'Education, economic development key to better nutrition in Chattogram hill tracts'

In the 2023 Global Hunger Index, Bangladesh ranks 81st out of the 125 countries with sufficient data to calculate 2023 GHI scores. With a score of 19 in the 2023 Global Hunger Index, Bangladesh has a level of hunger that is moderate.

In response to the challenge, the Leadership to Ensure Adequate Nutrition (LEAN) project has been implemented in the Chattogram Hill Tracts from September 2018 to February 2024. Funded by European Union, LEAN is a consortium project led by the United Purpose (UP) and partnered with the Global Alliance for Improved Nutrition (GAIN), Helvetas Swiss Intercooperation (HSI), Caritas Bangladesh (CB), Integrated Development Foundation (IDF), and Jum Foundation (JF).

The project's overall objective is to improve maternal and child nutrition in the Chittagong Hill Tracts, Bangladesh.

A roundtable meeting "Advancing Nutrition Commitments for Chattogram Hill Tracts" was held on 29 February 2024 at the CIRDAP Auditorium in Dhaka. The event was jointly organised by the Right to Food Bangladesh Network and the LEAN Project.

The event was chaired by Mohsin Ali, the General Secretary of Right to Food Bangladesh Network, and Executive Director of WAVE Foundation. The chief guest was Md. Mashiur Rahman NDC, the Secretary of the Ministry of Chittagong Hill Tracts Affairs. The guests of honor were Raja Devasish Roy, Chakma Circle Chief, Aung Shwe Prue Chowdhury, Chairman of Rangamati Hill District Council.

During the roundtable meeting, Dr. Md Ruhul Amin Talukder, the special officer in charge of the Ministry of Public Administration and former additional secretary of the Ministry of Agriculture, presented the main article. Dr Rudaba Khondker, Country Director of the Global Alliance for Improved Nutrition (GAIN), delivered the welcome speech.

The moderation of the proceedings was presented by Kaniz Fatima, Coordinator of the Right to Food Bangladesh and Deputy Director at WAVE Foundation. Representatives from civil societies and the media also participated in the event.

The roundtable meeting addressed various pressing challenges, including food habits and wastage among hill communities, malnutrition, low birth weight, and nutritional deficiencies. Discussions delved into the impacts of crises such as COVID-19 and the war in Ukraine on food security, alongside infrastructure inadequacies in agri-food processing and marketing, and the looming threat of climate change.

They also addressed concerns regarding fair pricing for farmers, gender wage equality, coordination gaps among ministries, manpower shortages for nutrition services, and inadequate funding for nutrition-sensitive programmes.

Recommendations included amending nutrition coordination committee procedures, enhancing budgeting, and tracking any improvement of nutrition status.

Here are the highlights of the discussion:

Dr Rudaba Khondker

Country Director, Global Alliance for Improved Nutrition (GAIN)

I would want to thank everyone for coming here today.

A nation's nutrition must be developed by coordinated efforts in all domains, from state-level programs to rural communities. Coordination amongst all parties involved, including Civil Society Organizations (CSOs), is essential for a sustainable program. 

To eradicate malnutrition from the country's population, proactive measures, teamwork, and sustained efforts are needed for Bangladesh's future.

Mohsin Ali

General Secretary, Right to Food Bangladesh, and Executive Director, WAVE Foundation

Without sustainable agricultural production, there will be no safe food, consequently jeopardising the nutrition of all. Therefore, discussions on nutrition extend beyond the Ministry of Health; involvement from the Ministry of Food and Agriculture and other relevant entities is crucial.

Food security must be ensured in order to create a Smart Bangladesh. Furthermore, although the Ministry of Health is the primary forum for discussing nutrition, other ministries ought to take up the matter as well. Bangladesh does not have comprehensive food security laws, in contrast to several of its neighbors, including India, Pakistan, Nepal, and Sri Lanka, while efforts are being made to get such laws implemented.

