View
1.477
Download
4
Embed Size (px)
DESCRIPTION
The economic consequences of high maternal and child undernutrition cannot be overstated. A combination of high maternal undernutrition and postnatal factors cause child undernutrition, which in turn can influence children’s school performance and their future occupational choices, and can undermine the future productivity of nations. Notwithstanding rapid economic growth in a number of South Asian countries (including Bangladesh and India), the pace of improvements in maternal and child undernutrition in the region remains deeply unsatisfactory. Bangladesh has made considerable progress in addressing the non-income poverty indicators for the first Millennium Development Goal (MDG1)—that is, reducing the prevalence of underweight children under five years of age—but improvements are slowing, which raises questions about whether the target will be achieved or not. Furthermore, the overall levels of maternal and child undernutrition are still high in Bangladesh, and further investments are needed to accelerate improvements and prevent the negative impact of maternal and child undernutrition on long-term development. This paper is, therefore, about the policy focus that is needed to greatly improve the current status of maternal and children nutrition. Although overweight and obesity are emerging problems in Bangladesh, this paper will not address this aspect of undernutrition. However, it is a potential concern in the future, and this trend should be monitored.
Citation preview
Bangladesh Food Security Investment Forum, 26–27 May 2010, Dhaka
Binayak Sen, Purnima Menon, Akhter U. Ahmed, and Fatema Parveen Chowdhury
Food Utilization and Nutrition Security
Interven!ons
Breas"eedingComplimentary feedingVitamin AZincHygiene
- Agriculture- Poverty Reduc!on- Educa!on- Health Systems Strengthening- Income genera!on- Women’s empowerment
Accessto food
Maternaland child-care
prac!ces
Water/Sanita!onhealth services
Food/nutrient intake Health
Child Nutri!on
INSTITUTIONS
ECONOMIC STRUCTURE
RESOURCESENVIRONMENT, TECHNOLOGY, PEOPLE
POLITICAL & IDEOLOGICALFRAMEWORK
Immediatecauses
Underlyingcauses
Basiccauses
SHORT
ROUTES
LONG
ROUTES
Adapted from UNICEF 1990Source: Ruel, SCN News 2008
Figure 1—The link between the UNICEF conceptual framework and direct/indirect interven!ons
-2.5
-2
-1.5
-1
-0.5
01 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59
Child age (months)
HAZ
Addressing maternal health and nutri!on prior to and during pregnancy and childbirth is
crucial
Intervening with evidence-based interven!ons to
prevent irreversible growth faltering and brain damage is
also cri!cal
HEIGHT-FOR-AGE Z-SCORES BY CHILD AGE, BANGLADESH, 2007
Figure 2—The window of opportunity for addressing undernutri!on – prepregnancy and the first two years of life.
Childhood anemia (HKI, NSP 2006) Anthropometric indicators (BDHS 2007)
05
101520253035404550
Anthropometric indicators
Stun!ng
Underweight
Was!ngWomen with low BMI
Women <145 cms tall
0102030405060708090
100
Child age groups
6–11 mo
12–23 mo
24–35 mo
35–47 mo
48–59 mo
Prevalence of maternal and child undernutri!on
Figure 3—Prevalence of anemia and undernutri!on (anthropometric indicators) among children and women in Bangladesh
0
10
20
30
40
50
60
70
Stun!ng Was!ng Underweight Maternal BMI
19962000
20042007
0102030405060708090
100
Inputs for ensuring good child nutri!on
%
Early ini!a!on of BFExclusive BF (0–6 mo)Introduc!on of CF at 6–9 mo3 expected IYCF prac!cesIron-rich foodAll basic immuniza!onsVitamin A suppl (<3s)Access to improved sanita!onWomen - > 3 ANC visitsWomen - normal BMI HH - access to improved water
Source: BDHS (2007)
BF = breast feedingCF = complementary feeding
ANC = antenatal careIYCF = infant and young child feeding
Status of keydirect interven!ons for child nutri!on
51.6
13.67.0 5.6
1.2
21.0
51.3
13.9
4.7 5.4 3.2
21.6
0
20
40
60
80
Rice Fish Meat & eggs
Pulses Milk & milk products
Otherfoods
Shar
e of
dai
ly p
er c
apit
a pr
otei
n co
nsum
p!on
% 2005 1995–96
0
5
10
15
20
25
1983
1986
1989
1992
1995
1998
2001
2004
2007
Real
pric
e of
rice
(Tak
a/kg
)
Fiscal Year
2009
0
10
20
30
40
50
6019
83
1986
1989
1992
1995
1998
2001
2004
2007
Real
pric
e of
len!
l (Ta
ka/k
g)
Fiscal Year
2009
02468
1012141618
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
Real
pric
e of
brin
jal (
Taka
/kg)
Fiscal Year
0
20
40
60
80
100
120
140
160
180
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
Real
pric
e of
Hils
ha fi
sh (T
aka/
kg)
Fiscal Year
This paper has been commissioned by the Government of the People’s Republic of Bangladesh for the Bangladesh Food Security Investment Forum, 26–27 May 2010. The Forum is organized by the Ministry of Food and Disaster Management with technical support from the International Food Policy Research Institute (IFPRI), the Bangladesh Institute of Development Studies (BIDS), and the Food and Agriculture Organization of the United Nations (UN-FAO). Financial support has been extended by the United States Agency for International Development (USAID), the United Kingdom Department for International Development (DFID), and the European Commission (EC). The views and opinions contained in this paper are those of the authors.
Cover graphics adapted from photography by © 2010 Hand Crank Films/IFPRI, © 2009 Pradeep Kumar Saxena/iStockphoto, and © 2006 G.M.B Akash/Panos.