Lack of campaigns and the counselling of mothers about nutrition and hygiene are responsible for malnutrition, experts said.
They are of the opinion that the lack of hygienic practice, such as washing hand before feeding the child or preparing baby food, causes drainage of nutrition form the children’s bodies and make them malnourished.
They also expressed their dissatisfaction as only 21 per cent of children under the age of two years were fed complimentary food properly after six months of their ages.
‘The picture of complimentary feeding is very dissatisfactory,’ said SM Mustafizur Rahman, the programme manager of National Nutrition Services of Institute of Public Health and Nutrition.
The people do not know what the balance food is due to lack of campaigns, he said, adding that the lack of hygiene practices was also contributing malnutrition.
Some of the experts observed that it would be tough to change the bleak picture of nutrition due to lack of dedicated workers in campaign and counselling.
The health workers engaged with other works cannot counsel the people properly about complementary food for child and hygienic practices including washing hand before feeding the child or preparing baby food, they said.
‘No significant guideline is there for the health workers to counsel the mothers at villages,’ said former World Health Organisation regional nutrition adviser Rukhsana Haider.
There is no monitoring system also for the health workers who are to implement this programme, she said.
‘If there is no reporting system to headquarters, no programme can be successful,’ she observed.
According to Institute of Public Health and Nutrition officials, the health workers dedicated for other health services are also responsible for counselling the mothers.
Institute of Public Health and Nutrition director M Ekhlasur Rahman, however, said, ‘It is difficult to ensure proper nutrition to the children only by counselling the mothers.’
The institute is nationally working for nutrition and running counselling programme by the existing health workers as the institute has no allocation to appoint separate staff for counselling about, he said, adding that monitoring was also very difficult.
The counselling programme, however, does not cover city and municipal areas, which are under the local government ministry, the officials said.
The experts also blamed lack of coordination between the health and local government ministries while the local government ministry was responsible for water and sanitation.
Shahnaj, a five-month girl, lives in the capital’s Agargaon area. Her mother Aklima is a housemaid and only earning member of the family that has four children.
When Aklima goes for work, Shahnaj stays at the slum with his brother and sisters.
‘Most of the time Shahnaj has to take plain rice with salt as she does not like vegetable curry and sometimes curry is not enough,’ said Aklima.
Aklima, who rarely can afford egg or fish for the family, feeds Shahnaj milk powder as she has heard that it is good for the child.
Aklima also said that she usually did not wash hands before feeding her children or preparing food for them.
‘Who will counsel this mother,’ said Rukhsana Haider.
Centre for Woman and Child Health research coordinator Khurshid Talukder said, ‘It is impossible to reach every person when you have one health worker for 6,000 people.’
Under the recently closed national nutrition programme, every community nutrition promoter, known as Pusti Apa, has to visit only 250 households and meet about 40 mothers, he said.
‘So,’ he added, ‘they had a good relationship with the mothers.’
These counselling activities had a revolutionary effect on reducing child mortality in the villages covered by the programme, Khurshid said.
He said that National Nutrition Programme was a 15-year project and it covered about 50 million people at 173 upazilas across the country.
The latest Bangladesh demographic and health survey 2011 showed that the exclusive breastfeeding rate was 64 percent while the proper feeding practices of children under two years of age had fallen from 42 per cent to 37 per cent, which was actually only 21 per cent if the stricter definition of infant and young feeding practices were followed.
-With New Age input
