In Bangladesh, 36 percent of children under the age of five suffer from stunting, a classic symptom of chronic malnutrition. PHOTO: COLLECTED


In Bangladesh, 36 percent of children under the age of five suffer from stunting, a classic symptom of chronic malnutrition. PHOTO: COLLECTED

Bangladesh, despite being one of the world’s fastest-growing economies with exceptional GDP growth, was unable to avoid extreme food insecurity during the pandemic, which was experienced by a substantial proportion of the population. The Covid-19 pandemic exacerbated “hidden hunger” all over the world, resulting in negative public health repercussions.

Bangladesh has made remarkable progress in the reduction of under-five mortality (from 94 deaths per 1,000 live births in 1999–2000 to 31 in 2019), for which the Prime Minister of Bangladesh Sheikh Hasina received the United Nations Millennium Development Goal (MDG) Award in 2010. However, despite this success, the prevalence of chronic undernutrition and micronutrient deficiency is still going up. Approximately 25 percent of the population remains food insecure, and 36 percent of children under the age of five suffer from stunting, a classic symptom of chronic malnutrition.

On top of that, a dissemination seminar on “Preliminary findings of the National Micronutrient Survey in Bangladesh 2019-2020” revealed that the vitamin A deficiency among children (0-59 months) has increased alarmingly, from 20.5 percent in 2011 to 52.8 percent in 2019-20. Vitamin A deficiency for non-pregnant non-lactating (NPNL) women also went up from 5.4 percent in 2011 to 8.5 percent in 2019-20. A similar trend can also be found with regard to iron deficiency 14.9 percent (2019-20). However, the opposite trend can be found in the case of iodine, zinc and vitamin D, even though the country is still far from solving the issue of micronutrient deficiencies.

Hidden hunger is a micronutrient (vitamin and mineral) deficiency that occurs when the quality of food people eat does not meet their nutrient requirements, which hinder their growth and development. This can have several negative health and social consequences, including an increased risk of malnutrition, multiple infections, chronic diseases, poor health and wellbeing, impaired learning, poor mental health, social conflict, and increased social and economic inequalities. These negative consequences also have the potential to jeopardise the overall developmental activities of citizens of various demographics.

Globally, USD 5.6 trillion economic loss is caused by malnutrition every year and in Bangladesh, this loss is more than Tk 7,000 crore (USD one billion). With over 12 lakh citizens affected by Covid-19 to date, the long-standing need to boost immunity and maintain a healthy diet is now more important than ever. In the Global Hunger Index (GHI) 2020, Bangladesh was ranked 75 out of 107 countries, indicating a serious malnutrition epidemic, possibly made worse by the pandemic-induced lockdowns. In March this year, The UN Food and Agriculture Organization (FAO) placed Bangladesh in a list of countries that require external assistance in food to brave “severe localised food insecurity”.

In this context, fortifying food is one of the most cost-effective and reliable investment choices in broader national initiatives to prevent chronic undernutrition. It is considered a highly effective intervention to reduce micronutrients deficiency among children and pregnant women, which has escalated amid the Covid-19 pandemic. Fortified foods are enhanced with six essential vitamins and minerals that the poor segment of the population may otherwise not be able to afford due to lack of access to meat, fish, fruits and other non-rice products.

The UN Food Systems Summit 2021, which is going to take place this September, focuses on strengthening food systems, promoting healthy diets and improving nutrition, especially for children and young people. Prime Minister Sheikh Hasina has already urged the government and private sectors to work to ensure nutrition as well as food security for the mass population.

On that note, the government has already integrated nutrition security into its existing policies, strategies and acts. The National Food and Nutrition Security Policy (NFNSP) 2020, which recognises that food systems contribute to multiple outcomes that are needed to improve food and nutrition security, has been incorporated into the Eighth Five Year Plan. In line with the SDGs, the government has formulated and implemented the Second Country Investment Plan for Nutrition-Sensitive Food Systems (CIP2) from 2015-2020.

Additionally, to improve the overall health, nutritional status, survival, growth, development and productivity of the population by preventing and alleviating micronutrient deficiencies, the National Strategy for Prevention and Control of Micronutrient Deficiencies in Bangladesh (NSPCMD), 2015-2024, is being implemented. The Food Safety Act 2013 has also been a monumental step in providing a proper legal framework for ensuring food security for the poorest of the poor in the country.

Another positive development with regard to food fortification is the Mandatory Oil Fortification Act 2013, which makes provisions for the fortification of edible oils with vitamin A. The Act made it mandatory for storing, selling, supplying and marketing of edible oil fortified with vitamin A, whether it is produced locally, refined or imported. Additionally, Bangladesh was one of the first countries globally to introduce mandatory salt iodisation in 1989, aligning with the Universal Salt Iodisation (USI) Programme. Bangladesh has achieved significant success over the years in this regard, with 80.3 percent of households consuming iodised salt and 57 percent of households using adequately iodised salt, according to the National Salt Iodization Survey 2015. However, efforts are still needed to achieve the USI target (more than 90 percent of households) of adequately iodised salt coverage in Bangladesh. In 2021, the government of Bangladesh passed the Iodised Salt Bill, making iodisation of edible salts mandatory to prevent iodine deficiency disorders and improve the nutrition of millions of people.

The Covid-19 pandemic has emerged with new opportunities for boosting immune systems by promoting food fortification. Ideas like rice and oil fortification, and salt iodisation, have already been in the spotlight. However, we still need to focus more on how other micronutrients can be mixed with staple foods like wheat, maize flour or milk at very low costs. Finally, preventing vitamin D deficiency among high-risk population groups is yet to receive enough attention, and must be integrated into the strategy of multiple micronutrient supplementation.

Avijit Saha is currently enrolled in a Master’s programme in the Department of Development Studies at Bangladesh University of Professionals.


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