what we do

Zoom in on a life-changing project in Binh Dai (Ben Tre province)

In over the last 10 years, in Binh Dai District, Ben Tre Province, there is a project that has been providing life-changing instrument for thousands of women to rise against poverty…

From poverty to financial independence

In the past, Ms. Truong Thi Phuong (born in 1972) and her husband, residents of Phu Thanh Hamlet, Phu Vang Commune, Binh Dai District, Ben Tre province used to made a living out of a small vegetables garden and some seasonal jobs, which generated a modest amount of income.

Despite being diligent, they still struggled to make ends meet. When their children got into college, the couple were over the moon but also extremely worried. The kids would have a brighter future than their parents but how could they manage to pay for their four-year tuition fees and other expenses in the city.

Ms.Truong Thi Phuong and her grocery store.

Phuong’s family life came to a turning point in 2015, when she became member of the Women Union of Phu Vang Commune and began to get accesss to the Micro Credit and Saving project, implemented by the Medical Committee Netherlands-Vietnam (MCNV) and sponsors.

With the loan provided by the project, Phuong and her husband shortly sleeved up to find their ways out of poverty. Part of the cash was spent on poultry rearing, while the rest was invested in launching a small grocery store.

“At the beginning, due to my lack of experiences, we faced a lot of challenges”, Phuong recalled.

Fortunately, thanks to active participation in science and technology transfer workshops held by local Women Union, Phuong and her husband soon acquired fundamental knowledges in farming as well as doing business. Step by step, their ‘startup’ started to yield profits, providing a stable source of income, and at the same time, could be used as capital to feed new investment.

After several microcredit cycles, following the advices of project staff and the senior members of local Women Union, Phuong bought a cow which later gave birth to two calves. After deducting all costs of rearing, they earned around VND tens million annually.

Since the rearing was not time-consuming, Phuong’s husband spent the rest of his day on some part-time jobs such as bricklaying, fishing, which earned him VND few hundred thousand per day.

After 5 years of participating in the Micro Credit and Saving project of Binh Dai district, Ms. Truong Thi Phuong and her husband have filed for crossing their name in the poor households list.

From the bottom where the couple could not make ends meet, now they have secured stable and sufficient income. As the two children have graduated from colleges and have found jobs, the family is free from worries about livelihoods. Their old wobbly house has been renovated into a fully furnished one.

Phuong also has more time for community activities. She is very enthusiastic about sharing her experience in doing business with her neighbors, fellows, and lending supports to those in need.

“‘A stitch in time saves nine’, more than anyone, I understand what it is like to live in poverty. At the moment, I am willing to help anyone in need”, she said.

Striving from the bottom, she is always grateful for what the Micro Credit and Saving project and her fellows have done to support her.

Freshwater security against salinity

Ben Tre is severely affected by saline intrusion. Illustration photo: VNA

Located in the Mekong delta region, Ben Tre is severely affected by saline intrusion. Even local water plants are affected with salinity of 2 grammes.

Located on an islet, Binh Dai district’s four sides were surrounded by rivers and seas, making the area more vulnerable to saline intrusion (high salinity, deep intrusion level). Local residents are facing huge challenges as saline intrusion negatively affected agricultural production and daily life.

In the fierce battle against salinity, Binh Dai district was lucky enough to receive aid from the Micro Credit and Saving project. Along with providing loans to support livelihoods, the project has also assisted poor, nearly poor, and disadvantaged households to build water containers and purchase rainwater and freshwater storing tanks for daily life and production.

Ms.Nguyen Thi Kim Oanh and her water container.

“In 2016, I registered for a loan of VND five million to build two 4m3 water containers; the costs for materials and workers was around VND six million …” , said Ms. Nguyen Thi Kim Oanh (Tan Long hamlet, Thanh Phuoc commune).

According to Oanh, thanks to the project, her family could store enough freshwater to use for the whole year. In the dry season, the family consume more well water therefore they always have extra stock of rainwater.

