Small fish consumption in rural Myanmar

**Background:** Fish is a critical component of diets in Myanmar, particularly in the Ayeyarwady Delta where capture fisheries and aquaculture are prominent. Despite relatively high fish consumption, malnutrition persists—38% of children under 5 are stunted and 40% of women of reproductive age are anemic. Previous studies relied on household-level data that may mask intra-household inequities. This study aimed to disaggregate fish consumption by gender, species, and fish size to identify patterns relevant to nutrition security.

**Methods:** The study was conducted in April–May 2018 (dry season) across four townships in southern Ayeyarwady Region. From a project participant database of 276 small-scale aquaculture farmers, 128 households were selected via purposive and random sampling; 123 individuals were interviewed (74 women, 49 men). Data were collected via a structured questionnaire covering socio-demographics, a single 24-hour dietary recall focused on fish consumption (using fish models for portion size estimation), and perceptions of fish health benefits. Fish were classified as small (<4 inches), medium, or large (≥11 inches) based on IHLCA definitions and FishBase. Descriptive statistical analysis was performed using SPSS.

**Key Results:** Ninety-seven percent of respondents had consumed fish in the prior 24 hours. Fermented fish paste was consumed by 90% of respondents (mean 43 g/person/day), fresh fish by 62% (mean 102 g/person/day), and dried fish by 24% (mean 60 g/person/day). Men consumed 132 g/person/day of fresh fish versus 84 g/person/day for women—a 57% higher intake. Among women, 43% consumed small fresh fish and only 19% consumed large fresh fish; among men, 34% consumed small fish and 36% consumed large fish. Small fish accounted for the majority of fresh fish consumption (57 of 98 total fresh fish consumption events). More than ten small fish species were identified, all sourced from capture fisheries. Dried fish consumption was similar between men (58 g/day) and women (61 g/day), but women consumed more dried small fish (78 g vs 64 g). Fish paste consumption was nearly equal (44 g/day women, 43 g/day men). Among 32 respondents with children under 5, 72% gave fish to the child, but only one child aged 6–23 months received small fish. Mola carplet (Amblypharyngodon mola) was the most frequently mentioned species perceived as beneficial for child health (282 responses), yet its actual consumption was low. Hilsa and striped catfish were perceived to cause illness in children. Annualized fish consumption was estimated at 32 kg/capita/year, higher than the 28 kg/capita/year reported in prior IHLCA surveys.

**Clinical Implications:** Women's fresh fish intake (84 g/day) falls below the EAT-Lancet recommended 100 g/day of animal-source food, placing them at risk for micronutrient deficiencies. Although women more frequently consumed small fish—which are richer in vitamin A, iron, and calcium when eaten whole—their absolute intake was lower than men's, limiting potential nutritional benefits. The near-absence of small fish in complementary feeding for children aged 6–23 months represents a missed opportunity to address stunting and anemia during the critical first 1000 days. Negative food taboos around certain fish species during pregnancy and lactation may further exacerbate nutrient gaps. The study underscores the continued reliance on wild capture fisheries for nutrient-rich small fish, despite declining stocks, and highlights the need for gender-transformative nutrition education, promotion of dried small fish powder for infant feeding, and investments in sustainable fisheries management and safe fish processing.