Food adulteration is a major problem for Bangladesh, highlighting the need for environmental coordination to guarantee food security and, in turn, sufficient nutrition. Promoting ecologically friendly farming methods is essential to ensuring that everyone has access to nutritious food.

Md Mashiur Rahman NDC

Secretary, Ministry of Chittagong Hill Tracts Affairs

The government is currently assisting in the implementation of numerous development projects in the hilly areas that were uninhabitable prior to the historic peace accord. The state of food and nutrition has also improved, but individuals still need to be able to support themselves financially; they cannot live only on food assistance or allowances.

Despite a decrease in poverty rate, the standard of living has not seen significant improvements.

Water scarcity remains a major issue in hilly areas, prompting the launch of a Tk1,300 crore project to address various challenges. Efforts are underway to identify and recover over 300 village forests.

Additionally, if dry fish is recognised as a nutritional ingredient, the government will pursue necessary research to ensure nutritional benefits in this regard.

Md Zakir Hossain Akanda

Former Secretary, Ministry of Planning

To improve the nutritional status of people in hilly areas, education and economic self-sufficiency are crucial.

While hilly areas comprise only 1% of the population and 10% of the land, there is significant potential for improvement. Dietary habits need to shift towards more nutritious foods, and there is a need for increased awareness about nutrition.

There is not enough development projects being done in the Chittagong Hill Tracts right now. Fruits and vegetables are abundant in this area, but access is restricted due to distribution issues. Water management is still a serious problem that requires attention.

Dr Md Ruhul Amin Talukder 

Special officer in charge, Ministry of Public Administration, and former Additional Secretary, Ministry of Agriculture

In the past 20 years, Bangladesh has made significant strides in improving nutrition, particularly among children. However, the nutritional status of children in the Chittagong Hill Tracts region remains comparatively poor.

The implementation of LEAN project has enhanced capacity and inter-departmental coordination in nutrition-sensitive programming, providing training to local communities on climate change adaptation and market linkages. These initiatives have improved farmers' ability to produce and market nutritious food, thereby promoting smallholder farming.

Moreover, awareness among school students regarding basic nutrition and personal hygiene has increased. Currently, three district and 18 upazila Nutrition Coordinating Committees are actively engaged in planning and implementing nutrition programmes, among other activities.

Dr Barun Kumer Datta 

Chief Scientific Officer (Director), Bangladesh Livestock Research Institute

No matter how many projects we undertake, coordination is essential at the union, upazila, and district levels. Projects initiated by our LGRD ministry often lack coordination with other ministries. Despite an abundance of nutritious food in the Chattogram Hill Tracts, inadequate coordination hinders its proper distribution to all areas.

Aung Shwe Prue Chowdhury

Chairman, Rangamati Hill District Council

It is possible to transform into a developed country by 2041 through strategic initiatives aimed at disseminating awareness messages in health, agriculture, environment, electricity, and communication systems, particularly targeting hilly regions. To foster societal change and enhance awareness, ensuring access to nutritious food is imperative.

There is a shortage of adequate manpower to provide nutritional services, necessitating appropriate budgeting and meticulous tracking. Initiating a nutrition project in the Chattogram Hill Tracts and sustaining efforts in this domain from inception are essential.

Communication management presents the foremost challenge in hilly areas, complicating food management. Therefore, specialised management tailored to these regions is imperative.

Climate change has worsened malnutrition in hilly areas, disrupting their traditional food sources due to environmental degradation. Institutional interventions are crucial to address these challenges, as mere discourse will not suffice.

Dr Md Arif Hossain

District Fisheries Officer, Khagrachhari

To ensure proper nutrition in Khagrachhari, it is imperative to prioritise diversified food production and enhance food security for farmers. A dedicated plan for agriculture could be developed to address these needs. 

Additionally, efforts should be directed towards improving milk production in the area. However, any initiatives undertaken should be preceded by thorough surveys and research.

Kaniz Fatima

Deputy Director, WAVE Foundation

Since its inception in 2015, Right to Food Bangladesh has been engaged in multi-dimensional activities, including nationwide campaigns and policy advocacy at the national level, focusing on food and nutrition rights, social security programmes, safe food, agriculture, land, water, and related issues. One of the network's key demands is the enactment of a Right to Food Act.

