1. Nutrition Security for the Poor
Professor Nazma Shaheen
Institute of Nutrition and Food Science
University of Dhaka

2. Nutrition Security for the Poor
Food Security Vs Nutrition Security
Current Nutrition Situation in Bangladesh
Poverty and Nutrition Security
Policy
Challenges
Approaches
Nutrition Security for the Poor

3. Nutrition Security Nutrition Security A condition which combines
Having access to a stable supply of adequate food.
Being well cared for.
Enjoying a healthy environment.
IFAD (1996)
Nutrition Security for the Poor

4. Food Security Vs Nutrition Security
Food intake
Stability
Food availability
Food accessibility
Nutrition Security
Food intake
Food availability
Caring capacity
Health service
Environment
Nutrition Security for the Poor

5. Conceptual Framework of the Nutritional Status
Nutrition Security
Food Security
Food Intake
Health Status
Food access
Health Status
Health Services
Environmental condition
Nutrition Security for the Poor

6. Bangladesh: Nutrition Security Scenario
Chronic and acute malnutrition
Micronutrient malnutrition
Consumption Pattern
Nutrition Security for the Poor

7. Current Nutrition Situation in Bangladesh
Malnutrition, 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

8. Prevalence of Underweight (<-2 z) Among U-5 Children in Bangladesh
Nutrition Security for the Poor

9. Trends of Nutritional Status of Bangladeshi Children
Nutrition Security for the Poor

10. Maternal Nutritional Status
Nutrition Security for the Poor

11. Micronutrient 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.
Nutrition Security for the Poor

12. Consumption Pattern in Bangladesh
Survey Years
Food items, g
2000
2005
2010
Poor
Non-poor
Total
913.8
893.06
947.75
816.22
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
Nutrition Security for the Poor

13. Consumption Pattern in Bangladesh
Survey Years
Food items, g
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
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
72.41
Nutrition Security for the Poor

14. Consumption by Ultra Poor
Food group
Intake (g/per capita/day) (BIGH, 2013)*
Desirable (g/per capita/day) ((DDP,2013)
Total Cereal
337.3
400
Fruits 50
100
Non-leafy Vegetables
68.1
200
Leafy Vegetables
43.8
Pulses
4.60
All animal foods
64.9
260
Fish
36.8 60
Meat
10.2 40
Egg
7.5 30
Milk and Milk products
32.4
130
Roots & tubers
48.3
* 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).
Nutrition Security for the Poor

15. Gap Between Original Intake and 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).
Nutrition Security for the Poor

16. Trend of Cereals Intake Over Years in Bangladesh (BBS)
Nutrition Security for the Poor

17. UNICEF Model of Malnutrition
Nutrition Security for the Poor

18. Underlying Causes Malnutrition Poverty Disease Inadequate Food Intake
Household Food Insecurity
Poor Social and Care Environment
Poor Access to Health care and Unhealthy Environment
Poverty
Nutrition Security for the Poor

19. Poverty and Nutrition Insecurity
Unavailability of food
Inadequate food intake
Unhygienic Environment
Poverty
Nutrition Insecurity
Increased infection
Poor health service
Improper care
Poor Education
Loss of resources due to health cost
Decreased Productivity
Nutrition Security for the Poor

20. Policy and Planning Frameworks in Bangladesh
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:
The National Food Policy (NFP) (2006)
a comprehensive food security policy framework
The National Food Policy Plan of Action (NFP PoA) ( )
a programming document
The Bangladesh Country Investment Plan (CIP)
an investment plan for food security and nutrition.
Nutrition Security for the Poor

21. Policy and Planning Frameworks in Bangladesh
Other policy documents that are relevant for food security in Bangladesh:
Roadmap for producing the CIP and NFP PoA Monitoring Report 2014
NFP PoA and CIP Monitoring Report 2013
Roadmap for producing the CIP and NFP PoA Monitoring Report NFP PoA and CIP Monitoring Report 2012
National Strategy for Accelerated Poverty Reduction II (Revised) ( )
Outline of Perspective Plan ( )
National Agricultural Policy (2013)
Nutrition Security for the Poor

22. Objective 1: Adequate and stable supply of safe and nutritious food
National Food Policy
Objective 1: Adequate and stable supply of safe and nutritious food
POLICIES
Agricultural research and extension
Use and management of water resources
Adequate supply and sustainable use of agricultural inputs
Agricultural diversification
Agricultural credit and insurance
Physical market infrastructure development
Agricultural marketing and trade
Policy and regulatory environment
Early warning system development
Producer price support
Public stock management / price stabilization
Nutrition Security for the Poor

23. National Food Policy POLICIES
Objective 2: Increased purchasing power and access to food of the people
POLICIES
Agricultural disaster management
Emergency distribution from public stock
Enabling environment for private food trade and stock
Effectiveness of targeted food security programs and other safety nets
Income generation for Women and the Disabled
Promotion of Agro-based/ Agro-processing and Micro/Small Rural Enterprises
Market-driven skill Development
Nutrition Security for the Poor

24. National Food Policy POLICIES
Objective 3: Adequate nutrition for all individuals, especially women and children
POLICIES
Long-term planning for Balanced nutrition
Balanced and nutritious food at Minimal Costs for Vulnerable Groups
Nutrition education for dietary diversification
Supplementation and fortification for balanced nutrition
Safe drinking water and improved sanitation
Safe, quality food supply
Women and children’s health
Promotion and Protection of Breastfeeding and Complementary Feeding
Nutrition Security for the Poor

25. Challenges
Nutrition Improvements not keeping pace with poverty situation (BBS, BDHS,2011)
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%
Income poverty improved faster than stunting and underweight
Nutrition Security for the Poor

26. Consumption is Diversifying Faster Than Production (FPMU,2014)
Production diversification could accelerate consumption diversification in rural areas
Nutrition Security for the Poor

27. Issues and Policy 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
Nutrition Security for the Poor

28. Strategies for Improvement of Nutrition Situation
Specific Action for Nutrition
Feeding practices & behaviors
Fortification of foods
Micronutrient supplementation
Treatment of acute malnutrition
Nutrition-Sensitive Strategies
Agriculture
Clean water & sanitation
Education
Employment & social protection
Health care
Support for resilience
Nutrition Security for the Poor

29. Approaches to Ensure Nutrition Security in Poor
To ensure adequate intake
Food based approach
Non-food based approach
To ensure care and health
Improvement of local health services
Ensuring proper access to health services
Education on Mother and child care
Education on proper sanitation
Nutrition Security for the Poor

30. Approaches to Ensure Nutrition Security in Poor
Food based approach
Increasing 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
Ensuring accessibility through policy
Nutrition Security for the Poor

31. Agriculture-Nutrition-Health
Horticulture
Pisiculture
Agriculture
Health
Food
Productivity
Risk taking
Education
Cognition
Endurance
Physical-
strength
Livelihoods
Income
Employment
Food Security
Dietary diversity
Income Equity
Nutrition
Nutrition Security for the Poor

32. Approaches To Ensure Nutrition Security
Non-food based approach
Identification 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.
Nutrition Security for the Poor

33. Recommendation
Achieving nutrition security requires a multi- sectoral approach
Nutrition Security for the Poor

34. The Way Forward and Implementation Challenges
The 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 activities
capacity development activities
strong momentum
strong dialogue
Policy dialogue
Knowledge sharing and effective learning
Nutrition Security for the Poor

35. The Way Forward and Implementation Challenges
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
Nutrition Security for the Poor

36. Thank you