EFFECT OF POLICY REFORMS ON FOOD AND NUTRITION TRENDS IN VIETNAM AND MYANMAR FROM 1960 TO 2015

Background and objectives: Global and national policy changes and events can affect food and nutrition trends. We conducted this study to examine the ecological association between policy changes and events and trends in food- and nutrition-related measures in Vietnam and Myanmar from 1960 to 2015. Methods: We used an interrupted time-series design at the country level for this study. We identified relevant policies and events from 1960 to 2015 in Vietnam and Myanmar from WHO's Nutrition Landscape Information System and other available sources. We examined national trends in economy, agriculture, nutrition, and health measures gathered from World Bank, FAO, WHO, and UNICEF databases in relationship to policy changes and events in the two countries. Results: In the last 50 years, both Vietnam and Myanmar had increased urban populations, increased life expectancy at birth, and decreased mortality rates for neonates, infants, young children, and mothers. Both countries had overall growth in gross domestic product, contributed to initially by increased agriculture production and then by trade, manufacturing, industry, and services. The two countries changed toward market economies, joining and getting support from Association of Southeast Asian Nations (ASEAN), lifting of economic sanctions, and implementing trade agreements. There were periods when the economies were negatively impacted by wars and conflicts (e.g., Sino-Vietnamese war and prolonged civil war and political unrest in Myanmar) or failed policies (e.g., "price, salary, and money" reform in Vietnam). In Vietnam, the implementation of policies, including National Nutrition Strategies, was associated consistently with economic, agricultural, and nutritional measures. In contrast, during Myanmar's 2011-2015 political, economic, and administrative changes, growth in gross domestic product slowed. Reduction in prevalence of stunting and underweight was negligible after the Myanmar's National Plan of Action for Food and Nutrition in 1994, but greater after the National Plan of Action in 2011. Conclusions: Policy changes toward becoming a market economy and National Nutrition Strategies contributed to economic growth, agricultural production, and improved nutritional status in Vietnam and Myanmar. In addition, political stability was critical for these improvements.