Being aware of the benefit in the long run, in 2018, Oanh continued to take a new loan of VND five million to build two 6m3 water containers, the two cost around VND seven million.

Ms. Nguyen Thi Phuong Thao (born in 1985) lives in Vinh Tan hamlet, Vang Quoi Dong commune is another beneficiary of the project. Thank to the 6m3 rainwater, freshwater container, her three-member family now can feel secured during drought season.

 “Because saline intrusion occurs every year, I decided to build container to store rainwater or freshwater for daily use. In 2016, I filed for a VND five million in 24 months to build two containers. I was thrilled as they were so helpful. Without them, we would have had to use saltwater like the previous years, which negatively affects sanitation. I am going to borrow some more to build another two containers. If salinization persists, I am afraid that there will not be enough freshwater…” 

  • The Micro Credit and Saving project in Binh Dai district was launched by MCNV and sponsors in 2009.
  • The project has been expanded to 11 communes and townships, providing financial services and facilitate socio-economic inclusion for over 5,000 disadvantaged and poor women, supporting household economy development, response to saltwater intrusion and new rural development.
  • The project has so far provided 954 households with loan to construct their own water containers. From the beginning of the year, 149 households have received the supports, leading to more registration for loan. 
  • Nowadays, the project has become financially self-sustained, and is being conducted with the permission of the State Bank of Vietnam, Ben Tre provincial branch.
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Skill training benefits members of credit groups in Binh Dai (Ben Tre province)

15 credit group leaders and prospective clients of the Micro Credit and Saving project in Binh Dai district, Ben Tre province have recently completed a 3-day workshop on microfinance skills.

The three-day workshop equips trainees with relevant knowledge and skills.

The training aims to provide trainees with relevant knowledge in micro credit, including the access to loan, financial services and the effective use of capital, contributing to poverty alleviation and economic development in the locality.

During the three-day workshop (February 17-19th), local-based project coordinators helped 15 trainees gain fundamental understanding of ‘credit’, ‘credit group’ concept ; provided guidance on how to develop, manage and coordinate credit groups as well as introduction to Microfinance (purpose, target clients, loan policy, etc).

The workshop also included a Q&A session, in which the trainers provided answer for trainees’ enquiries on how to solve the problems they encountered while leading/participating in a credit group.

In addition, the trainees were also instructed on bookkeeping, as well as other skills in a field-trip to learn about credit management in real life.

Better financial knowledge and skills can help change the lives of many women and their families.

“We expect that all of the trainees will become helpful assistants of Binh Dai district project management board in the time to come”, said Ms.Vo Thi Be Hai, Deputy Head of the Project management board.

  • The Micro Credit and Saving project in Binh Dai district was launched by MCNV and sponsors in 2009.
  • The project has been expanded to 11 communes and townships, providing financial services and facilitate socio-economic inclusion for over 5,000 disadvantaged and poor women, supporting household economy development, response to saltwater intrusion and new rural development.
  • Nowadays, the project has become financially self-sustained, and is being conducted with the permission of the State Bank of Vietnam, Ben Tre provincial branch.

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Improving nutrition for hundreds of Cham H’roi children

Located in the remote mountainous area of Phu Yen province, 100% of Phu Mo commune’s residents are of Cham H’roi ethnic group. 25% of the children in the community are malnourished. Being aware of this situation, MCNV has cooperated with local partners in Phu Yen to bring about better meals and better lives to the children.

Malnutrition obsession

On contrary to the name which means “rich and fertile”, Phu Mo is known as the highest, remotest and poorest commune in the southern central province of Phu Yen.

With a population of more than 3,000, 70% of the local residents are impoverished or living on the threshold of poverty.

Local people earn their living on shifting cultivation, earning for their livings mostly by planting cassava. Due to the instable price, this crop only can help them generate a limited and instable income. Rice, cassava leaves, wild vegetables and chili mixed with salt are what usually seen in their daily meal.

