Nutrition Security for the Poor

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

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

3. NutritionSecurity 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 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 Nutritional status 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 Nutrition Security for the Poor

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

13. Consumption Pattern in Bangladesh Nutrition Security for the Poor

14. Consumption by Ultra Poor * 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 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 Decreased Productivity Loss of resources due to health cost 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: 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) (2009-11) • Outline of Perspective Plan (2010-2021) • National Agricultural Policy (2013) Nutrition Security for the Poor

22. National Food Policy Nutrition Security for the Poor

23. National Food Policy Nutrition Security for the Poor

24. National Food Policy Nutrition Security for the Poor

25. Challenges Nutrition Improvements not keeping pace with poverty situation (BBS, BDHS,2011) • 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 Approaches to ensure nutrition security 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 • Ensuring accessibility through policy • 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 Nutrition Security for the Poor

31. Agriculture-Nutrition-Health 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