SBN Case Study: Gender

Working hard for women’s nutrition

Improving the workplace menu in Laos

To address high rates of anaemia and child stunting, the Scaling Up Nutrition Business Network in the Lao People’s Democratic Republic is focusing on improving workforce nutrition, particularly among women, by working with support from the government, the private sector, and various United Nations agencies.
The Lao People’s Democratic Republic (Lao PDR) is one of the most sparsely populated countries in Asia, but also has one of the fastest growing economies in the region. Although the proportion of people who are hungry has been falling, the Global Nutrition Report reveals 39.7% of women and girls aged 15 to 49 years are anaemic, and 33% of children under five are affected by stunting. Health and nutrition indicators also vary considerably across the 49 ethnic groups and tend to be worse for non-Lao-Thai groups, who are twice as likely to live in poverty according to the United Nations Educational, Scientific and Cultural Organization (UNESCO).
Women constitute 59% of internal migrants in Lao PDR, and poverty drives many of them to migrate to the capital, Vientiane, in search of work in the garment sector. This sector is a major industrial employer of women, particularly ethnic women, who are at an increased risk of malnutrition and are more likely to be affected by discriminatory cultural food practices around pregnancy and young child feeding.
To improve nutrition and address specific Lao health needs, Lao PDR joined the Scaling Up Nutrition (SUN) Movement in 2011. By 2016, the government had begun working to mobilise support to liaise with the private sector and, in 2018, with support from the World Food Programme, the Lao PDR SUN Business Network (SBN) was formed.
Through four key strategic areas – healthy food at work, nutrition education, health checks, and breastfeeding support – SBN Lao PDR is supporting the National Nutrition Center to encourage companies in the garment, food and beverage, and hydro power industries to implement workforce nutrition programmes. The programmes target women and men of reproductive age and pregnant and lactating women, to create a comprehensive understanding of nutrition and counteract gendered assumptions about the burden of care. Five district hospitals, 13 small food and beverage factories, and 30 garment factories are currently involved.

Working for better nutrition

A set of ‘Nutrition at Work’ guidelines, modelled on a handbook developed by the Global Alliance for Improve Nutrition (GAIN), are SBN Lao PDR’s primary strategy for improving workforce nutrition. They are widely applicable to a variety of work environments, including those that provide employment opportunities to ethnic women. For example, ensuring healthy food availability at work is one of SBN Lao PDR’s four priority areas, but achieving this goal is much more complex than simply introducing nutritious food products into workplaces.

Canteen food must cater to the tastes and requirements of all the workforce, which is no easy feat; particularly as factory employees come from all 49 ethnic groups living in Lao PDR, each with different nutritional challenges and cultural practices. Consequently, some employers have opted to offer cash, which is typically used to buy cheap, unbalanced meals to retain excess money for families, whilst others provide only one meal option. Currently, only one employer provides a varied menu.

The network’s guidelines provide six options to help ensure healthy food at work, including a combination of cash and nutrition education to encourage employees to make good health decisions, as well as company-subsidised healthy snacks. “This programme has been adapted and designed in the Lao context, with various choices for employers to implement,” explains Manilay Vanphavong, SBN Lao PDR Country Coordinator.

“The strength of the workforce nutrition programme is its ability to join together the public and private sectors, as well development partners, in their efforts to improve nutrition in Laos. By reaching vulnerable people, we can offer everyone an equal opportunity to provide good nutrition for themselves and their families, be it through exclusive breastfeeding or better dietary practices.”

Manilay VanphavongSBN Lao PDR Country Coordinator

Enhancing workplace wellbeing

SBN Lao PDR also provides support to factories in the implementation of education and nutrition improvement initiatives within the workplace. This includes the provision of training, advocacy materials, and a specially-developed check-up toolbox for factory nurses and district hospitals, which combine to form a comprehensive workforce nutrition programme.

Furthermore, SBN Lao PDR is working to incorporate nutritional aspects in the annual health check of garment factory workers, which is required by Lao labour law. They are adding basic nutritional checks such as BMI, a basic nutrition checklist, and nutrition consultation guidelines, which consider the specific needs of pregnant and lactating women. Business owners cover the cost of the checks and partner with public hospitals providing the services.

While many United Nations agencies and non-governmental organisations promote breastfeeding and infant and young child nutrition in rural areas, SBN has also identified a gap in services for urban migrants. As such, it is actively promoting breastfeeding through maternity leave, and developing guidelines for the setup of appropriate breastfeeding spaces at work and general guidelines and tips for pregnant and lactating women.

Strategy for success

Involving multiple sectors is critical to improving nutrition, as these industries – from government agencies to garment factories – employ large numbers of individuals. “Workforce nutrition has been implemented in many countries with positive evidence that both the employer and employee benefit, thanks to increased productivity and reduced sick leave,” Manilay enthuses.

In February 2021, SBN Lao PDR took a big step in the development and implementation of the workforce nutrition guidelines, holding an event gathering private sector corporations, such as garment factories, and public sector organisations, including the Ministry of Health and THE Ministry of Labour and Social Welfare. Hosted in collaboration with the European Chamber of Commerce and Industry, this was critical to SBN Lao PDR’s efforts to address workforce nutrition.

Increasing the private sector’s understanding of the importance of improved workplace nutrition was a key aim for the event, to enable companies to share good business practices on improved nutrition, encourage participation in the workplace nutrition programme, and further develop guidelines to be more practical and easier to implement in factory settings.

Partnering for bright prospects

By engaging multi-sectoral stakeholders in their workforce nutrition programme, SBN Lao PDR is making strides in identifying feasible strategies to implement all aspects of its initiative. The Association of Lao Garment Industry (ALGI) has requested another event to further discuss guidelines and goals, and the network continues to make plans and facilitate discussions to work towards a more nutritious future for Laos. According to Phimmasone Aminthalath, ALGI Vice President, the long-term goal is for all of their members to “eat well, be healthy, increase productivity, and enjoy a long life.”

The guidelines target both women and men to address discriminatory gender assumptions on the burden of care – including the family’s nutrition being a woman’s responsibility. However, to promote a holistic approach to household wellbeing and reduce women’s workloads, SBN would like to further incorporate men into nutrition education. With the cooperation of experienced actors, such as CARE International and the United Nations Population Fund, SBN also aims to include actions on gender-based violence and workplace harassment, which can have a significant impact on wellbeing.

For more information contact:

Maree Bouterakos

Head of Nutrition, WFP Laos