Breaking the Intergenerational Cycle of Under-nutrition: Community Based Interventional Approach in Bangladesh

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Source: ec.europa.eu

Source: ec.europa.eu

Malnutrition has always been one of the major Public Health issues in Bangladesh. Malnutrition includes both under-nutrition and over-nutrition. However, Bangladesh is a highly under-nutrition (wasting, stunting and underweight) prevalent country which include macro and micro-nutrient deficiency. In Bangladesh, commonly children aged under 5 years and women suffer most from under-nutrition . Among the children under 5 years, the prevalence of chronic under-nutrition (stunting) is around 44% (7.8 million) and acute under-nutrition (wasting) is 14% (2 million) which is nearly the WHO “critical threshold” of 15%. More than one in five newborns (22%) have a low birth weight in Bangladesh due to maternal under-nutrition and early pregnancy. Early pregnancy contributes to the inter-generational cycle of under-nutrition. Although the prevalence of under-nutrition has reduced over the past few years, but progress has been slow due to poverty, lack of health education, natural disaster, food insecurity and caring practices.

Source: WFP Bangladesh Nutrition Strategy

Intergenerational cycle of under-nutrtion; Source- WFP Bangladesh Nutrition Strategy

Improvement of maternal and child nutritional status has been a priority of the government of Bangladesh for several decades. In 2012, to reduce maternal and child under-nutrition, along with World Food Programme (WFP) Bangladesh govt. introduced National Nutrition Service (NNS) strategy 2012-2016 which is multi-sectoral collaborative approach aiming on strengthening national and local capacities to adequately deliver nutrition services, and improving access to nutrition services through integrated community based interventionsThe policy specifically focused on the first 1000 days of a child from conception to two years when nutrition needs are the highest and nutrition intervention have the most long-term effect and contribute to breaking the inter-generational cycle of under-nutrition.

We believe, this short-term comprehensive approach will be very effective to reduce nutritional problem in Bangladesh. However, active coordination of all sectors, adequate training of health worker, uninterrupted supply of nutritional services and active involvement of community need to be ensured.

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4 Responses to “Breaking the Intergenerational Cycle of Under-nutrition: Community Based Interventional Approach in Bangladesh”

  1. drtosintaiwo Says:

    Proper nutrition is a powerful good in a country because if people are well nourished, they are more likely to be healthy, productive and able to learn. This rate of undernutrition is quite high in Bangladesh, and i strongly agree with the National Nutritional Service Strategy, but i hope it will be extended beyond the year 2016, because this(malnutrition) condition has been going on for a long time or perhaps train community volunteers to identify and treat cases of malnutrition in children, so as to cover as many more children as possible within that period and beyond, thus empowering the communities to help themselves, and thus ensuring continuity. This will also improve access to integral communities in Bangladesh.

  2. ynangwenyi Says:

    Undernutrition is a major issue and your diagram showing the links between mothers and infants is powerful. I first heard about the 1000 days approach last year and it’s a great way to break this cycle in Bangladesh and similar settings. For policymakers and donors, it can also be powerful to also frame this as a cost-effective investment. When there are multiple needs, it can be a challenge to allocate resources but undernutrition should be among the highest priorities.

    Researcher Bjorn Lomborg and his team of economists examined UN targets and discussed how that tackling malnutrition in early life not only improves brain development and learning (as in comment above) but translates to greater economic returns as an adult. And as you pointed out, if that adult is a childbearing woman, she passes that on to the next generation. There’s a fascinating interview on this at Freakonomics: http://freakonomics.com/2014/10/02/108967/

  3. Sinae Sophie Suh Says:

    I’ve heard that Bangladesh had substantial progress in reducing malnutrition between 1990 and 2000, comparing to other countries in South Asia. But, the prevalence of child stunting and malnutrition is still very high. I do support that Bangladesh government introduced this program to address malnutrition problem as based on the multiple sector collaborative approach. I believe nutritional problems are very important, especially for children and early stage of life infant, and it is needed to be addressed in multiple aspects, such as health care system, social development, woman right issues, and infrastructures. I also believe that to educate women about proper child-care practices and adequate breastfeeding technique with family planning could be very good approach to address to these problems. Thank you for sharing this article, and wish all the children in Bangladesh won’t suffer from malnutrition in near future.

  4. shalinipammal Says:

    It is interesting to note that early pregnancy contributes to the intergenerational cycle of under-nutrition present in Bangladesh. This provokes the question of how to effectively supplement nutrition policy and initiatives with education and female empowerment efforts. I would imagine that in order for nutrition policy to be effective, it needs to be bolstered by strong community engagement and participation. If cultural attitudes still support early pregnancy, and mothers are not well-informed about contraception or pre-natal care for example, then nutrition policy is reactive and does not tackle root cause factors. Nevertheless, any initiatives that put Bangladesh on a path better nutritional status for this significant portion of its population would be a huge step in the right direction. Such policy would have to be enacted mindfully with context and baseline understanding of the population and community assets.

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