According to a survey conducted by MCNV and Hue University of Medicine and Pharmacy in March 2018, 76.7% of the households in Phu Mo and Xuan Quang 1 communes (Dong Xuan district) did not have sufficient food to eat each year. Besides low income, people in these localities face with another challenge in access to food, which is the shortage of supply, since most nearby groceries only sell dried food like instant noodles, porridge and snack for kids. Meanwhile, in kindergartens, neither lunch nor breakfast is provided due to the lack of funding.

In Phu Mo commune, out of 100 kids, 25 suffer from malnourishment, in the form of stunting or underweight. In some villages, this rate even exceeds 50%.

Mang Thi Su, 25 years old, is a mother of two children: one boy (6 years old) and one girl (3 years old). Both of them were pale and weak, due to malnutrition. Feeding the kids was a tough job for the young mommy, since regardless of how hard she tried, her children kept refusing to eat.

Mang Thi Su prepares a meal for her children

According to MCNV, the high rate of malnutrition in Phu Yen is caused by several factors. Apart from economic constraint and scarcity of quality food supply, parents’ lack of understanding and knowledges in childcare and nutrition is a critical factor which must be tackled.

Awareness change

In June 2018, the concerns of Su and other women in Phu Mo commune began to be relieved thanks to the project “Scaling up of malnutrition fighting initiatives based on agricultural solutions in the mountainous areas of Vietnam and Laos ”(referred to as Nutrition Sensitive Agriculture – NSA), implemented by MCNV.

Thanks to the project, for the first time, Su gained basic knowledge in nutrition, learn how to prepare suitable meals for her children with tasty, nutritious yet still affordable dishes.

The instruction of nutritionists and healthcare advisors has enabled Su to diversify the ingredients for the daily meals, and turn them into child-friendly dishes (pleasant to taste and easy to digest). The dishes Su cooks now looks more catchy, as they are added the colors of a variety of healthy ingredients. Some of them are very easy to find in her home garden, such as tomatoes, carrots, eggs, etc.

Nowadays, in Su’s family’s every meal, the pleasure has replaced the worry, and the excitement has filled the eyes of the children. Her home is now full of smile and laugher, instead of the sound of scolding and crying. “He (Su’s son) loves colorful dishes very much. He can eat one bowl or even one and a half bowl of rice with food. I am overwhelmed with joy, especially when he finishes eating, sits on a scale and asks me “Mom, how much do I weigh now?” In the young mom’s eyes, happiness sparkles.

The change in one individual step by step leads to the change of a group and later on spread to several groups. Every month or every week, members of each group gather for a meeting, at which they share about the health and nutrition situation of their children. They often exchange opinions and learn from healthy child-rearing examples and update cases that need to be monitored, practicing how to prepare nutritious and affordable dishes.

Joining hands to solve the malnutrition problem

Improving the community’s awareness about nutrition in childcare is one of the many activities conducted in the NSA project. A holistic approach has been implemented with the close coordination of four sectors: health, agriculture, education and private businesses.

Under the coordination of local health staff, district, commune and village workshops and trainings were implemented. Health workers, leaders of mother groups and pre-school teachers are trained in nutrition and environmental sanitation. Children get regular health checkups, and severely malnourished children receive treatment.

In addition, households are trained to increase production, improve nutrition from their own gardens, fields and yard, for example raising chicken to lay eggs, or intercropping with vegetables and fruits.

To increase the quality of children’s meals, the NSA project also gives funding to preschools to provide in-school lunches and breakfasts, as well as orienting the private sector (food and grocery stores) to sell nutritious products such as porridge, cakes, and cereal flour, and facilitating the household to access nutritional products.

The NSA project is implemented by MCNV in Dong Xuan district in the period of 2017-2020, in cooperation with different partners, including WOTRO, the Vrije University Amsterdam (Netherlands), Hue University of Agriculture and Forestry, and Hue University of Medicine and Pharmacy.

Not only does it solve the problem of malnutrition among Vietnamese children, the NSA project also supports Lao children in 10 villages of Nong district, Savannakhet province. Currently, the Lao side has completed the initial survey, knowledge sharing and quantitative research survey toolkit, trained on research methods, data analysis, development of intervention plans and organized some initial intervention activities.

