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Firdousi Naher
International Food Policy Research Institute, Dhaka, Bangladesh

Barkat-eKhuda
University of Dhaka, Bangladesh

Background. The improvements in nutrition status in Bangladesh, particularly child nutrition outcomes, have been relatively slow, despite remarkable improvements in the country’s food situation as well as in the health sector. At present more than 40% of children under 5 years of age are stunted. Objective. To examine the specific food, agriculture, and health policies that have existed and currently exist in Bangladesh from the perspective of nutrition and identify gaps in the policy framework for which improvements in nutrition have been slow. Methods. Policy documents, public financial and budget documents, and related papers were reviewed. Several interviews with former civil servants and bureaucrats were conducted. Results. The approach to achieving food security has been a partial one, with policy provisions focusing excessively on increasing the availability of food, primarily rice. The “accessibility” pillar of food security has received little attention, while the neglect of the “utilization” pillar is conspicuous by the dearth of appropriate policies and laws for ensuring food safety. The efforts in the health sector have largely concentrated on expanding the coverage of primary healthcare, with little consideration of equity and quality. Conclusions. There exists a wide window of unexplored opportunity to align the remarkable increases in food production and advances in the health sector with nutrition considerations toward an improved nutrition status in Bangladesh. 

  Agriculture policy, Bangladesh, Food and nutrition policy, Health policy
  In Bangladesh
  
  
  Quality and Nutrition
  Nutrition

The paper has been prepared from information obtained principally from secondary sources. Some interviews were done with academics and former civil servants who have a national perspective on agriculture, health, education, and nutrition issues. Interviews were also held with agricultural extension officials who have been directly associated with programs aimed at improving nutrition.

Advent of new technology and transformation of agricultural policies Against this backdrop, achieving food self-sufficiency has been an overwhelming component of the government’s food policy. Bangladeshi planners felt this was a necessary element for achieving economic and political sovereignty. Thus, the strategies and policies that Bangladesh has been following over the last four decades have been developed around the crop sector, particularly on the staple, rice. As a step toward this end, the government introduced voluntary paddy procurement at minimum support prices. But the big breakthrough came with the introduction of High Yielding Varieties (HYVs) of rice and also wheat in the latter half of the 1970s that marked the onset of the Green Revolution in Bangladesh [8]. The new technology in Bangladesh agriculture brought with it the dry-season, irrigated boro rice crop, which was largely responsible for providing farmers with a steady income all year round.* 

Crop diversification and noncrop agriculture The introduction of new technology set the ground for the next step in transforming traditional agriculture into a dynamic sector through agricultural diversification. However, the Green Revolution in cereal production was a mixed blessing. The rapid expansion in the area planted with boro rice and wheat was achieved partly through reduction of the acreage and production of pulses and oilseeds, which were important sources of protein and micronutrients, particularly for the poor. In fact recognizing the overemphasis on rice and the need to  high-value nutritious crops, the Ministry of Agriculture launched the Crop Diversification Program (CDP) in Bangladesh in 1987. The project continued until 2004, focusing on pulses, oilseeds, and tubers (potato and sweet potato). Several other projects aimed specifically at improving the nutrition of the people were also launched by the government. However, in recent years both the production and the acreage of wheat, pulses, and oilseeds have been greatly reduced. The growth has been respectable only for potatoes and vegetables, because of their high productivity and profitability compared with rice and wheat.

Food and agriculture policy There are a number of policies and strategy documents relating to broad agriculture and rural development in Bangladesh. These policies can be classified in three subcategories: crop, non-crop, and cross-cutting policies. About half of these pertain to the crop subsector, although these policies primarily deal with cereal crops, particularly rice. The National Agricultural Policy (NAP) formulated in 1999 by the Ministry of Agriculture only deals with the crop subsector. The NAP lays out 18 specific objectives toward the goal of achieving food self-sufficiency and food security. On nutrition, the NAP explicitly identifies “food-based nutrition” aimed at improving nutrition focus in development policies and programs, improving food security at the household level, and protecting consumers through improved food quality and food safety.

Agricultural research and development priorities As part of the agricultural sector policy reforms, the agricultural research system was strengthened by bringing 10 primary research institutes under the National Agricultural Research System (NARS) with the Bangladesh Agricultural Research Council (BARC) at the apex. However, the focus has continued to be on rice. To date more than 70 new varieties have been released by the Bangladesh Rice Research Institute (BRRI). BRRI is also experimenting with golden rice, which is biofortified with vitamin A. On the other hand, varietal releases by the Bangladesh Agricultural Research Institute (BARI), which is responsible for other nonrice food crops, have been slow and few. For instance, until now BARI has introduced only six HYVs each of lentils and mungbean, popular pulse varieties in Bangladesh. Pulses are a cheap source of protein for the poor and complement the rice-based diet in Bangladesh. However poor yields of pulses and lack of resistance to disease have caused many farmers to stop growing pulses. The share of GDP devoted to agricultural research and development has hovered between 0.25% and 0.38% in the past decade This compares with more than 1% in Malaysia, Taiwan, and Thailand and more than 3% in high-income countries. 

