• Bangladesh

  

• Population

  161 Million

• Pop. Under 5

  17.8 Million

• % Stunting

  41% Of Children Under 5

• % Underweight

  36% Of Children Under 5

Photo credit: Wasif Hasan/USAID

Background

Bangladesh is the most densely populated country in the world, with 161 million people living in a land area roughly the size of the U.S. State of Iowa. Bangladesh has maintained an impressive track record of six percent economic growth rate over the past decade, coupled with remarkable improvements in human development, and has reduced poverty by nearly one-third.¹

Considerable challenges remain, including deep poverty and food insecurity, with about 40 percent of the population living below the poverty line.² The agriculture and fisheries sectors are pillars of the economy, employing more than half the population. Population growth, urbanization, and soil and natural resource depletion have resulted in the degradation of land, water bodies, wetlands and forests, and pose a significant threat to the agricultural sector.

Bangladesh has achieved remarkable progress in the areas of poverty alleviation, primary school enrollment, gender parity in primary and secondary-level education, immunization coverage, and incidence of communicable diseases. Despite poverty, low spending on health care, and a weak health system, Bangladesh is on track to achieve the Millennium Development Goals with respect to maternal and child mortality, with a 40 percent reduction in maternal mortality between 2001 and 2010, and a 26 percent reduction in under-five child mortality between 2004 and 2010.³

Nutrition Situation

Despite significant economic progress and poverty reduction, a quarter of Bangladesh’s population remains food insecure,⁴ and the Bangladesh Development and Health Survey of 2011 found moderate to severe food insecurity among 10.1 percent of ever-married women.⁶ Loss of arable land, rising sea levels, frequent flooding and extreme weather patterns, due in part to climate change, compound the threats to food security.

Undernutrition is exacerbated by low dietary diversity, with 70 percent of the diet comprised of cereals,⁵ and inadequate protein and micronutrient intake. Poor sanitation and hygiene, which result in diarrhea and other infectious diseases, also contribute to undernutrition in children. Gender inequality in decision making related to household production and consumption also factors into the subsequent poor nutritional status of women and young children.

Stunting affects almost half of children under 5, which means that 7 million children are unable to develop to their full physical and mental potential. 16 percent of children under five are acutely malnourished; and a quarter of women of reproductive age are undernourished.⁶ Although the exclusive breastfeeding rate in infancy has increased over the past five years, only 21 percent of children 6-23 months old are receiving a minimum acceptable diet.⁶ Micronutrient deficiencies are widespread, driving high rates of anemia in women and children. Stunting is more prevalent in rural areas and urban slums, with the highest rates in the divisions of Barisal and Sylhet.

National Nutrition Policies

The Government of Bangladesh has laid out numerous nutrition strategies, plans and policies over the past 15 years. The recently developed Health, Population and Nutrition Sector Development Program 2011-2016 includes an operational plan for mainstreaming and scaling up nutrition services nationally through the National Nutrition Services (NNS), which intends to reduce the prevalence of undernutrition, especially among women and girls.

By focusing on the first 1,000 days (the period from pregnancy to a child’s second birthday), the government aims to ensure universal access to nutrition services, strengthen human resource capacity and nutrition information systems, and increase coordination with other relevant sectors such as agriculture, economic development and education.

The USAID-funded National Food Policy Capacity Strengthening Program is in place, and assisted the Bangladesh Ministry of Food and Disaster Management in developing the Country Investment Plan and National Food Policy Plan of Action. An established Nutrition Working Group (NWG) is comprised of UN agencies, bilateral donor agencies and civil society partners working together to support nutrition initiatives.

In 2011, Bangladesh joined Scaling Up Nutrition (SUN), a global movement that unites national leaders, civil society, bilateral and multilateral organizations, donors, businesses and researchers in a collective effort to improve nutrition. USAID and the World Bank are SUN donor conveners. The SUN Movement’s Multi-Partner Trust Fund recently funded the Civil Society Alliance for Scaling Up Nutrition in Bangladesh, which will fully operationalize the civil society organization network; enhance sharing of information, research findings and resources for nutrition programs; adopt and implement a costed national nutrition plan of action by 2014; and establish a joint tracking system to monitor progress of the NNS.

USAID Programs: Accelerating Progress in Nutrition

The Food for Peace (FFP) Title II program has funded food assistance programs in Bangladesh since 1976, and current programming targets approximately 650,000 food-insecure households, or about 3.25 million people. Currently, FFP receives 80 percent of the mission’s nutrition funding. FFP programs have shown success among target populations, with 33 percent reduction in stunting, 16 percent increase in dietary diversity and 128 percent increase in income.⁸ The FFP Title II programs emphasize the linkage with Feed the Future projects and, under this coordination, provide training and agricultural inputs to poor farmers.

In FY2012, more than 20,000 farmers received training on improved production techniques and technologies that will help them increase their food production through homestead gardening, fish farming and poultry raising.⁹

Bangladesh joined the campaign Committing to Child Survival: A Promise Renewed in 2012, and pledged to reduce under-five mortality to 20 or fewer deaths per 1,000 live births by 2035 by reducing the leading preventable causes of child mortality. The Government of Bangladesh will strengthen and scale up 17 evidence-based interventions, which include promotion of exclusive breastfeeding, appropriate complementary feeding practices, iron-folate supplementation during pregnancy, and management of severe acute malnutrition. To view the country action plan for ending preventable child and maternal deaths in Bangladesh, please see the Acting on the Call 2014 report.

