Dhaka, February 27 – Four-year-old Maruf Hossain sits listlessly, staring with large, sunken eyes at the whitewashed walls of the health clinic. His mother, Monwara Begum, looks on with increasing anxiety as the doctor examines Maruf, who has been suffering from frequent bouts of diarrhea.“His growth is stunted,” the doctor tells her. “He’s too short for his age and he’s underweight as well.”
Maruf is one of around five million Bangladeshi children under the age of five who exhibit stunting, or low height for their age, a manifestation of chronic undernutrition. Although the country in recent years has made impressive gains towards health and anti-poverty targets, including lowering of maternal and child mortality and significantly improving child nutritional status, the number of malnourished children remains among the highest in the world.
Bangladesh achieved the nutrition target of the United Nations’ Millennium Development Goals, cutting the prevalence of underweight children below the age of five from 66% to 32% between 1991 and 2015. However, a new report commissioned by the government warns that it will be difficult to meet the aim of ending malnutrition by 2030, as laid out in the Sustainable Development Goals that replaced the MDGs after they expired at the end of 2015.
Sustainable Development Goal 2 aims to end hunger and all forms of malnutrition by 2030.
A draft of the second Bangladesh National Plan of Action for Nutrition (NPAN 2016-2025), prepared by a committee of experts, says that if present trends continue, Bangladesh will struggle to achieve the SDG goal.
Among the reasons cited for the stubbornly high undernutrition rates among young children is a lack of safe toilets – nearly half of rural households lack sanitary latrines – leading to diarrheal diseases which sap the growth of children. The draft also points to poor infant and young child feeding practices, including failure to feed infants exclusively with breastmilk until six months of age.
The last National Action Plan for Nutrition was launched in 1997 and the Ministry of Health and Family Welfare has taken the initiative to prepare a fresh plan that will remain relevant until 2025.
Undernutrition costs Bangladesh more than 70 billion taka (US$900 million) in lost productivity every year, and even more in health costs, according to the World Bank, acting as an Achilles heel that is holding back national development.
According to data from the Bangladesh Demographic and Health Survey 2014, 36% of under-five children are stunted and 32% are underweight.
Children from low-income families bear a disproportionate burden of malnourishment. According to BDHS data, the prevalence of stunting in urban slums is roughly 50%.
Maruf Hossain’s family lives in the Kamrangir Char, a vast slum on the edge of Dhaka – a network of narrow alleys and corrugated iron shanties. Maruf’s mother Monwara, who arrived here with her husband from a southern district nearly six years ago, said she didn’t know about exclusive breastfeeding and complementary feeding practices until recently.
“When Maruf was born, we fed him honey and later my sister gave him powder milk because I was away working in a garment factory,” she said. “No one told us that might hurt him.”
Monwara said doctors had told her that poor feeding practices may have weakened Maruf’s immune system, leaving him vulnerable to infections.
Research has shown that not having a nutritious diet affects a child’s physical and mental growth, impairing cognitive ability and reducing productivity. – UNB
