Child malnutrition and household food insecurity remain major concerns for Bangladesh
Survey reveals that 1 in 4 household is food insecure and 2 million children are affected by acute malnutrition
Dhaka, 29 March, 2009. One in four households in Bangladesh is food insecure while two million children aged six months to five years are affected by acute malnutrition (wasting: 13.5%), according to a recent survey released today by WFP, UNICEF and the Institute of Public Health Nutrition (IPHN). Out of those two million malnourished children, half a million are suffering from severe acute malnutrition (severe wasting: 3.4%), a highly vulnerable condition where the child needs appropriate management and treatment. Given that the nationwide survey was carried out during a harvest season, the malnutrition levels are expected to be even higher during periods of food scarcity.
The survey was undertaken to assess the impact of the food price increases in Bangladesh in 2008. The key findings were shared during a presentation in Sonargaon Hotel in Dhaka attended by Professor Dr. A.F.M. Ruhal Haque, Minister of Health and Family Welfare, and Mr. Md. Mokhlesur Rahman, Secretary, Ministry of Food and Disaster Management. Carel de Rooy, UNICEF Representative, and John Aylieff, WFP Representative, were also present.
According to the survey, 58% of the households claimed that they had insufficient food during the last twelve months. Real household income dropped by 12% between 2005 and 2008. At the end of 2008, food expenditure represented 62% of total household expenditure, 10 percentage points higher than the national average of 2005. To cope with higher food prices, people have got themselves into a deeper spiral of debt from which it will take months to recover.
“Even if the prices of food are now falling, the crisis is far from being over”, said John Aylieff, WFP Representative in Bangladesh. “The proportion of households’ income that is now being spent on food is already higher than in 2005 and the impact of the global financial crisis on the poor is a major concern going forward.”
Almost half of the surveyed children aged six months to five years are stunted (48.6%) – too short for their age – which depicts a very high prevalence of chronic malnutrition – one of the highest in South Asia. In addition, 37.4% of the same children are also underweight..
“The situation of child malnutrition in this country is a silent emergency”, commented UNICEF Representative Carel de Rooy. “Not only is malnutrition a direct cause of death among children, but it is also a significant underlying cause of child mortality. It affects the development of the child, increases the risk of women dying during pregnancy/childbirth and contributes to neonatal mortality. In fact, it impacts on the society at large, affecting school performance, healthcare costs and productivity. Unless the current level of malnutrition is urgently addressed, Bangladesh is unlikely to achieve and sustain the Millennium Development Goals,” he said.
The survey was undertaken throughout the whole country from November 2008 to January 2009, with representative samples collected from the six divisions and by area (urban, rural). A total of 10,378 households were surveyed and 4175 children under five years were assessed for their health and nutrition status.
Barisal and Rajshahi divisions presented the highest acute malnutrition rates (wasting), exceeding the WHO emergency threshold of 15%. These same two divisions had the largest percentages of households that were food insecure – Barisal, 26% and Rajshahi 31%. Chronic malnutrition (stunting) was found highest in Sylhet division. Rural areas presented higher rates of all three types of malnutrition (wasting, stunting and underweight) when compared to urban areas.
Among the causes of malnutrition, the survey identified the diet diversity as a key problem. Almost half of the children aged 6 months to 2 years – a crucial age for development – did not receive the minimum meal frequency and two thirds of the children of the same age group did not meet the minimum dietary diversity (at least four food groups per day). Not surprisingly, children in their first two years presented the highest rates of acute malnutrition.
Poor infant and young child feeding practices are major factors for the nutritional situation. According to the assessment, only about one-half of mothers exclusively breastfeed children under six months and though most mothers (89%) continue to breastfeed their children to the recommended age of two years, complementary foods are introduced inappropriately and with insufficient dietary diversity.
The survey underlines the need to improve caring practices by parents – strengthening and expanding ongoing efforts to promote exclusive breastfeeding for the first six months of life and to educate families on optimum infant and young child feeding practices.
It recommends that routine food security and nutrition surveillance be strengthened to allow early detection of changes in nutrition, health, and food security status. Such surveillance systems should be integrated into government structures.
Although Bangladesh has already set up effective social safety net interventions, the study suggests they should be expanded and better targeted towards areas where malnutrition and household food insecurity are most prevalent. Food assistance interventions, food security and nutritional programmes should emphasize micronutrient-enriched foods and improved diet diversity. Provision of micro-nutrients in the worst affected geographic areas to specific age groups such as adolescent girls, pregnant women and 6-24 month old children would be a cost effective intervention to significantly impact on the nutritional status of children and women.
Finally, the expansion of therapeutic and supplementary food interventions was proposed for the management of acute malnutrition in both facility and community levels to take care of the large numbers of acutely malnourished children.For more information please contact: