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In Bangladesh, a partnership to prevent malnutrition

WATCH: Improving nutrition for women and children in Bangladesh


By Kamrul Hasan Khan

Through training and standardized assessments, UNICEF and the European Union are working to address malnutrion among the most vulnerable populations in Bangladesh. 

NETRAKONA, Bangladesh, 30 June 2015 –The signs of severe malnutrition were plain to see in 14-month-old Omi – an extremely bony appearance, low weight, infections and a distaste for food –  but her mother, Lucky Akter, thought she was fine.

© UNICEF/BANA2014-01439/Haque
Powamoni 3, looks on as a member of the Rapid Nutrition Assessment Team (RNAT) measures her height during a household survey at Chollisha Nagar, Netrokona, Bangladesh.

“Her poor health, continuous whimper, nagging cold and fever, irregular sleeping habit worry me a lot, but neighbours told me that these were not big problems,” says Lucky, 22. “They told me these bothering signs will go away when she grows up.”

A housewife and mother of two from Singher Gaon village, in the northern district of Netrakona, Lucky tried hard to buy better food as much as her construction labourer husband could afford, but Omi’s health did not change.

“I spend very busy days doing household and all other family chores, as my husband migrated to Dhaka for work. On top of that, it seems too much to me to take care of such a child,” she says.

A case for concern

After two of her infant children died within 30 minutes of birth, Lucky regularly consulted doctors when she became pregnant with Omi, who is now 3. The cost – 25,000 taka (US$320) – pushed them deeper into poverty.

As her daughter's health condition worsened, Lucky felt she had nowhere to turn.

“Sometimes I thought about taking Omi to doctors, but nobody around me could guide me,” she says.

It was then that a survey group supported by UNICEF visited her house during an assessment of the nutritional situation in the district.

The survey group leader, M. Akhtaruzzaman, found severe malnutrition in Omi and warned her mother.

“The child's clinical signs indicated severe malnutrition,” he explains. “So we asked the parents to take her to a doctor immediately and assured them that proper treatment can help her grow like other children.”

© UNICEF/BANA2014-01442/Haque
A member of the RNAT conducts a household survey on nutrition status in the area of Chollisha Nagar, Netrokona.

In Bangladesh, the prevalence of malnutrition remains high. According to the Bangladesh Demographic and Health Survey (BDHS) 2011, around 4 per cent of under-5 children suffered wasting, or acute malnutrition, which translates to about 600,000 severely malnourished children.

According to the BDHS 2011, some 41 per cent of under-5 children were stunted, 16 per cent wasted, and 36 per cent underweight.

Rapid assessement

Akhtaruzzaman is a professor at the University of Dhaka’s Institute of Nutrition and Food Science (INFS) and a member of the Rapid Nutrition Assessment Team (RNAT), part of the UNICEF-supported programme ‘Strengthening National and Local Capacities in Nutrition Assessments and Preparedness in 10 Disaster-prone Districts’.

Funded by ECHO, the European Union’s Humanitarian Aid and Civil Protection department, the programme aims to build national and local systems and capacities to assess and prepare for nutrition in emergencies. The project is being implemented in partnership with the Government of Bangladesh and the Dhaka University’s INFS.

Aside from Netrakona, it covers the districts of Faridpur, Sunamganj, Habiganj, Rajshahi, Tangail, Cox’s Bazar, Khulna, Jamalpur and Satkhira – among the 20 districts most vulnerable to cyclones, floods, flash floods and waterlogging.

Disruption of livelihoods in an emergency can increase the likelihood of malnutrition, causing rapid deterioration of nutrition situation, especially among the most vulnerable and the poor. Inadequate infant and young child feeding practices and poor hygiene leading to infections are the main causes of child malnutrition.

“The combination of pre-crisis vulnerability in relation to the nutrition and the impact of disasters on livelihood and child feeding practices means the nutrition situation should be assessed and monitored,” says Andrew Musyoki, Nutrition Cluster Coordinator for UNICEF Bangladesh.

Knowledge and experience

To conduct the surveys, the RNAT team has been trained on Standardized Monitoring and Assessment of Relief and Transition (SMART), a globally recognized survey method.

© UNICEF/BANA2014-01451/Haque
A mother and child participating in nutrition measuring procedure under the UNICEF/EU-supported programme.

“The main purpose of establishing and training the RNAT is to ensure that they can gain skills on how to undertake good quality nutrition surveys using SMART methodology,” Mr. Musyoki says.

“In case the nutrition cluster or any partner needs to undertake a nutrition survey, they can hire the RNAT to do it,” he says. “In the event of a disaster, these people will be deployed in the field to undertake a nutrition survey.”

RNAT training combines academic knowledge and working experience, explains SMART trainer Blessing Mureverwi, who says that the team members were already experts in nutrition and disaster response.

“The RNAT members have been trained on ways to guide the enumerators, who are essential for conducting a survey, and to take measurements of children as well as interview parents to ensure quality,” Mr. Mureverwi says.

SMART methodology is being used to harmonize the country's nutrition surveys, to ensure that trends in the nutrition situation can be tracked over time and compared.

The Netrakona survey is one among two surveys planned under the current project. Other key interventions include preparation of national nutrition survey guidelines and tools and the training of 300 disaster management committee members on nutrition in emergencies.



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