Overcoming the Identified Sociopolitical Barriers to a National Nutrition Response in Cambodia

Between 2000 and 2010, Cambodia’s national stunting prevalence among children under 5 was nearly 40%, with some provinces reaching 50%. As recently as 2014, more than one-third of children were stunted, giving Cambodia one of the highest proportions of chronically malnourished children in the East Asia and Pacific region. An important contributor to stunting in Cambodia are suboptimal complementary feeding practices. Stunted children suffer irremediable damage both physically and mentally; countries with a high prevalence also face severe economic consequences. Yet, stunting could be substantially reduced through existing nutrition interventions implemented at scale. This makes it vital to understand and address the intersecting sociopolitical factors hindering a national, effective response. This study sought to learn: 1) how favorable are current conditions in Cambodia for scaling-up evidence-based complementary feeding policies and programs to reduce child stunting? and 2) what strategies could be employed to create more favorable conditions? This qualitative study employed both document review and key informant interviews. Interviews with nutrition national working groups members, representing government, funders and civil society, were conducted using a question guide along with two card exercises, one to rank barriers to progress and another to prioritize strategies for improving complementary feeding. Participants noted that Cambodia faces challenges in ensuring political commitment, recognizing the extent of the problem, effective policy implementation and sufficient technical capacity, strong coordination and communication, and sufficient information evidence and research. Participants reflected that successful country-level efforts will require sustained political commitment, sufficient financial resources, strong multisectoral, multi-stakeholder and multi-level governance, and technical, managerial and implementation capacity. Study results suggest that key actors in the country must step beyond their organizational mandates to collaboratively build Cambodia’s capacity to lead its own response. A plan for change is proposed, in order to create policy community cohesion as a mechanism for generating traction toward coordinated action and funding around a set of agreed priorities to address malnutrition at scale in Cambodia.Doctor of Public Healt