Capacity building, awareness vital to prevent malnutrition in Bandarban: Stakeholders

Capacity and awareness building through coordinated efforts are the key to preventing malnutrition in Bandarban, where poverty, superstition, lack of knowledge and poor access are major challenges, said stakeholders at a roundtable on Tuesday.

Malnutrition causes people to suffer from becoming underweight, stunting and wasting away of the body, they said at the event, titled "Advancing Nutrition Commitments for Chattogram Hill Tracts", organised by the District Nutrition Coordination Committee (DNCC) of the Bandarban Hill District.

Photo: TBS

"People have a perception that higher priced foods are more nutritious. However, the people of the hilly areas have a variety of highly nutritious foods, such as fruits at meagre prices. People are not even aware of proper cooking methods," Sing Young Mro, chairman (in-charge) of the Bandarban Hill District Council, pointed out at the discussion held at the Parjatan Motel conference hall in Bandarban. The programme was supported by the Leadership to Ensure Adequate Nutrition (LEAN) project. 

Mentioning that Bandarban lags behind in all nutritional indicators, Dr Nihar Ranjan Nanday, civil surgeon and member secretary of DNCC, Bandarban, said, "Maternal and child health is the key focus of nutrition. If their nutritional status can be improved, the total social picture will change."

Speaking as chief guest, Dr Hasan Shahriar Kabir, director general of the Bangladesh National Nutrition Council (BNNC), said, "There are some barriers to eliminating malnutrition in hilly areas. Many of these are geographical. Including Bengalis, there are 12 ethnic groups here. We need to increase our capacity to work among them."

"Some innovative steps have to be taken which may not be applicable to Dhaka. The issue of nutrition should be raised at the local level," he added.

According to the Bangladesh nutrition profile (nutritionprofil.gov.bd), the prevalence of stunting is 30% in Bandarban. The figure is 27% in Chattogram division and 28% nationally.

On the other hand, the prevalence of underweight ranges from 28% in Bandarban, 23% in Chattogram division and 23% nationally, which also shows progress toward the national prevalence rate of underweight (23%).

Wasting away of the body is 14% in Bandarban, 10% in Chattogram division and 10% at the national level, which shows a good prevalence rate in terms of nutrition indicators. 

But it is not up to the mark according to the global standards for a malnutrition prevalence rate of wasting <5%, stunting <20% and underweight <10%.

In Bangladesh, more than 54% of preschool-aged children, equivalent to more than 9.5 million children, are stunted, 56% are underweight and more than 17% suffer from wasting away of the body, according to an FAO report in 2019.

Citing a Lancet journal study on "why we should invest in nutrition" Obaidur Rashid, technical coordinator-Nutrition Governance, LEAN, said, "If $1 is invested in nutrition, there will be a return of $16."

"If an expectant mother is adequately fed and cared for, a healthy baby will be born. He will have opportunities to do well in everything such as sports, studies and work. Through this it will contribute to the national GDP," he added.

He said that the main goal of LEAN is to improve nutrition in the hill districts through all stakeholders working together.

Some 4.59 lakh people live in Bandarban and of them, around 3.25 lakh live in rural areas, according to the available data.

In Bandarban, the use of improved drinking water is 57%, improved sanitation 39%, water and soap availability 44%, whereas in Chattogram division it is 97%, 84% and 69% and nationally 99%, 64% and 75% respectively.

Dr Bamong Prue, Ruma Upazila health and family planning officer, "Ruma Upazila is the most disconnected in Bandarban. Inaccessibility and safe water crisis are the greatest problems here. As a result, people suffer from diarrhoea and infections, which are the main causes of wasting."

"If the crisis of safe water can be eliminated, the nutritional challenge will be halved," he added.

As the chair of the event, Yasmin Parvin Tibriji, deputy commissioner and chairman of DNCC, Bandarban, said that addressing nutritional challenges is more feasible in Bandarban than in other districts. Because there is an abundance of various fruits and vegetables, people are unaware of their nutritional value.

She called upon the National Nutrition Council to make short videos about basic nutritious foods in the languages of each ethnic group in different districts.

The speakers also referred to the challenges to improving nutrition in the Chittagong Hill Tracts (CHT), namely, nutrition demand creation and service availability as well as addressing the lack of skilled manpower – doctors and nurses – and ensuring logistic support, regular monitoring, and training.

There is scope to develop inter-department coordination in DNCC that will help reduce the resource gaps of nutrition products and ensure an availability of supply, they said.

All key stakeholders in the CHT also expressed their commitment to achieving sustainable nutrition outcomes in line with the national commitments.

The Business Standard was the media partner of the event, which was funded by the European Union.

TBS Chattogram Bureau Chief Shamsuddin Illius moderated the event, while Rasheda Sultana, director of the Institute of Public Health; Dr Akhter Imam, deputy director of BNNC; AKM Jahangir, chairman of Bandarban Sadar Upazila Parishad; Tingting Mya, councillor and convener of Bandarban Hill District Council; Dr Fazle Rabbi, assistant director of BNNC; spoke at the event among others.

Under the leadership of DNCC, LEAN and all consortium partners have facilitated a nutrition governance process, particularly to improve maternal and child nutrition in 18 upazilas of the CHT since 2018 with funds support from the European Union.

The consortium partners of LEAN are United Purpose, the Global Alliance for Improved Nutrition (GAIN), HELVETAS Swiss Intercoorporation (HSI), Caritas Bangladesh (CB), Integrated Development Foundation (IDF) and Jum Foundation (JF).

BNNC has been working as an apex body in rolling out the plan and reports directly to the Prime Minister's Office.