Bangladesh National Nutrition Services: Assessment of Implementation Status

Abstract

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Trends and determinants of inequities in childhood stunting in Bangladesh from 1996/7 to 2014

“…Similarly, the national deworming program catered to only three-fourth of its under-specified target population in 2013 (children aged 24–59 months although WHO recommends 12–59 months) [19]. Issues of coverage appear to be of urgent concern, and calls for greater focus on the quality delivery of priority interventions and more effective outreach, appear consistent with our findings [39]. In this context, overcoming geographic inequities in service provision, and targeting the poorest who represent the group least likely to access or avail services, are important policy priorities.…”

“…Due to poor performance in the initial years of the program, and the need to place greater emphasis on improving coverage and efficiency, the National Nutrition Services (NNS) was created in 2011 to steward nutrition mainstreaming into health and related sectors. Implementation, however, has been slow due to poor management and coordination at the district and sub-district (upazila) levels, and the lack of skilled health workers able to deliver an ambitious range of nutrition services [14, 39]. The recent deployment of District Nutrition Support Officers to troubleshoot and support effective implementation and results-based training for health workers are efforts to overcome these challenges [21].…”

“…While this decline is impressive relative to similar or even more advanced developing countries in the region (e.g., India and Pakistan), rates remain unacceptably high. Recent efforts to mainstream priority nutrition interventions into the country’s health system have been criticized for failures in coverage and quality [39]. Given that one in three children remain stunted in Bangladesh, understanding how the prevalence of stunting is distributed across different socio-economic strata may be important in designing public policies and interventions that more effectively target children and families in greatest need [49].…”

Social determinants of inequalities in child undernutrition in Bangladesh: A decomposition analysis

“…The current program known as National Nutrition Service (2011–2016) has taken more holistic approach. Under this program, the government is implementing a mainstreamed, comprehensive package of nutrition services as well as trying to develop and strengthen the coordination mechanisms with other sectors to ensure a multisectoral response to malnutrition (Saha, Billah, Menon, El Arifeen, & Mbuya, )…”

Spatiotemporal heterogeneity of malnutrition indicators in children under 5 years of age in Bangladesh, 1999–2011

“…For instance, if in a division, the prevalence of malnutrition is high and also spatially clustered, this would mean that a targeted geographical deployment of interventions would provide maximum benefit compared with a random intervention. Previous research conducted in Bangladesh documented why interventions implemented under National Nutrition Services failed to provide maximum benefit to improve nutrition situation in the country (19) ; however, researchers are yet to explore the best delivery approach (i.e. geographically targeted v. random) to tackle malnutrition at the national and sub-national (divisional) levels in Bangladesh.…”