Exploring Food Quality in Vietnam: Nutrition, Culture, and Social Change Público

Abstract

The purpose of this thesis is to enhance governmental programs aiming to reduce micronutrient deficiencies in the Vietnamese population. This thesis explores the historical, cultural, and social development of Vietnam in relation to
food and nutrition.

This thesis will first present an overview of the political, public health, and economic reform history of Vietnam. Once this foundation is established, three interconnected issues provide the overarching structure: 1) development and social change, 2) cross-cultural aspects of nutritional behavior, and 3) individual nutritional beliefs based on the results of a series of interviews with Vietnamese women of different socioeconomic and rural-urban groups. These interviews provide an ethnographic window into the traditional importance of a specific food item - fish sauce - and how local perspectives on this food's quality shift as a result of government efforts at micronutrient fortification.

The implementation of nutritional programs requires ideas from theories of international development and food and nutrition as cultural phenomena. This research illustrates the need for increased attention to local perspectives of food quality in Vietnam's fish sauce fortification program. Whereas the traditional public health definition of food quality implies quantitative measurements of a food's constituent parts, the Vietnamese perspective supports a more holistic idea. Interviews with Vietnamese women indicate that food quality is inspired by cultural ideas of taste, gastronomic acceptability, and affordability, not individual nutrients.

Based on the results of archival and interview data, increasingly comprehensive, yet contextually appropriate policies are needed in global
micronutrient programs. This thesis presents a series of evidence-based recommendations to improve Vietnam's iron fortification program - both at the large-scale political, social, and economic levels and also at the grassroots level. These recommendations include:

1. Advocate for the role of the anthropologist and food ethnography;
2. Design and implement mandatory fortification legislation;
3. Enhance stakeholder collaboration and private sector investment;
4. Build fish sauce fortification into a broader, multi-dimensional
intervention package;
5. Invest in rural-low income women.

Table of Contents

TABLE OF CONTENTS

AUTHOR'S NOTE.......................................................................................................................... 1
INTRODUCTION .......................................................................................................................... 3
CHAPTER ONE: VIETNAM HISTORY, ECONOMICS, AND PUBLIC HEALTH...................................... 11
Vietnam's History and Economic Context.......................................................................................... 11
Government Attempts at Improving Vietnamese Nutritional Status ..................................................... 14
Public Health and Nutritional Context .............................................................................................. 17
Current Nutritional Situation in Vietnam .......................................................................................... 18
The Status of Micronutrient Programs in Vietnam .............................................................................. 20
Iron Fortification of Fish Sauce........................................................................................................ 23
CHAPTER TWO: DEVELOPMENT, SOCIAL CHANGE, AND FOOD QUALITY ..................................... 28
Development Discourse: A Background ........................................................................................... 29
Development Discourse: Addressing Food Quality ............................................................................. 31
CHAPTER THREE: FOOD AND CULTURE ....................................................................................... 37
Key Concepts of Flavor, Cuisine, and Taste ....................................................................................... 38
Theories on Food and Eating........................................................................................................... 40
Ethnographies of Food and Culture.................................................................................................. 41
Collection of Food-Based Observations............................................................................................. 43
CHAPTER FOUR: INDIVIDUAL NUTRITIONAL BELIEFS: ETHNOGRAPHIC
RESEARCH IN VIETNAM ............................................................................................................... 51
Methodology.................................................................................................................................. 51
Rural Low-Income Interviews........................................................................................................... 54
Urban Working-Class Interviews ...................................................................................................... 55
Urban Middle-Class Interviews......................................................................................................... 55
Results ........................................................................................................................................ 57
Rural Low-Income Interviews.......................................................................................................... 58
Urban Working-Class Interviews ...................................................................................................... 61
Urban Middle-Class Interviews......................................................................................................... 63
Discussion.................................................................................................................................... 65
Rural Low-Income Interviews.......................................................................................................... 66
Urban Working-Class Interviews ..................................................................................................... 67
Urban-Middle Class Interviews ........................................................................................................ 68
CHAPTER FIVE: RECOMMENDATIONS........................................................................................... 71
Recommendation 1........................................................................................................................ 73
Recommendation 2........................................................................................................................ 78
Recommendation 3........................................................................................................................ 82
Recommendation 4........................................................................................................................ 84
Recommendation 5........................................................................................................................ 88

Appendix A .................................................................................................................................. 92

TABLES:
Table 1: Rural and Urban Ha Noi Interviews....................................................................................... 52
Table 2: Market Interviews ............................................................................................................. 53
Table 3: Nutrition Questionnaire for Ha Noi University Students............................................................ 56
Table 4: Summary Table of Interviews ............................................................................................. 69

FIGURES:
Figure 1: Organizational Framework ................................................................................................. 7
Figure 2: Recommendations for Vietnam's Nutrient Fortification Programs............................................. 73
Figure 3: UNICEF Malnutrition Framework ........................................................................................ 87

About this Honors Thesis

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School	Emory College
Department	Interdisciplinary Studies in Society and Culture
Degree	BA
Submission	Honors Thesis
Language	English
Research Field	Health Sciences, Nutrition Anthropology, Cultural
Palavra-chave	Fish Sauce Nutrition Vietnam Iron Fortification Culture Development
Committee Chair / Thesis Advisor	Eisen, Arri, Emory University
Committee Members	Little, Peter, Emory University Brown, Peter J, Emory University

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