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Bulletins produced by Helen Keller International, Bangladesh

When I worked for Helen Keller International in Bangladesh we started to produce 4-page, gatefold Bulletins every two months on interesting topics in nutrition and health. They are no longer available to download, so I have put them here. I hope someone finds them and at least one of them is useful or interesting. Please let me know if you do, I'd like to hear from you. I highly recommend Bulletin 8, about women as household decision-makers: it's still relevant and important today. The domain hkidhaka.org no longer exists, so don't try to send any messages.

In memory of our colleague and friend Nasreen Pervin Huq, who contributed to them all.

(Page created on 15/8/2023)

●   Bulletin 1, September 2000: High anemia prevalence among Bangladeshi children in urban slums: An ethical and economic rationale for multimicronutrient supplementation?.

Findings from a survey of selected slums in Dhaka, Chittagong and Khulna suggest that anemia is a serious problem among preschool children. A special study from the urban slum sites of the GOB/HKI Nutrition Surveillance Project (NSP) shows that 75.8% of children aged 6-59 months suffered from anemia (hemoglobin < 110 g/L). The prevalence of anemia was highest among children aged 6-11 months (92.3%) and children aged 12-23 months (87.4%). Given the serious and longlasting consequences of iron deficiency anemia, the nutrition community should be mobilized immediately to try to improve iron status of women and children through iron and multi-micronutrient supplementation and fortification of infant foods.

●   Bulletin 2, March 2001: National Immunization Days in the Chittagong Hill Tracts: Are special strategies needed to eradicate polio in this region of Bangladesh?

A special study of the HKI/IPHN Nutritional Surveillance Project (NSP) in May 2000 on the nutrition and health of children and women in the Chittagong Hill Tracts (CHT) provided an opportunity to examine the coverage of the seventh polio National Immunization Days (NID) in children aged less than five years. Coverage in the CHT was found to be 80% during the first round and 76% during the second round, considerably less than the high coverage of 96% recorded by the NSP in other parts of rural Bangladesh in the second round. Coverage was lower in children living in remote areas far from markets, the usual site of vaccination, particularly among some local ethnic groups. This finding suggests that strategies to improve coverage should consider the remoteness of some communities and socio-cultural issues. The study demonstrates how the NSP can be used to obtain information outside its traditional field of nutrition and how it can provide stakeholders with crucial information on factors that are associated with low coverage which can be used to improve strategies in future NIDs.

●   Bulletin 3, April 2001: Progress in Bangladesh Towards the Goals of the 1990 World Summit for Children.

In 1990 the representatives of over 150 governments held a World Summit for Children and set goals to improve children’s health by 2000. Using data collected over the last decade by the Nutritional Surveillance Project (NSP), this bulletin examines the progress made in rural Bangladesh towards meeting four of the nutritional goals set at the World Summit. Bangladesh has lowered the percentage of vitamin A deficiency among preschool children and has achieved a steady decline in child undernutrition. However, at the end of the decade a large percentage of children in rural Bangladesh were still stunted and underweight, and more than a half of women and children were anemic. Many infants were not exclusively breast-fed for long enough and were not given complementary foods at the right age. This review demonstrates the importance of having high quality surveillance systems to monitor health and nutritional targets. It also provides information that can be used to guide ongoing and future food, health and nutrition policies and programs.

●   Bulletin 4, June 2001: Rickets in Bangladeshi children: a small focus or a widespread problem?

A survey in 1997 in Chakaria sub-district near Cox’s Bazar in south-east Bangladesh found that 4% of children aged 1 to 15 years had lower limb deformities due to rickets. The social, health and economic implications of this high rate of physical deformity triggered concerns about whether rickets occurs elsewhere in Bangladesh. Taking advantage of the nationwide survey sites of the Nutritional Surveillance Project (NSP), a special module was added to the NSP in October 2000 to rapidly estimate the prevalence of lower limb deformities. This bulletin describes how the survey was done and what was found.

●   Bulletin 5, June 2001: Evaluating national nutrition programs in Bangladesh: the role of the Nutritional Surveillance Project.

Malnutrition has been estimated to cost Bangladesh $1 billion a year1. The Government of Bangladesh has recognized that malnutrition is a barrier to development and that investing in nutrition is a key to unlocking the country’s greatest resource, its people. The model for this investment is the Bangladesh Integrated Nutrition Project (BINP) which provides a range of nutrition services specifically targeted at malnourished children and mothers. In an innovative role for nutritional surveillance, the Nutritional Surveillance Project is now providing an independent evaluation of the BINP and, over the long-term, will evaluate its successor, the National Nutrition Project, as well.

