Rima Rani Paul, 25, is currently eight months pregnant. During her recent visit to the doctor, she was recommended a balanced diet rich in nutrient-dense foods because the fetus was not growing as expected.
Despite this, most of the time, Rima’s husband, Shipon Paul – a street vendor in Kapasia, Gazipur – cannot afford to buy his nutrient-dense fruits and vegetables after providing for their family of eight. .
The situation was particularly difficult during her first trimester, which coincided with the lockdown of Covid 19. Shipon did not have a regular income and it was difficult for Rima to put food on the table, let alone have a balanced diet, she told this correspondent.
“Last month, when I visited the local union family health and wellness center for prenatal vitamin supplements, I was only given iron and folic acid supplements due to a shortage of ‘supply,’ Rima told the Daily Star.
“However, the centers are supposed to provide free B vitamin complexes and calcium carbonate supplements,” she said.
Rima also does not know how she can receive the government’s maternity allowance, which is intended for poor and disadvantaged pregnant women to meet their increased nutritional needs.
According to public health and nutrition experts, despite Bangladesh’s significant improvements in various nutritional indicators in the past, direct interventions aimed at improving nutritional status – such as ensuring maternal nutrition to reduce low birth weight in children. babies, managing acute malnutrition, providing allowances for poor pregnant and breastfeeding mothers and so on – require more attention, especially during the Covid-19 pandemic.
For example, a BRAC study found that 73 percent of women and 67 percent of men did not eat nutritious foods during the pandemic, while the pandemic affected the diets of 28 percent of households.
However, a recent publication from the Bangladesh National Nutrition Council (BNNC) showed that although the government spent Tk 23,210 crore on nutrition-related interventions in 2016-2017, which represented around one percent of GDP and around nine percent of GDP. percent of the national budget, only two percent of nutrition spending was for direct interventions.
Of the two percent, the Department of Health and Family Welfare (MoHFW) spent only four percent of its budget on nutrition while the Department of Women and Children (MoWCA) spent seven percent of its nutrition budget. These were the two main ministries working on direct interventions through 13 operational plans.
Contrary to this, the vast majority of expenditure (around 98%) was devoted to the fight against the underlying causes of malnutrition, such as water and sanitation, the status of women, social protection, agriculture, education, environment and climate change, etc.
Dr Nazma Shaheen, Professor of Nutrition and Food Sciences at the University of Dhaka, said: “In order to achieve our goals of sustainable development and nutrition, it is imperative to scale up the most important and most important interventions. effective and strengthen them by expanding coverage to include more beneficiaries. “
INSUFFICIENT CURRENT INTERVENTIONS
When The Daily Star recently visited a number of Sima’s upazila centers, it was found that there was a shortage of prenatal vitamins for pregnant women.
According to the pharmacist at the Rima center, they only receive 2,000 iron and folic acid supplements, 500 pieces of calcium carbonate and 1,000 B vitamin complexes, which is far below the actual demand of an average of 250 pregnant women in each union.
“Most of the time our stock runs out in the first 10 days of the month, and when they arrive later they have to come in empty-handed, which discourages many from coming back,” he said, under the guise of ‘anonymity.
According to experts, increasing expenditure on micronutrient distribution, ensuring maternal and adolescent nutrition, is crucial as the prevalence of stunted children under 5 is still 28 percent.
Spending for MoWCA’s Karmajibi Lactating Mother Sohaita Tohbil project was also found to be insufficient. According to the project director, Mr. Jamal Uddin Bhuiyan, the project provided training and a monthly stipend of Tk 800 for three years to only 2,77,000 breastfeeding mothers in each town, municipality and workers in the BGMEA and BKMEA factories.
Urging for more allocations, the PD said: “We have an allocation of Tk 276 crore 65 lakh, which is not enough because in the last two years we have not been able to increase the number of our beneficiaries, even though there is huge demand in the midst of the pandemic, ”he said.
BNNC chief executive Dr Md Khalilur Rahman said Covid 19 had pushed back progress in nutrition for at least three years.
In terms of the shortage of human resources for direct interventions, the CEO of BNNC asserted that there is not a single person at the district level who can talk to people about nutrition or do the necessary advocacy.
Dr Iqbal Kabir, Chief Consultant, BNNC, also said there is a need to increase allocations to expand coverage of existing interventions, while tracking where the budget is spent.
“For this, we must develop a multisectoral budget monitoring system in order to know where the money is going,” he added.