A Multi-faceted Approach to Improving Nutrition in Vietnam

Ha Thi Theu was still learning the ropes of motherhood when she became a widow. Her husband died when their baby son was only 8 months old. Theu, who lives in a village of subsistence farmers in northern Vietnam’s Son La Province, worried how she would make already-tight ends meet.

“When I became a single mom, I faced a lot of difficulties,” she said. “It’s very hard to play both roles—as both the mother and the father of my son.”

Though their family situations vary, the mothers in Theu’s community confront the same challenges in raising their children.

• 82 percent of Son La residents are from minority ethnic groups, which have historically have had less access to education, health care, and economic opportunities than the majority Viet.
• 12 percent of Vietnamese households overall are considered poor, but in Son La it’s 36 percent.
• 14.5 percent of children under five in the general population are underweight, but in Son La that number rises alarmingly to 27 percent.

Food insecurity, limited access to nutritious food sources, and poor nutrition practices all lead to a disproportionate rate of child malnutrition here.

To improve food security and nutrition in communities like Theu’s, Helen Keller International partnered with the Vietnamese government in 2013 to pilot the Enhanced Homestead Food Production (EHFP) program. It targets households with mothers of children under two years of age and teaches the women not only how to grow micronutrient-rich food but also how to incorporate it into a well-balanced, appealing diet for their children.

As part of the pilot, Helen Keller trained volunteers from 24 farms in the community to provide technical support to almost 500 households and 3 schools. Now, when program participants visit a volunteer’s “village model farm,” the volunteer teaches them agricultural techniques, answers their questions, and shows them how to replicate the farms’ best practices in a home or school garden.

Helen Keller Intl also provided thousands of livestock, seeds, seedlings, and fruit trees—as well as organic fertilizer—to village model farmers and households who were already producing or who wanted to produce food in home gardens. This jump-start, combined with training for the locally-based model farmers, created a sustainable way for the community to maintain its production of micronutrient-rich foods like orange sweet potatoes, leafy greens, and melons.

Theu, who didn’t have a home garden of her own before joining the program, now grows spinach, pumpkins, and tomatoes on her land, as well as vegetables to feed the chickens and pig she received through the program. 

Meanwhile, a nutrition education component of the EHFP program empowered caregivers with knowledge about how to optimally feed their children.  

It can be easy to take for granted how much information about nutrition and hygiene we pick up by the time we become parents. Most of us have heard about the food pyramid and can name several food groups, for example. We also know that we are supposed to wash our hands before cooking food. But in Son La, many impoverished caregivers cook for and feed their children without the benefit of that knowledge. 

Helen Keller took a multi-pronged approach to improving nutrition, hygiene, and cooking expertise. We trained a cohort of village volunteers to become nutrition facilitators who demonstrate sanitary cooking techniques and teach healthy eating practices to their neighbors. So far, they have reached more than 10,000 families—mothers, fathers, and other caregivers.

They also conduct home visits—almost 2,000 to date—to participating households to provide nutrition counseling for pregnant women and children under five years of age. In order to reach the broadest possible swathe of the community, HKI also organized a series of annual nutrition festival days, during which cooking competitions and quizzes reinforced villagers’ knowledge in a fun and accessible way. 

That all sounds great, right? But to ensure that the program was actually benefiting the community, Helen Keller conducted an evaluation in 2016. We found that year-round production and consumption of micronutrient-rich foods among target households had improved dramatically. The vast majority of children in participating households had an adequately diverse diet including four or more food groups. Food security scores from 2015 to 2016 had nearly doubled. Many households were generating additional income from the sale of excess produce. And women reported feeling more empowered and capable of contributing to the nutrition and well-being of their families and communities. As a side benefit of the program, we also saw a growth in the percentage of women who reported that they were involved in their household’s decision-making, especially as it pertains to purchasing food and other items.

As for Theu, she feels far more confident as a single mother than she did before joining the program. 

“I promised myself that I would try my best to improve the quality of my son’s life,” she said. “It really helped to join the program. It benefited not only my child but also me. It helped to improve our standard of living, and it really helped to relieve the pressure of life.” Having achieved remarkable results in Son La Province, Helen Keller is now working to expand the EHFP model to Hoa Binh and Lai Chau Provinces.