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This manual provides expert practical guidelines for the management of severely malnourished children. Addressed to doctors and other senior health workers, the manual explains exactly what must be done to save lives, achieve successful management and rehabilitation, prevent relapse, and thus give these children the greatest chance of full recovery. Throughout, the importance of treating severe malnutrition as both a medical and a social disorder is repeatedly emphasized. As successful management does not require sophisticated facilities and equipment or highly qualified personnel, the manual also performs a persuasive function, encouraging health professionals to do all they can to save these children and meet their great need for care and affection. Recommended procedures draw on extensive practical experience as well as several recent therapeutic advances. These include improved solutions of oral rehydration salts for the treatment of dehydration, better understanding of the role of micronutrients in dietary management, and growing evidence that physical and psychological stimulation can help prevent long-term consequences of impaired growth and psychological development. Noting that the physiology of malnourished children is seriously abnormal, the manual gives particular attention to aspects of management - whether involving the interpretation of symptoms or the use of specific interventions - that differ considerably from standard procedures for well-nourished children. Details range from the reasons why IV infusion easily causes overhydration and heart failure, through a list of treatments that have no value and should never be used, to the simple reminder that underarm temperature is not a reliable guide to body temperature in a malnourished child during rewarming. Further practical guidance is provided in eight appendices, which use numerous tables, charts, sample recording forms, instructions for preparing feeds, and examples of easily constructed toys to help ensure that management is thorough, safe, and in line with the latest knowledge.
Rapid urbanization in developing countries brings numerous problems and challenges; urban poverty is one important issue. This important volume presents the findings of a revealing multidisciplinary cohort study conducted in the slums of Dhaka, Bangladesh. It forms the basis for understanding groups who are vulnerable to economic and environmental shocks and stresses, and for differentiating strategies which might be adaptive in situations of hardship and scarcity.
Urbanization is occurring at a rapid pace in Bangladesh, accompanied by the proliferation of slum settlements, whose residents have special health needs given the adverse social, economic, and public environmental conditions they face. Over the past 45 years, the country's health and nutrition policies and programs have focused largely on rural health services. Consequently, equitable access of urban populations--particularly the urban poor--to quality health and nutrition services has emerged as a major development issue. However, the knowledge base on urban health and nutrition in Bangladesh remains weak. To address the knowledge gap, Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance examines the health and nutrition challenges in urban Bangladesh--looking at socioeconomic determinants in general and at health sector governance in particular. Using a mixed methods approach, the study identifies critical areas such as financing, regulation, service delivery, and public environmental health, among others that require policy attention. The study also proposes specific actions within and outside the health sector to address the issues, providing guidance on their sequencing and the specific responsibilities of government agencies and other actors. This study should be useful to policy makers and practitioners working on urban health and nutrition issues in Bangladesh and in other low- and middle-income countries.
An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting estimates the costs, impacts, and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs US$70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between US$4 and US$35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000-day window of early childhood are inalienable and portable and will pay lifelong dividends—not only for children directly affected but also for us all in the form of more robust societies—that will drive future economies.
The food system of Dhaka, the Bangladeshi capital area, is undergoing deep and rapid transformations. Such changes are associated with the process of accelerated urbanization and sustained economic growth experienced by Bangladesh. In supporting a sustainable food system transformation in urban areas, the Food and Agriculture Organization of the United Nations (FAO) is giving specific emphasis to the dynamics of the system’s foundations. This Dhaka food system atlas offers a perspective of the urban food system, encompassing production, processing, distribution, consumption habits, and disposal. The atlas specifically maps out various factors and actors of the urban food sector, including infrastructure such as markets. This atlas also shares some current trends, food system outcomes as well as perspectives as to possible future scenarios to 2041 for food consumption for the megacity. The Support for Modelling, Planning and Improving Dhaka’s Food System (DFS) project developed this atlas as data-driven insights to inform policies and interventions for improving food security, nutrition and a sustainable food system in the Dhaka metropolitan area.
