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Fill the Nutrient Gap - Bangladesh Concise Report, December 2019

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Bangladesh
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Govt. Bangladesh
+ 1
Date de publication
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Executive Summary

Bangladesh has made significant progress over the last 20 years to reduce rates of malnutrition among its population. Childhood stunting rates decreased from 60 percent in 1997 to 31 percent in 2018; underweight in women has nearly halved from 34 to 19 percent since 2004 (1a). Yet malnutrition persists. The country is facing a triple burden of malnutrition, with decreasing but still high stunting and wasting rates (31 and 8 percent respectively), high prevalence of micronutrient deficiencies (anemia in non-pregnant, non-lactating women is at 26 percent), and steeply increasing rates of overweight and obesity (24 percent in ever married women aged 15–49 in 2014, up from 9 percent in 2004) (1, 4, 2).

Investments in nutrition interventions in Bangladesh have been estimated to provide a 1:10 return (3), making nutrition a powerful tool to improve human capital development and accelerate growth and productivity.

A multisectoral policy framework to enhance nutrition interventions is largely in place. A comprehensive agenda for nutrition is provided by the National Nutrition Policy 2015 and the second National Plan of Action for Nutrition (NPAN2), in tandem with the Food Policy 2006, Micronutrient Strategy and Second Country Investment Plan.
Recent policy mapping has shown that in most relevant sector policies, availability and access have been adequately addressed. Yet food utilization, and thus food consumption and nutrient intake, is poorly articulated in many sectors policies. Matters related to women’s agency are particularly identified as a common gap, even in recent policies like the Agriculture Policy (July 2019).

A recent World Bank study shows the need to re-examine the changing drivers of malnutrition to ensure programmes and policies address the triple burden effectively (5). The FNG analysis draws five overarching conclusions.

  1. Food Environment – At least one in eight (13 percent) households cannot afford to meet their nutrient needs. Food safety concerns might jeopardize availability and affordability of nutritious foods.

Within the scope of the FNG analysis, the minimum cost for a household to consume a nutritious diet calculated as a basis for comparison (174 Bangladeshi Taka - BDT) is more than twice as high as that calculated for meeting energy needs only (80 BDT). Energy needs can be met cheaply by a combination of wheat and rice, while an optimized nutritious diet includes a combination of staples (rice, wheat), tubers, legumes, animal source foods (fish, milk), vegetables (including green leafy vegetables), fruit and oil. The optimized nutritious diet is composed of less rice and more vegetables, milk and pulses than what is currently consumed.

Comparing the cost to actual food expenditure, all households can afford an energy-only diet, but at least one in eight (13 percent) cannot afford an optimized nutritious diet. This figure is in line with the prevalence of extreme poverty (11.3 percent) (6). The widespread affordability of foods, including nutrient-dense foods, is a major achievement in recent years and in large part due to the government’s efforts to reduce poverty and promote agricultural production.

The FNG analysis assumes that all foods included for analysis are not adulterated and are safe for human consumption. The limited evidence on the actual extent of food adulteration is mixed (7–11) and regulation was put in place to prevent food adulteration and inform public opinion. Yet in recent years numerous reports of food adulteration have heightened public awareness of the practice, and of contamination. Evidence suggests that some food might be tampered with to preserve or increase its commercial value, for example by preserving fish with formaldehyde or adding water to milk. The efforts to ensure food is not adulterated throughout the supply chain might increase food prices, reduce availability of certain foods, and reduce affordability.