Nutrition: Basis for Healthy Children and Mothers in Bangladesh
Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourish...
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Published in | Journal of health, population and nutrition Vol. 26; no. 3; pp. 325 - 339 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Bangladesh
ICDDR,B: Centre for Health and Population Research
01.09.2008
BioMed Central Ltd BioMed Central International Centre for Diarrhoeal Disease Research, Bangladesh |
Subjects | |
Online Access | Get full text |
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Summary: | Recent data from the World Health Organization showed that about 60% of
all deaths, occurring among children aged less than five years
(under-five children) in developing countries, could be attributed to
malnutrition. It has been estimated that nearly 50.6 million under-five
children are malnourished, and almost 90% of these children are from
developing countries. Bangladesh is one of the countries with the
highest rate of malnutrition. The recent baseline survey by the
National Nutrition Programme (NNP) showed high rates of stunting,
underweight, and wasting. However, data from the nutrition surveillance
at the ICDDR,B hospital showed that the proportion of children with
stunting, underweight, and wasting has actually reduced during
1984-2005. Inappropriate infant and young child-feeding practices
(breastfeeding and complementary feeding) have been identified as a
major cause of malnutrition. In Bangladesh, although the median
duration of breastfeeding is about 30 months, the rate of exclusive
breastfeeding until the first six months of life is low, and practice
of appropriate complementary feeding is not satisfactory. Different
surveys done by the Bangladesh Demographic and Health Survey, United
Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding
Foundation (BBF) showed a rate of exclusive breastfeeding to be around
32-52%, which have actually remained same or declined over time. The
NNP baseline survey using a strict definition of exclusive
breastfeeding showed a rate of exclusive breastfeeding (12.8%) until
six months of age. Another study from the Abhoynagar field site of
ICDDR,B reported the prevalence of exclusive breastfeeding to be 15%
only. Considerable efforts have been made to improve the rates of
exclusive breastfeeding. Nationally, initiation of breastfeeding within
one hour of birth, feeding colostrum, and exclusive breastfeeding have
been promoted through the Baby-Friendly Hospital Initiative (BFHI)
implemented and supported by BBF and UNICEF respectively. Since most
(87-91%) deliveries take place in home, the BFHI has a limited impact
on the breastfeeding practices. Results of a few studies done at
ICDDR,B and elsewhere in developing countries showed that the
breastfeeding peer-counselling method could substantially increase the
rates of exclusive breastfeeding. Results of a study in urban Dhaka
showed that the rate of exclusive breastfeeding was 70% among mothers
who were counselled compared to only 6% who were not counselled.
Results of another study in rural Bangladesh showed that
peer-counselling given either individually or in a group improved the
rate of exclusive breastfeeding from 89% to 81% compared to those
mothers who received regular health messages only. This implies that
scaling up peercounselling methods and incorporation of breastfeeding
counselling in the existing maternal and child heath programme is
needed to achieve the Millennium Development Goal of improving child
survival. The recent data showed that the prevalence of starting
complementary food among infants aged 6-9 months had increased
substantially with 76% in the current dataset. However, the adequacy,
frequency, and energy density of the complementary food are in
question. Remarkable advances have been made in the hospital management
of severely-malnourished children. The protocolized management of
severe protein-energy malnutrition at the Dhaka hospital of ICDDR,B has
reduced the rate of hospital mortality by 50%. A recent study at
ICDDR,B has also documented that home-based management of severe
protein-energy malnutrition without follow-up was comparable with a
hospital-based protocolized management. Although the community
nutrition centres of the NNP have been providing food supplementation
and performing growth monitoring of children with protein-energy
malnutrition, the referral system and management of complicated
severely-malnourished children are still not in place. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 ObjectType-Article-1 ObjectType-Feature-2 Correspondence and reprint requests should be addressed to: Dr. A.S.G. Faruque, Clinical Sciences Division, ICDDR, B, GPO Box 128, Dhaka 1000, Bangladesh. Email: gfaruque@icddrb.org |
ISSN: | 1606-0997 2072-1315 |