Elements of a National Food- Fortification Program for Bangladesh

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