The prevalence of child undernutrition and micronutrient deficiencies in Viet Nam is among the highest in the world. Despite some progress, maternal and child undernutrition remains a persistent social and economic concern.

• 90% of the world’s stunted children live in just 36 countries, including Viet Nam.
• While Viet Nam has made significant progress in reducing child underweight (by one-third in the last decade) stunting still affects more than one-third of Vietnamese children, with the highest incidence in rural areas and among ethnic minorities.
• Deficiencies of the key micronutrients – iron, vitamin A, zinc and iodine – persist in Viet Nam and significantly affect child survival, children's growth and cognitive development and maternal. 

Efforts to reduce undernutrition, in particular stunting, must focus on women before and during pregnancy and in a child’s first two years—a time when significant damage occurs and nutrition programs are most cost-effective for the health of children and the economic and social development of Viet Nam.

• Improved nutrition among Viet Nam’s population is achievable when proven interventions are effectively brought to scale.
• Effective programs in Viet Nam and internationally include micronutrient supplements for women in reproductive age, particularly during pregnancy, deworming, nutrition education on breastfeeding and good complementary feeding, supplementary food for children 6-24 months and conditional cash transfer.  Significant focus and coordination is needed to bring these interventions to scale, and reach those in need.

Breastfeeding promotion, appropriate complementary feeding and vitamin A and zinc supplementation have the greatest potential for reducing child deaths and undernutrition.

• Breastfeeding. In Viet Nam, all newborns should be put on the mother's breast immediately after birth and breastfed, without receiving water or anything else, until they are six months old.  Only slightly more than half of all newborns in Viet Nam are breastfed within one hour after birth and less than one in five of those younger than six months old are exclusively breastfed.
• Vitamin A. Vitamin A supplements could benefit more children and mothers.  Currently, vitamin A is given only to children from 6 to 36 months, but in some areas vitamin A deficiency continues to afflict children up to five years of age.  Only half of children under five who need vitamin A receive it, and only one-third of mothers receive the recommended dose after giving birth.
• Zinc. Every child with diarrhea should receive zinc tablets which will reduce the severity of the disease and prevent future attacks.  Currently, zinc treatment is not given to Vietnamese children with diarrhea.

Interventions to reduce iron and iodine are important for maternal survival and children's cognitive development, educability, and future economic productivity.

• Iron. All pregnant women should receive and take iron-folate supplements to prevent anemia and improve birth outcomes.  Approximately 60% of women currently take iron during pregnancy.  A program selling weekly iron folic acid supplements to women of reproductive age has reduced the prevalence of anemia, and improved iron status during pregnancy and birthweights.
• Iodine. All salt in Viet Nam should be iodized to prevent the goiter and other iodine deficiency diseases.  Viet Nam has made progress battling iodine deficiency and should not relax efforts to iodize salt.

The Lancet’s Series on Maternal and Child Undernutrition

The Lancet’s Series on Maternal and Child Undernutrition is a landmark series of research papers published in the world’s leading international medical journal that offer new information regarding the critical factors related to undernourished children, where and why they are undernourished, and makes recommendations based on evidence-based interventions to reduce undernutrition.

• The five-part series reviews and analyzes the effectiveness and potential impact of nutrition-related interventions and policy options in developing countries and includes recommended actions to accelerate efforts to improve maternal and child undernutrition.
• It follows a number of earlier important series from The Lancet, such as those on Child Survival and Neonatal Health, which have shaped policy and action in countries around the world.

The launch of the series in Viet Nam provides an important opportunity to draw national attention to this critical issue and what can be done to accelerate actions to improve maternal and child undernutrition.

• Coordinated efforts to implement proven interventions and address the causes of malnutrition at the national and provincial levels will improve the health and well-being and future development of generations.

Undernutrition is caused by a poor dietary intake that does not provide sufficient nutrients and by common infectious diseases, such as diarrhea.

• Undernutrition includes a wide array of effects including intrauterine growth restriction (IUGR) resulting in low birth-weight; stunting, a chronic restriction of growth in height indicated by a low height-for-age; wasting, an acute weight loss indicated by a low weight-for-height; and Micronutrient deficiencies.
• These conditions are most significant in the first two years of life, highlighting the importance of nutrition in pregnancy and the window of opportunity for preventing undernutrition from conception through 24 months. 

Undernutrition is a key factor in child development and has a long-lasting adverse impact on health, education and productivity.

• Efforts to reduce undernutrition in children must focus on improved nutrition of women before and during pregnancy and of children during the first two years of life.  
• Poor fetal growth or stunting in the first two years of life leads to irreversible damage, including shorter adult height, lower attained schooling, reduced adult income, and offspring with lower birth weight.
• Children who are undernourished in the first two years of life and put on weight rapidly at later in childhood and in adolescence are at high risk of nutrition-related chronic diseases.