Nutrition education, technical delivery go hand in hand

Almost a third of Bangladesh’s population lives below the poverty line and a significant proportion exist in extreme poverty. As a result, rates of malnutrition in Bangladesh are among the highest in the world. The problem is particularly acute in rural and urban slums. The Global Alliance for Improved Nutrition’s (GAIN) micronutrient survey showed that more than half of Bangladeshi children living in slum areas suffer the effects of stunting – failing to grow to their potential height.

The underlying causes of malnutrition in Bangladesh include: a lack of access to diverse foodstuffs, high level of social and geographical exclusion, inter-intra household disparities, discrimination and a lack of education on nutrition. Impoverished families don’t have the means to grow or purchase a nutritionally adequate amount and variety of food, so often rely on staples with low natural levels of nutritional value such as polished rice.

GAIN nutrition educationRice is the most widely consumed staple food in Bangladesh. While it constitutes between 70% and 80% of diets, its low nutrient density is a likely contributor to the high rates of zinc deficiency among Bangladeshis. To improve dietary quality, GAIN supports a wide range of nutrition programs in Bangladesh, including an innovative new process called rtifying through soak’ to improve the zinc content of rice.

After a thorough research phase, the pilot program on Zinc enrichment of rice at soaking stage is on its way to rolling out. Given its widespread consumption, rice with improved nutritional quality can be a powerful vehicle to reach a large part of the country’s malnourished with the micronutrients they need.

The technical delivery of food fortification is progressing well, but a crucial focus is improving education and awareness of trition amongst the general public. The challenge was illustrated by a recent mill visit by GAIN staff in Bangladesh.

“We spoke to Ayesha Khatun, 55, who has been working in rice mills for 20 years. Male labourers at the mill earn between 5000 to 6000BDT, depending on their level of experience, but female workers typically earn only 3000 per month. Their work involves drying and collecting the paddy, doing less of the physical work dragging the bags and other materials to and from the mill. The manager of the rice mill told us that the wage gap exists because they cannot carry the weight of the paddy bags.

“Speaking to her, it was clear that nutrition is not a familiar subject for the women working at the rice mill at all, despite their central role in the production of the country’s staple food. According to Ayesha, the workers are very used to having meals of only rice.

“When we started to discuss rice fortification with zinc she was surprised with the new word she had never heard and asked, ‘zinc! What is this?’ We tried to explain in simple terms what the mineral is and why it is needed,” says Debashish Chanda, project manager at Global Alliance for Improved Nutrition.

There is clearly a challenge to be met when workers involved in producing staple foods are unaware of nutrition and food fortification.

One program in Bangladesh focuses on female factory workers to improve the nutritional and social status of them and their children. The new program takes a dual approach – ensuring access to nutritious foods, as well as providing health and nutrition education.

A similar approach is taken in Bangladeshi schools, where GAIN’s program to provide hot cooked school meals is integrated with education, participation and empowerment; as well as de-worming, safe drinking water, sanitation and hygiene.

Creating more nutritious products is not a means to an end. Communicating education and behaviour change is essential to convince people that micronutrients are important and worth the small added cost.

-Courtesy: The Guardian