Better Rice for a Better Health

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Better Rice for a Better Health

Vietnam
Organization type: 
government
Budget: 
< $1,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Rice is integral stable food in Vietnam. This makes rice an ideal vehicle for micronutrients fortification. Micronutrient deficiency is “hidden hunger” which Vietnam is severely affected. Through practical training, media education and social marketing techniques, the project will promote people enrich their rice with provided micronutrients fortified rice at millers

About Project

Problem: What problem is this project trying to address?

In Vietnam, anemia, iron, vitamin A, zinc deficiency and other micronutrient deficiencies are still prevalent. Despite major improvements over the last decades, the prevalence of stunting and micronutrient deficiencies remain high in Vietnam. Stunting affects over 30% of the children (2005 National Survey). Under nutrition includes not only a lack intake of proteins and/or energy, but also deficiencies of micronutrients. The national survey in 2006 showed that 37% of the pregnant women and 26% of the non-pregnant women were anemic. 30% of the children under 5 years of age had vitamin A deficiency (serum retinol <0.70 µmol/L). There is no nationwide data on zinc deficiency. A food consumption survey in Vietnam showed a lack of zinc-rich foods in the diet. According to IZiNCG (2004) around 28% of the Vietnamese are at risk of zinc deficiency, based on the dietary intake estimates. Vietnamese population has poor diets with limited foods from animal sources such as meats, milk or milk products. Therefore, it is believed that micronutrient deficiencies are common in Vietnamese.
About You
Organization:
National Institute of Nutrition
Section 1: About You
First Name

Van

Last Name

Tran

Website
Organization

National Institute of Nutrition

Country
Section 2: About Your Organization
Organization Name

National Institute of Nutrition

Organization Phone

84-4-3-971-7090

Organization Address

48 Tang Bat Ho, Hanoi, Vietnam

Organization Country
Your idea
Country your work focuses on
Website URL
Innovation
What makes your idea unique?

“Better rice for a better health” is a program that can reach all Vietnam population and can be applied in any country in which rice is a stable food. The project mobilizes community in action for their own health. With applied social marketing model, people pay an additional low price for fortified rice for their better life. The negligible increase price of rice is contribution of poor people in taking care of their health. Selling micronutrients fortified rice with slightly increased price compared to normal rice is a technique to make people value what they pay for and use it (The added cost that a person needs to pay for ultra rice is about 9 cents/month.) Moreover, the project is not only rural-focused by providing micronutrients fortified rice to local millers but also community-oriented by promoting people to mix their normal husking rice with micronutrients fortified rice at millers. Millers are in every village therefore it is convenience and easy for every one to access the fortified rice. The available health volunteer network and strong women union in each commune can be used for monitoring, training and education of the social marketing program. Training will target consumers and millers to motivate them in changing behavior of using “new rice” – micronutrient fortified rice. The loud speaker system in commune which is located in populous areas of the commune and broadcasted three times a day can be used for media education program to motivate and remind people in action.

Do you have a patent for this idea?

Impact
What impact have you had?

In Vietnam, several public health interventions have been implemented to control micronutrient deficiencies including iodine of salt, half-yearly vitamin A supplementation for children from 6 – 36 months, and a protein-energy malnutrition control program focusing on children under 5 years old and pregnant women. My present institute had pilot programs including micronutrient supplementation for women, iron/folate supplementation for women at child bearing age, and micronutrient fortified biscuits for school children. Since 2003 with support from GAIN, my present institute implemented iron fortified fish sauce in whole country. In that project, fish sauce factories have been provided iron fortificant (in a component of NaFeEDTA), equipments, and technical supports to produce iron fortified fish sauce. The media education program helped to improve people awareness about iron deficiency and encourage them to use fortified fish sauce. Province preventive medicine centers involved in monitoring and impact evaluation of the project. About 20 big fish sauce factories with capacity of producing more than 1000 l/year have been involved in the program. Iron fortified fish sauce was distributed in manufactories distribution channel and women union network to increase the product availability for consumers. The micronutrients fortified rice will address more emerging problems of micronutrients deficiencies than a single iron fortification. The rice will be fortified with iron, zinc, riboflavin, folate, vitamin B1, B12, and B6. Rice is needed in every meal of Vietnamese family as energy from carbohydrate accounts for more than 60% of their total energy intake. The program is committed a national wide decrease in micronutrient deficiencies. Moreover, the nutrition knowledge on micronutrient rich foods will be spread out from millers to consumers and from consumers to consumers in villages and entire regions thereby bring in the sustainable vitality for the fortification program

Actions

Project will provide fortified rice, technical supports for mixing fortified rice with normal rice for millers and monitoring and evaluation training for local health workers, educational supports for local media system including health volunteer network and women union in order to motivate the use of fortified rice in every day meals.

Results

The first goal of the program is to remarkable decline of 20% in the micronutrient deficiencies prevalence at projected regions in first 3 years and eliminates this “hidden hunger” in next 5 years at national wide level by providing micronutrients fortified rice and nutritional knowledge. By providing micronutrients fortified rice for millers in whole country, the project will benefit whole 85 millions Vietnamese populations over 8 years.
The second goal of the program is that after a voluntary involvement of rice millers in the project, the rice fortification will become mandatory in Vietnam by a law passed by our government.

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

The first goal of the program is to remarkable decline of 20% in the micronutrient deficiencies prevalence at projected regions in first 3 years and eliminates this “hidden hunger” in next 5 years at national wide level by providing micronutrients fortified rice and nutritional knowledge. By providing micronutrients fortified rice for millers in whole country, the project will benefit whole 85 millions Vietnamese populations over 8 years.
The second goal of the program is that after a voluntary involvement of rice millers in the project, the rice fortification will become mandatory in Vietnam by a law passed by our government.

