The government must boost efforts to eradicate malnutrition among Cambodia’s women and children, many of whom are still chronically malnourished despite improvements in recent years, according to a new report in the International Journal of Food and Nutritional Science.

Basing the study on a review of research from UN organisations, non-profits and the government, the authors determined that stunting among Cambodia’s children under the age of 5 dropped from 45 percent in 2010 to 32 percent in 2014. Nevertheless, malnutrition is still thought to contribute to around 45 percent of child deaths in Cambodia, the study says.

“The drop in stunting is a great achievement for the country, but 32 percent is still very concerning,” said David Raminashvili, a nutrition expert at World Vision Cambodia. “If this trend continues for five years, then we’ll see some progress.”

The study considers children “stunted” if they are below an average height range for their age. A designation of “wasted”, meanwhile, is applied for children who are below average weight for their height, and “underweight” applies to children who are below average weight for their age. As of 2014, 24 percent of Cambodia’s children under the age of 5 were underweight, while 10 percent were wasted.

Global development experts widely believe that stunting in developing nations has a long-term negative impact on a country’s economic growth and development. According to a study cited in the report, malnutrition is among the most important factors causing poverty in Cambodia.

Meanwhile, zinc deficiencies are the most common deficiency in Cambodia, with around 73 percent of infants and toddlers suffering from a shortage. Around 71 percent of the same group are anaemic, and 28 percent have a Vitamin A deficiency.

But while the government is nominally committed to solving malnutrition, releasing a 2014-2020 roadmap to improve nutrition, the study determined that an “efficient effort” to allocate resources to combat malnutrition has “not been seriously taken into account in this country”.

Raminashvili, meanwhile, said the government often claimed it had insufficient resources for programs to provide nutritional supplements to poor communities.

These issues are acutely felt by Cambodia’s women and children, the study said, adding that around 19 percent of non-pregnant women between the ages of 15 and 49 are underweight. In Cambodia, this is especially true among women who have entered the labour force. The study noted that women who work have less time to ensure that their children are eating properly, and often don’t have time to feed themselves.

“Most of the women who work in factories are definitely malnourished during pregnancy, which means their children will also be malnourished,” said Raminashvili. “We definitely know that working, and not having enough time to eat, is affecting the health of mothers and children.”

Meanwhile, the authors noted that Cambodian cultural norms may contribute to the problem. Family hierarchies ensure men eat first while mothers and daughters usually eat last. “This could lead to wasting and undernutrition in younger girls which can later affect their reproductive health and cause maternal health issues ultimately contributing to the intergenerational cycle of malnutrition,” the study reads.