Lack of money threatens Vietnam's height initiative

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A controversial plan to make Vietnamese people taller has been criticized from every angle, but it might be low funding that sinks this strange ship

A young ethnic Hmong hill tribe woman (L) carrying a baby on her back as she makes way home in the mountainous district of Mu Cang Chai, in the northwestern Vietnamese province of Yen Bai.  A nationwide plan to improve Vietnamese people's height has attracted controversy and is facing financial challenges. PHOTO: AFP

Dang Thi Kim Oanh exhausts herself each day pushing her nine-year-old son to drink milk. He prefers sugary, unhealthy soft drinks and sodas instead.

"I'm short and so is his father. My son is already shorter than other boys in his class," said the 47-year-old grocer in Ho Chi Minh City.

Like other parents, Oanh wants her son to be tall, believing it is a sign of good health.

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"All milk brands are abundant in my shop. But he doesn't like any of them. It's an irony considering the fact that children in remote areas like milk but it's what their parents can't afford," she said.

Concerns about improving children's height have prompted governmental agencies to launch an ambitious plan on the issue last May. However, the plan has attracted controversy over its feasibility and now faces another hurdle due to a funding shortage.

The Ministry of Labor, War Invalids and Social Affairs has put off a US$10 billion program to provide free milk to school children part of the plan at least until next year due to a government cut in public spending.

For the last several months officials from the ministry have been discussing the plan to provide fresh milk daily to 400,000 children at nurseries and primary schools in the country's 62 poorest districts.

A ministry source told Tuoi Tre (Youth) newspaper that the plan, which was to have been submitted to the government at the end of this year for approval, would have to wait until the economy recovers.

The government, whose finances are in the red, is cutting spending on many public programs.

GDP growth fell to a 13-year low of 5.03 percent last year.

Longing for new heights

According to a survey by the National Nutrition Institute, an average Vietnamese man measures 164.4 centimeters (5 feet 4 inches) and woman 153.4 centimeters (5 feet), and the figures put Vietnam at among the lowest in the region.

The plan aims to increase the average height of Vietnamese men at 18 years to 1.67 meters by 2020 and 1.685 meters by 2030. The target heights for women are 1.56 meters and 1.575 meters respectively.

The project, approved by Prime Minister Nguyen Tan Dung in 2011 and estimated to cost around US$287 million, covers studies and action programs that will increase awareness and encourage exercise and other healthy habits.

At a recent government meeting, Minister of Culture, Sports and Tourism Hoang Tuan Anh said the local workforce will not be able to satisfy the country's growth demands if Vietnam fails to improve the height and physique of its residents.

"The physique of Vietnamese people remains at low levels. They couldn't become a workforce strong enough for the process of industrialization and modernization. Improving their height and physique is an urgent demand," he said.

According to Anh, the height of Vietnamese men and women is 8 and 9 centimeters shorter than "the standard". He did not elaborate on what "standard" he was referring to.

According to a report released at a conference last week held by the National Nutrition Institute in Hanoi, the average height of Vietnamese men between 22-26 years old is 1.644 meters.

Meanwhile, the average height of the same group is 1.675 in Thailand, 1.706 in Singapore and 1.739 in South Korea.

The average height of Vietnamese women at the same age group is also the lowest in the region, it found.

Undernourished generation

Nguyen Thi Lam, deputy director of the National Nutrition Institute, said the average height in Vietnam is low due to socio-economic difficulties.

"This group was born in the 1980s when the country suffered from post-war economic difficulties. People did not have enough food for their children's full height growth," she said.

Lam said nutrition plays an important role in maintaining good health and in helping children grow to their optimum height.

At the last week conference, many experts said the height of a person depends 20 percent on genes and 80 percent on other factors, including nutrition, physical exercise and living environment.

Nguyen Gia Khanh, vice chairman of the Vietnam Association of Pediatrics, said 60 percent of children under 6 years old often have digestive disorders that result in stunted growth or sometimes fatality.

Nguyen Cong Khan, director of the health ministry's Department of Science and Technology, said conditions have not been conducive for Vietnamese to maximize their height potential.

Studies have found that many Vietnamese living in France since birth are as tall as their French counterparts, he said.

Infections also hinder a person's growth, so any program to increase height should combine nutrition with food and environmental hygiene, he added.

How high is enough?

Experts have also said that in the context of limited funding, investments should be used to improve nutrition and healthcare rather than just focusing on a target height.

Nguyen Van Tuan, a Vietnamese senior researcher on bone genetics at the Garvan Institute of Medical Research in Australia, said it is unreasonable to set a "standard" height of 176.8 centimeters for men and 163.7 centimeters for women.

"I think that standard is also out of reach of many western countries. In Australia, the average height is only 175.6 and 161.8 centimeters for men and women respectively," he told Vietweek.

He also advised that thorough scientific research be done before any plan is launched.

"Dozens of studies have found that genetics play a major role in deciding human height, not only 20 percent," he said, adding that one study found genetics accounting for 76 percent of human height.

"There should be variations for targeted height among different groups instead of a fixed average target," he added.

Tuan said he and his colleagues had surveyed more than 1,200 people in HCMC and their height was well above the targets for 2020.

"The average height of men is 170 centimeters and of women is 156 centimeters, with a variation of 6.3 and 5.8 centimeters among men and women respectively.

"This means the height of the youths in HCMC is well above the targets set for 2020," he said.

From another angle, Nemat Hajeebhoy, Vietnam country director for Alive & Thrive, a Washington-based non-profit organization that seeks to improve health and nutrition and reduce stunting, said the stunting prevalence is still unacceptably high for a lower middle income country.

There should be effective implementation of relevant programs, especially to improve the nutrition of children in remote region instead of focusing solely on the height, she said.

"Investments are needed at national and provincial levels to implement the National Nutrition Strategy and ensure that interventions and services have good coverage and are targeting hard to reach areas, poor households and ethnic minority groups," she said.

"Capacity needs to be built of the health sector to address this problem. At the same time, support from other sectors particularly agriculture and education is needed to make sure that the investments in nutrition per se are effective."

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