MCNV’s nutrition project is an effort towards the UN’s Sustainable Development Goal No. 2 on hunger eradication, food security, nutritional improvement and agricultural development.

By Phi Yến (Vietnam Times)

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Learning about the use of Innovative Communication Methods (LICM)

Background

Disadvantaged and discriminated groups of people such as handicapped people, older people, HIV/AIDS infected people or people with a different sexual orientation are often shy, tend to stigmatise themselves, and often struggle with feelings of shame and self-doubt.

MCNV’s response

To assist disadvantaged groups in overcoming their shyness and to encourage them to engage in dialogues with a wider public, MCNV has experimented a lot with the use of Innovative Communication Methods (ICM). MCNV uses the term ‘Innovative Communication Methods’ to denounce creative and entertaining styles of communication such as community-based theatre, shadow drama, narrative story-telling, body mapping, songs, dance and participatory video.

The experience was so successful that MCNV decided to expand the application of the ICM approach to other areas of work including awareness raising on health issues and policy advocacy in areas like garbage collection and Sexual and  Reproductive Health and Rights. The ICMs that MCNV supported to use in Vietnam included theatre based approach, puppet plays, participatory video, dance and folk singing.

 

Achievements

The use of arts (drama and songs) improved the social status of both the Village Health Worker Association (VHWA) and Community Based Organisation (CBO) they cooperated with.  Besides that, the Village Health Worker Association (VHWA) and Community Based Organisation (CBO) members became more confident of themselves through the use of arts and became less afraid of speaking out in public meetings. In 2015, Disabled People Organisations (DPOs) and Old People’s Organisations (OPAs) in ethnic minority areas of Quang Tri province managed to collect Eur 30,000 from their communities through campaigns and public meetings where they performed drama and songs, and they use this money to sustain their community development activities. LICM demonstrated its positive contributions to advocacy as well. For example, in 2014, the Old People’s Organisations (DPO) in Quang Tri successfully lobbied for an increase of the budget of the district allocated to old people’s health by organising lobby events during which they performed drama.

Future plan

Recently, MCNV obtained funding of OXFAM-NOVIB and HIVOS to experiment with the use of ICM in Laos as well. MCNV will assist three vulnerable youth groups i.e. handicapped youth, LGBTQI youth and girls working in garment factories in Laos in using ICM for their own empowerment and for advocacy. The project allows MCNV to enlarge her experience in this field and promote the method further.

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Collaboration And Networking To Enhance Education and Nutrition (CANTEEN)

Background

Improvement on nutrition and food security continues to be MCNV’s work priorities in Laos and especially in the areas where more ethnic minority groups are living. Nutrition and food security are closely interlinked and requires multi-sectoral approach as per the 8th National Social Economic Development Plan by the Government of Lao PDR, which states: “Nutrition is one of the sectors that faces challenges in the implementation since it is associated with several sectors such as food security, food access and food consumption. To counter these, it requires effective collaboration and shared responsibilities among the concerned agencies including sector of health, education, agriculture, environment, industry and commerce, etc.[1]”.

MCNV’s response

In Lao PDR, MCNV has recently started CANTEEN programe (Collaboration And Networking To Enhance Education and Nutrition). This is a 4.5 year-program (between Jan 2017 – June 2021), which is funded with 75% budget contribution by the EU delegation to strengthen the capacity of Civil Society Organisations (CSOs) and Local Authorities (LAs) to work in partnership towards the achievement of development goals. The programme has two specific objectives as follows:

  1. To build the capabilities of at least 6 LAs, 1 non-profit association (NPA) and 20 village development committees (VDCs) to work together to deliver nutrition sensitive services that improve food security, nutrition, and overall well-being of more than 6,000 poor ethnic minority people in 20 remote upland villages in Nong District, Savannakhet province.
  2. To strengthen capacity in policy dialogue and promote participation, transparency and accountability in multi-sector partnerships to encourage the uptake of successful models and to increase involvement of CSOs in development processes.

