Nutrition Security for the Poor

Ahmad Kaikaus, PhDAdditional 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

Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet Bangladesh0

10

20

30

40

50

60

70

80

90

70.2

81.6

70.1

77.274.1

64.3

70.672.8

Pe

rce

nt

of

ho

use

ho

lds

7

Does Income Growth Leads to Reductions in Malnutrition?

Yes, but effect is modest…

0

10

20

30

40

0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000GNP per capita in $ (PPP)

Per

cent

of u

nde

rwei

ght

child

ren

<5 (%

)

1990's

1970's1980's

Source: Haddad et al. 2002; in: Repositioning Nutrition, WB, 2006

10% increase in GNP/PC: 3-5% ↓ underweight

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

0 2,000 4,000 6,000 8,000 10,000 12,0000

10

20

30

40

50

60

70

Gross National Income per capita

Un

der

wei

gh

t ch

ildre

n (

i%)

1990

1998-99

2005-06

1992

1998 20051990

2002-31996

1992-93

1990

2000 2004

2007

1996-7

1990

1982-83

India

Bangladesh

Vietnam

Brazil

ChinaThailand

1987

1995

2005-06

2006-7

2008

2000

Guatemala

1987

1998-91995

2002

Malnutrition in Bangladesh is much Higher than Expected, given its

National Income

IFPRI, Global Hunger Index, 2010

Family Welfare Indicator:Percent of people living on less than PPP $1.25/day

Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet Bangladesh0

10

20

30

40

50

60

70

41.8

31.034.0 35.8

42.4

65.5

35.638.2

Pe

rce

nt

of

po

pu

lati

on

Food Energy (calorie) Deficient Households

Rural Bangladesh0

5

10

15

20

25

30

35

40

35.3

16.5

Consuming <2,122 kcal/person/day Consuming <1,805 kcal/person/day

Perc

ent o

f hou

seho

lds

14 Food Energy (calorie) Share of Rice

Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet Bangladesh60

62

64

66

68

70

72

74

76

78

72.2

66.4

71.1 71.670.6

77.0

70.071.1

Pe

rce

nt

of

tota

l h

ou

seh

old

ca

lori

e

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

1 2 3 4 50

102030405060708090

100

77 76.772.4 74.4 71.7

Stunting

1 2 3 4 50

10

20

30

40

50

60

4944.5

4237.9

27.5

Page 16

%

***

*

Source: Alive & Thrive Baseline Survey 2010; * p < 0.05, ** p < 0.01, *** p < 0.001

Expenditure quintiles

Underlying factors matter for stunting: household food security and maternal education

Food security

Food

secu

re

Mild

ly fo

od in

secu

re

Mod

erat

ely fo

od in

secu

re

Seve

rely

food

inse

cure

0

10

20

30

40

50

60

Maternal education

Primary or less

Secondary school

High school

College or higher

0

10

20

30

40

50

60

Page 17

% s

tun

ted

% s

tun

ted

A&T Bangladesh Baseline Survey, 2010

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 fortificationAddress stunting among children through a multi-pronged approach that addresses maternal and household factors in addition to direct nutrition-specific interventions

Policy considerations

18

Health

Nutrition

Agriculture Income

Employment

Food security

AGRICULTURE BENEFITS NUTRITION + HEALTH

THROUGH:

AGRICULTURE POSESRISKS:

Productivity

Physical strength

Endurance

Cognition

Risk taking

Water-related diseases

Food-borne diseases

Zoonotic diseases

Dietary diversity

Livelihoods

AGRICULTURE – NUTRITION - HEALTH

HEALTH & NUTRITIONBENEFITS AGRICULTURE THROUGH:

Gender equity

Education

Social Behavior Change and Communications

All components

Enhancing Nutrition

along the Value

ChainComponent 1

Prevention , Control of Ag-

AssociatedDiseases

Component 3

BiofortificationComponent 2

Integrated Programs and

PoliciesComponent 4

Health

Nutrition

Agriculture

RESULT: A better nourished, healthier population, esp. mothers and children < 2

Risk of AAD

Income and

gender equity

Labor productivi

ty

Conceptual Framework

Availability,

access, intake

of nutritious, safe foods

Knowledge of

nutrition, food

safety

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