Elements of a National Food- Fortification Program for Bangladesh

More documents

Recommendations

Info

Section 2: Nature of the Micronutrient ProblemMicronutrient DeficiencyTable 2.3 describes nutrition adequacy interms of estimated average requirement(EAR). Micronutrient intake is low forcalcium, iron, vitamin A, and vitamin B-2.Although not evaluated in the table, intakesof vitamin B-12 and zinc are likely to be lowbecause their sources are similar to thosefor the other micronutrients listed. Table 2.3shows that intake is adequate (higher than100 percent of EAR) only for vitamin B-1 andniacin.Table 2.4 shows vitamin A indicators forchildren and women. In all cases, serumretinol levels indicate the presence of a seriouspublic health problem (percent deficiencyhigher than 15 percent). Deficiency figures arelower among preschoolers due to the vitaminA supplementation program. However, whilesupplementation has reduced clinical andocular signs of vitamin A deficiency in this agegroup, their serum retinol level remains low.Table 2.2. Percent of Population Able to Meet Calorie, Protein, and FatRequirements in Bangladesh (1995-96)Intake as a %Calories Protein Fatof RequirementRural Urban All Rural Urban All Rural Urban All< 80% 36 50 39 32 31 32 70 49 6580-90% 15 16 15 11 10 11 5 6 590-99% 14 12 14 11 10 11 4 5 4100% & above 35 22 32 45 49 36 21 40 25Source: Jahan and Hussain 1998Table 2.3. Micronutrient Adequacy in Bangladesh (1995-96)Intake (mg/day) % EARNutrient EAR (mg/day) Rural Urban Rural UrbanCalcium 833 328 363 40 43Iron 21.6 11 13 51 60Vitamin A * 429 259 378 43 88B-1 1 1.2 1.1 120 110B-2 1.1 0.5 0.5 41 41Niacin 12 19 17 160 141Note:* Based on new equivalence factor of 1:12 for B-carotene, instead of 1:6 (retinol: B-carotene).Source Calculations using data in Jahan and Hossein 19984 MOST The USAID Micronutrient ProgramTable 2.4. Vitamin A Deficiency in Bangladesh(percent below the reference point)Age Group & GenderReferencePoint (mmol/l)% Deficiency1-5 years old < 0.7 22School Children < 1.05 74Adolescent Girls < 1.05 47WomenNon-pregnant < 1.05 30Pregnant < 1.05 47Lactating < 1.05 46Source: Mannan 2002
Section 2: Nature of the Micronutrient ProblemTable 2.5. Anemia Prevalence inBangladesh (percent)YearAge Group &1995-96Gender1999Rural UrbanPreschoolers 52Male — 60.4 29.3Female — 79.4 47.15-14 yearsMale — 78 65Female — 83 76WomenNon-pregnant 38.9 85.2 69.2Pregnant * 49.2 60 53.4Lactating 48.7 83.7 80.9Note:* Anemia is normally higher for pregnant women.The reference criteria used to assess anemiamight explain the unusual results presented here.Source: Johan and Hussein 1998; Helen Keller 2001.Current Efforts to ReduceMicronutrient DeficiencyTable 2.5 demonstratesthat anemia is avery serious healthproblem for all ageand population groups.Anemia is substantiallyhigher in rural areasthan in urban areas forboth men and womenand for all age groups.It is also significantlyhigher for womenthan for men for allgeographic locationsand age groups.As reflected in its National Plan of Actionfor Nutrition (NPAN), prepared incollaboration with government professionals,non-governmental organizations (NGOs),private-sector agencies, and donororganizations in 1997, Bangladesh regardsimproved nutrition as a top governmentpriority. The NPAN is tasked with analyzingthe current nutrition situation in Bangladesh,defining objectives and targets, formulating astrategic framework for plan implementation,and defining the institutional framework fortranslating those plans into action.NPAN has five central components:Promote breastfeeding andcomplementary feedingCare for the economically deprived andnutritionally vulnerablePromote appropriate diets and healthylifestylesOngoing programs to reduce micronutrientdeficiency in Bangladesh are dietarydiversification and other food-basedinterventions, including development ofhome gardens, poultry, fisheries, and othersmall farm animals at the community level;salt iodization; and universal vitamin Asupplementation for young children andlactating women.Food Fortification andMicronutrient MalnutritionDespite the success of vitamin Asupplementation and related activities,especially for preschoolers, significant effortsare still needed to reduce micronutrientmalnutrition. As part of its strategy tofurther reduce this deficiency, the GOBrequested USAID assistance to introduce foodfortification.Food fortification — the addition ofmicronutrients to processed foods — is afood-based approach for the prevention ofmicronutrient malnutrition. Fortification ofwidely consumed foods can result in rapidimprovements in the micronutrient statusof large segments of the population. Otheradvantages of food fortification are that itdoes not require changes in consumptionpatterns and relies upon an existing deliveryinfrastructure.The food-fortification program in Bangladeshwas initiated with the implementation of apilot wheat-flour fortification activity. Buildingon that initiative, the GOB has launchedan effort to examine the suitability of otherfood-fortification vehicles. As a result ofthese interventions, it is expected that foodfortification will soon become an importantelement of the country’s strategy to reducemicronutrient malnutrition.Enhance nutrition education, advocacy,and community participationReduce micronutrient deficiencyElements of a National Food-fortification Program for Bangladesh5
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 and 12: Section 1: IntroductionSection 1: I
Page 13: 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

Create successful ePaper yourself

Delete template?

Save as template?