1. FOOD SECURITY
Concepts, Basic Facts,
and Measurement Issues
June 26 to July 7, 2011
Dhaka, Bangladesh

2. Kazal 4d:
Issues in Nutrition and Policies for Its
Promotion in Bangladesh
Learning: The goal is to identify and
understand links between food and
nutrition, and available and potential policy
instruments and institutional arrangements.
Focus on policy documents related to
nutrition aimed at expanding and
strengthening nutritional support.

3. Brief Contents
• food and nutrition plans and policies
• conceptual framework in designing food &
nutrition security interventions
• linkages between food security and nutrition
• National Nutrition Services
• important issues of nutrition and malnutrition
situation in Bangladesh
• institutional arrangements and nutrition
interventions of MH&FW

4. Food and nutrition plans and policies
What is food and nutrition policy?
“The Food and Nutrition Policy encompasses the collective
efforts of the government and other stakeholders to influence the
decision-making environment of food producers, food consumers
and food marketing agents in order to improve the nutritional
status of the population.”

5. Food and nutrition plans and policies
Key elements for developing the food and
nutrition policy
Sustainable food production, processing,
distribution and consumption
Ensure optimal food quality and safety
Collective/multi-sectoral efforts for sustainable
food and nutrition security
Achieve and maintain nutrition well-being and
healthy lifestyle of the population

6. Food and nutrition plans and policies
Key stakeholders for developing Steps involved in developing the
food and nutrition policy food and nutrition policy
 Government Understanding the need for a policy;
Review the current food and nutrition status of
 UN agencies the population;
Review the existing the policies (if any) and
 International organizations identify the lacunae;
 Nongovernmental organizations Develop appropriate food and nutrition policy
using:
(national and international)
− Direct policy instruments; and
 Industry − Indirect policy instruments;
 Develop plans of action for implementation;
 Professional bodies  Evolve an effective and strong monitoring and
 Academia/researchers evaluation mechanism;
 and
 Consumers  Establish a nutrition surveillance system to
facilitate programme appraisal and follow-up
 Mass Media
action.

7. The evolution of Food and Nutrition Security
concerns

8. Conceptual framework in designing food
& nutrition security interventions
(Source: adapted from Metz, 2000)

9. A Conceptual Framework – Food and
Nutrition security

10. Figure: Conceptual framework of the nutritional
status at household level

11. The Food and Nutrition Security Conceptual
Framework
The household food security conceptual framework adopted by EFSAs considers food
availability, food access and food utilization as core determinants of food security, and links
these to households’ asset endowments, livelihood strategies, and political, social,
institutional and economic environment.
Figure : The Food and Nutrition Security Conceptual Framework

12. Linkage between nutrition, poverty alleviation,
employment generation and gender

13. Linkages between food security and
nutrition
 Gender of the head of the household and nutritional status of children
and women
 Relationship between household food consumption pattern and
nutritional status of children and women and young child-feeding
practices
 Relationship between food consumption score and nutritional status of
children and women
 Relationship between food consumption score and young child-feeding
practices
 Relationship between household food consumption groups and
nutritional status of children and women
 Relationship between Coping Strategy Index and nutritional status of
children and women
 Relationship between Coping Strategy Index and nutritional status of
children and women by area and by division
 Relationship between most affected livelihoods and nutritional status of
children and women

14. Linkages between food security and
nutrition
 Relationship between percentage of food expenditures and nutritional
status of children and women
 Relationship between wealth status and nutritional status of children and
women
 Relationship between households without enough food in the past 12
months and nutritional status of children and women
 Relationship between decrease in health expenditures in the past 12
months and nutritional status of children and women
 Relationship between monthly income per household and nutritional
status of children
 Relationship between “informal borrowing” and nutritional status of
children

15. Linkages between food security and nutrition
Figure : Food consumption score and nutritional status
of children and women

16. Linkages between food security and nutrition
Figure: Average CSI at household level amongst acutely
malnourished children by division, by area, and nationality in
Bangladesh

17. National Nutrition Services
Important Nutrition Projects in Bangladesh
• Bangladesh Integrated Nutrition Project (BINP)
• National Nutrition Project (NNP)
• Expanded Program on Immunization (EPI)
• Nutritional Surveillance Project (NSP)
• The National Immunization Days (NIDs)
• National Vitamin A Plus Campaign (NVAC)
• The Integrated Horticulture and Nutrition Development
Project

18. National Nutrition Services
Policy and Programmatic Responses to Malnutrition
The Government of Bangladesh (GoB) finalized and endorsed
the National Plan of Action for Nutrition (NPAN) in 1995.
NPAN was a cross Ministerial Action Plan, but could be
adequately implemented and monitored
Nutrition needs to be firmly highlighted on the national
development agenda, articulating the roles of the various
Ministries.
NFP and the NFP PoA and NNS are recent policy and
programmatic actions towards strategic nutrition
improvement

19. Important issues of nutrition and malnutrition
situation in Bangladesh
Key statistics of child and maternal nutrition in Bangladesh
Nutrition % of the population
Malnutrition, in children (birth to 59 months)
Wasting (weight-for-height) 17.4
Stunting (height-for-age) 43.2
Underweight (weight-for-age) 41
Low birth-weight 36
Exclusive breastfeeding (birth to 6 months) 43
Anemia, in children (6-23 months) 64
Chronic energy deficiency, in mothers 32
Night blindness (Vitamin A deficiency), in children 0.04
(18-59 months)
Iodine deficiency, in children (6-12 years) 33.8
Source: UNICEF, April 2009

