We are in an emergency because nearly .6 million children are severely malnourished which is above the emergency level, and 53,000 children die each year from preventable complications. Undernutrition costs Bangladesh 7000 crore taka in lost productivity per year.
If we go into details we will find that undernutrition in children, adolescent girls and women of Bangladesh is among the highest in the world. About half the children below 5 years and one-fourth of women of reproductive age are undernourished regardless of financial status.
Our progress in nutritional status of children is very slow. If we look at the trends in nutritional status of children under five we see stunting rate was 51% in 2004 BDHS, 43% in 2007 BDHS and 41% in 2011 BDHS.
Malnutrition rates in Bangladesh are as follow: stunting 41%, underweight 36%, wasting 16%, iodine deficiency 10%, anemia 51%, anemia (P) 42%, Vitamin A deficiency 21% and low birth weight 36%.
Stunting and poor cognitive development share many risk factors: nutritional deficiencies, intra uterine growth retardation, social and economic conditions such as poverty and maternal depression.
According to Dr.Rukhsana Haider, Chair, Civil Society Alliance for Scaling Up Nutrition, Bangladesh, mutrition is intrinsically linked with development because when girls and women are well nourished, they have healthy newborn babies who will receive proper nutrition and develop strong body and mind. When these children will grow up, they will learn better and achieve higher grade in school. At the adult age, these young people will be able to find better job and earn more, and their families and communities will emerge out of poverty. This will lead to a productive and stable community and nation.
Improved feeding practice is key to better nutrition status. Feeding indicators of WHO for children below 24 months showed direct relationship of child feeding practices with stunting and underweight in 14 poor countries. According to Professor Dr. Md. Ruhul Amin, President, Bangladesh Paediatric Association, we should give top priority to breast feeding programme because it is the only investment that can do miracle like the vaccination programme. It reduces underweight and stunting. It also results in reduction of diseases where underweight is linked as an underlying cause.
Our structure of health facilities is quite good but we are not using it properly. In our country, family workers do not tell about exclusive breast feeding .If they disseminate the message with other antenatal care related messages it will be a great boon, opined Dr. Rukhsana Haider.
Different scaling up programmes in nutrition emphasize on the first 1000 days programme that includes pregnancy, the first six months of a child's life and six months through the second year till the baby is two years old. All through this period proper nutrition should be given to both the mother and the child.
At the macro level, we should give proper emphasis on preventing child marriage and adolescent reproductive health issues because, in our country, every third pregnancy is adolescent pregnancy. And adolescent mothers give birth to underweight babies
Schooling is important for nutrition of the current and next generation. It is reported that risk of child stunting is less in mothers with some schooling and even lower in those with secondary school education.
We need more investment in nutrition sector. According to Dr. Sushil R. Howlader, Professor at the Department of Health Economics, University of Dhaka, “We need 9% of the budget for the health sector of which 1% will be for nutrition.”
Investment in nutrition is a smart investment because it prevents intergenerational transmission of poverty. Both are key and mutually reinforcing determinants of long-term economic growth. It helps increase a country's GDP by at least 2 to 3 % annually. Investing $1 in nutrition can result in $30 return in increased health, schooling and economic productivity.
The writer is Editorial Assistant, The Daily Star.