Under-nutrition, particularly childhood stunting has emerged as a major public-health concern, especially in the less-developing countries of the world. Its prevalence in Bangladesh is 36%, which needs continued attention. The determinants of childhood stunting are multi-factorial, and inappropriate feeding practice is one of them. BRAC has long experience in providing nutrition interventions, particularly for maternal and child nutrition in Bangladesh. BRAC, jointly with Alive and Thrive (A&T), provided rigorous counseling and demonstration in promoting infant and young child-feeding (IYCF) practice since 2010 for more than five years. This initiative was aimed at addressing the high prevalence of stunting among children aged 6-59 months. Results of an evaluation of their impact indicated that child stunting did not improve significantly compared to non-intervention areas.
The findings of the evaluation guided that, to pursue a more comprehensive and effective intervention programme, it is essential to understand what is actually happening in the A&T areas in relation to the mothers’ feeding practices and the dietary patterns of children and mothers and also other related behaviours that are linked to their nutritional outcome. Therefore, the Research and Evaluation Division (RED) of BRAC conducted a study in January 2016 to understand the dynamics of feeding practices and behaviours of children aged 6-23 months and their mothers to see if there was any gap. The study also intended to depict an idea about the food recipes for children aged 6-23 months in those areas based on their existing practices and nutritional requirements.
The overall findings of the study indicate that, although the mothers/caregivers are aware of the ideal feeding and hygiene practices for their children, they could not translate these into practice given the contextual norms and barriers. Some factors act as bottlenecks to practising EBF for six months, timely introduction of CF with adequate quality, diversity, quantity, and also feeding during illness. A key message of this study is that any comprehensive strategy for addressing the problem of child undernutrition must include actions to address the sociocultural norms (i.e. forced feeding, beating during food refusal, food avoidance during illness, not washing hands with soap before feeding and after using the toilet, etc.) to enable people to improve their practices. To ensure adequate nutrition of children, the community should have the capacity to translate the good knowledge into practice. It is also important to increase their knowledge on how to grow various nutrient-dense foods within their household premises. If the intake of nutritious foods could not be addressed using locally-available foods, other options may include encouragement of homestead agricultural production, delivery of micronutrient powder following the standard guidelines. To improve the affordability of income-generating activities, credit support based on the feasibility may be considered. Rigorous monitoring and the supervision process are also necessary to translate good knowledge into practice.