Elements of a National Food- Fortification Program for Bangladesh

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Section 1: IntroductionObjectiveThe primary objective of this study isto identify major elements of a foodfortificationstrategy in Bangladesh, includingmicronutrient formulation for the foodvehicles identified as suitable for fortification,equipment needed, and packaging andlabeling requirements.MethodologyThis study, conducted in April-May2004, collected data from availabledocuments with relevance to the oil, wheat,and sugar industries, and from extensiveinterviews with GOB officials and other keypersonnel in Dhaka during a two-week visitto Bangladesh. Two visits were made to oil,wheat flour, and sugar mills in the Dhaka areaand Natore. Major findings and conclusionswere presented to USAID, GOB officials, andmembers of the technical committee of thenewly created National Fortification Alliance(NFA).The study is divided into five sections.Following this introductory material, section2 describes the nature of the micronutrientproblem in Bangladesh. Section 3 examinesthree potential food-fortification vehicles:edible oil, wheat flour, and sugar, withcost analysis of fortification for the threecommodities presented in section 4. Majorelements of a national food-fortificationprogram are identified in the final section,which examines food vehicles and fortificationformulation, production, and packaging andlabeling requirements.2 MOST The USAID Micronutrient Program
Section 2: Nature of the Micronutrient ProblemSection 2: Nature of the Micronutrient ProblemMalnutritionBangladesh has achieved considerable progress in reducing poverty, child mortality, andmalnutrition. Despite these improvements, however, poverty remains alarmingly high.Nearly 45 percent of the population remained below the poverty line in 2000, and 20percent lived in hardcore poverty — defined as consuming fewer than 1,800 calories per day. Inurban areas, those percentages are 52 percent and 25 percent, respectively (Bangladesh Bureauof Statistics 2001).Children in Bangladesh suffer from short-term acute food deficits (as reflected in low weightfor-age)as well as from longer-term chronic under-nutrition (as reflected in high rates ofstunting). As shown in table 2.1, the rate of stunting for children below six years of age wasabout 49 percent in 2000 (38 percent in urban areas and 50 percent in rural areas). Withinthe same age group, the proportion of underweight children was about 50 percent (42 percentin urban areas and 53 percent in rural areas), and wasting was over 10 percent. Between 13percent and 19 percent of children were severely underweight or stunted.Table 2.1. Trends in Various Indicators of Malnutrition in BangladeshNutrition Status Indicator Child Nutrition Survey, 2000Demographic &Health Survey1999-2000Urban Rural AllStunting (height-for-age)% below 2 standard deviationsUnderweight (weight-for-age)% below 2 standard deviationsWasting (weight-for-height)% below 2 standard deviationsSource: World Bank 2002a.38.3 50.7 48.8 4542.2 53.8 51.1 4811.8 11.9 11.7 10The overall level of child malnutrition in Bangladesh remains one of the highest in the world.In the late 1990s, Bangladesh ranked second in terms of the proportion of underweight childrenbelow five years of age and fourth in terms of the proportion of children stunted. Bangladeshalso had the second-highest percentage (30 percent) of infants with low birth weight in theworld (Ministry of Finance 2002b).Malnutrition in Bangladesh varies by geographic location, with children in rural areas havinghigher incidence of malnutrition than in urban areas. The lowest rates of child malnutritionare found in the urban areas of Dhaka and Khulna division. There are large differences inchild malnutrition across economic groups, with the poor having the highest incidence ofmalnutrition.As shown in table 2.2, only 32 percent of the population meet calorie requirements, 36percent meet protein requirements, and 25 percent meet fat requirements. In rural areas, theseproportions are higher for calories (35 percent) but lower for protein (45 percent) and fat (21percent) — reflecting the importance of cereals in their diet, especially rice.Elements of a National Food-fortification Program for Bangladesh3
Page 1 and 2: Elements of a National Food-Fortifi
Page 3 and 4: Elements of a National Food-Fortifi
Page 5 and 6: Table of Contents and AcronymsTable
Page 7 and 8: Table of Contents and AcronymsAcron
Page 9 and 10: SummaryElements of a National Food-
Page 11: Section 1: IntroductionSection 1: I
Page 15 and 16: Section 2: Nature of the Micronutri
Page 17 and 18: Section 3: Potential Food-Fortifica
Page 19 and 20: Section 3: Potential Food-Fortifica
Page 21 and 22: Section 4: Cost Analysis of Food Fo
Page 23 and 24: Section 4: Cost Analysis of Food Fo
Page 25 and 26: Section 5: Elements of a National F
Page 27 and 28: Section 5: Elements of a National F
Page 29 and 30: ReferencesReferencesBangladesh Bure
Page 31 and 32: Annex TablesAnnex B: Estimated Cost
Page 34: Bangladesh has the necessary human

Elements of a National Food- Fortification Program for Bangladesh

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