Little success in nutrition

Girls being married off before reaching adulthood, too many teenage pregnancies and subsequent births of babies with low birthweight have put Bangladesh in a 'cycle of undernutrition'.

Statistics and studies show the country has gained fairly good economic growth and succeeded in halving incidents of poverty in last two decades.

But Bangladesh's nutrition challenges remain far to be over largely because of this 'cycle of undernutrition' stemmed from high rate of teenage pregnancy.

Over 20 years ago a third of 15-19-year-old young Bangladeshi women used to bear children and the rate today still hovers around 30 percent.

"It is alarming to note that the proportion of 15-19-year-old young women already bearing children has fallen only marginally in the past two decades -- from 33 percent in 1993-94 to 30.8 percent in 2014," states the Strategic Review of Food Security and Nutrition in Bangladesh.

This Strategic Review is a United Nations World Food Programme (WFP) commissioned report launched in Dhaka at the end of last October. 

"A matter of particular concern is the persistently high rate of teenage pregnancy. When the body of the mother is still growing, pregnancy leads to competition between the mother and the fetus for access to nutrients, a battle which the fetus invariably loses," the Strategic Review observes.

Though legal age of marriage is 18 for women in Bangladesh, with 30 percent girls being married at 15 or below, the country has the highest rate of child marriages outside sub-Saharan African nations.

"Early marriages, underweight babies -- this is a 'cycle of undernutrition.' The Strategic Review gives us insight; hope, it'll trigger wider discussion," WFP Chief of Staff James Harvey told The Daily Star.

For the past decade, the Strategic Review notes, prevalence of low birthweight in Bangladesh has hovered around 36-37 percent, which is high by international standards. Low birthweight babies tend to be more susceptible to stunting in later life.

 More than one-third (36 percent) of under-five children in Bangladesh suffer from stunting, which means some 5.5 million children are suffering from chronic undernutrition. Furthermore, prevalence of acute malnutrition, as reflected in wasting, remains alarmingly stubborn, afflicting more than 2 million children.

Undernutrition includes being underweight for one's age, too short for one's age (stunted), too thin for one's height (wasted), and deficient in vitamins and minerals.

 Development economist Prof SR Osmani, who led a six-member team in the 10-month exercise of Strategic Review, told The Daily Star that a massive campaign to the magnitudes of Bangladesh's previous successful ones -- population control, immunisation, sanitation -- is a must to break free the 'cycle of undernutrition.'

Often the teenaged mothers, he noted, are themselves malnourished and as a result many of them give births to babies with low birthweight.

According to the Strategic Review, "The problem of low birthweight is aggravated by a lack of access to diets of adequate nutritional quantity and quality. More than half the adolescent girls and women of reproductive age eat diets that are inadequate in both macro- and micronutrients."

 Finance Minister AMA Muhith, who was present at the Strategic Review launch ceremony and was particularly perturbed by the sheer high number of child marriages, said: "This is causing us pains and the burden of which has to be borne by the future generations. We have to do something about it."

The minister said he would make budgetary allocation in the next fiscal year so that society and village-based movement could be launched against child marriage.

Defying the women and right bodies' outcry, government placed a bill - Child Marriage Restraint Act-2016 - in the parliament on Thursday (December 8) incorporating provision that allows girls under 18 to get married if the marriage was held in her best interest with prior permission of a court, which would consider the special circumstances, and the consent of the parents. Critics fear misuse of this provision if the bill is passed as a law in its current form.

Christa Räder, country director of WFP Bangladesh, told The Daily Star that for the sake of reaping full benefits of the country's growth and prosperity, nutrition challenges have to be taken care of. She put emphasis on mother and childcare.

"The entire biological history of the mother matters, starting from her own birthweight at the beginning of her life, how she was fed and taken care of as a child, her physical stature as an adult, at what stage in life she started childbearing, and the quality of antenatal care and nutrition she received during pregnancy," observes the Strategic Review. 

"Undernutrition already costs Bangladesh more than $1 billion in lost productivity every year and even more in health costs,” said Prof SR Osmani, who teaches at the UK's University of Ulster. "No country can expect to build a thriving economy on the backs of hungry and undernourished people."  

All the experts strongly advocated for a social campaign with sole objective to increase the age of marriage as well as to postpone pregnancy of those girls who get marry early, and said family planning support should be provided to them to achieve the latter (postponing pregnancy).