nutrition security for the poor professor nazma shaheen institute of nutrition and food science...

Nutrition Nutrition SecuritySecurity for for the Poorthe Poor

Professor Nazma ShaheenInstitute of Nutrition and Food

ScienceUniversity of Dhaka

NutritionNutrition Security for the Security for the PoorPoor

Nutrition SecurityFood Security Vs Nutrition

SecurityCurrent Nutrition Situation in

BangladeshPoverty and Nutrition SecurityPolicyChallengesApproaches

Nutrition Security for the Poor

Nutrition Security

A condition which combinesHaving access to a stable supply of adequate food.Being well cared for.Enjoying a healthy environment.

IFAD (1996)

NutritionNutrition Security Security


Food SecurityFood intakeStabilityFood availabilityFood accessibility

Nutrition SecurityFood intakeFood availabilityCaring capacityHealth serviceEnvironment

Food Security Vs Nutrition Food Security Vs Nutrition SecuritySecurity


Food access

Environmental

condition

Health Status

Conceptual Framework of the Conceptual Framework of the Nutritional StatusNutritional Status

Nutritional status

Health Status

Food Intake

Nutrition Security

Food Security

Health Services


Bangladesh: Nutrition Bangladesh: Nutrition Security ScenarioSecurity Scenario

Chronic and acute malnutritionMicronutrient malnutritionConsumption Pattern


Current Nutrition Situation in Current Nutrition Situation in BangladeshBangladeshMalnutrition, in Children (birth to 59 months)

2011/12 2012/13

Stunting 41.3% (BDHS) 38.7% (UESD)Underweight 36.4% (BDHS) 35.1% (UESD)

Wasting 15.7% (BDHS) 16.3% (UESD)Low birth weight 26% (BDHS) Exclusive breastfeeding (6 -59 months)

64% (BDHS) 95.3% (MICS)

Breast feeding until 2 years

90% (BDHS) 87.5% (MICS)

Anemia, in children (6-23 months)

51% (BDHS)

Iodine deficiency, in children (6-11 years) and (12-14 years)

3.9% and 9.5 % respectively (BDHS)

Zinc deficiency, in pre-school age children

44.6% (BDHS) Nutrition Security for the Poor

Prevalence of Underweight (<-2 z) Prevalence of Underweight (<-2 z) Among U-5Among U-5Children in BangladeshChildren in Bangladesh


Trends of Nutritional Status of Trends of Nutritional Status of Bangladeshi ChildrenBangladeshi Children


Maternal Nutritional Maternal Nutritional StatusStatus


Micronutrient DeficiencyMicronutrient Deficiency


A persisting problem of micronutrient deficiencies.

2/3 of preschool children and1/3 of mothers and school going children are still iodine deficient.

Iron deficiency anemia is prevalent in 2/3 of under-five children and 1/3 of pregnant women and overall anemia in 93.5% of adolescent girls.

1/5 of under-five children suffer from vitamin A deficiency.

Consumption Pattern in Consumption Pattern in BangladeshBangladesh

Survey Years

Food items, g

1995-96

2000 2005 2010

Poor Non-poor Total

Total 913.8 893.06

947.75 816.22

1084.53 999.99

Rice 464.3 458.54

439.64 406.19

420.52 416.01

Wheat 33.7 17.24 12.08 20.36

28.73 26.09

Potato 49.5 55.45 63.30 63.44

73.78 70.52

Pulses 13.9 15.77 14.19 10.15

16.22 14.30

Vegetables

152.5 140.47

157.02 141.8

177.25 166.08

Edible oil

9.80 12.82 16.45 14.20

23.41 20.51

Onion 11.6 15.41 18.37 15.69

24.74 21.89

Beef 6.60 8.30 7.78 1.55 9.27 6.84

Mutton 1.00 0.49 0.59 0.11 0.83 0.60


Consumption Pattern in Consumption Pattern in BangladeshBangladesh

Survey Years

Food items, g

1995-96

2000 2005 2010

Poor Non-poor

Total

Chicken/Duck

4.00 4.50 6.85 4.11 15.09 11.22

Eggs 3.20 5.27 5.15 3.40 9.02 7.25

Fish 43.80 38.45 42.14 31.16 57.81 49.41

Milk & milk products

32.60 29.71 32.40 12.18 43.63 33.72

Fruits 27.60 28.35 32.54 20.46 56.0 44.80

Sugar/ Gur 9.20 6.85 8.08 3.32 10.88 8.50

Food taken outside

- - 24.76 17.70 35.41 29.83

Miscellaneous

50.90 55.42 48.38 50.28 81.81 72.41Nutrition Security for the Poor

Consumption by Ultra Consumption by Ultra PoorPoor

Food group Intake (g/per capita/day) (BIGH,

2013)*

Desirable (g/per

capita/day) ((DDP,2013)

Total Cereal 337.3 400Fruits 50 100

Non-leafy Vegetables

68.1 200

Leafy Vegetables 43.8 100Pulses 4.60 50

All animal foods 64.9 260Fish 36.8 60Meat 10.2 40Egg 7.5 30

Milk and Milk products

32.4 130

Roots & tubers 48.3 100


* Baseline Survey Report On Integrated Agriculture And Health Based Intervention For Improved Food And Nutrition Security In Selected Districts Of Southern Bangladesh by BRAC Institute of Global health (BIGH).

Gap Between Original Intake and Gap Between Original Intake and Desirable Intake*Desirable Intake*


* Baseline Survey Report On Integrated Agriculture And Health Based Intervention For Improved Food And Nutrition Security In Selected Districts Of Southern Bangladesh by BRAC Institute of Global health (BIGH).

