Maximising the growth of children

Speeding up the work to reduce stunting

বস্তির শিশু বসে আছে পুকুরের পাশে
UNICEF/UNI139213/Noorani

The challenge

Stunting reflects the long-term effects of malnutrition in a population

Children who suffer from stunting are too short for their age. Their brains do not receive nutrition at the most critical stages of growth, resulting in impaired development.

The failure to receive adequate nutrition over a long period of time and is worsened by
recurrent and chronic illness.

In many aspects, the effect of stunting is irreversible beyond the second year of a child’s life. It has long-lasting consequences, such as diminished mental ability and learning capacity that lead to poor school performance.

In Bangladesh, nutritional challenges can begin from the moment of conception to birth outcome. The cycle continues with low birth weight, limited access to quality foods, and poor feeding or dietary practices.

Bangladesh has reduced childhood stunting, but the Average Annual Rate of reduction of stunting is at a slower rate from 2007 to 2014. Wasting, which is having low weight for height, has barely declined since 2007.
 
Wasting rates in Bangladesh are classified as high, while stunting and underweight are considered very high, according to WHO thresholds.

Mothers’ education, besides social and wealth status, has a significant connection to children’s nutrition, according to a 2013 survey by UNICEF. Access to safe water and sanitation are basic determinants of better nutrition.

Children living in slums are always at high risk of undernutrition also because of lack of access to safe water. Children from households with unimproved drinking water sources are significantly more at risk. 

In these households, 57 per cent of children were found to be stunted, wasted or underweight, compared to 31 per cent from households with improved drinking water sources.

Bangladesh, due to the effects of climate change, is prone to more frequent and devastating natural disasters. In the aftermath of floods or cyclones, more and more young children fall prey to undernutrition and infectious diseases.

শিশুর মাপ নেওয়া হচ্ছে

36 per cent of children younger than age 5 are stunted

গ্রামের শিশু

Stunting rates in 39 out of 64 districts are above WHO critical threshold

শিশুর পুষ্টি পরীক্ষা

Stunting rate is declining at a slower rate. Just 43 to 36 per cent between 2014 and 2017

The solution

A multi-sectoral platform works to prevent stunting, a national priority

UNICEF supports the government in developing evidence-based planning to reduce stunting across a child’s first 1,000 days of life – that is until the child becomes two years old.
 
The work encompasses appropriate counselling on maternal nutrition during ANC and PNC visits, reducing low birth weight, improving infant and young child feeding practices, quality and diversity of complementary foods, improving vitamin and mineral intake status, protection against infectious diseases and treating severe acute malnutrition or SAM.

UNICEF supports strategies and guidelines for the implementation of the National Nutrition Policy and the Second National Plan of Action for Nutrition 2016-2025. 

It advocates for agricultural policies that include nutritional analysis and actions. For managing of SAM with complications, UNICEF helps the government to provide therapeutic foods at a facility level. 

For better nutrition of mothers, UNICEF supports more screening and monitoring of pregnancy weight gain, besides emphasising on dietary diversity and consumption during pregnancy. 

UNICEF supports ‘nutrition counselling’ of pregnant mothers through development of service delivery skills and by increasing Individual Tracking of Pregnant women and children U-5 and supportive supervision.
   
For ensuring access to safe drinking water in urban areas, UNICEF works in partnership with Ministry of Local Government to facilitate legal connection with safe water supply for urban slum dwellers. 

UNICEF continues the work to identify and remove barriers in ensuring adequate nutrition for children and mothers by taking lessons from District Nutrition Support Officers, who were deployed at district level by UNICEF which is instrumental to accelerating Implementation of national nutrition services. 

UNICEF works with partners to communicate information and knowledge to young girls and women as they are proven to have positive influence on nutritional outcomes for children.

Resources

Bangladesh Demographic and Health Survey 2014; National Institute of Population Research and Training, Ministry of Health and Family Welfare

District Health Information System (DHIS2), Director General of Health Services (DGHS), Ministry of Health and Family Welfare, Bangladesh

Health, Population and Nutrition Sector Programme (4th HPNSP); Ministry of Health and Family Welfare

Nutrition Landscape Information System (NLIS), Country Profile Indicators, WHO