ACCORDING to the Constitution of Bangladesh, nutrition is a basic human right, and the government has made significant investments to ensure it. Over the years, the nation has made substantial progress in reducing malnutrition, with the hunger score improving from 26.1 in 2018 to 19.6 in 2022, stunting reducing from 41 per cent in 2011 to 31 per cent in 2017鈥�18, and wasting declining from 16 per cent in 2011 to 8 per cent in 2017鈥�18. This commitment to improving the nutritional status of its population was also reflected at the Tokyo Nutrition for Growth (N4G) Summit in 2021, where our honourable prime minister reaffirmed Bangladesh鈥檚 commitment to the nutrition of its population. Building on the pledges made during the previous N4G summits, the 2021 commitments aligned with the Sustainable Development Goals and the World Health Assembly targets for maternal, infant, and child health, and reflected evolving global and national priorities.
A total of 12 commitments under four thematic categories were made at the N4G Summit 2021.
Health: Focused on making nutrition integral to universal health coverage, six commitments were made in this category to reduce the prevalence of childhood stunting, the prevalence of childhood wasting, the prevalence of childhood obesity, the incidence of low birth weight, the prevalence of anaemia in women of reproductive age, and to strengthen the recruitment of nutrition officers at the subnational level.
Food system: To build food systems that promote healthy diets, the three commitments made under this theme were aimed at reducing the prevalence of undernourishment, the prevalence of severe and moderate food insecurity, and the dependence on cereals for dietary energy.
Resilience: To address malnutrition in fragile and conflict-affected areas, a commitment was made to increase the coverage of nutrition-related social safety net programmes so that the potential impact of nutritional outcomes is enhanced.
Accountability and finance: The commitments under this category included strengthening the multi-sectoral nutrition surveillance system and tracking finances allocated for nutrition, securing new investments, and driving innovation in nutrition financing.
An N4G operational framework capturing key strategies and priority actions for achieving the commitments in each category has been developed under the supervision of the SUN Multi Stakeholder Platform along with the Bangladesh National Nutrition Council with technical support from Nutrition International.
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Key strategies to achieve health sector, food systems and resilience commitments
TO ACHIEVE the health-related commitments, some of the proposed strategies include improvement of sexual and reproductive health services, maternal health services, screening of children for severe and acute malnutrition and their referral for in-patient treatment, control of parasitic diseases, and provision of nutrient supplements such as iron and folic acid. At the school level, there are plans to train health workers to counsel adolescents on healthy lifestyles and physical activity, with such topics being included in the school curriculum. To reduce the prevalence of obesity in children, the strategies focus on regulating packaged, ultra-processed foods, especially their marketing to children. Appointment and training of nutrition officers in all districts and dieticians at health facilities are also proposed. Provision of potable water and sanitation facilities to prevent water-borne diseases is also one of the key approaches recommended to achieve health-related commitments.
The food system-related commitments are directed towards ensuring adequate, quality food and its consumption, especially among women, children, and adolescents. This has a bearing on school feeding programmes, and actions have been suggested for the provision of higher-nutrition meals in schools. Dietary diversification is boosted with a focus on locally available and affordable foods. Farmers are encouraged to cultivate more drought-resistant and ethnic crops and to diversify towards fisheries and livestock to reduce their dependency on cereals.
In order to meet the challenges posed by disasters and emergencies, the coverage of social safety programmes is proposed to be expanded to maximise its reach to the most vulnerable sections. Alternative livelihood programmes can be provided to people living in coastal and other disaster-prone areas.
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Multi-sectoral synergy with full accountability
WHILE the operational framework provides specific actions to achieve each commitment, multi-sectoral collaboration is core to the success of these plans. The framework has identified the lead ministries for each intervention. For instance, seven commitments (1, 2, 3, 4, 5, 9, and 10) need to be led by the Ministry of Health and Family Welfare, while three of them (6, 7, and 8) come under the Ministry of Food, and the remaining two (11 and 12) will be managed by the Ministry of Planning and Ministry of Finance, respectively. However, what is important to note is that beyond these four ministries, there are 17 other ministries that have a crucial role in achieving these commitments. Every ministry of the government at all levels needs to view its development interventions through a nutrition lens.听
To ensure closer coordination across ministries as well as across levels of governance, a multi-sectoral nutrition surveillance system has been developed that will regularly monitor key indicators of the various programs. A multisectoral budget tracking system for nutrition has also been developed to check budget allocation and its utilisation for nutrition-specific or nutrition-sensitive interventions across various sectors and ministries at the national and sub-national levels.
To expedite the sub-national operationalization of N4G actions through the District and Upazila Nutrition Coordination Committees, the Bangladesh National Nutrition Council is set to hold workshops to familiarise the relevant stakeholders with the operational guidelines and promote engaging discussions with them.
Bangladesh鈥檚 firm commitment to nutrition, demonstrated through active participation in N4G Summits, underscores its unwavering dedication to its citizens鈥� well-being. With substantial financial backing and well-defined strategies, Bangladesh is poised for significant advancements in nutrition and overall health outcomes. This effort signifies a united pursuit of a healthier future for all, emphasising nutrition鈥檚 pivotal role in the nation鈥檚 development.
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Saiqa Siraj is country director for Bangladesh at Nutrition International. Dr Hasan Shahriar Kabir is former director general, Bangladesh National Nutrition Council.