What would prevent your project from being a success?

There are cultural, environmental, socio-economical and political factors that can challenges the project team. It is hard to change people behavior in accepting “new rice – micronutrient fortified rice”. It is hard to convince the millers involve in the program that adding micronutrient fortified rice for consumers will not affect their normal business. However, there are several steps can be push in place to help project team to overcome those challenges. 1) The Ministry of Health already supported micronutrient fortification program in general therefore they will continue officially support fortified rice project. 2) The National Institute of Nutrition will take leading role in guiding their network at lower level in the process of project implementation. 3) The Ministry of Health and the National Institute of Nutrition will assign responsible and capable staff together with employing competent and committed personnel. 4) The formative research will be done in develop project activities and documents in order to make sure that all those will meet cultural standards. 5) The health volunteer’s network and women union will be enhanced. They will play a role in monitoring and evaluation of the project in order to make sure that project activities will be carries as planned and identify and address unexpected or unforeseen issues/problems.

How many people will your project serve annually?

More than 10,000

What is the average monthly household income in your target community, in US Dollars?

Less than $50

Does your project seek to have an impact on public policy?

Yes

Sustainability
What stage is your project in?

Idea phase

In what country?
Is your initiative connected to an established organization?

Yes

If yes, provide organization name.

The National Institute of Nutrition

How long has this organization been operating?

More than 5 years

Does your organization have a Board of Directors or an Advisory Board?

Yes

Does your organization have any non-monetary partnerships with NGOs?

Yes

Does your organization have any non-monetary partnerships with businesses?

No

Does your organization have any non-monetary partnerships with government?

Yes

Please tell us more about how these partnerships are critical to the success of your innovation.

As the National Institute of Nutrition (NIN) is a government office, the partnership is very important. We can have official guidelines from government level to lower levels such as province, district and commune levels so that it make project activities run more smoothly. This also helps the NIN easily interact with other stakeholders. For example, the health workers, health volunteers and women union are easier to mobilize into the project activities. After first three pilot years in two provinces and next 5 years expanded in all provinces, the government will review success of the project for mandatory law of rice fortification. Sharing information with NGOs is one way to contribute our efforts to the combat of micronutrient deficiencies.

What are the three most important actions needed to grow your initiative or organization?

Action 1: Project structure: the project will have an advisory board including policy makers from MOH and NIN to guarantees the policy supports for the project implementation. The project personnel will be organized in three components with one national coordinator for efficient management. Action 2: Social marketing program: The project will purchase micronutrient fortified rice at first but the fortified rice will be sold. Money collected from first phase of the project will be turnover to purchase fortified rice later to continue serve community. By this turnover process, the project will be sustained. Action 3: stakeholder involvement: I have worked with government authorities at national and local level for the community development and recognize the concern about nutrition status of Vietnamese people. Therefore, I am confidence that the success of this rice fortification program will be an essential premise for the government to pass a law of mandatory rice fortification in Vietnam.

The Story
What was the defining moment that led you to this innovation?

High prevalence of stunting children in Vietnam (30% in the year 2007), impressive prevalence of micronutrient deficiencies, and poor diet intake guided me to think about a solution to resolve the exiting problems step by step. When I am seeking a topic for my PhD thesis, I knew about four strategies for micronutrient deficiencies control which include 1) supplementation 2) fortification 3) food diversification 4) diseases control. The supplementation program is an effective solution however the compliance is low. Micronutrients supplementation is usually considered as “medication” which can only used for sick people while we try to promote normal people to take the supplementation therefore the supplementation solution itself creates challenge for its sustain. The food diversification is not feasible in Vietnam although this is our long term goal as micronutrient rich foods are usually very expensive. The poor who are suffering the most from the micronutrient have limited resources to have micronutrient rich foods. I searched documents from PATH organization about their ultra rice grains. The ultra rice grains are a micronutrient fortified food product which rice cost for only 9 cents/person/month in order to meet their micronutrient recommended dietary allowances. This is slightly increased price compared to normal rice. This is reasonable for the poor so that the fortification program can be adapted to Vietnam. Rice is integral stable food in every Vietnamese family. This makes rice an ideal vehicle for micronutrients fortification.

Tell us about the social innovator behind this idea.

I graduated from Hanoi Medical school in 1994 and have been working for the National Institute of Nutrition ever since. I received master degree in public health from the University of Massachusetts Amherst in 2003. My main responsibilities at NIN are: 1) Conduct quantitative and qualitative research on health/nutrition behaviors 2) Develop health education materials for grass-root community health workers 3) Design and implement nutrition communication campaigns at national level. 4) Develop training programs for health workers on special health care for mothers and children at the regional level. 5) Monitor and evaluate nutrition education programs. From 2006 to now, I am pursuing PhD degree in Nutrition Department, University of Massachusetts Amherst. From 2003 to 2006, I am the co-coordinator of social marketing component in the project “National Launch for anemia control” funded by GAIN. The project used social marketing techniques to promote people to use iron fortified fish sauce. I designed all education and social marketing activities of the project. I had implemented these activities in the first phase in order to all can be run smoothly before I joined in the PhD program. I am back to the National Institute of Nutrition now and take part in several projects including development and implementation of national guidelines for acute malnutrition management and the development of micronutrient fortified rice project.

How did you first hear about Changemakers?

College or university

If through another, please provide the name of the organization or company

Loraine Cordeiro, PhD., MPH., Assistant professor, Department of Nutrition, University of Massachusetts Amherst

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