Inheritance of a poor health system Bangladesh has made significant progress in several health indicators. This remarkable progress has been made possible largely through the simultaneous efforts of the government and NGOs, particularly with respect to family planning and immunization. Although major gaps and challenges continue to exist, one can gauge the long way Bangladesh has traversed if the health situation at independence is taken into cognizance. In 1971 Bangladesh inherited a health system that was grossly inadequate to provide even the basic minimum healthcare services to the masses. The existing health system catered primarily to the urban elite and was basically curative rather than preventive. Given the very high fertility rate and population density in the country, early health sector initiatives had a strong focus on family planning and population control. Accordingly, the First Population Project (1975–82) provided support for reestablishing the physical infrastructure for health and family planning service delivery, which had been badly damaged during the war of liberation. The Second Population and Family Health Project (1979–85) provided funds for further development of the national family planning program. In fact, it was not until the Third Five-Year Plan (1985–90) that primary healthcare was identified as the main strategy toward the goal of “Health for All by 2000.” The plan added a new component of health services, Maternal and Child Health (MCH), as being integral to effective population control. Thereafter, the Population and Family Health Project (1986–91) began to provide some support for child survival services and home-based delivery care along with support for family planning services. The Expanded Program on Immunization (EPI), the campaign for distribution of vitamin A, and control of diarrhea were strengthened.

Nutrition in Bangladesh: A hitherto neglected sector By the end of the 1980s, family planning and primary healthcare efforts were well in place, but nutrition continued to take the back seat, despite prevailing high levels of undernutrition, particularly child undernutrition in the country. One of the first institutional setups to tackle undernutrition in Bangladesh was the Bangladesh National Nutrition Council (BNNC), formed in 1975. The BNNC was responsible for coordinating and overseeing national-level nutrition activities. However, these activities at the start were limited to a few patchy ones. Over time, these activities have included subsidized food supplements to vulnerable population groups under the Ministry of Relief and Rehabilitation, homestead garden production implemented by the Ministry of Agriculture, distribution of vitamin A capsules twice a year to children aged 6 months to 6 years, and distribution of iron–folic acid tablets to pregnant women through satellite clinics.

  Food and Nutrition Bulletin, vol. 35, no. 1 © 2014,
  
Funding Source:
1.   Budget:  
  

The cross-cutting nature of nutrition has been such that policy makers in Bangladesh have tended to consider good nutrition status to be an inevitable outcome of progress in the agriculture and health sectors. In Bangladesh, among the three pillars of food security—food availability, food accessibility, and food utilization—the focus for long has basically been on the first pillar. Lingering memories of famine and hunger and inability to import in times of need have quickted successive governments to concentrate on achieving self-sufficiency in the staple, rice. Thus, food security has been treated as synonymous with rice self-sufficiency. With the advent and rapid spread of the Green Revolution technology, the country is now producing surplus rice. The time has come to look beyond rice and perceive food and nutrition security in its entirety.  

The issue of food safety and quality control has received very little attention from policy makers. The failure to ensure this aspect of food security is causing a huge public health burden. The existing food safety laws are outdated and few. Moreover, the capacity to deal with food safety at all levels along the supply chain is grossly inadequate. It should be an immediate priority of the government to tackle this problem. A beginning should be made with determining the magnitude of the problem of hazardous food that needs to be addressed. It was not until 1997 that the government formally recognized nutrition as a human right. Despite this recognition, efforts at improving nutrition continued to be a fragmented set of programs. The concept of nutrition has evolved over time. In recent years, the focus has shifted to the 1,000-days window of opportunity, which refers to the first 1,000 days between conception and 2 years as the critical period that determines a child’s future growth and development. It was only in 2011, with the launch of the NNS, that this lifecycle approach to tackling malnutrition was formally recognized. Bangladesh has a commendable policy framework for food, agriculture, and health. What is needed is an update of these policies with a nutrition focus and ensuring their proper implementation. With an effective and nutrition-sensitive collaboration among all sectors affecting nutrition, Bangladesh can significantly improve its nutrition status.

  Journal
  


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