Nutrition Security for Poor

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Nutrition Security for the
Poor
Professor Nazma Shaheen
Institute of Nutrition and Food Science
University of Dhaka
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
Nutrition Security
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
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
Conceptual Framework of the Nutritional
Status
Nutrition Security
Nutritional
status
Food Intake
Food access
Health
Status
Food Security
Health
Status
Health
Services
Environment
al condition
Nutrition Security for the Poor
Bangladesh: Nutrition Security
Scenario
 Chronic
and acute malnutrition
 Micronutrient malnutrition
 Consumption Pattern
Nutrition Security for the Poor
Current Nutrition Situation in Bangladesh
Malnutrition, in Children
(birth to 59 months)
2011/12
2012/13
Stunting
41.3% (BDHS)
38.7% (UESD)
Underweight
36.4% (BDHS)
35.1% (UESD)
Wasting
15.7% (BDHS)
16.3% (UESD)
Low birth weight
26% (BDHS)
Exclusive breastfeeding (6 59 months)
64% (BDHS)
95.3% (MICS)
Breast feeding until 2 years
90% (BDHS)
87.5% (MICS)
Anemia, in children (6-23
months)
51% (BDHS)
Iodine deficiency, in
children (6-11 years) and
(12-14 years)
Zinc deficiency, in preschool age children
3.9% and 9.5 %
respectively (BDHS)
44.6% (BDHS)
Nutrition Security for the Poor
Prevalence of Underweight (<-2 z) Among U-5
Children in Bangladesh
Nutrition Security for the Poor
Trends of Nutritional Status of
Bangladeshi Children
Nutrition Security for the Poor
Maternal Nutritional Status
60%
50%
CED BMI<18.5
% of women
40%
OVERWEIGHT BMI>23
30%
20%
10%
0%
1996 BDHS
1999 BDHS
2004 BDHS
2005 CMNS
2007 BDHS
2010 FSNSP
Year
Nutrition Security for the Poor
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 underfive 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
Consumption Pattern in Bangladesh
Survey Years
Food
items, g
1995-96 2000
2005
2010
Total
913.8
893.06
947.75
816.22 1084.53
999.99
Rice
464.3
458.54
439.64
406.19 420.52
416.01
Wheat
33.7
17.24
12.08
20.36
28.73
26.09
Potato
49.5
55.45
63.30
63.44
73.78
70.52
Pulses
13.9
15.77
14.19
10.15
16.22
14.30
Vegetables 152.5
140.47
157.02
141.8
177.25
166.08
Edible oil
9.80
12.82
16.45
14.20
23.41
20.51
Onion
11.6
15.41
18.37
15.69
24.74
21.89
Beef
6.60
8.30
7.78
1.55
9.27
6.84
Mutton
1.00
0.49
0.59
0.11
0.83
0.60
Poor
Non-poor
Total
Nutrition Security for the Poor
Consumption Pattern in Bangladesh
Survey Years
Food items, g
1995-96 2000
2005
2010
Poor
Nonpoor
Total
Chicken/Duck 4.00
4.50
6.85
4.11
15.09
11.22
Eggs
3.20
5.27
5.15
3.40
9.02
7.25
Fish
43.80
38.45
42.14
31.16
57.81
49.41
Milk & milk
products
32.60
29.71
32.40
12.18
43.63
33.72
Fruits
27.60
28.35
32.54
20.46
56.0
44.80
Sugar/ Gur
9.20
6.85
8.08
3.32
10.88
8.50
Food taken
outside
-
-
24.76
17.70
35.41
29.83
48.38
50.28
81.81
72.41
Miscellaneous
50.90
55.42
Nutrition Security for the Poor
Consumption by Ultra Poor
Food group
Intake (g/per capita/day)
(BIGH, 2013)*
Total Cereal
Fruits
337.3
50
Desirable (g/per
capita/day)
((DDP,2013)
400
100
Non-leafy Vegetables
68.1
200
Leafy Vegetables
43.8
100
Pulses
4.60
50
All animal foods
64.9
260
Fish
36.8
60
Meat
10.2
40
Egg
7.5
30
Milk and Milk products
32.4
130
Roots & tubers
48.3
100
* 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
Gap Between Original Intake and Desirable
Intake*
450
400
350
300
250
200
150
100
50
0
Intake by Ultra Poor
Desirable (DDP,2013)
* 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
Trend of Cereals Intake Over Years in
Bangladesh (BBS)
Nutrition Security for the Poor
UNICEF Model of Malnutrition
Nutrition Security for the Poor
Underlying Causes
Malnutrition
Inadequate Food
Intake
Household Food
Insecurity
Disease
Poor Social and
Care
Environment
Poor Access to
Health care and
Unhealthy
Environment
Poverty
Nutrition Security for the Poor
Poverty and Nutrition Insecurity
Unavailability
of food
Unhygienic
Environment
Poverty
Poor health
service
Poor
Education
Loss of resources due
to health cost
Inadequate
food intake
Increased
infection
Nutrition
Insecurity
Improper
care
Decreased Productivity
Nutrition Security for the Poor
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:
The National Food Policy
(NFP) (2006)
a comprehensive food
security policy framework
The National Food Policy
Plan of Action (NFP PoA)
(2008-2015)
a programming document
The Bangladesh Country
Investment Plan (CIP)
an investment plan for food
security and nutrition.
Nutrition Security for the Poor
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
Objective 1: Adequate and stable supply of safe
and nutritious food
National Food Policy
POLICIES
• Agricultural research and extension
• Use and management of water resources
• Adequate supply and sustainable use of agricultural inputs
• Agricultural diversification
• Agricultural credit and insurance
• Physical market infrastructure development
• Agricultural marketing and trade
• Policy and regulatory environment
• Early warning system development
• Producer price support
• Public stock management / price stabilization
Nutrition Security for the Poor
Objective 2: Increased purchasing power and
access to food of the people
National Food Policy
POLICIES
•
•
•
•
•
•
•
•
•
•
•
•
•
Agricultural disaster management
Emergency distribution from public stock
Enabling environment for private food trade and stock
Effectiveness of targeted food security programs and other safety nets
Income generation for Women and the Disabled
Promotion of Agro-based/ Agro-processing and Micro/Small Rural
Enterprises
Market-driven skill Development
Agricultural disaster management
Emergency distribution from public stock
Enabling environment for private food trade and stock
Effectiveness of targeted food security programs and other safety nets
Income generation for Women and the Disabled
Promotion of Agro-based/ Agro-processing and Micro/Small Rural
Enterprises
• Market-driven skill Development
Nutrition Security for the Poor
Objective 3: Adequate nutrition for all
individuals, especially women and children
National Food Policy
POLICIES
• Long-term planning for Balanced nutrition
• Balanced and nutritious food at Minimal Costs for Vulnerable
Groups
• Nutrition education for dietary diversification
• Supplementation and fortification for balanced nutrition
• Safe drinking water and improved sanitation
• Safe, quality food supply
• Women and children’s health
• Promotion and Protection of Breastfeeding and
Complementary Feeding
Nutrition Security for the Poor
Challenges
Nutrition Improvements not keeping pace with poverty situation
(BBS, BDHS,2011)
Year
Poverty
Stunting
Underweight
2000
48.9%
50.8%
42.3%
2010
31.5%
41.0%
36%
Change/year
-4.30%
-1.86%
-1.36%
Income poverty improved faster than
stunting and underweight
Nutrition Security for the Poor
Consumption is Diversifying Faster
Than Production (FPMU,2014)
Production diversification could accelerate
consumption diversification in rural areas
Nutrition Security for the Poor
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
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
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
Approaches to Ensure Nutrition
Security in Poor
Food based approach
Increasing agriculture productivity
 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
 Ensuring
accessibility through policy
Nutrition Security for the Poor
Agriculture-Nutrition-Health
Productivity
Risk taking
Education
Cognition
Endurance
Physicalstrength
Food
Agriculture
Horticulture
Pisiculture
Nutrition
Livelihoods
Income
Employment
Food Security
Dietary diversity
Income Equity
Health
Nutrition Security for the Poor
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
Recommendation
Achieving nutrition security requires a multisectoral approach
Nutrition Security for the Poor
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
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
Thank you
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