Combating child marriage in Bangladesh
Workplace lactation support programs in Cambodia
Sensory evaluation of thiamine-fortified salt in Cambodia
Combating child marriage in Bangladesh
Bangladesh has the world’s highest rate of child marriage among girls under the age of 15. Two-thirds of Bangladeshi girls are married before they turn 18, nearly half become pregnant before 19, and the rates of stunting and underweight are 26% and 36%, respectively. Poverty is the most commonly cited reason for driving families towards child marriage, but the drivers of early marriage are diverse.
Previous research has shown that homestead food production is an effective tool to diversify diets, improve nutrition, and generate income in a range of geographical areas and livelihood conditions. This project will test the hypothesis that by enhancing food production and generating income, young girls in Bangladesh will experience lower rates of marriage and pregnancy, and improved food security, dietary diversity, nutritional status, and better livelihood conditions overall as compared to a control group. The project aims to implement a gender-transformative enhanced homestead food production and income generation program to document its efficacy in preventing child marriage, and in turn, adolescent pregnancy-induced malnutrition, among girls aged 13-15 years in southern Bangladesh’s Khulna division, a high-risk area for child marriage.
The study will involve formative research to identify the root causes of child marriage, and community perceptions of negative aspects of early pregnancy including birth outcomes in regards to adolescents’ and their birth newly born babies’ health and nutritional status. Then, researchers will conduct a cluster-randomized controlled trial in which 1,200 girls in afterschool youth clubs participate in a 24-month program on women’s empowerment through hands-on workshops. Participants will be trained in sexual and reproductive health, water, sanitation, and hygiene. Those in the enhanced homestead food production group will also be trained in vegetable, poultry, and small livestock production to help improve nutrient intake and provide a source of income for the families of adolescent girls.
The project will also address the traditional beliefs and social norms associated with the high prevalence of child marriage in Bangladesh by using a gender-transformative approach that has reported positive effects on women’s decision-making, mobility, and time use.
This study is funded by the International Development Research Centre, and being conducted in partnership with Helen Keller International Bangaldesh.
Workplace lactation support programs in Cambodia
Human milk is the optimal food for infants, especially in low- and middle-income countries, supplying required nutrients and hydration, but also essential immune protection. Breastfeeding exclusively for the first 6 months is one of the most cost-effective ways to prevent infant illness and death, averting approximately 125,000 child deaths each year. However, while the World Health Assembly seeks to increase breastfeeding rates globally, women's engagement in the paid labour market is also growing, creating a tension between women as workers and as caregivers. In Cambodia, a low-income country in Southeast Asia, 70% of women are now formally employed. Cambodia has experienced a marked drop in exclusive breastfeeding from 74% to 65% between 2010 and 2014, with rates plummeting from 64% to 34% in urban areas.
Workplace lactation support programs provide a potentially low-cost solution by allowing women employees to continue breastfeeding upon their return to work. Such programs appear 'win-win' for employers and employees: low-cost changes such as dedicated breaks and equipped pumping rooms can increase employee productivity, and reduce absenteeism and health insurance costs, while women workers have reported increased workplace satisfaction, and achieved better health outcomes for themselves and their families.
Although previous research on workplace lactation support programs is promising, programs cannot follow a 'one-size-fits-all' approach. Our goal is to evaluate the impact of comprehensive, locally appropriate, evidence-based workplace lactation support programs, including lactation rooms, on employers and employees. This study will be the first to assess the impact of workplace lactation support programs in Cambodia.
This study is funded by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) MUSEFO Project, and a Canadian Social Sciences and Humanities Research Council (SSHRC) Partnership Engage Grant, and is being conducted in partnership with Helen Keller International Cambodia.
Sensory evaluation of thiamine-fortified salt in Cambodia
Thiamine (vitamin B1) deficiency remains a concern in Southeast Asia because the traditional diet composed mainly of white, polished rice is thiamine-poor. Thiamine deficiency can disrupt cognitive development in infants, or can cause a potentially deadly disease called beriberi. Fortification, or adding this vitamin to a commonly consumed food, could be a sustainable and cost-effective way of improving thiamine intake and preventing disease. Our previous work indicates that salt could be an ideal vehicle for thiamine fortification given its global success as an iodine fortification vehicle in over 120 countries. From our Trial of thiamine supplementation in Cambodia, we know the amount of thiamine that should be added to salt to confer health benefits, but lack key insights about the taste and smell of thiamine-iodine fortified salt, as well as data on shelf-life. This study aims to address this gap.
This study is funded by the New York Academy of Sciences, and is being conducted in collaboration with Helen Keller International Cambodia, the University of British Columbia, and Acadia University.
