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Nutrition Security for the
Poor
Ahmad Kaikaus, PhD
Additional Secretary
Power Division
01 November, 2014
Bangladeshi Poor in 1971
Bangladesh Now:
Bangladesh Now:
Bangladesh Now:
Poverty Reduction in the Past
Decade
Bangladesh made a remarkable record in reducing
poverty in the past decade
Poverty incidence dropped from 49 percent in 2000
to 32 percent in 2010
About 1.6 million people have escaped poverty
every year since 2000
Poverty rate declined modestly between 1995 and
2000, from 51 percent to 49 percent
Households with Functioning Mobile Phone
7
90
81.6
77.2
80
Percent of households
70
70.2
70.1
74.1
70.6
72.8
64.3
60
50
40
30
20
10
0
Barisal
Chittagong
Dhaka
Khulna
Rajshahi
Rangpur
Sylhet
Bangladesh
Does Income Growth Leads to Reductions
in Malnutrition?
Yes, but effect is modest…
Percent of underweight children <5 (%)
10% increase in GNP/PC: 3-5% ↓ underweight
40
1970's
1980's
1990's
30
20
10
0
0
1000 2000
3000 4000 5000 6000 7000 8000 9000 10000
GNP per capita in $ (PPP)
Source: Haddad et al. 2002; in: Repositioning Nutrition, WB, 2006
If we were to Wait for Income Growth
Alone to Achieve the Nutrition MDG:
 India would likely achieve the MDG in 2067
(3% GDP/PC growth; income/underwt elasticity 0.3)
 Bangladesh would achieve the MDG in 2044
(6% GDP/PC growth; income/underwt elasticity 0.3)
 Tanzania would achieve it in 2105
(2.1% GDP/PC growth; income/underwt elasticity 0.3)
Source: Repositioning Nutrition, WB, 2006
Malnutrition in Bangladesh is much Higher
than Expected, given its National Income
70
Bangladesh
1982-83
1990
60
1990
India
50 1996-7
1998-99
Underweight children (i%)
2000
2005-06
1990
40
2007
1992-93
Vietnam
30
1987
2000 2004
Guatemala
1995
20
1998-9
1987
2008
2002
1995
1992
Thailand
China
10
1998
2005
2005-06
1990
Brazil 1996
2002-3
2006-7
0
0
2,000
4,000
6,000
8,000
10,000
12,000
Gross National Income per capita
IFPRI, Global Hunger Index, 2010
Family Welfare Indicator:
Percent of people living on less than PPP $1.25/day
70
65.5
Percent of population
60
50
42.4
41.8
40
31.0
30
34.0
35.8
35.6
38.2
20
10
0
Barisal
Chittagong
Dhaka
Khulna
Rajshahi
Rangpur
Sylhet
Bangladesh
Food Energy (calorie) Deficient Households
40
35.3
35
Percent of households
30
25
20
16.5
15
10
5
0
Rural Bangladesh
Consuming <2,122 kcal/person/day
Consuming <1,805 kcal/person/day
Food Energy (calorie) Share of Rice
Percent of total household calorie
14
78
77.0
76
74
72
72.2
71.1
71.6
71.1
70.6
70.0
70
68
66.4
66
64
62
60
Barisal
Chittagong
Dhaka
Khulna
Rajshahi
Rangpur
Sylhet
Bangladesh
Trends in maternal and child undernutrition, 1996-2007
Source: BDHS data 1996-2007; Chart from HKI, Bangladesh
Anemia & stunting among children 6-23
months old, by per capita expenditure quintile
Anemia
%
100
90
80
70
60
50
40
30
20
10
0
Stunting
60
50
77
76.7
72.4 74.4 71.7
40
49
44.5
42
30
*
37.9
20
***
27.5
10
0
1
2
3
4
5
1
2
3
4
5
Expenditure quintiles
Page 16
Source: Alive & Thrive Baseline Survey 2010; * p < 0.05, ** p < 0.01, *** p < 0.001
Underlying factors matter for stunting: household
food security and maternal education
Food security
Maternal education
60
60
50
50
% stunted
% stunted
40
30
20
10
0
40
30
20
10
0
Page 17
Primary or Secondary
less
school
High
school
College or
higher
A&T Bangladesh Baseline Survey, 2010
Policy considerations
18
As Bangladesh moves towards a National Nutrition
Services approach for nutrition, specific attention is
needed to:
Address the high levels of anemia among infants and young
children through targeted interventions such as micronutrient
powders, iron supplements and/or fortification
Address stunting among children through a multi-pronged
approach that addresses maternal and household factors in
addition to direct nutrition-specific interventions
AGRICULTURE – NUTRITION - HEALTH
HEALTH & NUTRITION
BENEFITS AGRICULTURE THROUGH:
Productivity
Risk taking
AGRICULTURE BENEFITS NUTRITION +
HEALTH THROUGH:
Agriculture
Income
Employment
Education
Cognition
Livelihoods
Nutrition
Endurance
Food security
Dietary diversity
Gender equity
Physical strength
Health
AGRICULTURE POSES
RISKS:
Water-related diseases
Food-borne diseases
Zoonotic diseases
Conceptual Framework
Health
Enhancing
Nutrition along
the Value
Chain
Integrated
Programs and
Policies
Component 1
Biofortification
Component 2
Prevention ,
Control of AgAssociated
Diseases
Component 3
Component 4
Nutrition
Agriculture
Social Behavior Change and
Communications
All components
Availability,
access,
intake
of nutritious,
safe foods
Labor
productivity
Risk of AAD
Income and
gender
equity
Knowledge
of nutrition,
food safety
RESULT: A better nourished, healthier population, esp. mothers and children < 2
Policy Implications
 Agriculture alone will not improve nutrition fast enough
 We have opportunities and examples of success on how
to bridge the agriculture-nutrition divide
 We have challenges
 Our biggest challenge AND opportunity is to work together
- cross-sectorally (how?)
 We need to do much better at documenting successes –
and failures; we need the evidence for advocacy, to
stimulate investments
 In Bangladesh we have a momentum, new initiatives,
committed government and donors, experienced NGOs,
strong research community and partners