Poorest People of Bangladesh: Special Comprehensive Nutritional Program is Needed

The poorest people of Bangladesh are described by donor community in different ways. These are: i) ‘Extreme Poor’ named by World Bank, ADB, GTZ,Irish Aid,USAID, AusAID,AIDCO, CIDA,DANIDA, SIDA, NORAD and DFID (UKaid), ii) ‘The hard-core poor’ called by UNDP-Bangladesh, iii)  ‘The ultra poor’ called by World Food Program and World Vision, iv) ‘Poorest-of-the-poor’ given by UNDP and UNEP and v)‘Most marginalized, the poorest, poorest communities in the world’, ‘very poor’, etc. called by INGOs including Oxfam International, Care International, ActionAid, Caritas, etc. However, the main definition of extreme poverty, as offered in its Poverty Reduction Strategy Paper (PRSP), is calculated using the Cost of Basic Needs method (CBN). 

This poverty line represents the level of per capita expenditure at which the members of a household can be expected to meet their basic needs (food consumption to meet calorie requirements and also nonfood consumption). The food bundle used to calculate this poverty line is based on the minimum nutritional requirements to provide 2,122 Kcal per person per day. Two lines are then used for non-food consumption: a ‘lower allowance’ and an ‘upper allowance’. The use of two allowances is to take into account that food expenditure as a proportion of total expenditure decreases as expenditure increases. The result is two poverty lines, with the lower poverty line corresponding to extreme poverty. According to this method, in 2005 the headcount poverty ratio for Bangladesh stood at 40% and that of extreme poverty at 25%, or 35 million people. But by 2010, the figured had fallen to 17.6%. This reduction confirms that Bangladesh continues to make meaningful progress to reduce levels of poverty in the country.

With an estimated population of almost 160 million, today there remain around 28 million people living in extreme poverty. Chronic illness and disability have serious consequences for the extreme poor who are entirely dependent on the quality and quantity of labor at their disposal to meet their food needs. Health care is extremely costly and constitutes a major part of extreme poor households’ overall expenditure. Adult earners in the household often become chronically ill or disabled, and have to remove themselves partly or wholly from the workforce. The Bangladesh Demographic and Health Survey found that 41 % of children under five are stunted and 36% were underweight. The percentage of underweight children in Bangladesh is 16 % higher than in sixteen other Asian countries at similar levels of per capita GDP; about 400,000 children under 5 years of age suffer from severe acute undernutrition. In Bangladesh, extreme poor women are severely undernourished and suffer from multiple nutrition-induced problems. A high proportion of women (15 %) are below the critical height of 145 centimeters. The BDHS 2007 survey data indicated that, 30% of women have a Body Mass Index (BMI) <18.5 (the cut-off for chronic energy deficiency). Roughly 10% of women suffer from more serious undernutrition (BMI <17).

However, Bangladesh has made impressive progress towards attainment of the Millennium Development Goals, particularly in reducing child mortality, but improvement in overall nutritional status has been relatively slow. In case of extreme poor people it is too higher. Lack of access and insufficient level of protein intake particularly animal protein among extreme poor households is noticed very significantly lower. But Protein is the major functional and structural component of all body cells and tissues. It is also the principle material in blood, enzymes, antibodies and many hormones. It has reported that lack of adequate protein in the diet is associated with impaired immunity and increased risk of infection and disease. Hence, undernutrition remains a major public health issue in Bangladesh. The National Nutrition Service (NNS) Targets by 2016 as i) Underweight reduced from 41% to 33%, ii)  Stunting reduced from 43% to 38%, iii)  Low birth weight reduced to 12%, iv) Anemia in pregnant women, adolescent girls, and children reduced by one-third, iv)  Night blindness sustained at <1%, iv)  Iodine deficiency reduced by one-third, v)  Exclusive breastfeeding increased to 60%, vi)  Appropriate complementary feeding increased to 65%, vi)  More food intake in pregnancy increased to 75%.

It is noted that poor nutritional status is inextricably linked with poverty and illness; improving the nutritional status of the poor will be vital if MDG 1 (eradicating poverty and hunger), MDG 4 (reducing child mortality) and MDG 5 (improving maternal health) are to be met. Under and above circumstances to address a systematic level of undernutrition improving across nutrition intervention integration throughout the country a special comprehensive program initiative need to be taken for extreme poor people without any dely.  Otherwise, to achieve the expected overall result will be challenging in the long run. 

Habibur Rahman

Manager-Nutrition, Practical Action Bangladesh

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