17 million Bangladeshi women between the ages of 15 and 49 are malnourished. 5 million of them are underweight. On the other hand, 12 million women are obese since they weigh more than they need. They are obese due to malnutrition. This means that 45 per cent of women are malnourished. This terrible picture of the country's nutrition situation has shown how far behind we are in ensuring the nutritional security of women.
This information about the nutrition situation of women in the country was given on August 16 in an event organized by ICDDRB, USAID, and data for Impact.
When underweight and overweight or obese people exist simultaneously in a society or state, it is called a "Double Burden of Malnutrition. Micronutrient deficiency, added to this, makes the Triple Burden of Malnutrition.
An analysis of the Bangladesh Demographic and Health Survey (BDHS) 2018 report shows that underweight among married women in Bangladesh has decreased significantly from 2007 to 2017 (from 30 per cent to about 13 per cent). On the other hand, the number of obese women has increased from 12 per cent to 32 per cent. That is, in the last 10 years, even though undernutrition has decreased, the overall obesity situation has deteriorated. Undernutrition is more common among women in rural areas than among men, while obesity is more common in urban areas.
Micronutrient deficiency has a strong correlation with both emaciation and obesity. Obesity and emaciation are strongly correlated with micronutrient deficiencies. According to the World Bank, 37 per cent of reproductive-aged women have iron deficiency anemia. Anemia hinders children's growth and intellectual development and raises the chance of miscarriage, preterm birth, and low birth weight. Anemia raises the burden of illness by resulting in excessive fatigue and poor performance.
In Bangladesh, 30 per cent of women of reproductive age had iodine deficiency, according to the 2019–20 National Micronutrient Survey. Iodine deficiency increases the risk of various thyroid problems and mental retardation in children. 9.7 per cent of women are vitamin A deficient.
Children who are iodine deficient are more likely to experience mental impairment and other thyroid issues. 9.7 per cent of the women are vitamin A deficient.
Inadequate vitamin A does not allow the body's immune system to function properly and is responsible for various complications during pregnancy.
In addition, women in this country suffer from a deficiency of many other micronutrients like calcium, zinc, etc.
Literally, the Triple Burden of Malnutrition exists in Bangladesh now. The current price hike of essential commodities could exacerbate the problem of malnutrition.
There are many reasons behind the curse of malnutrition. Despite an increased literacy rate, most people are not aware of nutrition. Proper nutrition and care of mothers and children are not ensured due to a lack of nutrition knowledge. Inadequate food in the family and social stigma cause inadequate nutrition for women. Moreover, dietary diversity is often ignored.
On the other hand, many people like fast food, processed food, and restaurant food a lot. Foods high in carbohydrates and oil/fats lead to excess body fat, which leads to weight gain in the long run.
In the era of globalization, people are now urban-oriented; even walking a short distance is anecdotal. Regular exercise, on the other hand, is difficult due to busyness or laziness. Bad eating habits, luxury, and laziness are the main causes of obesity.
Lack of safe drinking water, improper hygiene, and sanitation are some of the many other causes of malnutrition. Moreover, a child's nutritional status is largely determined early in life. The malnutrition of a mother before and during pregnancy has a significant impact on the health of the child.
Regardless of the conditions and causes of malnutrition, its consequences are dire and negative. Childhood malnutrition increases the risk of mortality and impedes normal physical growth and cognitive development. Again, overweight/obesity is one of the causes of non-communicable diseases like diabetes, heart attack, stroke, kidney problems, etc. Obesity and underweight in women are both because of pregnancy-related complications and problems for the unborn child.
If someone is malnourished in childhood, later on, more nutrition cannot maintain the balance in the body, which can lead to obesity. Underweight children suffer from various diseases, including malnutrition, later in life. Obese women are at greater risk of gaining weight during pregnancy and developing gestational diabetes, which is often difficult to overcome.
When women are malnourished, the malnutrition cycle continues in subsequent generations. After all, malnutrition, directly and indirectly, hinders the overall economic development of the country. The last progress report on the Sustainable Development Goals (SDGs) highlights some of the achievements in Bangladesh. However, the progress in the field of nutrition is not promising. Populations of different age groups are still suffering from different forms of malnutrition. Various factors are responsible for this situation.
Bangladesh government has already taken many steps to overcome the double and triple burden of malnutrition. At present, nationwide nutrition interventions are being implemented in light of the Second National Plan of Action for Nutrition (2016–2025). Along with the government, many development organizations are working together.
WorldFish Bangladesh supports and promotes nutrition-sensitive fish farming in order to meet nutritional needs and raise nutrition awareness through a number of nutrition-specific and nutrition-sensitive activities. The organization is facilitating to ensure the availability and accessibility of fish and vegetables, women's empowerment, and livelihood improvement.
Most of the fishers in Bangladesh are landless, destitute, and completely dependent on fishing for their livelihood. Due to various socio-economic factors, including the high population in households, low income, lack of alternative income-generating activities, being stuck in the cycle of debt, being a victim of robbery, and natural calamities, malnutrition rates are high among them.
The USAID-funded ECOFISH II activity of WorldFish Bangladesh provided income opportunities to ensure better nutrition for fisher families. One thousand forty fisherwomen have received training and input support for safe and hygienic dried fish production.
To ensure protein and other nutrients for families, including women and children, ECOFISH II distributed dried fish and fish powder as supplements to 3,000 families during the 65-day marine fishing ban last year. ECOFISH II has provided seasonal vegetable seeds to ensure nutrition for over 9,000 beneficiary families.
In addition, the project is also conducting various research on the huge potential sea resources so that they can be utilized for nutrition security and strengthen the blue economy of the country.
The health and family planning departments are working on nutrition-specific interventions through the National Nutrition Service, and a multi-sectoral initiative has been undertaken to improve the nutrition situation. The activities must be strengthened and ensure accountability for the benefit of the people. In addition to underweight or undernutrition, over nutrition or obesity should be a focus of all concerned departments' activities.
Apart from under nutrition, over nutrition or obesity should be in focus in the activities of all departments concerned. In addition, the government should have a special plan for the backward communities so that they are able to get proper nourishment. Government policy-making groups, including political leaders, need to focus more on nutrition.
In short, addressing the malnutrition crisis requires concerted and multi-sectoral efforts by various government departments, donor agencies, and non-governmental development organizations. Nutrition activities should be strengthened through proper participation, accountability, and coordination at every level of the respective departments. Besides, to have sustainable food and nutrition systems, it is high time to focus more on marine and freshwater aquatic food systems rather than on land.
Finally, taking proper steps to improve the nutrition situation of women, in particular, can support achieving the Sustainable Development Goals (SDGs), Bangladesh's Eighth Five Year Plan, and Vision 2041.
The writer is Senior Nutrition Specialist, USAID/ECOFISH II activity of WorldFish Bangladesh. He can be reached through [email protected]