Ensuring nutrition should be a priority for the interim government

In Bangladesh, one-fourth of adolescent girls aged 15–19 years are stunted. The proportion of adolescents with a height less than 145 cm (the cut-off level for height) has remained unchanged since 2011. 

The percentage of women aged 20-24 years who have had a live birth before age 18 was 24% (BDHS 2017/18). According to the Bangladesh Demographic and Health Survey (BDHS) 2022, the age of marriage is increasing slowly. 

Half of women aged 20-24 marry before age 18 (the legal age of marriage), and more than one in four (27%) marry by age 16. The proportion of women who marry before age 18 declined from 65% in 2011 and 59% in 2017-18 to 50% in 2022. As per BDHS 2014, one in three children aged under five years is stunted, while 14% of children in the same age group are affected by acute malnutrition or wasting. 

Women of reproductive age (15-49 years) also suffer from malnutrition, with 19% being underweight and 24% overweight or obese (Body Mass Index ≥ 25).

The majority of affected children enter adolescence and adulthood with these nutritional deficits, which can affect their school performance, future productivity, and the overall development of the country.

Key factors contributing to this situation include poverty and food insecurity, insufficient access to basic social services such as health, education, and water, sanitation, and hygiene (WASH), as well as insufficient dietary diversity, nutrient adequacy, and lack of nutrition knowledge. 

To address this overwhelming challenge of malnutrition in all its forms, urgent action is needed by adopting a lifecycle approach. This should include the active engagement of both demand- and supply-side actors, including children, adolescents, youth, teachers, parents, government, the private sector, and development partners.

Young people can be engaged in knowledge sharing, awareness building, and catalysing the learning process. Most people in our country are unaware of the deeper impact of nutrition, focussing primarily on physical wellness, while the critical components of cognitive development and intellectual nourishment have been missing in all communication and learning materials.

For a long time, Bangladesh has experienced a very poor version of nutrition education and practice for children and adolescents. Various isolated, disconnected, uncoordinated, quick-win and project-based short-term initiatives by the government and development partners have created a chaotic system in this domain.

This situation worsened when the Bangladesh government adopted high-sounding and ambitious development plans without considering the ground realities, as well as the absence of subsequent implementation plans, proper monitoring, and resources. It is critically important to rethink the existing and long-established nutrition education approach followed by the government and development agencies.

As the interim government has taken on the mammoth task of reform, this process will take time, but setting priorities is immensely important to move in the right direction. Nutrition is considered a major indicator of development and is extremely important for building a well-nourished generation, which will ultimately contribute to creating an intellectually rich and healthy population. 

As a result, healthcare costs will decrease for both the government and citizens.

The good news is that the National Plan of Action for Nutrition (NPAN) has already identified key action items and the Plan of Action for the National Food and Nutrition Security Policy (NFNSP) 2020 by the Ministry of Food has specifically recognised adolescent platforms like Girl Guides, Girl Guide Associations, and Nutrition Clubs as key platforms to disseminate knowledge on healthy diets and lifestyles.

It would be beneficial if the Ministry of Health and Family Welfare (MoHFW) took the lead and engaged other relevant ministries to focus on the activities and targets set in these policies. There is no reason to delay implementing these activities to reduce malnutrition and build a healthy generation.

Another critical issue that needs immediate attention is the lack of coordination in the nutrition sector. Different government agencies, UN organisations, donors, INGOs, and NGOs are working in isolation and are often reluctant to learn from each other, adopt successful models, or pursue a common agenda in a coordinated manner. Since nutrition is a multi-sectoral development agenda, it involves many actors, which requires a proper and accountable coordination mechanism.

All these efforts should aim for behaviour change among different segments of society (from children to senior citizens), primarily on the demand side. It is also important to focus on the nutrition ecosystem, particularly on the supply side.

In the nutrition ecosystem, ensuring access to and availability of nutritious food with proper quality and safety is critical. The school meal program has been established as a proven and effective model to ensure nutrition for students from an early age. Bangladesh has long implemented the school meal program, but a scalable model is yet to be developed. The newly adopted school meal policy and guidelines are extremely dependent on NGOs, which needs to be reviewed, and the private sector should be prioritised to ensure an efficient and quality supply chain for raw materials and processing. 

Bangladesh could also consider adopting successful models from countries like Japan, which could help develop a local business ecosystem that benefits young entrepreneurs, the agricultural sector, and the food industry.

Without proper direction and monitoring systems, there is a high risk of reverting to the previous cycle of paper-based development. Hence, it is high time for the interim government to address these issues and bring nutrition to the forefront of the development agenda.

As we aspire for a well-nourished Bangladesh that is more competitive on the global stage and healthier as a nation, we hope the government will consider investing more in nutrition as a priority sector. 

Md Shahid Uddin Akbar is the Chief Executive Officer of  BIID Foundation and the Founder of the Nutrition Club and International Nutrition Olympiad

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard