Tackling the Double Burden of Malnutrition

Cambodia is facing a particularly challenging situation

At a cooking demonstration preparing complementary food with Care Group members
Photo: © Dominique Uwira

Continued economic growth and increased household income have resulted in remarkable shifts in everyday lifestyle and eating patterns in Cambodia. The new dynamics and the altered nutrition situation have led to an emerging twofold problem called the double burden of malnutrition. It is a situation wherein undernutrition — described by wasting, stunting and micro-nutrient deficiencies — and overweight or obesity coexist within the same household and even within the same individuals throutout their lives. Both extreme forms of malnutrition impact people for their entire lives and can even be passed on to the next generation. This disproportionately affects the poorest and most vulnerable.

The change in Cambodia is driven by a new nutrition reality, characterised by a transformation in the way people grow food, live, work, eat, and move, alongside shifts in global and local food systems, from production to marketing, purchasing and consumption. Less and less traditional healthy dishes are being self-prepared while more food is purchased from outside the home, where it is difficult to control ingredients and cooking procedures. Ultra-processed convenience food has become readily available even in the most remote areas where it lightens the already heavy burden of busy mothers who are increasingly entering the workforce.

Addressing malnutrition in all its forms

The Multisectoral Food and Nutrition Security Project operates in the provinces Kampong Thom and Kampot using a multisectoral and multi-level approach. Activities are carried out in the health, nutrition, WASH and agriculture sectors on household, village, provincial and national levels. With policy advice on national level, the project supports the integration of food security and nutrition aspects in national policies and guidelines.

Care Group session  | Photo: © Dominique Uwira

At the local level, care groups provide a platform for women to meet on a regular basis and learn about mother, infant and young child nutrition, childcare and hygiene practices, focusing on interpersonal behaviour change communication. The leaders of the care group, who are community-based health volunteers, meet regularly with project staff for training and supervision. They are responsible for continuous training and coaching of the care group members in care group sessions and home visits. In the sessions, the group leaders share their knowledge on nutrition and health and encourage participants to put their newly acquired knowledge into practice at the household level and within their community.

In addition, nutrition-sensitive agricultural activities are implemented using seasonal calendars which combine agricultural practices with nutrition and health information and practical cooking recipes for young children. The seasonal calendars are supporting farmers to identify the right timing and techniques for cultivation and harvest.

Furthermore, the Multisectoral Food and Nutrition Security Project looked into possibilities to promote healthy snacking options. The project worked together with food vendors from the target areas to develop recipes for healthy snacks such as brown rice waffles with moringa, purple sweet potato smoothies or ice cream with pink dragon fruit and unsweetened coconut milk. The recipes were tested with the target group and are currently compiled in a recipe booklet to be promoted to the wider population.


Dominique Uwira, dominique.uwira@giz.de, MS Teams