Asia-Pacific, Development & Aid, Headlines, Health

BANGLADESH: Improving Caring Practices To Tackle Malnutrition

Tabibul Islam

JAMALPUR, Bangladesh, Jul 29 1998 (IPS) - Dr. Amir Ali, fresh out of medical college and working in a clinic in his village in north Bangladesh, says he has had to learn very quickly to deal with dietary deficiency disorders.

Ailments related to chronic malnutrition like goitre and anaemia are the most common complaints of most of his female and child patients, he says.

More than 90 percent of children under five in Bangladesh are severely malnourished, but poverty is not the only reason for malnutrition. Most infants are born underweight since their mothers are chronically malnourished.

Half a million children die every year due to complications resulting from malnutrition, annually 30,000 children go blind due to Vitamin A deficiency and 56 million people have visible and palpable goitre due to iodine deficiency.

Dietary deficiency diseases afflict children of even well-to- do farmers who eat three meals a day, but not the right kind of food, it appears. Most people eat mounds of the staple rice, and little else in a country criss-crossed by rivers that make it among the most fertile in South Asia.

The Bangladesh Integrated Nutrition Programme (BINP), a brain child of the U.N children’s agency, UNICEF, which was introduced in late 1995 has been trying to reduce malnutrition through household food security, behavioural changes related to food intake, infant feeding practices, growth monitoring and caring practices.

BINP will run for five years, and by the turn of the century, the government hopes to cover 40 of the 460 ‘thanas’ or sub- districts.

Poor food intake has meant that per capita protein consumption has declined by at least 15 percent in the last three decades curtailing the average growth of children, exposing them to anaemia, mental retardation and threatening the next generation that is already less taller, a research study says.

Protein plays a vital role in the physiological development of the body, its growth and maintenance and immunity to diseases, said the author of the study Prof. Khurshid Jahan of the Institute of Food and Nutrition Science, in Dhaka University.

Prof. Khurshid who conducted a nation-wide survey in 1995-96 said the average per capita protein consumption had declined from 55.31 gm daily in 1964 to 64.93 gm in 1996.

Participants in a recent seminar on the BINP, organised by the Press Information Department, were told that Bangladesh was currently losing 2.3 billion dollars annually because of malnutrition. Losses related to the intellectual and physical stunting of its people were calculated.

“The people of Bangladesh are getting shorter due to malnutrition. Between 1937 and 1982, the average height of 12 year old boys in the rural areas fell by seven percent,” an expert from UNICEF said.

‘Thanas’ covered by BINP are reversing that trend, says the pioneering International Centre for Diarrhoea Disease Research, Bangladesh, in an assessment report. The severe malnutrition rate was brought down to 2.88 percent over an eight-month period in six ‘thanas’, it announced.

The government-run programme financed by the World Bank and overseen by UNICEF has set up a network of Community-based Nutrition Centres that provide infants with supplementary foods and teaches their mothers what kinds of food are best suited for children including the home-made ‘pushti’ nutritious meal.

Women are the BINP’s primary beneficiaries. Apart from raising awareness on health issues, the programme also seeks to tackle poverty alleviation by advising women on income generating activities like kitchen gardens and cattle raising, money for which is given as loans from a credit scheme.

Apart from BINP, the government is also implementing other programmes to tackle problems of nutrition deficiency like the iodised salt scheme and breastfeeding promotion.

The National Nutrition Programme, a new initiative, is to be launched by the Ministry of Health and Family Welfare in phases to cover the entire country within five years, which will only strengthen the efforts of the BINP, official say.

The BINP itself is based on the experiences of successful nutrition programmes in India, Indonesia and Tanzania. UNICEF says it is the result of bringing together the world’s best experts in the field of nutrition and nutrition planning from the government, non-governmental organisations, World Bank, World

Health Organisation and UNICEF.

The BINP which incorporates the world’s best practices and most promising experiences in tackling malnutrition seeks to change inadequate caring practices about food and feeding, about health and hygiene and about psycho-social development that account for malnutrition.

The world children’s agency is optimistic malnutrition is immediately removable without having to wait for more economic development or increased food production. Optimistic project officials think the BINP may finally improve the problem of malnutrition that has remained unchanged since 1990.

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