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Consumption

Nutrition Surveys

Malnutrition is undoubtedly the biggest problem affecting public health in Bangladesh today. Some 80 per cent of the population lives below the poverty line and is therefore not able to afford a balanced diet. Two nutrition surveys, conducted in 1962/64 and 1975/76 (United States 1966; Anon 1978), have confirmed the existence of widespread malnutrition among the rural and urban poor. The highlights of the comparison between these surveys are given in tables 4 and 5. Salient features are as follows:

TABLE 4. Per Capita Food Consumption in 1962/64 and 1975/76 (in grams/per capita per/day)

TABLE 5. Per Capita Nutrient Intake during 1962/1964 and 1975/1976

1. Computed on the basis of 1974 WHO recommendation (Who 1974).

Per capita availability of all the food items was reduced during the intervening period, the least reduction being in cereals and the most in fruits. Calorie availability was reduced by 7 per cent in 12 years. Availability of fats and oils and animal products was reduced markedly. Reduced animal products critically affected the availability of calcium and vitamin A in the diet.

TABLE 6. Relationship between Cultivable Land Holding per Family and Nutrient Intake of Family Members (per capita per day)^a

Source: University of Dacca 1978b. Figures for rural Bangladesh 1975/76.

The 1976 survey showed the following features:

Protein deficiency was evident in 60 per cent of families, and 30 per cent were calorie-deficient.

A total of 81 per cent of households were deficient in calcium intake (this was the same in the two surveys).

Households were deficient in vitamin A (89 per cent), riboflavin (85 per cent), and vitamin C (93 per cent).

Cereal intake in adult males was significantly higher for children and females of all categories .

All children up to 15 years of age, and adults between 20 and 39 years of age did not get enough calories.

All children up to six years of age, and lactating as well as pregnant mothers, were deficient in proteins and calories.

Vitamin A and C intake did not exceed 70 and 54 per cent of requirement, respectively, for any agegroup.

Sixteen per cent of children were found to be wasted and stunted (concurrent acute and chronic malnutrition), 54 per cent had chronic undernutrition, and 6 per cent were wasted. Only 20 per cent had normal height and weight. Girls were found to be more malnourished than boys.

About 0.8 million of the population was found to suffer from night blindness.

Ten per cent of children had angular stomatitis.

Despite more iron than required being present in the diet, 70 per cent of the population were anaemic; 82 per cent of children had haemoglobin levels below normal.

Income showed a positive relationship with the intake of cereals, pulses, and fish, but not with vegetables.

Average intake of all families having less than three acres of land is lacking in calories, calcium, vitamin A, riboflavin, and vitamin C (table 6).

Total food intake is more in the first six months of the year than in the last six months. Inadequacy, maldistribution, and lack of knowledge about food are responsible for malnutrition. Lack of hygiene and sanitation further exaggerates the situation. All these factors are linked with poverty.

National Nutrition Council

In 1977, a sub-committee appointed by the National Nutrition Council made the following important recommendations:

Nutrition must receive topmost priority in the national development plan.

Being a multidisciplinary area, nutrition planning calls for an integrated approach.

Nutrition education, both formal and informal, has an important role to play in improving the nutritional status of people.

Production of all food commodities needs to be increased by harvesting more calories per unit area in the least time and with the minimum inputs.

Post-harvest losses should be reduced to the minimum.

Fisheries, poultry, and livestock management needs to be improved.

Environment and health care need to be improved to enhance absorption and retention.

Employment and integrated rural development must receive importance.

Special feeding programmes, based on local ingredients, should be launched for the under-five age-group.

A permanent secretariat for the Nutrition Council and a Parliamentary Committee on

Nutrition should be established.

Nutrition in the SFYP

The basic needs method has been used to estimate the food demands projected in the SFYP. Unfortunately, population figures used to compute the requirements are underestimates, as was proved by the recently completed census. On the production side nutrition needs have been simply translated into agricultural production figures without considering feasibility. While the 1975/76 nutrition survey indicated that the availability of all but carbohydrate (starch) crops had reduced markedly since 1964, the SFYP continues to lay emphasis on increased production of cereals with relatively less resource allocation on other crops. This bias, coupled with unequal distribution of food, is likely to lead to further malnutrition in the vulnerable classes of the population. Furthermore, seasonal and regional differences in the availability of food ingredients need to be taken into consideration in preparing the food balance sheets and in formulating agricultural strategies for affected areas and populations (Kaul 1977b).

High incidence of roundworm (Ascaris lumbricoides), hookworm (Anclystoma duodenable), and whipworm (Trichuris trichiura) has been reported in Bangladesh. The population affected may range from 50 to 80 per cent, depending on the location and living conditions. Roundworm is the most common parasite found. The incidence of anaemia, despite a satisfactory average iron intake of 22 mg per day, is a direct consequence of parasitism. Similarly, other parasites and communicable diseases lead to serious malnutrition, particularly in children. This aspect of health care must be taken into consideration in nutrition planning (Ahmed 1981).

Several million children and women located in three northern districts of Bangladesh suffer from goitre. These areas, being specifically iodine-deficient, can be effectively attended to through programmes involving the supply of iodized salt and injection of iodized oil (Ahmed 1981).

Interfaces

A successful food policy, besides production aspects, must take into account distribution, conservation, utilization, and retention of nutrients. Increasing production and productivity is only one aspect of the problem. In Bangladesh a major cause of malnutrition is inability of the poor to purchase adequate supplies of nutritious foods or to retain home-grown food for family consumption. Therefore it is primarily a question of raising incomes. Other factors leading to malnutrition are infection, ignorance, biased intra-family distribution of food, poor health, and sanitation. These factors lead to losses and poor utilization of what little is available. Other policy issues concern pricing, investment, resource allocation on pertinent research areas, and degree of interaction and feedback between agriculture, food, nutrition, and social sciences. Plan projections should not be based exclusively on the "basic needs" principle but on practical feasibility. Tools increasing productivity must simultaneously generate employment, purchasing power, and overall well-being of the society.

