There is little doubt that Bangladesh has made remarkable progress in the realm of food output by tripling rice production since independence. The country is now said to be on the verge of self-sufficiency in rice and is even exporting the cereal although in a small quantity. It is now well established that by virtue of massive food production, especially of rice - and thanks to the green revolution - the proportion of the people going hungry or incapable of accessing three meals a day has gone down drastically over time.
But the bright side of the story hides its bleaker part also. Although availability of food has definitely improved, malnutrition stills grips a vast majority. For example, a whopping 50 per cent of children aged 6-59 months are anaemic; Bangladesh is among the 34 countries where 90 per cent of the global burden of under-nutrition resides. At present more than 40 per cent of children less than 5 years of age are stunted.
Firdousi Naher, Barkat-E-Khuda, Shaikh Shamsuddin Ahmed and Mahabub Hossain point out in a paper that improvement in nutritional status, particularly of the children, has been relatively slow notwithstanding remarkable improvement in the country's agricultural and health sectors. This paper is a timely one and we can, with an allowance for paraphrasing at times, recapitulate its observations while talking about the future course of action.
According to the authors, the cross-cutting nature of nutrition seems to emanate from a wrong assumption of policymakers that good nutrient status is an inevitable outcome of progress in agriculture and health sectors. In Bangladesh, among the three pillars of food security -food availability, accessibility, and utilisation - the focus for long has basically been on the first pillar. This was not unexpected either as "lingering memories of famine and hunger and inability to import in times of need have prompted successive governments to concentrate on achieving self-sufficiency in the staple, rice. Haunting memories of famine and starvation had a deep and bitter impact on the people, prompting Bangladesh's policymakers to stress excessively public intervention in the country's food policy." The problem exacerbated with the presence of recurrent natural calamities and the absence of sufficient imports. It is thus no wonder that food security has been treated as synonymous with rice self-sufficiency. Despite a structural change in agricultural sector with significant growth and diversification in the livestock and fisheries sub-sectors, rice in crop sector continues to dominate claiming three-fourths of the cultivated land. This has apparently resulted in the average per capita daily intake exceeding the required intake by 19 per cent.
On the other hand, given the very high fertility rate and population density in the country, early health sector initiatives had a strong focus on family planning and population control. "In fact it was not until the Third Five Year Plan (1985-90) that primary healthcare was identified as the main strategy toward the goal of health for all by 2000. The subsequent nutritional programmes, notwithstanding width and depth, had so far been unsystematic and isolated, directed at specific micronutrient problems such as iron, iodine and vitamin A deficiency. There were also large programmes to address the food insecurity of the under-privileged ones." The authors reckon that the National Food and Nutritional Policy of 1997 was the first to recognise nutrition as a human right. "…the time has come to look beyond rice and perceive food and nutrition security in its entirety".
With growing realisation of the huge burden of under-nutrition in the country, it was finally the Fourth Five Year Plan (1990-95) that for the first time included a macro chapter on nutrition in the plan document. But the nutrition programme have so far been unsystematic and isolated. The authors have also come up with some policy suggestions in improving nutrition status:
First, agricultural policy should categorically indicate micronutrient outcomes as a fundamental goal and realign accordingly. This calls for policies that emphasise research and development of nutrient-rich, high-yielding foods and provide a congenial environment for their adoption.
Second, nutrition policies need to be integrated with livestock, poultry and fisheries sectors.
Third, although wages have risen over time, the increased purchasing power has not increased the capacity of the poor to buy more nutritious food. Agricultural price policies should look beyond the staple and consider a range of crops and ensure that farmers incentives are ensured while at the same time prices are within the reach of masses. The ongoing rice and wheat-based safety net programmes could also incorporate well-targeted nutrition-rich foods to improve nutrition among the poor households.
Fourth, the issue of food safety and quality control has received very little attention from policy makers.
The upshot of the researchers' findings, drawing upon a vast pool of documents, is that Bangladesh has a commendable policy framework for food, agriculture and health. What is needed is an update of these policies with a nutrition focus and ensuring their proper implementation.
The virtuous circle of agriculture-health-nutrition nexus is now well-recognised. The former, being the fountain of food and income for the households, can significantly improve poor people's nutrition and health, an outcome that would raise their productivity and hence income. It is good news that there has been dramatic change in the mindset of policymakers who are now taking the nexus seriously. However, while reviewing policies, the authors identified eight issues that caused a divergence of policies with nutrition--absence of any price regulatory body, rice-centric research efforts, lack of inter-ministerial coordination, weak development administration, inequality, inefficiency and poor quality of health services, lack of focus on critical pathways to improve nutrition and stagnant and declining share of public expenditure. Once the prevailing gaps are adequately addressed there is no reason why pervasive mal- and under-nutrition would prevail.
The writer is a Professor of Economics at Jahangirnagar University.
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