Third and Fourth Periodic Report on CRC - Unicef

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<strong>Third</strong> <strong>and</strong> <strong>Fourth</strong> <strong>Periodic</strong> <strong>Report</strong> Iron deficiency anaemia: Iron deficiency during pregnancy is a common problem Data from anaemia surveys in urban areas, the Chittagong Hill Tracts <strong>and</strong> the rest of rural Bangladesh (BBS/UNICEF, 2004), indicated that the prevalence of anaemia is a public health problem in preschool children (49 percent) <strong>and</strong> pregnant women (46 percent), <strong>and</strong> a moderate public health problem in non-pregnant women (33 percent) <strong>and</strong> adolescents (28 percent). The government arranges distribution of iron tablets through regular health programme. C. GoB Measures in Promoting Nutrition The Government is committed to achieving food security <strong>and</strong> nutrition for all. This is reflected in its policies <strong>and</strong> plans, including the National Agricultural Policy (1999), Comprehensive Food Security Policy (2000) <strong>and</strong> National Food Policy (2006), all address issues of availability, access <strong>and</strong> utilisation. Other key Government commitments related to food <strong>and</strong> nutrition include the NSAPR (2004/05 - 2007/08) <strong>and</strong> the HNPSP 2003-10. The Government has been implementing the National Nutrition Programme (NNP). This is the successor to the Bangladesh Integrated Nutrition Project (BINP), which was operated by the MoHFW from1995 to 2003. National level services include micronutrient supplementation (iron-foliate <strong>and</strong> vitamin A), universal salt iodization, <strong>and</strong> breastfeeding promotion. The NNP also has a Area-Based Community Nutrition (ABCN) services for children under two years, pregnant <strong>and</strong> lactating women, newly wed couples, <strong>and</strong> adolescent girls <strong>and</strong> a Behaviour Change Communication (BCC). ABCN includes growth-monitoring, promotion of supplementary feeding for malnourished <strong>and</strong> stunted children, special care for LBW infants, micronutrient supplementation, <strong>and</strong> referral to health services. The BCC component covered all 23,246 nutrition centres in 105 Upazilas with 20 communication materials to disseminate information on nutrition <strong>and</strong> related issues to pregnant <strong>and</strong> lactating women, newly wed couples <strong>and</strong> adolescent girls. 6.7.2 Breastfeeding Bangladesh has a culture of breastfeeding since long. However, many aspects of infant <strong>and</strong> young child feeding are far from optimal. In order to improve the feeding practices particularly in terms of timing <strong>and</strong> duration some initiatives have been undertaken. An NGO named Bangladesh Breast Feeding Foundation (BFF) has been working in enhancing <strong>and</strong> popularizing breast milk in the country. Government <strong>and</strong> NGOs interventions in the recent years are working for building awareness about different aspects of mother’s milk including benefits of breast feeding. For last couple of years, Bangladesh has been observing Breast Feeding Week, 01 to 08 August. Almost all children (98 percent) are breastfed at some time in their lives <strong>and</strong> over 80 percent of children are still breastfed at 20-23 month of age (NIPORT, 2004). According to MICS 2006, slightly above one-third infants (35 percent) are put to the breast within an hour of birth <strong>and</strong> four-fifths (82 percent) within a day, <strong>and</strong> approximately 50 percent of infants are exclusively breastfed up to 3 months <strong>and</strong> 37.4 percent of children aged less than six months are exclusively breastfed. While colostrum feeding has improved in the past decade, the traditional practice of giving pre-lacteal feeds (48 percent) to the newborn has remained static (BBF, 2005). Other liquids <strong>and</strong> complementary foods are given too early in the country. Over one in five (22 percent) of infants aged under 6 months <strong>and</strong> 27percent of infants aged 6-9 months are bottle-fed (NIPORT, 2004). 64
Convention on the Rights of the Child 6.8 Environmental conditions including water <strong>and</strong> sanitation facilities 6.8.1 Overview Major environmental concerns of Bangladesh include arsenic contamination of shallow aquifer, air pollution in cities, river water pollution near industrial estates, solid waste, degradation of agricultural soil due to inappropriate use of fertilizer <strong>and</strong> pesticides, soil erosion, salinity of soil in coastal zones, <strong>and</strong> deforestation. The underlying causes of these challenges cover a range of issues including proper implementation of policies <strong>and</strong> regulations. To protect <strong>and</strong> promote environment, the State Party is trying to integrate national poverty reduction strategies outlined in NSAPR with programmes <strong>and</strong> policies such as Sustainable Environment Management (SEMP) Project, National Environmental Management Plan (NEMAP) <strong>and</strong> the Declaration of World Summit of Sustainable Development 2002. In recent years, many NGOs are working for protecting <strong>and</strong> promoting environment through mainly awareness development <strong>and</strong> tree plantation in rural areas <strong>and</strong> waste management programmes in urban areas. 6.8.2 Safe water <strong>and</strong> sanitation Since 1970s Bangladesh’s drinking water <strong>and</strong> sanitation policy had focused on the installation <strong>and</strong> promotion of tube wells resulting over 97 percent of the population have access to safe water. However, progress towards ensuring universal access to safe drinking water took a serious blow with the discovery of arsenic in ground water above WHO recommended st<strong>and</strong>ards, dictating downward revision of achievements. About 20 million people are potentially at risk of arsenicosis. The situation in Khulna Division (92 percent) in terms of access to improved water is relatively worse than other Divisions. Integrated data on tube-wells in 269 Upazilas indicate that 30 percent of the wells tested were contaminated (DPHE <strong>and</strong> DGHS, August 2002). And the figure is increasing everyday with discovery of new contaminated area. About 98 percent of households in Bangladesh, 99 percent in urban <strong>and</strong> 97 percent in rural areas, have access to drinking water from an improved source. However, because of presence of arsenic contamination in many parts of the country (48 of the 64 districts), the coverage of safe drinking water is reduced to around 75 percent. The Government has a set of interventions for reducing the impact of arsenic in water. Large-scale screening in tube wells is the first thing that identifies tube wells with high level of contamination <strong>and</strong> seals those. Interventions include water treatment plants, piped water system, surface water treatment plant, installation of deep tube wells, pond s<strong>and</strong> filters <strong>and</strong> rain water harvesting systems. By <strong>and</strong> large, deep tube-wells are free from arsenic contamination. Health workers were trained on identification <strong>and</strong> management of Arsenicosis patients. A recent survey in 15 Upazilas has shown that awareness regarding arsenic contamination <strong>and</strong> arsenocosis has risen from 31 percent in 2000, to 72 percent in 2003. The Bangladesh Arsenic Mitigation Water Supply Project (BAMWSP) has been established for arsenic mitigation. The Government has conducted a baseline survey in 2003 where it was found that only 33 percent households were using sanitary latrines. Within 3 years. i.e at the end of December 2005, as Shown in Table 6.5 below, the country has been able to achieve around 67 percent sanitation coverage. The Table also shows that maximum increase was in rural areas (37 percent), followed by Pourashava (27 percent) during the period. As of June 2005, 15 Pouroshavas, 20 Upazilas <strong>and</strong> 444 Union Parishads have achieved 100 percent sanitation coverage (Source: Sanitation Secretariat). Through cooperation with NGOs <strong>and</strong> development partners access to sanitary latrines <strong>and</strong> safe water in slums has also increased in the recent years. 65
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Third and Fourth Periodic Report on CRC - Unicef

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