Bangladesh Food Security Investment Forum, 26–27 May 2010, Dhaka

Binayak Sen, Purnima Menon, Akhter U. Ahmed, and Fatema Parveen Chowdhury

Food Utilization and Nutrition Security

Interven!ons

Breas"eedingComplimentary feedingVitamin AZincHygiene

- Agriculture- Poverty Reduc!on- Educa!on- Health Systems Strengthening- Income genera!on- Women’s empowerment

Accessto food

Maternaland child-care

prac!ces

Water/Sanita!onhealth services

Food/nutrient intake Health

Child Nutri!on

INSTITUTIONS

ECONOMIC STRUCTURE

RESOURCESENVIRONMENT, TECHNOLOGY, PEOPLE

POLITICAL & IDEOLOGICALFRAMEWORK

Immediatecauses

Underlyingcauses

Basiccauses

SHORT

ROUTES

LONG

ROUTES

Adapted from UNICEF 1990Source: Ruel, SCN News 2008

Figure 1—The link between the UNICEF conceptual framework and direct/indirect interven!ons

-2.5

-2

-1.5

-1

-0.5

01 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59

Child age (months)

HAZ

Addressing maternal health and nutri!on prior to and during pregnancy and childbirth is

crucial

Intervening with evidence-based interven!ons to

prevent irreversible growth faltering and brain damage is

also cri!cal

HEIGHT-FOR-AGE Z-SCORES BY CHILD AGE, BANGLADESH, 2007

Figure 2—The window of opportunity for addressing undernutri!on – prepregnancy and the first two years of life.

Childhood anemia (HKI, NSP 2006) Anthropometric indicators (BDHS 2007)

05

101520253035404550

Anthropometric indicators

Stun!ng

Underweight

Was!ngWomen with low BMI

Women <145 cms tall

0102030405060708090

100

Child age groups

6–11 mo

12–23 mo

24–35 mo

35–47 mo

48–59 mo

Prevalence of maternal and child undernutri!on

Figure 3—Prevalence of anemia and undernutri!on (anthropometric indicators) among children and women in Bangladesh

0

10

20

30

40

50

60

70

Stun!ng Was!ng Underweight Maternal BMI

19962000

20042007

0102030405060708090

100

Inputs for ensuring good child nutri!on

%

Early ini!a!on of BFExclusive BF (0–6 mo)Introduc!on of CF at 6–9 mo3 expected IYCF prac!cesIron-rich foodAll basic immuniza!onsVitamin A suppl (<3s)Access to improved sanita!onWomen - > 3 ANC visitsWomen - normal BMI HH - access to improved water

Source: BDHS (2007)

BF = breast feedingCF = complementary feeding

ANC = antenatal careIYCF = infant and young child feeding

Status of keydirect interven!ons for child nutri!on

51.6

13.67.0 5.6

1.2

21.0

51.3

13.9

4.7 5.4 3.2

21.6

0

20

40

60

80

Rice Fish Meat & eggs

Pulses Milk & milk products

Otherfoods

Shar

e of

dai

ly p

er c

apit

a pr

otei

n co

nsum

p!on

% 2005 1995–96

0

5

10

15

20

25

1983

1986

1989

1992

1995

1998

2001

2004

2007

Real

pric

e of

rice

(Tak

a/kg

)

Fiscal Year

2009

0

10

20

30

40

50

6019

83

1986

1989

1992

1995

1998

2001

2004

2007

Real

pric

e of

len!

l (Ta

ka/k

g)

Fiscal Year

2009

02468

1012141618

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

Real

pric

e of

brin

jal (

Taka

/kg)

Fiscal Year

0

20

40

60

80

100

120

140

160

180

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

Real

pric

e of

Hils

ha fi

sh (T

aka/

kg)

Fiscal Year

This paper has been commissioned by the Government of the People’s Republic of Bangladesh for the Bangladesh Food Security Investment Forum, 26–27 May 2010. The Forum is organized by the Ministry of Food and Disaster Management with technical support from the International Food Policy Research Institute (IFPRI), the Bangladesh Institute of Development Studies (BIDS), and the Food and Agriculture Organization of the United Nations (UN-FAO). Financial support has been extended by the United States Agency for International Development (USAID), the United Kingdom Department for International Development (DFID), and the European Commission (EC). The views and opinions contained in this paper are those of the authors.

Cover graphics adapted from photography by © 2010 Hand Crank Films/IFPRI, © 2009 Pradeep Kumar Saxena/iStockphoto, and © 2006 G.M.B Akash/Panos.