CANTEEN works closely with CODA (a Lao NPA – non for profit association) and Provincial Health Department of Savannakhet province to promote collective and coordinative working among different local authority organisations and community based organization in Nong district to work together for improvement in nutrition and food security at village and district levels. The experience and lesson learnt from such multisectoral coordination will contribute to and be shared with other stakeholders at provincial and national levels who are working together to improve the situation of nutrition and food security in Lao PDR.

Expected results

During its 4.5 years implementation, CANTEEN program will support a range of activities in order to achieve the following expected results:

Expected result 1.1: Strengthened capacities of the participating LAs, CSOs and CBOs to deliver relevant, effective nutrition services to marginalised and vulnerable people, in particular women and children: This focuses on strengthening capacities of participating CSO and LA organisations and their staffs and members. The specific paths for capacity-building will be designed based on analysis of current gaps and future needs of each participating organisation. For the 20 participating Village Development Committees (CBOs) the Action will use a small-grant support scheme to help them improve their skills by practicing a full cycle of small experimental projects.

Expected result 1.2Reduced malnutrition and food insecurity in target villages through adoption of convergent approaches that include key stakeholders in health, agricultural and education sectors: This is designed specifically to demonstrate effectiveness of the convergent approach in reducing the incidences of malnutrition and food insecurity in the selected villages. This emphasises the importance of working together to achieve a common goal. All sectoral interventions (i.e. educational, agricultural or health) are designed for nutrition sensitivity and are aimed at generating evidence on how to contribute to reduction of food insecurity and malnutrition. The proposed interventions under this refer to 14 of the 22 priority actions identified in the recently published National Nutrition Strategy to 2025 and Plan of Action 2016- 2020, designed to reduce malnutrition rapidly and sustainably with an emphasis on gender equality and the rights of women and girls.

Expected result 2.1: Increased effectiveness of institutional environment for CSOs and LA, with stronger networks that have better capacity to advocate for sustainable approaches using evidence arising from the action. This will show the up-scaled and sustainable interventions in Nong District, using evidence-based advocacy to argue for their replication, adaptation and adoption in other areas of Lao PDR. It will strengthen links with civil society networks such as the Scaling Up Nutrition (SUN)-Alliance. This adds value to GoL’s plans, as it currently is expanding the rollout of convergent approaches to other provinces, including Savannakhet, and will be seeking evidence and support for effective implementation and expansion.

[1] The Five Year National Social Economic Development Plan VIII – 2016 – 2020: part I: 7th NSEDP 2011-2015: achievement and lessons learned. Lao PDR.

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Nutrition sensitive agriculture in Lao PDR and Vietnam

Background

Despite significant development progress in recent years, hunger remains a significant problem in Lao PDR, with 44% of children under 5 years old being malnourished placing their lives at risk and damaging their lifelong health. This issue is particularly severe in Nong District, one of the poorest areas in Lao PDR, and where the people can suffer food shortages for many months in the year. To tackle these problems MCNV takes a nutrition-sensitive approach to its agricultural and livelihoods work within some of poorest villages in the district.

MCNV’s responses

This approach seeks to maximize agricultures contribution to nutrition and recognizes the multiple benefits derived from enjoying a varied and nutritious diet, the social significance of food and the importance of agriculture in supporting rural livelihoods. Instead of focusing exclusively on crop production for the market, villagers use their land to cultivate a variety of commodities including fruits, vegetables, small livestock and fish. In Nong, MCNV has supported this approach by supporting the development of fish ponds, providing seeds and equipment for home gardens and strengthening village veterinary services to ensure healthy livestock. MCNV’s approach to agriculture also entails promoting gender equity, and providing nutrition education so that household resources are used to improve nutrition, especially that of women and young children. For example, the approach looks at the division of labour between men and women, to ensure mothers have enough time to breastfeed their infants. Finally, MCNV adopts a multi-sectoral approach to nutrition linking agriculture to sectors that address other causes of malnutrition, namely education, health and social protection.