Increasing the production of cereals is the easiest of all challenges. There is considerable scope for increasing rice and wheat production. Maize has excellent prospects in Bangladesh. By shifting from rice to wheat and maize, protein output per unit area is likely to increase. The prospect of harvesting ample calories from tuber crops, particularly potato and sweet potato, has been realized only recently. Tuber crops had not received much attention in the past.

Increasing the production of pulses is an urgent need. Introduction of new varieties of traditional pulses from neighbouring countries has brightened the prospects for production of these crops. The prospects for soybean and winged bean use are bleak as long as their acceptability is not increased in the rural areas. Processing and preparation of soybean for the urban market remains an important objective of the Food Sciences Division of the BCSIR, but the production and agronomy of this crop remain divorced from industry. The result has been very slow progress in soybean cultivation, despite sizeable investment on research. The seed viability and post-harvest preservation aspects were completely missed in earlier planning. Conventional pulses have by necessity to be encouraged. Postharvest preservation must receive utmost attention. The complementary role that pulses play in the cereal-based diet needs recognition and demonstration through feeding experiments.

The acute shortage of fats in the diet has been realized. There are bright prospects of increasing the production and productivity of oilseed crops in Bangladesh. Besides brassica, groundnut, sunflower, sesame, and safflower have immediate prospects. Extraction processes are rather primitive but, in the interest of rural employment, these might be left undisturbed.

The acute shortage of animal proteins is hardly necessary in Bangladesh. Fisheries, both inland and marine, goat husbandry, backyard poultry, and animal husbandry can all be organized in a manner that ensures higher production and employment generation at the same time. Processing technology and improvement of storage methods could be improved considerably even with the available know-how. Fish production can be increased twofold to threefold in five years' time.

Augmentation of vitamins and minerals in the diet through increased production and consumption of fruits and vegetables is possible. However, the landless, who represent more than 50 per cent of the rural population, can have access to these food items only if their earning capacity is increased. Yield potential can definitely be increased by a factor of two but preservation and processing require sizeable capital inputs. On the nutritional front, mass education on the value of fruits and vegetables needs to be emphasized. This is one food item that was found not to be correlated with income. Several local fruit and vegetable species are excellent sources of vitamins, but for lack of knowledge of their value, the same have not been utilized effectively. Food sciences have not exploited this wealth so far.

A good deal of food is wasted in Bangladesh through pests in the field, during storage, and in the human gut. While integrated pest- and disease-control mechanisms have to be developed for the field, effective storage and processing methodology needs to be perfected to prevent post-harvest losses. Education and improvement of sanitation and health care could avoid considerable losses during consumption.

Improving the nutritional status of the Banglalee population does not merely involve increasing production through harvesting of more food per unit area in less time with minimum expenditure. It calls for perfecting a production machanism that gives opportunity to the producers to consume the food they produce and educating them on methods that would avoid losses at all levels of production, processing, and consumption. Such an approach demands integration of hitherto separate policies of food production distribution, and consumption. The concept of the integrated Crop-Livestock-Energy farm deserves to be explored.

Conclusion

Agriculture provides 55 per cent of the GNP, 85 per cent of the employment, and 80 per cent of the export earnings of Bangladesh. Yet more than 70 per cent of the population suffer from second- and third-degree malnutrition. Landless families constitute the bulk of the nutritionally disadvantaged. Only a policy of drastic land redistribution might promote both production and equity. Considerable scope exists for increasing the production of all food commodities. Prevention of post-harvest losses, which may not exceed 5-7 per cent, should not be treated as a third soft option of food policy. Food scientists have yet to address themselves to the rural problems of Bangladesh. Infection, parasites, and poor sanitation add to rural malnutrition. Lack of education on the food value of local fruits and vegetables is unfortunate. In Bangladesh a production mechanism needs to be perfected that gives opportunity to the producers to consume the food they produce and that will educate them on methods to prevent losses at all levels of production, processing, and consumption. Such an approach calls for integration of hitherto separate policies of food production, distribution, and consumption. The concept of an integrated "Crop-Livestock-Energy" model family farm is discussed.

Bangladesh: important statistics on agriculture (1978/79)

Physiography

Situation: latitude 20.70°-26.80° N./longitude 80.01°-92.75° E. Topography: flat. Maximum elevation from sea level: 3 m.

Agriculture

Land area (ha): 14.30 million; forest: 2.19 million; shifting agriculture: 1 million. Area cultivated: 9.1 1 million ha; cropping intensity: 153 per cent.

Land Occupancy

4.1 per cent own 32 per cent of land; 45.1 per cent own 8 per cent of land; 23 per cent do sharecropping.

Population

92.6 million. Density: 610/km; rate of growth: 2.8 per cent; children (10-14 years): 44.1 per cent.
Infant mortality: 152/1,000; average size of family: 6.3.
Rural population: 85.3 million 192 per cent); landless 54 per cent.
Cattle: about 22 million; poultry: about 40 million.

Income

National per capita: US$80 per annum.
Below poverty line: 80 per cent.
Rural unemployed: 42 per cent (growing at 2.4 per cent per annum).
Real agricultural wage: dropped 40 per cent in past 15 years, though production increased 9 per cent.

Literacy

22 per cent.

Food Supply - 1975/80 (mill. t.)

Total: 13.05; available: 11.75; import: 2.78.
Internal procurement: 0.35.

Average Dietary Intake (g)

Food grain: 800; animal food: 42; fruits and vegetables: 130; fats and oils; 3.

References

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