Developing strategies to end hunger
 

Changing Nutrition Behaviors in Bangladesh

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A community health worker explains nutrition to a pregnant mother in Barisal, Bangladesh. Photo: Scott Bleggi/Bread for the World Institute.

Readers of our blogs and those who work to reduce hunger know the critical importance of nutrition for pregnant and breastfeeding women and small children. This 1,000-day window presents an opportunity to intervene nutritionally before the lasting effects of malnutrition lead to greater problems with life-long consequences. Sometimes hidden problems like stunting and learning difficulties–related to nutrition deficiencies–go undetected in a village of people living under similar conditions. However, other related problems like being more prone to illness can end a life tragically.

In many countries the cycle of poverty, hunger, and malnutrition has continued for generations, especially among vulnerable groups such as ethnic minorities and those who live in hard to reach areas. It is a sad reality that poorly nourished mothers have low birthweight babies who do less well in school, attend fewer classes, and tend to have health difficulties. Sometimes in their teenage years girls get married, and the detrimental cycle continues.

So how does one break this cycle of malnutrition? How does one get mothers who don’t read or write to understand, and how does one get the nutrition message to children who might only stay in school until they are 10 or 11 years of age?

One way to do it is to design a program of Behavior Change Communication (BCC) that is easily understood, can be repeated, and can be reinforced in the family and throughout the village. Effective BCC becomes a part of the daily routine and is successful when it produces positive results in health and nutrition. I saw it during my trip to Ghana last year, and I am seeing good examples of it here in Bangladesh.

I also saw the consequences of poor nutrition during a period in which cholera increased in the capital city of Dhaka. With the onset of the disease, dehydration quickly becomes a problem and if poorly nourished children don’t receive prompt treatment they are likely to die. At the International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B) we were taken through a children’s treatment ward. ICDDR, B is a facility that has received funds from the sale of donated surplus U.S. agricultural commodities under USDA’S 416(B) program. I was introduced to Mita and her daughter Anjali, who were admitted the night before. Mom was anxious to begin feeding her again since she responded so well to intravenous liquids.

Once the child is able to again eat solid foods, mothers in the ward are shown food that is available locally. It is explained that these foods are inexpensive, can be grown in a homestead garden, and, if eaten regularly, can provide good nutrition. They are taught about dietary diversity and “color is good,” meaning that most anything added to rice like greens, chick peas, and squash adds nutrition.

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Nutritious foods given to recuperating children are sourced locally and are inexpensive. Photo: Scott Bleggi/Bread for the World Institute.

What is being learned about nutrition through BCC in Bangladesh is that changing traditional diets isn’t difficult, and doesn’t have to be expensive. Instruction is hands-on and is repeated in the village by health workers and local volunteers. Children learn about gardening at school and see raising their own healthy vegetables as an activity that can be done with Mom after school. Surplus production is shared in the village, as is the message that a traditional rice-based diet doesn’t have to be abandoned, just supplemented with healthy foods that they can grow themselves.

Nutrition’s links to health and agriculture are clearly being taught in Bangladesh. USAID-funded programming by in-country implementing partners, like Helen Keller International and Save the Children, includes local organizations as a key element. Working with these organizations will help sustain the lessons learned as examples for the government of Bangladesh which is sincere about its commitment to scale up nutrition. My next blog from South Asia will look at some examples of how local groups are sustaining developmental assistance programs after funding from donors ends.

Scott Blog PicScott Bleggi is senior international policy analyst for hunger and nutrition with Bread for the World Institute.

 

Changing Nutrition Behaviors in Bangladesh

 

 

Readers of our blogs and those who work to reduce hunger know the critical importance of nutrition for pregnant and breastfeeding women and small children. This 1,000-day window presents an opportunity to intervene nutritionally before the lasting effects of malnutrition lead to greater problems with life-long consequences. Sometimes hidden problems like stunting and learning difficulties–related to nutrition deficiencies–go undetected in a village of people living under similar conditions. However, other related problems like being more prone to illness can end a life tragically.

In many countries the cycle of poverty, hunger, and malnutrition has continued for generations, especially among vulnerable groups such as ethnic minorities and those who live in hard to reach areas. It is a sad reality that poorly nourished mothers have low birthweight babies who do less well in school, attend fewer classes, and tend to have health difficulties. Sometimes in their teenage years girls get married, and the detrimental cycle continues.

So how does one break this cycle of malnutrition? How does one get mothers who don’t read or write to understand, and how does one get the nutrition message to children who might only stay in school until they are 10 or 11 years of age?

One way to do it is to design a program of Behavior Change Communication (BCC) that is easily understood, can be repeated, and can be reinforced in the family and throughout the village. Effective BCC becomes a part of the daily routine and is successful when it produces positive results in health and nutrition. I saw it during my trip to Ghana last year, and I am seeing good examples of it here in Bangladesh.

I also saw the consequences of poor nutrition during a period in which cholera increased in the capital city of Dhaka. With the onset of the disease, dehydration quickly becomes a problem and if poorly nourished children don’t receive prompt treatment they are likely to die. At the International
Center for Diarrheal Disease Research, Bangladesh
(ICDDR,B) we were taken through a children’s treatment ward. ICDDR, B is a facility that has received funds from the sale of donated surplus U.S. agricultural commodities under USDA’S 416(B) program. I was introduced to Mita and her daughter Anjali, who were admitted the night before. Mom was anxious to begin feeding her again since she responded so well to intravenous liquids.

Once the child is able to again eat solid foods, mothers in the ward are shown food that is available locally. It is explained that these foods are inexpensive, can be grown in a homestead garden, and, if eaten regularly, can provide good nutrition. They are taught about dietary diversity and “color is good”, meaning that most anything added to rice like greens, chick peas, and squash adds nutrition.

 


 

What is being learned about nutrition through BCC in Bangladesh is that changing traditional
diets isn’t difficult, and doesn’t have to be expensive. Instruction is hands-on and is repeated in the village by health workers and local volunteers. Children learn about gardening at school and see raising their own healthy vegetables as an activity that can be done with Mom after school. Surplus production is shared in the village, as is the message that a traditional rice-based diet doesn’t have to be abandoned, just supplemented with healthy foods that they can grow themselves.

Nutrition’s links to health and agriculture are clearly being taught in Bangladesh. USAID-funded programming by in-country implementing partners, like Helen Keller International and Save the Children, includes local organizations as a key element. Working with these organizations will help sustain the lessons learned as examples for the government of Bangladesh which is sincere about its commitment to scale up nutrition. My next blog from South Asia will look at some examples of how local groups are sustaining developmental assistance programs after funding from donors ends.

Scott Bleggi is senior international policy analyst for hunger and nutrition in Bread for the World Institute

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