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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