The State of Health and Development
- The mortality rate of children under five is 65 per 1,000 live births.
- The infant mortality rate is 52 per 1,000 live births.
- 21.7% of pre-school children suffer from vitamin A deficiency.
- 34% of children and 39% of women of child-bearing age are iodine deficient.
- 68% of preschool children are iron deficient.
- 46% of pregnant women are anaemic.
MI is working to achieve the following priority objectives in Bangladesh:
Programs and Results
- Sustain high vitamin A supplementation (VAS) coverage and advocate to lower the age for the first dose of vitamin A from 9 to 6 months.
- Advocate to include hard-to-reach and newborn VAS within the national VAS program.
- Scale up zinc supplementation, combined with oral rehydration salts (ORS), to treat diarrhoea in children.
- Increase the amount and quality of iodized salt being produced.
- Increase the percentage of iodized salt being consumed at the household level, compared to non-iodized salt.
- Increase the number of women receiving iron and folic acid (IFA) supplements.
- Increase access to double fortified salt (DFS).
Child Survival: Supporting Immune Systems and Reducing Deaths from Common Childhood Diseases
Vitamin A Supplementation
MI, in collaboration with UNICEF, continues to support twice-yearly vitamin A supplementation. Through the National Vitamin A Plus Campaigns (NVAC), children 12-59 months receive a twice-yearly dose, while the first dose for infants 9-11 months is given along with measles vaccinations during National Immunisation Days. In 2010, MI successfully advocated for including a hard-to-reach approach within the national VAS program and decreasing the age of dosing to 6 months.
Field Story: Reaching the Hard-to-Reach in Bangladesh with Vitamin A
Since 2004, the Government of Bangladesh has secured funds and procured its own supply of vitamin A capsules. This is an important part of in-country ownership and sustainability of this child survival program.
New Born Vitamin A Supplementation
Clinical research has suggested that giving newborns a single lower dose of vitamin A (50,000 IU) within the first two days of life may reduce infant mortality by 20 per cent. MI, in partnership with the Government of Bangladesh (GoB), A2Z, AED, USAID and UNICEF, supported operational research in Bangladesh examining the feasibility of newborn vitamin A supplementation. This pilot project tested different newborn VAS delivery mechanisms.
MI is undertaking a zinc supplementation demonstration project to support the government´s efforts to scale up the use of zinc through the Primary Health System. This three-year project aims to see an increase in the coverage of the zinc and ORS for the treatment of diarrhoea in two districts and compliance to at least 50%.
Child Development: Preventing Mental Impairment with Iodine
MI is supporting the Ministry of Industries´ Control of Iodine Deficiency Disorders (CIDD) project, under the Bangladesh Small and Cottage Industries Corporation (BSCIC), to increase household coverage of adequately iodized salt. MI refurbished 200 Salt Iodization Plants (SIPs), upgraded eight government salt testing laboratories and supported private salt millers in setting up salt testing laboratories. MI is also working with UNICEF, GAIN and BSCIC on an operational strategy to make the purchase and management of potassium iodate financially sustainable.
Field Story: Strengthening the Salt industry in Bangladesh
New Technologies to Increase Salt Iodization
MI developed the GIS-based Salt Industries Information System GSIIS software that contains data on salt production, a brief about the salt factories and their owners, and data on the quality of iodized salt, average sales and distribution by wholesalers. The GSIIS will be used to plan interventions with individual salt processors. MI also developed the user-friendly Bangladesh Salt Iodization Information System BSIIS software to analyze salt iodization-related data.
Women´s Health: Improving Health and Quality of Life with Iron
Double Fortified Salt
MI signed a Memorandum of Understanding with Confidence Salt Ltd. to introduce double fortified salt (DFS), fortified with iodine and iron, to deficient populations through commercial channels in the Bangladesh market. MI is providing Confidence Salt with technical support and assisting them with DFS information sharing, quality control and procurement procedures and training. Confidence Salt launched DFS in November 2011.
Iron and Folic Acid Supplementation
In the News: MI Welcomes the Launch of Double Fortified Salt in Bangladesh
MI initiated a situational analysis of Bangladesh´s iron and folic acid (IFA) supplementation program in consultation with the government and stakeholders. MI will help demonstrate an effective three-year program model for increased IFA supplementation coverage and compliance. The project will be implemented through the existing health infrastructure, among pregnant women in two districts over two years. Based on lessons learnt, the positive deviances will be replicated in another two districts in the third year. The project is expected to increase coverage to 70% and compliance to at least 50% in project areas during the three years.
Progress and Challenges
- 99% coverage of children 9-59 months with two doses of Vitamin A through the NVAC in 2010.
- Hard-to-reach approach for 11 districts now included in the national VAS program and 0.42 million hard-to-reach children reached with vitamin A supplementation in 2010.
- Areas within Bangladesh still exist where vulnerable children are yet to be reached with vitamin A supplementation.
- Increased salt iodization capacity by an additional 236,870 MT, with scope to supply an additional 59M people with iodized salt.
- Fifty percent of the salt produced in Bangladesh is not adequately iodized.
- Pilot project to test delivery mechanisms for Newborn Vitamin A supplementation initiated.
- Implementation of zinc provision for children with diarrhoea and IFA supplementation for pregnant women now underway.
- Coverage of iron and folic acid supplements for pregnant women is sporadic.
- Under the government´s Nutrition Task Force, MI helped formulate the micronutrient-related strategies of the new Health Population Nutrition Sector Program.
- As of early 2010, no zinc supplementation was taking place through the public health system.
- Wheat flour fortification for vulnerable groups is the only form of food fortification taking place nationwide.
Contact MI in Bangladesh
Dr. S M Mustafizur Rahman
Apartment 102, House 06 (Lake View),
Road 104, Gulshan 2,
Dhaka 1212, Bangladesh
Tel: + 880 2 989 9896, Ext 102
Fax: + 880 2 881 5154