Malnutrition in Bangladesh and What to Do

 

The term malnutrition is commonly used to refer to nutritional deficiencies necessary for the normal growth, development and well-being of the body. One of the major causes of malnutrition is deficiency of protein. Consumption of fruits, fish, meat, milk, eggs and oil has been reduced significantly in the last few decades and total food intake has also been reduced which is a big problem for the whole society and nation. Children, pregnant and lactating mothers are most affected by malnutrition.

Limited purchasing power is not the only cause of malnutrition. Loss of appetite in old age and chronic illness, throat and esophageal cancer, diseases of the stomach, pancreas, problems with absorption, liver disease, and diabetes can also cause malnutrition.

 In addition, lack of nutritional knowledge, traditional eating habits, unscientific food processing and cooking, biased distribution of food among family members, widespread adulteration of food, breastfeeding breaks, worms in the stomach and other factors have led to deterioration of nutritional value.

About 5 lakh people in Bangladesh have mental retardation due to iodine deficiency. In addition, there is anemia due to the lack of iron and folic acid and sores on the mouth and tongue due to the lack of vitamin B-2. Due to high food prices, the consumption of protein has declined significantly and therefore there is a risk of increasing malnutrition. On the other hand, due to frequent overeating, lack of physical labor, introduction of fast food, junk food and other reasons especially in urban areas, many suffer from obesity. The evolution of this problem is being observed in Bangladesh.

Bangladesh has recently become almost self-sufficient in food, mainly rice and wheat production. But due to limited purchasing power of parents, adequate food does not reach to those children. Moreover, rice alone cannot provide essential nutrients for balanced growth. This requires protein, such as fish, meat, milk and eggs, and fruits and vegetables rich in vitamins and minerals. The most common manifestation of malnutrition in children is malnutrition due to lack of protein energy i.e. protein rich food and energy rich cereals.

According to the body height and weight classification system, the ratio of normal height and weight children increased slightly, but the growth rate of weak and disturbed body remained unchanged. Gender-based analysis has shown that rural children are more malnourished than urban children of the same age. Although the infant mortality rate is now declining, 50-60% of children under the age of five die due to direct or indirect malnutrition.

Severe malnutrition is the cause of about one-third of infant deaths. The incidence of such deaths is much higher in girls than in boys. About 4% of infants are completely dependent on breast milk. In urban areas, about 90% of mothers feed their babies with milk powder. However, these ratios are now downward. About 80% of mothers suffer from anemia due to lack of iron and folic acid. Maternal mortality rate has come down recently. Night blindness, softness of cornea and corneal opacity due to vitamin deficiency in children is very common in Bangladesh.

About 30,000 children go blind every year due to lack of vitamin A. Children in Bangladesh also have iodine deficiency disorders. There are also rickets due to lack of vitamin D. Another cause of malnutrition is stomach worms. A large portion of rural children in Bangladesh are at risk of malnutrition, mainly due to povery and lack of knowlwdge. The United Nations has warned that if the countries of Asia and the Pacific do not reaffirm their commitment to end all forms of malnutrition and establish a hunger-free zone by 2030, the region's people and economy will suffer greatly.

More than half of the world's malnourished people live in Asia and the Pacific, numbering close to 500 million. According to recently released global statistics, the overall number of hungry people worldwide has increased and is back to the level it was a decade ago. As a result, large numbers of people in Asia and the Pacific are suffering from hunger and malnutrition, according to the regional report.

As migration from rural areas to urban areas, especially from poor families, continues to increase, urban malnutrition has become a new challenge in many countries. If the current state of urbanization continues, by 2030, most of Asia's population will be urbanized. While urbanization may create opportunities for the economy, this growth rate is not always equitable and it can often lead to high and long term child malnutrition and for the same reason obesity rates in children and adults can increase rapidly.

In 2010, 925 million people worldwide were malnourished, an increase of 80 million since 1990. It is estimated that more than one billion people are deficient in vitamins and minerals. Protein-energy malnutrition killed an estimated 600,000 people in 2010. During the transition to a free market system, the government undertook a number of nutrition projects with the help of the World Bank to address the adverse effects on the health of the poor.

The two major projects were the National Integrated Nutrition Project and the Vulnerable Group Feeding Program funded by the World Bank. The two projects were launched with a special focus on those living below the poverty line who are most affected by the transition from a controlled economy to a free market economy. Some recent surveys show that about 2% of children aged 1-6 years suffer from vitamin A deficiency night blindness.

Lactating mothers can easily provide about 70% of Vitamin A to their baby. Over the past decade, the benefits of breast milk and the promotion of breastfeeding at the public and private levels have been met with encouraging response. Vegetables and fruits are rich in Vitamin A, which can be grown almost free of charge in the backyard. The government's expanded immunization program is providing high-potency 'A' vitamin capsules to children under the age of five. The government has introduced iodized salt to reduce iodine deficiency.

Malnutrition results from eating according to a diet where the nutrients are not enough or so much that it causes health problems. Related nutrients may include: calories, proteins, carbohydrates, vitamins or minerals. It is often used to indicate specific nutritional deficiencies. However, it also includes over-nutrition. If malnutrition occurs during pregnancy or before the age of two, it can result in permanent problems with physical and mental development.

Efforts to improve nutrition are the most effective form of development assistance. Breastfeeding can reduce malnutrition and mortality in infants, and increase efforts to promote the habit. Feeding infants with breast milk between the ages of six months and two years along improves the results. There is also good evidence to support the development of many micronutrient supplements during pregnancy and in young children in the developing world. People, who need food the most need to be fed, delivered and paid for, so that people can buy food from the local market.

Just feeding at school is not enough. It is possible to control acute malnutrition inside the person's home with the help of ready to eat nutrient rich foods. Those who have severe malnutrition and other health problems that make it more complicated are advised to seek hospital treatment. This often involves controlling low blood sugar, body temperature and dehydration. Due to the high risk of infection, conventional antibiotics are usually recommended. Long-term measures include: improving agricultural practices, reducing poverty, improving the sewerage system, and empowering women.


Md Arafat Rahman is a Columnist & Asst. Officer, Career & Professional Development Services Department, Southeast University