The LEAN Project has been working on nutrition since 2018, adopting a locally led but nationally connected approach. Collaboration with the government is prioritised to facilitate the implementation of the right to food. While Bangladesh has made significant progress in food security over the past 20 years, there are areas that still require improvement. We provide training to small farmers to further advance their skills and productivity.

Dr Shibli Saifullah

Deputy Civil Surgeon, Rangamati

There is a need to raise awareness among women in hilly areas to promote the production of green peas. Since the mountains do not produce oil, many essential vitamins found in oil are lacking in the people of this region. 

Vitamins A, D, E, and K, primarily obtained through oils, are not consumed in adequate amounts in the Chattogram Hill Tracts.

Further research is required to determine if there is a deficiency in these vitamins among the population. Providing digital height and weight machines can facilitate the measurement of children's height in these areas, enabling the assessment of nutritional quality based on body weight and height.

Raja Devasish Roy

Chief of Chakma Circle

In hilly regions, efforts should be made to identify and encourage dietary practices that are high in nutrients. The most successful nutrition programs will be those that are coordinated amongst all districts and upazilas. 

While each of the many ethnic groups in the Chittagong Hill Tracts has its own distinct culinary customs, these customs can benefit from the addition of more nutrient-dense foods. Although abrupt changes won't work, a culture of healthy eating can be fostered by educating people and sharing local expertise. 

In the hills, pregnant women need special attention. For them to have access to wholesome food, local governments ought to take a more proactive approach. 

Implementation of multifaceted programs (education, healthcare, job creation) aimed at reducing poverty, including food and nutrition security, is hindered, particularly in areas of high poverty such as hilly regions. These attempts are further hampered by little government funding.

There is clear evidence that educating women about nutrition has a greater impact than educating men. It's important to honor the long-standing culinary customs of the area. The emphasis needs to be on adding more nutrient-dense options to already-existing recipes. 

The three circles in this region are home to around 4,000 families. Concerns about nutrition affect people of all social groups, occupations, and castes.

Susmita Khisa

Deputy Director, Department of Women and Children Affairs, Khagrachhari District

We provide rice to women in the Chattogram Hill Tracts on a monthly basis, and there is no longer delays in maternity allowance; they receive it within a month.

Previously, under the Vulnerable Group Development (VGD) programme, we provided regular rice, but now we provide rice fortified with six micronutrients, aiming to enhance its nutritional value. This fortified rice is distributed to 15,000 families. Additionally, we are actively raising awareness about food and nutrition among teenagers in the region.

Apru Marma

Upazila Agriculture officer, Ramgamati Sadar, Rangamati

In the Chattogram Hill Tracts, offering teenage allowances may be taken into consideration. Furthermore, independent initiatives might be started to guarantee that hygienic restrooms are available in these locations. It is imperative that the local populace have access to nutritionists, since receiving counsel from a nutritionist prior to seeking medical attention is frequently advantageous. Moreover, it takes initiative and government help to include nutrient-rich foods in their diet.

Dr S M Mustafizur Rahman

Ex-Line Director, National Nutrition Services

Food should not only fill the stomach but also contain all the nutrients. Nutrition during pregnancy should be kept in mind. At the same time, it is important to take care of mental health.

We want to see the Chattogram Hill Tracts as Switzerland. If the hill tracts are good, Bangladesh will be good.

Open discussion

The open discussion following the presentation involved officials from the World Bank, Institute of Public Health Nutrition (IPHN), Department of Women and Children Affairs, Department of Agriculture Extension.  They covered topics such as farmer engagement in nutrition activities, fair pricing of crops, and food habits in hilly regions.

Additionally, the discussion addressed the importance of creating nutrition-friendly environments and enhancing nutrition education for children. Allocation of budget for social security programmes, distribution of nutritious rice, and implementation of awareness activities through para clubs were also highlighted as key points of interest.