preferences or limitations. This in turn impacts the nutrition of minority groups through the determinants above. Vietnam has achieved the easier portion of stunting reduction through national economic growth and sustained commitment to socially-oriented policy. In order to tackle the remaining pockets of high malnutrition, more attention, thought and funding will need to focus on marginalised ethnic minority communities. The current national development discourse aims to incorporate minorities into mainstream majority systems. This paper argues that policy should rather take into account their particular needs and preferences to address and overcome the identified determinants of malnutrition.

Objectives To evaluate the efficacy of fermented milk containing Lactobacillus casei strain Shirota (LcS) on the incidence of constipation, diarrhea, acute respiratory infections (ARI), and nutritional status of young Vietnamese children. Methods A controlled field trial was conducted with 1003 children (3–5 years old) in Thanh Hoa province in Vietnam. The probiotic group (n = 510) consumed fermented milk 65 mL/day containing 108 CFU/mL of LcS for the 12-week intervention period, whereas the control group (n = 493) was not given any. The incidence of constipation, diarrhea, ARI, and anthropometry in children was determined at baseline, after 4, 8, and 12-week intervention, and after the 4-week follow-up period. Results Probiotic drink decreased the incidence of constipation after the 12-week intervention period (12.0% vs. 32.0%, OR = 0.28 (95% CI: 0.21–0.40), p p = 0.068), and prevented the occurrence of ARI (15.9% vs. 24.5%, OR = 0.58 (95% CI: 0.42–0.79), p p Conclusions Daily intake of fermented milk containing LcS strongly prevented the incidence of constipation and ARI in Vietnamese children. This study also revealed the potential effects of the use of a probiotic drink on diarrhea prevention as well as nutritional status improvement.

To determine the nutritional status of patients with esophageal cancer, and to investigate its relationship with performance status and prognosis.This clinical, cross-sectional study was conducted from August 2014 to February 2015 at National Cancer Hospital, Hanoi, Vietnam. Stage III/IV esophageal cancer patients were assessed for their nutritional status (patient-generated subjective global assessment (PG-SGA) and SGA scores, BMI, mid-arm circumference (MAC), energy and protein intakes, weight changes, Karnofsky and Eastern cooperative oncology group performance scores (KPS/ECOG), and Glasgow prognostic score (GPS).Sixty-four male patients were enrolled. The mean ± standard deviation of PG-SGA score was 9.88±4.41. SGA revealed 44% as class B and 6.2% as class C. The BMI revealed 43.8% of patients were underweight. MAC measurement revealed 29.7% of undernourished patients. Patients with an energy intake25 kcal/kg/d comprised 54.7%, and 48.4% with1 g/kg/day of protein. Totally, 68.8%, 84.4% and 92.2% patients exhibited weight loss past 2-weeks, one-month and six-months, respectively. The PG-SGA and SGA strongly correlated with the KPS (r=-0.717 and 0.632, both p0.001) and ECOG (r=0.672 and 0.626, both p0.001), but were weakly correlated with the GPS (r=0.332 and 0.278, p0.01 and 0.05). The KPS, ECOG, BMI, MAC, energy and protein intakes, and weight change were not correlated with the GPS.Malnutrition, weight change, and insufficient intake were noteworthy in esophageal cancer patients. The PG-SGA and SGA were strongly correlated with the performance status, but weakly correlated with prognostic indices.

Background In Vietnam, malnutrition remains a public health problem, even though much progress has been made in the last decades. The number of cases of severe acute malnutrition (SAM) is more than 200,000 per year. To accelerate the treatment of SAM, community-based treatment with ready-to-use-therapeutic foods (RUTFs) is preferred. However, a locally available and acceptable RUTF for the treatment of SAM was lacking. Objective In a joint effort by the National Institute of Nutrition, UNICEF, and the Institut de Recherche pour le Développement, a local RUTF was developed and tested. Methods The product was optimalized for impact and acceptability. At the same time, capacity for the Integrated Management of Acute Malnutrition (IMAM) was developed. Results The local product was found to be highly acceptable and effective. After training of health staff, the product could be introduced in the IMAM program. Conclusions The IMAM program was highly successful in treating children with SAM, with more than 90% of the children recovering. Production capacity of the factory is currently being increased to enable up-scaling of the IMAM program and potential export of the product to countries in the region.

With a global economic crisis, undernourished peoples in South East Asia, as elsewhere, face even greater food insecurity. Future challenges to food availability include increasing food prices, increasing population size and climate change. National policies are required which emphasise improved intersectoral coordination, enhanced government credibility and accountability, as well as a shift in food aid to investment in agriculture and the empowerment of independent institutions.