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Bangladesh: New initiative to combat malnutrition, anaemia

DHAKA, 1 September 2009 (IRIN) – There have been mixed reactions to a private-public partnership to popularize a nutritional supplement known to reduce the incidence of anaemia in infants and young children.

The supplement, known as Sprinkles, is a blend of powdered micronutrients which, when sprinkled onto food, provides children with all the necessary vitamins and minerals.

Renata, a leading generic drugs manufacturer based in Dhaka, will produce, market and sell the food supplement alongside BRAC (Building Resources Across Communities), the biggest NGO in the developing world, and the Social Marketing Company (SMC), a not-for-profit enterprise.

But the cautious Bangladeshi government has declined to comment on Sprinkles or its promotion. Fatima Parveen Chowdhury, director of the government-run Institute of Public Health Nutrition (IPHN), explained that since Sprinkles is a new product, the government would only be in a position to comment once its effect on Bangladeshi children had been established.

Recent research indicates that Sprinkles can halve the incidence of anaemia in infants and young children.

The UN Children’s Fund (UNICEF) has endorsed Sprinkles but is not convinced that the market-based approach taken by Renata, SMC and BRAC can provide a satisfactory solution for poorer Bangladeshis.

“It is scientifically proven that Sprinkles can work against anaemia but if we only promote the sale of this product not everyone will have access to it,” said Josephine Ippe, nutrition manager with UNICEF in Bangladesh, which is piloting the free distribution of Sprinkles in a limited number of badly-affected districts.

Sprinkles costs around three US cents per sachet and has been available in Bangladesh since last year but, with no marketing or public information campaign, only one million sachets are currently sold every month in a country of more than 150 million people.

Bangladesh was hit badly by recent food price hikes and with the expanding population and food security issues, there has been a slowdown in the battle against malnutrition
Too expensive?

“The prevalence of anaemia is very high in rural areas and urban slums,” explained Ippe. “The vast majority of people cannot afford Sprinkles, even at two taka [three US cents] a sachet. Sprinkles needs to be taken every day or every other day, so that’s 30-60 taka a month, which is a lot of money for a poor family.”

Sales have hitherto been held back by the government’s decision to class Sprinkles as a drug, which means it can only be bought in pharmacies.

Bangladesh has two million children aged six months to five years suffering from acute malnutrition because of poverty, badly-balanced diets and poor infant-feeding practices, according to a recent study by the World Food Programme (WFP), UNICEF and the government’s Institute of Public Health Nutrition.

Surveys in early 2003 in Bangladesh found that anaemia, which is largely due to iron deficiency, affects about 50 percent of children under five, a level which denotes a severe public health problem, according to UNICEF.

“Iron deficiency is a massive problem here, with more than half of the children under-two suffering from anaemia,” Kaiser Kabir, chief executive of Renata, told IRIN at the company’s main production facility in Dhaka.

Progress in the fight against malnutrition has been mixed.

The proportion of underweight children under five fell from above 70 percent in the early 1990s to around 50 percent by 2000, Monira Parveen, head of WFP’s nutrition unit in Dhaka, explained, citing data from the Bangladesh Demographic and Health Survey.

However, since 2000, only small reductions have been achieved, with the latest survey from 2007 showing that 41 percent of children are still underweight.

“Bangladesh was hit badly by recent food price hikes and with the expanding population and food security issues, there has been a slowdown in the battle against malnutrition,” Parveen noted.

Earlier this year, UNICEF warned that the extent of child malnutrition in Bangladesh amounted to a “silent emergency” and that unless urgent action was taken, the country was unlikely to achieve and sustain the Millennium Development Goals.

The knock-on effects for the country’s fragile economy are severe, both in terms of increased healthcare costs and decreased productivity.

Public-private initiative

The new public-private initiative has been cultivated and part-financed by the Global Alliance for Improved Nutrition (GAIN), a Geneva-based nutrition advocacy organization.

GAIN will provide US$3m to Renata and BRAC to ramp up production of Sprinkles and launch a nationwide campaign to promote it in rural areas and slums.

SMC has also received funds from GAIN to push ahead with a social marketing drive which includes an interactive theatre group which visits 600 villages every month to educate the population about the benefits of home food fortification using Sprinkles.

The new food fortification initiative is very ambitious, with Renata hoping to nearly double sales of Sprinkles to 20 million sachets in the first year and hit 70 million by the second year.

Source – Sept. 1, 2009, http://www.irinnews.org/Report.aspx?ReportId=85954

Categories: Bangladesh
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