Promoting nutrition-sensitive agriculture in Bangladesh

Bangladesh has an impressive development record over the past decades. It has substantially reduced the number of people in poverty; and gained impressive improvements in primary school enrollment, gender parity in primary- and secondary-level education, immunisation coverage, incidence of communicable diseases, and child and maternal mortality. The success can, in part, be attributed to strong policies and programmes that promote universal education and seek to improve access to and use of quality maternal and child health services.

However, considerable challenges remain, including high levels of food insecurity (about 40 million people are food insecure), gender disparities (e.g. lower access to health care, lower access to and control over household resources-including food, and few employment opportunities and low wages for women), and frequent natural disasters (e.g. floods and cyclones). In addition, although the fertility rate has dramatically declined over the past quarter century, adolescent fertility rates have remained largely stagnant, contributing to intergenerational cycles of poverty and malnutrition. In 2017, Bangladesh ranked 120th of the 157 countries in progress in meeting SDGs (Sustainable Development Goals).

Malnutrition in childhood and pregnancy has many adverse consequences for child survival and long-term well-being. There are also significant far-reaching consequences for human capital, economic productivity, and national development in Bangladesh, especially in terms of achieving the SDGs and reaching other development goals. The consequences of malnutrition is also a significant concern for the policy makers in Bangladesh, since about 5.5 million children under 5 years (36 per cent) are suffering from chronic malnutrition (stunting or low height-for-age) and 14 per cent are acutely malnourished (wasting or low weight-for-height).

For eliminating malnutrition, nutrition-sensitive agriculture is a recent concept that promotes a food-based approach to agriculture. The concept puts emphasis on nutritionally rich foods, dietary diversity, and food fortification for overcoming malnutrition and micronutrient deficiencies. Further, it stresses on multiple benefits from enjoying a variety of foods, recognising the nutritional value of food for good nutrition, and the importance and social significance of food and agriculture for supporting rural livelihoods. The overall objective of nutrition-sensitive agriculture is to make the food system better equipped to produce good nutritional outcomes. The approach thus seeks to maximise agriculture's contribution to nutrition.

Nutrition-sensitive agriculture also targets the poor households, promotes gender equity, and provides nutrition education so that household nutrition, especially that of women and young children, is improved. It involves linking agriculture to sectors that address other causes of malnutrition, such as education, health, and social protection.

The production of nutrition-sensitive agriculture covers three main areas: (i) making food more available and accessible by increasing agricultural production that improves both health and economic status of households; while sustained income growth reduces malnutrition; (ii) making food more diverse and production more sustainable through nature-friendly production practices like conservation agriculture, water management, and integrated pest management (IPM) that improve nutrition levels without depleting natural resources. For instance, family farming, home gardens and homestead food production can make a wider variety of crops available at the local level; and (iii) making food itself more nutritious. Fortification can prevent micronutrient deficiencies by enhancing micronutrient content in foods through processing, plant breeding and improved soil fertility.

Most farmers in Bangladesh, with multiple and small plots of land, can use their land to cultivate a wide variety of produce, including fruits, vegetables and small livestock like chicken. This improves household food security, nutrition and economic status of the households. For many households, agriculture is also a key source of income which can be used to purchase a wider assortment of foods as well as access health care, clean water and hygienic sanitation. The government, for instance, may implement school feeding programmes that use home-grown nutritious food products produced by local communities. This will not only support small farmers by giving them a guaranteed market, but also encourage the production of food crops that are nutritionally beneficial to the children.

For promoting nutrition-sensitive agriculture, the important issue is to change the perspective of viewing agriculture just as rice (or cereal) production; rather look at agriculture from horticulture to field crops to forestry and fisheries production. Agriculture is not only a means to an end, but is an essential process for improving the quality of food, ensuring healthy soils and ecosystems for farming in the future as well.

Nutrition needs to be considered at all aspects of the value chain of the agriculture production system - starting with nutrient-rich soils that improve the quality of crops, and extending across the food value chain to other elements like food safety, food processing, food fortification and proper food preparation and consumption in households. Food processing is essential for making nutritionally rich foods, such as fruits, vegetables and dairy products, available year-round. It can also reduce food preparation time, and thus-like other labour-saving technologies-enable women to spend more time caring for their children. Nutrition education initiatives that explain which food combinations will provide essential vitamins and minerals can have a big impact as well.

In recent years, food system is rapidly changing in Bangladesh. There is an increasing reliance on purchased and processed foods, even in the rural areas. While agricultural modernisation and greater market integration is leading towards decreased undernutrition in the country, we also observe an increase in obesity and diet-related chronic diseases such as diabetes. Further, deficiencies in vitamins and minerals also remain unacceptably high, especially among women and children. Thus, it is time to place the promotion of healthy diets and nutrition at the heart of our agriculture policies and programmes. These should focus more on prevention of all forms of malnutrition, and nutrition should remain at the centre of all agriculture development initiatives.

It is recognised that nutrition at the early stages of life is essential to being well nourished, healthy and productive throughout one's lifetime. For the children, quality ingredients for complementary feeding programmes can provide essential nutrients for growing children's dietary needs and for their optimal physical and mental development. The policies can promote improved school nutrition through school gardens, healthy school meals, and integration of nutrition education in school curricula. The school authorities can work to develop local procurement of fruits, vegetables, beans, and fish from local producers to diversify school meals.

Agriculture in Bangladesh will be nutrition-sensitive when it goes beyond food production to address the underlying causes of malnutrition. These efforts will be more effective when the programmes will include nutrition and health behaviour change communication (BCC) and women's empowerment interventions. Similarly, greater impacts on child nutritional status are achieved when programmes incorporate health and water, sanitation and hygiene interventions and micronutrient-fortified products. The efforts should focus on improving access and consumption of high-quality diets for all household members, rather than on reducing childhood stunting alone. The design of nutrition-sensitive agricultural programmes should also take into account contextual, cultural, economic, food environment, and other factors (including markets) for success. Further, one should also recognise that there still exist significant knowledge gaps, especially at the local level, on sustainability, scaling-up and cost-effectiveness issues of nutrition-sensitive agriculture in Bangladesh.

Mustafa K. Mujeri is Executive Director, Institute for Inclusive Finance and Development (InM)

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