Combatting the coming malnutrition crisis

COVID-19 has profoundly impacted all countries, with even the most prosperous nations overwhelmed by the pandemic. For low- and middle-income countries, the consequences are even more severe. With reduced purchasing power, interruptions in critical welfare programmes, and disruptions in global supply chains, many families no longer have access to adequate nutritious food. Shutdowns and fear of infection lead to reduced access to health systems and nutrition services. These factors may create a malnutrition crisis, with the potential to cause even more devastation than the pandemic itself.

While the provision of food may resolve the hunger issue, this does not guarantee people the nutrients their bodies need. Without access to proper nutrition, there will be long-term health impacts, including weaker immune system, lowered resilience to disease, and increased stunting and wasting. Addressing hunger and, more specifically, 'nutrition' need to be a key component of the global COVID-19 response.

Since 2010, Bangladesh has made immense progress in economic growth, food security, health and nutrition, and until COVID-19, the country was on track to achieve the child nutrition targets set in the second Bangladesh National Plan of Action for Nutrition (NPAN2) by 2025.

The pandemic, however, threatens to reverse the gains made so far, especially for children, pregnant and lactating women and adolescent girls. A study to determine the impact of COVID-19 on nutrition, conducted by the Bangladesh National Nutrition Council (BNNC), supported by Nutrition International and other partners, observed that the pandemic has disrupted most food commodity supply chains, causing high-quality protein and micronutrient-rich foods to become more expensive.

School closures have brought weekly iron-folate supplementation for adolescent girls to a halt. This severely impacts the 45 million people in the country who are extremely poor and already cannot afford the minimum food consumption basket. Compounded by food shortages and limited access to essential health services, malnutrition among the country's young children will become more pronounced in the long term, and chronic stunting may return to the 2011 rate of 41%, up from the current 31%.

Pregnant women – and those who become pregnant during the pandemic – are being significantly affected by the disruptions resulting from the need for social distancing and overburdened health facilities. This is leading to decreased quality care visits, increased anxiety, contradictory messages and recommendations, and even increased home births without properly skilled birth attendants.

A timely, well-coordinated and preventive approach is critical to combat the malnutrition crisis. The NPAN2 and the 'Bangladesh Second Country Investment Plan for Nutrition' (CIP2) need to jointly focus on prioritising nutrition security interventions through various implementation platforms including digital platforms, Nutrition Information Systems and multiple community platforms.

Supply chain disruptions of health and nutrition essentials including iron and folic acid, calcium, and vitamin A need to be streamlined urgently. Immunisation drives, which were suspended due to lockdowns, need to be revitalised. Bangladesh's inclusive social safety net programmes and uninterrupted food value chain system can be leveraged strategically to avoid any future crisis of food insecurity and malnutrition.

New plans and strategies for reopening health facilities, resuming school feeding programmes, and delivering nutrition-specific services and programmes must be developed. Home visits and counselling services by frontline workers can play an important role in reaching vulnerable populations with regular health and nutrition services, while dispelling myths and delivering verified facts about the disease and methods to control it.

COVID-19 has created a confluence of nutrition risks that endanger an entire cohort of women and children. Nutrition must be integrated into every phase of the pandemic response – the immediate response, the resilience-building, and the recovery. With nutrition as a key pillar of the response, nations will be able to build back better, healthier and strong enough to overcome the next challenge.

The author is the Country Director of Nutrition International, Bangladesh.

E-mail: ssiraj@nutritionintl.org