Successful Multisectoral Approach to Improve Child and Women Nutrition in Bangladesh

THE PROBLEM. To address child and women nutrition is one of Bangladesh's human development priorities. Major nutrition programs addressing it from a health and nutrition perspective have had limited achievements. THE PROGRAM. Plan Bangladesh, an international, humanitarian NGO is currently implementing multi-sector development programs among 500,000 poor rural and urban inhabitants of the country. Its Integrated Nutrition Program (INP) begun in 2005 to demonstrate the effectiveness and feasibility of an innovative multi-sector approach to improve the nutritional status of under-five children and of pregnant/lactating mothers (with consequent improved pregnancy outcomes) by utilizing a participatory, multi sector approach. PROGRAM COMPONENTS: (1) Extensive consultation on the causes of and solutions to malnutrition among community members led to a program design involving the health, sanitation, agriculture, and livelihood sectors. (2) Trained Community Nutrition Workers supported household nutrition education while Village Nutrition Committees linked these efforts to the local government agencies. (3) At sub-district, district and national levels, multi-sector coordination committees of the ministries of health, livestock, education and water collaborated on the program implementation. (4) The program's learnings were shared with government and community actors continuously. RESULTS. Comparison of two population surveys at the baseline study (early 2005) and midterm review (late 2006) showed significant improvements in (a) the early use of colostrums and of exclusive breastfeeding, (b) the use of skilled antenatal and birth delivery care, (c) the use of appropriate complementary feeding, (d) the practice of livestock and poultry vaccination and of home gardening, (e) household intake of iodized salt and (f) the household's access to and use of sanitation facilities. It is also important to note that (1) government and communities contributed the majority of the program's resources. (2) the results and methods of the program were discussed as part of the design of a National Nutrition Policy. CONCLUSION. This program has successful results ontained through community ownership and multi-sector collaboration among government departments. Plan Bangladesh will extend it for another 5 years to additional districts.