New study finds dismal state of nutritional services

A new study has found dismal state of nutritional services at public health facilities in the country's hard-to-reach areas -- something that goes against the principle of inclusive development.

For example, no pregnant woman or children under five years had their weight or height measured at upazila- and union-level health facilities in haor (wetlands) areas of the country, though it is a must to assess nutritional status, says the study.

The study, titled “Situation analysis and needs assessment for nutrition services in hard-to-reach areas in Bangladesh” was conducted by the Department of Public Health and Informatics of Bangabandhu Sheikh Mujib Medical University (BSMMU) between February and September this year. National Nutrition Services (NNS) commissioned the study that was presented at BSMMU yesterday.

Only 33 percent mothers of children under the age of five were provided calcium, iron and folic acid, while vitamin A was provided to only 18 percent children under five in the haor areas, the study said.

The study covered 15 upazila health complexes (UHC) and 14 union sub-centers (USC) in 11 districts -- Kurigram, Sirajganj, Bagerhat, Khulna, Kishoreganj, Sunamganj, Netrokona, Rangamati, Bhola, Cox's Bazar and Noakhali -- all of them localities on haor, char, hills, coast or island.

According to the study, 64 percent of the public health facilities of these areas have Integrated Management of Childhood Illness and Nutrition; 52 percent have antenatal care corners; 38 percent have breastfeeding corners and only 14 percent of the facilities have adolescent corners.

“These facilities don't have skilled manpower or logistics. Whatever is available is not properly utilised,” said Dr M Khalequzzaman, one of the researchers.

He said on an average, around 90 percent of the facilities have weighing scales to assess nutritional status of pregnant women, 77 percent of which are functional in the abovementioned areas.

However, only 50 percent of it is utilised, he said.

For measuring weight of children under five, only 33 percent facilities use scales though 86 percent facilities have the equipment.

“Salter scales, length scales were never used in the facilities. Growth measure cards were used in less than 10 percent facilities,” Dr Khalequzzaman told this correspondent.

The study recommended training and recruitment of female healthcare providers in these areas, strengthening counseling services for pregnant women and mothers, supplying adequate logistics, and the use of information, education and communication materials for counseling.

It also suggested that nutritional awareness be raised among adolescents in schools.

According to the study, some 28 million people currently live in hard-to-reach areas of Bangladesh.