Trend of Cereals Intake Over Years Trend of Cereals Intake Over Years in Bangladesh (BBS)in Bangladesh (BBS)


UNICEF Model of MalnutritionUNICEF Model of Malnutrition


Underlying Causes Underlying Causes

Malnutrition

DiseaseInadequate Food Intake

Household Food

Insecurity

Poor Social and Care

Environment

Poor Access to Health care

and Unhealthy Environment

PovertyNutrition Security for the Poor

Poverty and Nutrition Poverty and Nutrition InsecurityInsecurity

Poverty

Unavailability of food

Unhygienic Environme

nt

Poor health service

Poor Education

Inadequate food intake

Increased infection

Improper care

Nutrition

Insecurity

Decreased Productivity

Loss of resources due to health

cost


Policy and Planning Policy and Planning Frameworks in BangladeshFrameworks in Bangladesh


The National Food Policy (NFP) (2006)

a comprehensive food security policy framework

The National Food Policy Plan of Action (NFP PoA) (2008-2015)

a programming document

The Bangladesh Country Investment Plan (CIP)

an investment plan for food security and nutrition.

Since the World Food Summit of 1996, the Government of Bangladesh has undertaken an in-depth and consultative process of food security policy reform. This has provided the Government with:

Policy and Planning Policy and Planning Frameworks in BangladeshFrameworks in BangladeshOther policy documents that are relevant for food security in Bangladesh:

Roadmap for producing the CIP and NFP PoA Monitoring Report 2014NFP PoA and CIP Monitoring Report 2013 Roadmap for producing the CIP and NFP PoA Monitoring Report NFP PoA and CIP Monitoring Report 2012National Strategy for Accelerated Poverty Reduction II (Revised) (2009-11)Outline of Perspective Plan (2010-2021)National Agricultural Policy (2013)


National Food PolicyNational Food Policy


ChallengesChallenges

Year Poverty Stunting Underweight

2000 48.9% 50.8% 42.3%

2010 31.5% 41.0% 36%

Change/year -4.30% -1.86% -1.36%

Nutrition Improvements not keeping pace with poverty situation (BBS, BDHS,2011)

Income poverty improved faster than stunting and underweight


Consumption is Diversifying Consumption is Diversifying Faster Than Production Faster Than Production (FPMU,2014)(FPMU,2014)

Production diversification could accelerate consumption diversification in rural areas


Issues and Policy Issues and Policy Challenges Challenges Average calorie intake well below the FAO

recommended level; rural urban divide U5 underweight almost stagnant >>>

specific program intervention Calorie intake from cereal still very high

>>> food and diet diversification cereals and other foods

Still 1/4 of adult women suffer from CED Anemia prevalence among women

increasing (!!) People suffering from FBD and WBD still

significant (around 9% for diarrhea only) Data heterogeneity; non-availability


Specific Action for NutritionFeeding practices & behaviorsFortification of foodsMicronutrient supplementationTreatment of acute malnutrition

Nutrition-Sensitive StrategiesAgricultureClean water & sanitationEducationEmployment & social protectionHealth careSupport for resilience

Strategies for Improvement of Strategies for Improvement of Nutrition SituationNutrition Situation


Approaches to Ensure Nutrition Approaches to Ensure Nutrition Security in Poor Security in Poor

Approaches to ensure nutrition securityTo ensure adequate intakeFood based approachNon-food based approach

To ensure care and healthImprovement of local health servicesEnsuring proper access to health servicesEducation on Mother and child careEducation on proper sanitation


Ensuring accessibility through policy

Food based approachIncreasing agriculture productivity

Local level Interventions in largely non-commercial agricultural systems, where large part of the produce is consumed by producer, may result in diversified diets.

Mitigation of extreme poverty by increasing productivity

Approaches to Ensure Nutrition Approaches to Ensure Nutrition Security in Poor Security in Poor


Agriculture-Nutrition-Agriculture-Nutrition-HealthHealth

Nutrition

Livelihoods Income Employment Food Security Dietary diversity Income Equity

Productivity Risk taking Education Cognition Endurance Physical- strength


Approaches To Ensure Approaches To Ensure Nutrition SecurityNutrition Security

Non-food based approachIdentification of most vulnerable group.Supplementation program to manage extreme condition.Fortification of staple foods with required nutrient.Ensuring proper utilization and minimizing loss by providing proper health care services and proper education.


RecommendationRecommendationAchieving nutrition security requires a multi-sectoral approach


The Way Forward and The Way Forward and Implementation ChallengesImplementation ChallengesThe CIP is a tool in the hand of the Government to increase and improve investment in food security, i.e. agriculture, fisheries and livestock, food access and safety nets and nutrition activities.Resource mobilization activitiescapacity development activitiesstrong momentumstrong dialogue Policy dialogueKnowledge sharing and effective learning


Strong momentum developed with all actors involved, including consumer groups, farmer and producer organizations, private sector, NGOs, Government and development partners to ensure their support of the CIP, including its financing and implementation.

A strong dialogue on investment in food and nutrition security using the CIP as the key strategic and collaborative instrument for creating a more enabling framework for increased investments from both the public and the private sector.

The policy dialogue on investment should be mainstreamed in the National Food Policy, focused on the critical elements for the CIP


The Way Forward and The Way Forward and Implementation ChallengesImplementation Challenges

Thank youThank you

nutrition security for the poor professor nazma shaheen institute of nutrition and food science...

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