Bangladesh Under-nutrition Maps 2012, developed in a joint exercise by the Bangladesh Bureau of Statistics (BBS) and the World Food Program (WFP), were released on November 30, 2014. Funded by the International Fund for Agricultural Fund (IFAD) and the WFP, this mapping exercise was initiated on May 2013. The Massey University of New Zealand provided technical expertise to conduct and complete this mapping exercise.
Stunting (low height for age) and underweightedness (low weight for age) result from under-nutrition. The first-ever upazila-level (sub-district) under-nutrition maps of 2012 provide estimates for children under five years of age and are based “on data from the Population and Housing Census 2011, Child and Mother Nutrition Survey 2012 and Health and Morbidity Status Survey 2012.”
The important findings of this mapping exercise are: (a) Although Bangladesh has made marked improvements in economic and social fields, it is lagging behind in the area of nutrition; (b) about four out of ten children under the age of five are chronically undernourished; and (c) nutritionally-challenged regions are not necessarily the poorest.
Bangladesh Poverty Maps 2010, jointly developed by the BBS, the World Bank (BB), and the WFP on the basis of data from the Household Income and Expenditure Survey (HIES) 2010 and the Population Census 2011, released on August 27, 2014, have shown that, at the national level, Rangpur division has the highest incidence of poverty and extreme poverty, at 42.3% and 27.7% respectively.
It is followed by Barisal division, which has incidence of poverty and extreme poverty at 39.4% and 26.7% respectively. On the other hand, Chittagong division has the lowest incidence of poverty and extreme poverty, at 26.2% and 13.1% respectively. It is followed by Sylhet division with incidence of poverty and extreme poverty at 28.1% and 20.7% respectively. This is against the 2010 HIES estimated incidence of poverty and extreme poverty, which were at 31.5% and 17.6% respectively.
Poverty maps show that Chittagong division and Sylhet division have the lowest and second lowest incidence of poverty respectively. The scenario reverses in the under-nutrition maps, which show that both stunting and underweight are the highest in Sylhet. The percentages of stunting and the underweight population in Sylhet are 46.6% and 38.5 % respectively. Sylhet is followed by Chittagong, where the rates of stunting and the underweight are 42.1% and 36.8%.
On the other hand, Rangpur division with the highest incidence of poverty in the country has stunting and underweight percentages below those of Sylhet division and Chittagong division. They are 42.1% and 35.7% respectively. Barisal division, with the second highest incidence of poverty in the country, has stunting and underweight percentages at 39.7% and 33.4% respectively.
Of all the 64 districts in the country, the stunting rate is the highest in Bandarban district in Chittagong division. Here, 48% of the children below the age of five years suffer from stunting. It has also the second highest percentage (40%) of underweight children. The rates of stunting and the underweight in Bandarban district are higher than those of Kurigram district (stunting and underweight population rates are 42% and 39% respectively) which, according to poverty maps, has the highest incidence of poverty in the country.
Bandarban district is followed by Cox’s Bazar district, also in Chittagong division, and Sunamganj district of Sylhet division. The under-nutrition maps show that 39 out of 64 districts in the country have stunting rates above the World Health Organization (WHO) critical threshold level for stunting (40%). And 55 districts are above WHO critical threshold level for underweight (30%).
At the upazila level, 55% of the upazilas have a stunting rate above 40%, and 81% have an underweight population rate above 30%. The upazilas surrounding the divisional cities of Dhaka, Chittagong, Khulna, and Rajshahi have the lowest rates of stunting in their respective divisions.
It transpires from the above discussion that richness alone is not a guarantee against under-nutrition. A number of factors stand in the way of ensuring nutrition to people, particularly to children and women. They include: Underlying causes at household/family level, and basic causes at societal level. The underlying causes at household/family level are: (a) Insufficient access to food due to lack of purchasing power; (b) absence of equal distribution of food among all the members of a household/family, particularly among the children and women even though a household/family has enough food at its disposal; (c) unscientific cooking practices causing huge loss of food values; (d) inadequate maternal and child care practices; and (e) poor water, sanitation, and inadequate health services. Basic causes at the societal level include power relationships and socio-economic conditions that are not specific to nutrition but can have powerful impacts.
As we can see, under-nutrition mapping is a statistical exercise to estimate the percentage of the total population of children under five years of age who are suffering from under-nutrition. What the government should do now is to use the under-nutrition maps to serve as a valuable planning tool to aid targeting areas which are lagging in child nutrition.
The maps may provide critical inputs for the Seventh Five Year Plan. The undertaking of under-nutrition mapping exercise will be meaningful when our planners, policy-makers, and finally the government, make proper use of it.