20. Nutrition and malnutrition situation in Bangladesh
Nutrition situation in Bangladesh
 Dietary pattern
 Childhood Under-nutrition
 Maternal malnutrition
 Micronutrient Deficiencies

21. Nutrition and malnutrition situation in Bangladesh
The underlying causes include
(i) household food insecurity resulting from inability to grow or
purchase a nutritionally adequate amount and variety of food;
(ii) lack of dietary diversity;
(iii) inadequate maternal and child care due to inappropriate hygiene,
health and nutrition;
(iv) low rates of exclusive breast feeding;
(v) inadequate access to quality health services;
(vi) poor environmental hygiene and sanitation along with low levels
of income and maternal formal education.
Malnutrition early in life has long-lasting and negative effects on
overall growth, morbidity, cognitive development, educational
attainment and adult productivity.

22. Institutional arrangements and nutrition interventions
of MH&FW
INSTITUTE OF PUBLIC HEALTH NUTRITION (IPHN)
IPHN is implementing quite a good number of important work
intended for the improvement of the nutritional status of the
people particularly for the under 5 children and mothers.
IPHN Activities:
A. Vitamin A Plus Campaign :
• Children under 1 year - High potency vitamin A capsule (1 lack I.U)
Supplementation during measles vaccination at EPI site.
• Children 1 to 5 years-High potency vitamin A capsule (2 lack I.U)
supplementation through national events 2 times (4-6 month Intervals) a year.
• Children 2 to 5 years- Supplementation of Albendazole through national events
2 times (4-6 month Intervals) a year.
• Mother - High potency vitamin A capsule (2 lakh i.u.) supplementation during
postpartum period. (With in 6 wks of delivery).

23. IPHN Activities
B. Reduction in the incidence of iodine deficiency diseases (IDD)
• Iodized salt monitoring
• Awareness creation activities
• Training of field workers of health and family planning on control of
iodine deficiency disorder (CIDD)
• Training for testing Iodized salt
• Surveillance of salt for iodization
C. Reduction of incidence of Anemia:
• Awareness creation activities to control anemia
• Parasitic disease control
• Strategy implementation address the major causes of the malnutrition
and anemia including iron-foliate supplementation, longtime food
fortification & implementation.

24. IPHN Activities
D. Reduction of Protein Energy Malnutrition (PEM) by training program
• Awareness program for PEM control.
• Growth monitoring of 1-3 years old children
• Communication on weaning
E. Infant and Young Child Feeding (IYCF)
• Strategy implementation.
• Promotion and protection of Breast feeding through proper
implementation of BMS code and proper child weaning Practice
F. To strengthen laboratory activities:
• To develop the effective laboratory facilities of food and biochemical
aspects of nutrition.
• Serological tests for Nutrition related diseases
G. Guideline for the “Management of Severe Malnutrition of Children in
Bangladesh”

25. IPHN Activities
H.Nutritional survey.
• To evaluate nutrition related situation at present in selected districts
• To assess rapidly the impact of price hike on household food security, food
quality and nutritional status among poor women and children in Bangladesh
• Recently a survey prepared from 164 family in Bangalypoor union, Sayidpur
Upazila, Nilphamary district
I. Strengthening Nutrition & Food Safety Education WHO supported
Program
• Training for nutrition Sector.
• Training for nutrition vulnerable population.
• Development of Radio & Television spot on Nutrition awareness creation.
• Research on nutrition.
J. Strengthening of Child Nutrition Unit:
• Identification of malnourished children under 1-3 years of age through growth
monitoring
• Orientation and education program for mother

26. Institutional arrangements and nutrition
interventions of MH&FW
Currently few nutrition services are delivered as part of core health service delivery.
These are
 Iron Folic Acid (IFA) supplementation is a part of antenatal care for pregnancy, but only
about 50% of women make one visit to a health facility
 Zinc Supplementation: Zinc supplementation during treatment of childhood diarrhea has
recently gained importance under the leadership of ICDDR,B and MOHFW.
 De-worming and distribution of Vitamin A capsules.
 IPHN also manages the program to combat iodine deficiency disorder
 The National Nutrition Program has prime responsibility for implementing the
area based community nutrition (ABCN) program.
The core components of ABCN include: Behavior change and
communication (BCC) activities; Growth Monitoring and Promotion
(GMP); Food supplementation to children under 2 years of age and
pregnant women from ultra poor households; Micronutrient
supplementation (vitamin A and iron-foliate); deworming. Additionally it is
responsible for promoting infant and young child feeding, particularly
breast feeding.

27. A Multi-sectoral Approach of National Food and
Nutrition Policy in Bangladesh
A draft national food and nutrition policy (FNP) was prepared and
approved by the Bangladesh National Nutrition Council (BNNC) and the
Council of Ministers (Cabinet).
The strategy for effective implementation of the FNP is divided into four
major sectors:
(a) Food, agriculture, fisheries, livestock, and forestry for increased
production, proper distribution, and food security;
(b) Health, family welfare, and environment for primary health care,
caring practices, disease control, sanitation, and hygiene;
(c) Nutrition education and communication for the creation of awareness
at different levels with formal and non-formal education; and
(d) Community development and social welfare for poverty alleviation,
income generation, and economic growth.
To implement the various provisions of the FNP, a national plan of
action for nutrition has been approved.