Achievements

Through working in partnership with organisations ranging from village development committees to the Ministries of Agriculture, MCNV has improved agricultural production whilst preserving the soil, land and water that villagers depend upon, but most importantly it has helped to reduce hunger and malnutrition improving the health of children with lifelong benefits.

Future direction

In the coming years MCNV is working with the Food and Business Knowledge Platform and VU University in the Netherlands to conduct research into the impacts of nutrition-sensitive agriculture to ensure that it can be scaled-up so many more people in Lao PDR and elsewhere can benefit from this approach.

http://knowledge4food.net/research-project/scaling-up-nutrition-sensitive-agricultural-initiatives-in-vietman-and-laos/

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Learning through health research

Background

Research is vital for informing and underpinning MCNV’s interventions and ensuring that we can understand their impact. It also helps to ensure that knowledge is generated to inspire new ideas, catalyse innovations, and provide evidence to policy makers to inform their decision making and help ensure that policies are effectively implemented. The publication of research also helps to inform others of new processes, methods, techniques and ways of thinking that contributes to improved ways of working to reduce poverty and improve health.

MCNV’s responses

In Lao PDR, MCNV runs the LEARN (Lao Equity through policy Analysis and Research Networks) this a 5 year program that is funded by the EU Commission to enhance the capabilities of public health institutes in Laos. Working together with a range of partners the program aims to ensure that the Laos National Institute of Public Health becomes of centre of excellence for the provision of evidence-based and contextually adapted policy advice. This evidence is used to enhance decision making and improve the implementation of health policies both within Laos and the wider Greater Mekong Sub-region (GMS)

LEARN brings together a unique range of partners to achieve this goal. As well as the Laos National Institute of Public Health, LEARN also brings together the University of Health Sciences in Laos, the VU University in the Netherlands, the Hanoi School of Public in Vietnam and MCNV, an international NGO that has been working in the health sector in the GMS for many decades.

These partners come together to help ensure that:

  • Effective and convincing evidence is available to policy-makers who are better able to use it for policy making and programming
  • The National Institute of Public Health and its partners have increased access to finance, skilled human resources and information.
  • Researchers are able to produce high quality research and are able to convincingly present results and recommendations to a wide range of stakeholders.

Expected results

During its 5 year implementation the program will support a range of activities including;

  • International scholarships for Lao researchers to gain Phd’s
  • A joint Masters in Public Health Program between University of Health Sciences and Hanoi School of Public Health
  • Upgrade of IT facilities and introduction of public health e-learning resource centre
  • A research grant scheme to support the production of high quality research with Laos
  • Development of a long-term strategic plan for National Institute of Public Health
  • A wide range of workshops and trainings in areas ranging from ethics, transdisciplinary research practice, and production of policy briefs.

In addition to this major project, MCNV also conducts research in a wide range of areas including the impact of its agricultural interventions on nutrition and how these can be scaled-up, the use of IT in development, the control and prevention of malaria, the effectiveness of self-help groups in empowering people living with HIV and examining barriers to policy implementation in areas as diverse as the provision of mental health services and access to mother and child healthcare. Research is often conducted in partnerships with Dutch Universities such as VU University. The research is action-based and reflective and is designed to ensure that all people are involved in the process, for complex issues such as malnutrition, multiple stakeholders and engaged in the research and transdisciplinary approaches are used. MCNV’s works in research helps us to understand better the world around us and ensures we can support people within development processes to make the world a better place.

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Stimulating Entrepreneurship among vulnerable groups

BACKGROUND

Entrepreneurship is about leadership, innovatively, creativity and about envisioning and exploiting possibilities. Several programs have shown the positive influence of entrepreneurship on poor and marginalised people. When they find ways of earning money they feel respected, it helps them to get into daily routines, and it makes them proud to be able to contribute money to their families and communities. The development of different types of Community managed Development Funds combined with entrepreneurship trainings and trainings on financial literacy, have already assisted thousands of people to improve their living conditions. MCNV plans to increase activities in the field of entrepreneurship especially in Vietnam.

