Cambodia Integrated Nutrition, Water, Sanitation, and Hygiene ( NOURISH )

One out of three (32.4%) children under the age of five in Cambodia are stunted. The prevalence of stunting is 10% higher among children born to mothers from the lowest wealth quintile (42%). Recent data also suggest that exclusive breastfeeding rates in Cambodia have declined, and only 30% of children 6-23 months receive a minimum acceptable diet. Cambodia’s Council for Agriculture and Rural Development (CARD) estimates that malnutrition costs the country nearly $400 million in gross domestic product annually.

The Royal Government of Cambodia (RGC) has made a commitment to address the nutrition and stunting challenge, and reverse its effect on the Cambodian population by focusing on the most vulnerable and poor food-insecure households. In 2014, many national policies were developed and Cambodia became the 53rd member to join the SUN Movement. The SUN Secretariat led by CARD focuses on the development and implementation of multi-sectorial approaches to improve nutrition and food security. In addition, in September 2015, CARD established a cross-sectoral WASH and Nutrition sub-working group co-chaired by CARD and NOURISH. To support the government’s commitment to improving nutrition, targeted assistance from donors and expertise from local and international organizations is necessary to translate this commitment into practice and to realize an impact on malnutrition.

In June 2014, USAID awarded a $16.3 million Cooperative Agreement (No. AID-442-A-14-00006) for a five-year integrated nutrition, hygiene and sanitation project (NOURISH). Led by Save the Children, NOURISH is implemented in close collaboration with the host-country government, two international non-government organizations (NGO)—The Manoff Group and SNV—and three local NGO-partners— Partners in Compassion, Operations Enfants du Cambodge, and Wathnakphea.

Activity Description

With funding from USAID and the U.S. Presidential Initiative Feed the Future, NOURISH works to assist the RGC in accelerating stunting reduction by focusing on key determinants of chronic malnutrition in Cambodia across sectors. NOURISH contributes to USAID Cambodia’s Strategic Objective of Improved Health Services in HIV/AIDS and Infectious Diseases, Maternal, Child and Reproductive Health under Program Component 3: Improved Maternal and Child Health and Nutrition. NOURISH also contributes to Feed the Future’s overall goal in Cambodia to reduce stunting by 20%. More specifically, NOURISH contributes to Objective 1 ‘Inclusive Agriculture Sector Growth through increased investment in agriculture and nutrition-related activities and increased resilience of vulnerable communities and households’ as well as to Objective 2 ‘Improved Nutritional Status of Women and Children through improved access to diverse and quality food, improved access to sustainable sanitation and hygiene behaviors, improved nutritionrelated behaviors and improved use of maternal and child health and nutrition services’.

NOURISH aims to reduce anemia in women and children and reduce the proportion of children who are stunted. Over the life of the project, NOURISH is expected to reach over 500,000 people in 555 under-served rural villages across Battambang, Pursat, and Siem Reap provinces. The project is colocated with USAID Feed the Future agricultural investments (HARVEST and RFFEP) to capitalize on the linkages between nutrition and agriculture.

Expected Outcomes

The project expects to

  •  Improve community delivery platforms to support improved nutrition.
  •  Create demand for health, WASH, and agriculture practices, services, and products.
  • Expand supply of agriculture and WASH products using the private sector.
  • Enhance capacity of government and civil society for integrated nutrition.
Actual Outcomes


  • Trained 440 Community Agents (269 Village Health Support Group members, 76 agriculture extension workers, and 95 WASH focal points) and 194 caregiver groups’ facilitators in integrated nutrition.
  • On average each month, NOURISH-trained Community Agents conducted 312 home visits to pregnant women, 1,148 home visits to children under two year, and provided monthly community nutrition sessions for 2,348 “first 1,000 days” beneficiaries.
  •  Nearly 5,000 “first 1,000 Days” householder members attended integrated nutrition group education sessions led by caregiver group facilitators empowered by NOURISH with new knowledge and skills.
  • Together with health workers, NOURISH-trained Community Agents screened 5,214 children under the age of five years for malnutrition across three provinces.