The coronavirus pandemic has upended local, national, and global food systems, and put the Sustainable Development Goals further out of reach. But lessons from the world’s response to the pandemic can help address future shocks and contribute to food system change. In the 2021 Global Food Policy Report, IFPRI researchers and other food policy experts explore the impacts of the pandemic and government policy responses, particularly for the poor and disadvantaged, and consider what this means for transforming our food systems to be healthy, resilient, efficient, sustainable, and inclusive. Chapters in the report look at balancing health and economic policies, promoting healthy diets and nutrition, strengthening social protection policies and inclusion, integrating natural resource protection into food sector policies, and enhancing the contribution of the private sector. Regional sections look at the diverse experiences around the world, and a special section on finance looks at innovative ways of funding food system transformation. Critical questions addressed include: - Who felt the greatest impact from falling incomes and food system disruptions caused by the pandemic? - How can countries find an effective balance among health, economic, and social policies in the face of crisis? - How did lockdowns affect diet quality and quantity in rural and urban areas? - Do national social protection systems such as cash transfers have the capacity to protect poor and vulnerable groups in a global crisis? - Can better integration of agricultural and ecosystem polices help prevent the next pandemic? - How did companies accelerate ongoing trends in digitalization and integration to keep food supply chains moving? - What different challenges did the pandemic spark in Asia, Africa, and Latin America and how did these regions respond?
South Asia Migration Report 2020 documents key themes of exploitation and entrepreneurship of migrants from the region. This volume: • Includes dedicated fieldwork from India, Pakistan, Bangladesh and Nepal; • Analyses the impact of South-Asia-migrant-established businesses; • Examines legal and legislative recourse against exploitation in destination countries; • Factors in how migration as a phenomenon negotiates with gender, environment and even healthcare. This book will be indispensable for scholars and researchers of economics, development studies, migration and diaspora studies, gender studies, labour studies and sociology. It will also be useful to policymakers, think tanks and government institutions working in the area.
The national food system of Bangladesh has made substantial progress since experiencing famine in 1974, soon after independence. After the famine, the government placed a strong emphasis on policies required to attain grain self-sufficiency; since attaining self-sufficiency, the production system, policies related to it, and resulting diets have begun to diversify. Nonetheless, undernutrition remains a problem, and fruit and vegetable consumption are inadequate for most people relative to international recommendations. Moreover, as the food system has begun to transition towards a modern one, challenges related to food safety and perceived food adulteration have begun to rise. Further, increased processed food intakes are potentially associated with existing rising overweight and obesity status. Both government interventions and innovations are needed to help shift the national food system to improve nutrient-dense food availability, particularly among the poor, and to limit the increase in processed food consumption.
This report presents the findings of an operations research study conducted to assess the implementation of the Government of Bangladesh’s National Nutrition Services Program (NNS) and to identify the achievements, determine the bottlenecks that adversely impact these achievements, and highlight potential solutions to ensure smooth delivery of the program. A mixed methods research approach was used to evaluate five major domains of the program: management and support services; training and capacity development; service delivery; monitoring and evaluation, and; exposure to interventions. The study found that the overall NNS effort is an ambitious, but valuable approach to support nutrition actions through an existing health system with diverse platforms. The results indicate that although the maintenance of strong and stable leadership of NNS is an essential element to ensure integrated and well-coordinated comprehensive service delivery for the line directorate, the current arrangement is unable to ensure effective implementation and coordination of NNS. Focusing on some of the critical challenges related to leadership and coordination in the first instance, and on embedding a small core set of interventions into well-matched (for scale, target populations, and potential for impact) health system delivery platforms is most likely to help achieve scale and impact. Strategic investments in ensuring transparency, engaging available technical partners for monitoring and implementation support, and not shying away from other potential high coverage outreach platforms like some NGO platforms also could prove fruitful. Moreover, although the Government of Bangladesh, and the health system in particular, must lead the effort to deliver for nutrition, it is clear that development partners who have expressed a commitment to nutrition must coordinate their own activities and provide the support that can deliver on nutrition's potential for Bangladesh.
Funded by ADB and Embassy of Sweden.