MCNV’S RESPONSES

The market economy offers a proportion of marginalized people chances to escape their poverty. However, many face barriers of access, lack necessary capabilities or do not recognize, or even believe, that they have chances. For this reason it is important for MCNV to study and take into account how local market systems work and identify barriers and facilitators for access by marginalized groups. The work with market systems takes various forms in different programs/projects, and at different levels of development.

Almost all ethnic minorities were dependent on self-subsistence farming and have increasingly come into contact with ‘the markets’. First the traders came via the new roads (opened for ‘development’) to them from elsewhere to buy agricultural products at the farm gate. But after that these traders established shops right in the farmers’ communities and used their knowledge and networks to become ‘middlemen’ between the local producers and outside markets. The impact of these middlemen is manifold: on the one hand they help poor farmers creating new sources of income, new crops and agricultural knowledge, but on the other hand it is in their interest to keep the farmers dependent on them, for instance via debt traps and protecting their local monopolies. In the Community-Managed Health and Livelihood Development project in Khanh Hoa province (2004-2016), MCNV has worked long with ethnic minority communities to help them increase their aspiration, self-confidence and knowledge and to gradually reduce their dependencies on the middlemen, as well as on the local government.

A next step in ‘working with the market to alleviate marginalisation and poverty’ is best illustrated by MCNV’s Microfinance projects, such as that managed by the Women’s Union in Ben Tre, where poor women groups learn to save and invest money to set up and grow small businesses. Basic “financial literacy” is often lacking among the marginalised target groups and therefore MCNV is building this capacity among many groups, like for Disabled People’s Organisations to know how they could act best to maintain and gradually grow their Revolving Funds.

Future plan

Many further steps are needed to make the market work best for the poor. A large majority of Vietnamese farmers are small-holder farmers who certainly do not lack entrepreneurship or financial literacy, but they are poorly organised, which significantly decreases the influence and the “Value Chains” of their products. In Quang Tri province, Vietnam, MCNV is developing relationships with farmer’s cooperatives, and agricultural producer groups. In the near future, MCNV intends to link these initiatives to farmer groups and value chain development in neighbouring area’s in Lao PDR, thus enhancing cross-border value chain development.

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Civil Society Development

Background

Civil Society embraces the general public at large, representing the social domain that is not part of the State or the market. Civil Society is a sphere where people combine their collective interests to engage in activities with public consequence. The increasingly accepted understanding of the term Civil Society Organisations (CSOs) is that of non-state, not for-profit, voluntary organizations formed by people within the social sphere of civil society. These organisations draw from community, neighbourhood, work, social and other connections.

The Disabled People’s Organisation (DPO) encouraged disabled people to share their dreams, to develop personal plans, and to help them to make those dreams and plans come true. As an organisation we grew our capabilities to support the holistic development of individuals, families and groups of people with disabilities (written by a disabled person from a village in Quang Tri Province during a reflection session in 2015).

MCNV’s response

MCNV has increasingly strengthened and cooperated with CSOs over the years. CSOs have become an increasingly common channel through which we assist elderly, women with HIV/AIDS, ethnic minorities, youth and People with a Disability (PWD) to exercise citizenship and contribute to social and economic change. The involvement of Community Based Organisations that are organised by the marginalised people themselves, ensures their full participation in our programs.

Besides working with a myriad of Community Based Organisations in Lao PDR and Vietnam, MCNV also collaborates with civil society organisations at provincial and national level. For example, MCNV has established and cooperates with provincial ‘Village Health Workers Associations’(VWHAs).

In the health system we are so close to villagers that people call us the “long arm” of the health sector. Our Village Health Workers Association was founded in 2006, and now has 1,115 members based in 138 communes in nine districts and towns of the province. On basis of our experiences in Quang Tri, two other Village Health Workers’ Associations have been established in Cao Bang and Phu Yen provinces, in 2010 and 2011. We for example support the Disabled People’s Organisations (DPO) and Old People’s Organisations (OPA) in fundraising activities. We also assist the Community Based Organisations to prepare dramas or to make video clips to lobby and advocate for better health practices and policies (Interview with Board Member of Village health Workers Association, 2015).