Feed the Future Progress

Feed the Future, the U.S. government’s global hunger and food security initiative, has a multi-year strategy with several key areas of nutrition intervention. The main objective is to intensify staple production while simultaneously diversifying agriculture into high-value, nutrient-dense products to increase the availability, accessibility and utilization of nutritious food. The strategy seeks to strengthen the business-enabling environment to promote linkages to the private sector and market access for farmers and small enterprises, and to build capacities in government agencies and local institutions, including farmers’ and women’s groups.

Feed the Future is carrying out nutrition education and behavior change communication interventions in regions where Title II and Global Health Initiative projects are also operating. Target beneficiaries include rice farmers, the landless poor who are net purchasers of rice, small- and medium-sized farmers who can diversify production, agricultural-based enterprises, and people employed in the fishing and aquaculture sectors.¹⁰

Furthermore, the Feed the Future Nutrition Innovation Lab is initiating operations research in Bangladesh to determine the impact on nutrition of interventions integrating aquaculture, horticulture, and behavior change communication.

A number of projects link agriculture and nutrition. These include Aquaculture for Income and Nutrition (AIN); Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING); Integrated Agriculture and Health Based Interventions (IAHBI) and the USAID Horticulture Project.

The AIN project aims to improve nutrition and incomes through aquaculture and horticulture activities targeted at poor and vulnerable households. The strategy develops and delivers improved quality lines of tilapia and carp (“rohu” and “catla”), prawn and shrimp to fish farmers in target divisions and assists government and private hatchery operators to produce fish seed. The project also promotes the growth of vitamin A-rich sweet potato and salt-tolerant rice on dikes along the fishponds, especially in the fishing off-season.

Cosponsored by USAID and the European Union, the IAHBI project is jointly implemented by UNICEF and FAO. The project supports the provision of evidence-based direct nutrition interventions and homestead food production. The project identifies bottlenecks to achieving optimal coverage and addresses them through government and NGO mechanisms. IAHBI provides training and demonstrations to communities on food preparation, preservation and processing in order to increase intake of diversified foods and improve complementary feeding practices to reduce child undernutrition.

The Horticulture Project seeks to improve the income, nutrition and health of poor households through the promotion of potato, sweet potato and selected vegetables (eggplant, beans, tomato, amaranth, kongkong, jute mallow, gourds and peppers) based on calculated cost-benefit ratios. The project also analyzed the nutrition gap in diets and identified inadequate protein energy intake, anemia and vitamin A deficiency as key problems.

Active Global Nutrition Mechanisms

The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project is working under the Feed the Future portfolio in 40 subdistricts (“upazilas”) in the Khulna and Barisal divisions, with 148,800 resource-poor households with pregnant and lactating women and children under two. Globally, SPRING’s mandate is to prevent child stunting and reduce maternal and child anemia. In Bangladesh, the project combines homestead food production through a farmer field school training approach with social and behavior change communication, which includes essential nutrition and hygiene messages, to improve household nutrition, increase household assets, and improve the nutrition of women and young children.

In FY2013, the project established 1,149 Farmer Field Schools and trained 5,693 health and agricultural workers on social behavior change in 40 subdistricts in southern Bangladesh, resulting in more than one million nutrition counseling contacts with women and other family members.⁹

The Global Alliance for Improved Nutrition (GAIN) is working with the Institute of Development Studies to increase the zinc density of rice through fortification during the soaking process, utilizing a private sector approach. The specific objectives of the project are to conduct field validation of the concept with the private sector (purchase, treatment, storage and total cost implication for industry); determine customer acceptance of the new rice and willingness to pay; develop quality assurance standards and guidelines and conduct an environmental impact assessment; develop a detailed business case, including analysis of the supply chain; and design the market pilot launch.

Other USAID Nutrition-Related Development Assistance

USAID has begun a partnership with the UN Food and Agriculture Organization (FAO) for the "Meeting the Under-nutrition Challenge (MUCH): Strengthening the Enabling Environment for Food Security and Nutrition". The new five-year, $9.8 million activity will allow FAO to assist the Government of Bangladesh (GOB) in developing and implementing more effective food policies to eradicate malnutrition. The MUCH activity will strengthen the capacity of the GOB and other relevant stakeholders in establishing food security and nutrition policy frameworks, investment plans, and programs.

References

1. World Bank Bangladesh Country Overview
2. Feed the Future Bangladesh Profile
3. Millennium Development Goals, Bangladesh Progress Report 2012, June 2013. General Economics Division (GED), Bangladesh Planning Commission, Government of Bangladesh.
4. World Food Program Bangladesh Country Overview
5. Bangladesh Household Income and Expenditure Survey, 2010.
6. Bangladesh Demographic and Health Survey 2011. National Institute of Population Research and Training (NIPORT) & Mitra and Associates, Dhaka, Bangladesh; Macro International, Calverton, Maryland, USA.
7. Bangladesh Demographic and Health Survey 2007. National Institute of Population Research and Training (NIPORT) & Mitra and Associates, Dhaka, Bangladesh; Macro International, Calverton, Maryland, USA.
8. Feed the Future Bangladesh Strategic Review, August 6, 2012.
9. Bangladesh Mission Full Performance Plan Report 2012. USAID.
10. Bangladesh Landscape Analysis Mission Report, Feed the Future, April 2013. USAID & SPRING.