Stethoscope

Nutrition

The time to act on

nutrition is now

SYED SHABAB WAHID

evelopment leaders have

credited the Millennium
Development
Goals
(MDGs) in concentrating the collective focus of governments and
the development community like
never before. Tangible targets provided direction and allowed prioritisation of interventions and advocacyeffortstowardsachievingthese
goals. However, while most of the
MDGs provided clarity in their simplicity,inMDG-1:Eradicateextreme
hunger and poverty by 2015; two
highly complex and multi-layered
socialproblemswereusheredunder
one goal. Eradicating extreme
hungeralonedoesnotdealwiththe
more complex problem of malnutrition, which can manifest as
under-nutrition,over-nutritionand
micronutrient deficiency, also
knownasthehiddenhunger.Even
though the link between extreme
poverty and malnutrition is undeniable, poverty is only one of the
multipledeterminantswhichcause
malnutrition. An overwhelming
body ofevidencestatesthatachieving good sustainable nutrition for a
countrys population is beyond the
scope of any one sector. It requires
the culmination of multi-sectoral
actions in the following areas to be
trulysuccessful:agricultureandfood
security, health, fisheries and livestock,womenempowerment,social
justice and human rights, industri16

al and private sectors, education,

safe water accessibility, sanitation
andhygiene,andpoverty reduction
and livelihoods. Growing recognitionofthisissueindevelopmentcircles led to nutrition being termed
as thehidden MDG, and the calls

By ensuring proper
nutrition for mothers
during pregnancy,
exclusively breastfeeding the child for
six months following
birth, and introducing
complementary foods
till the second birthday,
families can dramatically reduce stunting
rates in our children.

to address the multi-faceted nature

of this challenge continued to grow.
Inresponsetothisrealisation,the
United Nations established the
Scaling Up Nutrition (SUN) movement - a global collective which
seekstobuildamulti-sectoralnutritionstrategyincountrieswheremal-

nutrition remains a key problem.

Acknowledging the challenges in
coordinating a coherent multi-sectoral response, the SUN movement
seeks to engage and foster political
ownership over the nutrition agenda. In countries like Malawi and
Vietnam, deeply committed governmentshavetakenuptheresponsibility of rolling out and scaling up
nutrition movements, which has
energized and motivated people at
the grassroots. In Cte dIvoire, the
SUN movement is housed and
directed from within the Prime
Ministers office. The consensus is
clear: in order to be successful, it is
vital that SUN movements in countries have political buy-in and leadership at the highest level.
In Bangladesh, one of the more
nefarious ways malnutrition manifests in children is when they have
low height for their age (short
stature). This condition, although
referring to physical stunting, also
affects the cognitive abilities of a
child, and affects his or her ability
to grow and learn, experience a
healthy life, earn a livelihood and
eventually contribute to a countrys
economy.Unfortunately,41%ofthe
children in this country are stunted. However, we have a simple, yet
highly effective set of interventions
which can dramatically reduce
stunting rates in our children. We
can do this by intervening during

Health & Medicine Journal, The Independent, March 31, 2014

Stethoscope
the 1,000 days window of opportunity-thetimeperiodfromwhen
a mother conceives a child, to the
childs second birthday. By ensuring proper nutrition for mothers
during pregnancy, exclusively
breastfeeding the child for six
months following birth, and introducing complementary foods till
the second birthday, families can
dramatically reduce stunting rates
in our children.We need to educate
our communities, especially mothers and family members, on these
proven low-cost, high-impact practices.

effective health services to disadvantaged communities at scale.

Several of our result-oriented
approacheshavegainedwidespread
acclaim and have been replicated
across the globe. Our scientists and
collaborators devised oral rehydration therapy in the seventies, and
subsequently showed its effectiveness at scale, transforming the
response to cholera and diarrhea.
Our life-saving approach to community-based tuberculosis treatment is also recognized as a global
standard of excellence. Through
country-wide mobilization efforts,

commitment and indispensable

leadership of the Government, and
the actions of our non-government
organizations and civil society. We
have the experience, expertise and
thepublichealthinfrastructurenecessarytodelivernutritionmessages
and interventions to the grassroots,
andovertime,establishthoseasthe
new dominant nutrition norms.
Non-government organizations
have already started mobilizing
nutrition efforts across the country.
Now, we need political consensus
and commitment to rally around
the nutrition agenda and give this

Though the SUN movement

started strongly in Bangladesh, it
has since faltered somewhat. A real
opportunity now exists for the
Government to demonstrate true
leadershipandtakeownershipover
the SUN movement. Historically,
Bangladesh has been an international leader in public health innovations and providing highly cost-

Bangladeshs achievements in
immunisation and family planning
are exemplary as well.We were successful in these interventions
because we dispelled competing
traditions and practices, and established these measures as new social
norms. The long-term success of
these interventions was primarily
ensured due to the tremendous

movement the much needed push

it requires. !
The writer is a Senior Sector
Specialist in BRACs Health,
Nutrition&PopulationProgramme
andiswritingon behalfofthe Civil
Society Alliance for Scaling Up
Nutrition in Bangladesh.
The writer may be contacted at :
<sswahid21@gmail.com>

Health & Medicine Journal, The Independent, March 31, 2014

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