Achievements

To date, MCNV has strengthened and collaborated with over a hundred CSOs and CS movements in Lao PDR and Vietnam. In addition to that, MCNV has provided Technical Advice to Civil Society Partners in Sri Lanka, Tajikistan and Georgia, on the strengthening of Civil Society Organisations in their country.

Through CBOs and their clubs, peer-to peer support is channelled and improvements in policy implementation and policy development are lobbied for. For example, Old People’s Organisations in Quang Tri successfully lobbied for an increase of the district budget for health of the elderly.

Due to the flexible characteristics of CSO organisations and due to their profound local knowledge on the culture and values of communities in remote areas of Lao PDR and Vietnam, they are in an excellent position to collaborate with other societal groups in experimenting new approaches in health and sustainable livelihood. For example in Lao PDR, the CBOs at village level named ‘Village Development Committees’ (VDC) have been partners of the district department of agriculture in experimenting new rice varieties, cattle raising and fish ponds.

Trust relationships between villagers and district partners has improved. The VDCs are able to articulate the needs of the ethnic minority groups in the villages and this has led to more communication and achievements of program interventions in the villages. (Interview with consultant evaluating the program in Lao PDR, 2014).

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Nutrition improvement for children

Background

Children who are born underweight or do not receive sufficient nutritious food during their first years of life have a much higher chance to die in childhood. If children are able to survive their malnutrition childhood results in a lifelong disadvantage in health as well as the capacity to develop intellectually. While the malnutrition rates for whole countries such as Vietnam and Lao PDR have steadily improved over the last decades, this masks the fact that it remains unacceptably high among ethnic minorities and other marginalized groups. Due to the developmental disadvantages that malnourished children face, they also encounter difficulties when it comes to progressing financially. These obstacles leave them at a young age to grow up as the next generation’s marginalized youth.

Good nutrition is a Child’s Right

Malnutrition in children is strongly correlated with the poverty of their parents and the education level of their mothers. It is a complex problem comprising not only of the access to safe and nutritious food but also awareness and knowledge, food beliefs and taboos, as well as the deteriorating quality of natural resources and global developments in food systems. For many previously self-subsistent ethnic minorities economic development (growing cash crops instead of their own food) and a more ‘modern way of life’ (money to buy junk foods at the market) have made things worse rather than better.

The government of Vietnam has invested big efforts over many years but among ethnic minorities in remote areas the improvement is very slow, if any at all. Therefore NGO’s like MCNV work side by side with government agencies to try out better approaches that fit better to the local contexts.

MCNV’s response

Over the past ten years, MCNV has paid special attention to child malnutrition among ethnic minorities, specifically in the provinces Khanh Hoa and Phu Yen in Vietnam, as well as Savannakhet in Lao PDR. In Phu Yen the focus was on awareness raising and self-help activities in mother groups at the village level. In Khanh Hoa a nutritious cereal powder was developed that was locally produced and distributed by the health system to all families with malnourished children in the district. In Lao PDR the emphasis is on agricultural changes, such as home gardens, fish ponds and small livestock rearing. Positive effects have been demonstrated in several of these pilots but now it becomes urgent to combine the best approaches to find the most effective way to increase the scale in order to reach vast locations.

Future plan

In the coming years MCNV will focus its work on malnutrition in Lao PDR where the problem is most severe. This will be done by systematic learning, taking the experiences in Vietnam and Lao PDR and seeing how the best interventions can be applied using the local context of Lao PDR. Together with the local population, the health, agriculture and education services will need to work together. MCNV will collaborate with researchers from the Free University of Amsterdam and the important national institutes in Vietnam and Lao PDR to produce evidence about effectiveness and sustainability of interventions. This evidence will then be widely disseminated to convince government authorities and policy makers to increase their efforts to increase the number of children who can start their life with more hope for a healthy future.

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