●   Bulletin 6, July 2001: Complementary feeding in rural Bangladesh: family food for breast-fed infants

The transition from being exclusively breast-fed to eating the same food as the family is crucial in the life of a young child. The World Health Organization and UNICEF recommend that infants should be exclusively breast-fed for the first 6 months of life and that breastfeeding should continue well into the second year of life.1 From 6 months of age infants should be given frequent small complementary meals that are rich in micronutrients, protein and energy. Findings from the Nutritional Surveillance Project indicate that, while breastfeeding is sustained, infants are rarely given foods containing micronutrients and protein, even when these foods are available in the household. This suggests that there is potential to improve infants’ diets by making better use of the foods already available in the household. Breast-milk and a good mixture of well-prepared family food can meet the needs of young children during this vulnerable time.

●   Bulletin 7, September 2001: Undernutrition in mothers in rural Bangladesh: findings from the NSP indicate 'critical' food insecurity.

Nearly one half of all mothers in rural Bangladesh are undernourished according to data collected by the Nutritional Surveillance Project (NSP). Surveys in 2000 showed that 45% of rural mothers had a low body mass index, a prevalence that is amongst the highest in recent surveys in Asia and indicates ‘critical’ food insecurity. This high prevalence is clear evidence that many mothers still do not get enough food to eat even though the country is nearly self-sufficient in rice production. Policies and programs to improve the quality and quantity of mothers’ diets are essential, as a failure to address this problem will impede social and economic development in Bangladesh.

●   Bulletin 8, November 2001: When the decision-maker is a woman: does it make a difference for the nutritional status of mothers and children?

Data from the Nutritional Surveillance Project (NSP) in Bangladesh suggest that when women participate in household decisions they are better able to care for their family. Women are the principal decision-makers in less than one in twenty households that have pre-school children in rural Bangladesh. These households spend more on food and medical care, make better choices of food, and enjoy a better nutritional status, even though they have a lower income than households with a male decision-maker. The findings challenge the rationale of programs that focus on mothers’ caring practices without adequate attention to women’s low status in society. Women are an integral part of the solution to improving nutrition in Bangladesh and more attention must be given to empowering them to make the decisions that promote the nutrition and health of their families. Nutrition and health surveillance is essential for monitoring the nutritional status of households in Bangladesh and for evaluating the impact of policies and programs designed to reduce undernutrition and social imbalances.

●   Bulletin 9, January 2002: Urban poverty in Bangladesh: the perspective of the Nutritional Surveillance Project.

Many tens of thousands of people live in desperately poor circumstances in the slums of towns and cities in Bangladesh, and all the evidence suggests that their numbers are rising. How can they be raised from poverty and employed, housed, fed, educated and cared for? This bulletin presents data from the Nutrition Surveillance Project that show how living conditions and food security vary widely from one poor area to the next suggesting that the solutions to urban problems may not be the same everywhere. Accurate and up-to-date information is needed to understand the manifestations and causes of poverty and how they vary between and within cities. This information can then be used to design policies and programs adapted to local circumstances. A surveillance system can provide the data needed to inform, guide and evaluate this process.

●   Bulletin 10, March 2002: Anemia is a severe public health problem in pre-school children and pregnant women in rural Bangladesh.

A half of all pre-school children and pregnant women in rural Bangladesh are anemic, a prevalence that indicates a severe public health problem, according to new data from the Nutritional Surveillance Project. A national anemia survey completed in November 2001 during routine nutritional surveillance has also shown that about one third of school-age children, adolescents and non-pregnant mothers had low hemoglobin concentrations. The data indicate that 23 million children in rural Bangladesh and 9 million women of reproductive age are anemic. The scale of the problem, the harmful effects of anemia on child growth and development, and the danger anemia poses to the lives of pregnant women and their unborn babies are clear reasons for key stakeholders to urgently tackle this problem. Until fortified foods become widely available, or until poor rural people eat enough foods rich in micronutrients, iron supplements will be a key means to prevent and control anemia in Bangladesh. All opportunities to deliver iron supplements to children and women need to be explored.

●   Bulletin 11, April 2002: Eggs are rarely eaten in rural Bangladesh: why and how to improve their availability.

In many ways an egg is an ideal food for a child: it is a handy and hygienic source of easily digested, high quality protein, and a single hen or duck egg provides almost enough vitamin A to meet a young child’s daily needs. Yet the Nutritional Surveillance Project found in 2000 that the majority of people in rural Bangladesh had not eaten an egg in the last week even though raising poultry is a traditional part of village life. Why is this, and what can be done about it?