Dr. A M M Anisul Awwal, PhD :
Although, latest data depicts that the extent and magnitude of malnutrition has reduced significantly from that of the previous surveys (surveys undertaken in last 43 years), nevertheless, the percentage of malnutrition level is still unacceptably high. In the developing countries, about 50% deaths among children under 5 years of age are attributable to malnutrition. About 60% pregnant women and children less than 5 years of age have been suffering from nutritional anemia (iron deficiency anemia). About 25% populations have iodine deficiency and almost 20% population have goiters of various grades. The incidence and prevalence of night blindness and blindness due to Vitamin-A deficiency are also noticeably high, but within acceptable range amongst the under five children.
Among all the manifestations of malnutrition, LBW (birth weighing equal or less than 2.5 kg) is the most visible stigma of poor maternal health and nutritional status before and during pregnancy. The more the incidence of LBW, the more the women are deprived of their rights – safe motherhood, decision making power and gender equity. The weight of a newborn basically reflects the quality of its intrauterine development, respect for women in the society, and the health care including the services the woman received during pregnancy. Adolescent marriage and adolescent pregnancy is universal in this country, which is associated with poverty, lack of social empowerment, different types of health problems including UTI etc. The other immediate causes of LBW are also an integral part of their life – lack of food, lack of caring practices, lack of health services including lack of environmental sanitation.
In normal physiological state, a healthy mother gives birth to a child weighing usually about 3 to 3.3 Kg. The rate of growth of children since birth should be at least 3.3 Kg at birth, 6.0 kg at three months, 7.8 kg at five months, 9.2 kg at nine months, 10.2 kg at 12 months, 11.5 kg at 18 months and 12.6 kg at 24 months. Birth weight is an important parameter which could be indicative of (1) the immediate viability of the neonate, (2) the state of maternal health and nutrition before and during pregnancy, (3) respect for the women (4) women’s rights and most importantly (5) the future quality of life of the baby.
Every child since the beginning of the journey of life should have the best possible start, every child should receive a stimulation of connectivity, every child should get good quality of basic education, every child should have the opportunities to develop his or her full potential and contribute to society in meaningful ways. Most of the brain development happens before a child reaches three years of age. In a short span of 36 months of time, children develop their abilities to think and speak, learn and reason, and lay the foundation for their values and social behavior as adults. Choices made and actions taken on behalf of children during this critical period affect not only how a child develops but also how a country progresses. In reality, the future of a country depends on the quality of early childhood. This aspect of national growth and development must be recognized.
When infants are held and touched in soothing ways, they tend to thrive. The brain’s malleability during these early years also means that when children do not get the care they need, or if they experience starvation, malnutrition, abuse or neglect, their brain development may be compromised. Early childhood period starts from fertilization of ovum in the uterus. The effects of what happens during the prenatal period and during the early months and years of a child’s life can last a lifetime. It affects all the key ingredients of emotional intelligence, confidence, curiosity, intention, self-control, relatedness, capacity to communicate and cooperativeness that determine how a child learns and relates in school and in life. It is, of course, never too late for children to improve their nutrition, health and development, to learn new skills, overcome fears or change their beliefs.
In the first three years of life, brain connections proliferating explosively, and children discover new things in every sphere of their life. At birth, a baby has about 100 billion brain cells (neurons). Most of these cells are not connected to each other and cannot function on their own. They must be organized into networks that require trillions of connections or synapses between them. These connections are miracles of the human body, depending partly on genes and partly on the events of early life. Many kinds of experiences affect: how young brains develop, but nothing is more important than early care and nurturing.
The uniqueness of the human brain lies not only in its size and complexity but also in the properties that make it extraordinarily interactive with experience. Every touch, movement and motion is translated into electrical and chemical activity that shifts the genetic momentum. Human interactions are as important to the development of brain connections as having food to eat, sounds to hear and light to see. There are periods in life when the brain is particularity open to new experiences and especially able to take advantage of them. If these sensitive periods pass by without the brain receiving the stimulation for which it is primed, opportunities for various aspects of development may be substantially reduced.
When children do not get the care they need during developmental prime times, or if they experience starvation, abuse or neglect, their brain development may be compromised. Many children living in emergency, displaced or post-conflict situations experience severe trauma and are under exceptional and unresolved stress or conditions that are particularly debilitating for young children. Only a few synapses fire, while the rest of the brain shuts down.
Malnutrition is a cross-cutting issue, and thus, should be tackled from multiple directions. The core importance lies in the efficient management of BCC (behavioral change communication) activities at all levels of intervention with optimum services utilizing the experts of the country. There should be a separate set of medical professionals and paramedics under the health services headed by a separate DG or ADG (Nutrition). Similarly, new positions should be created in the family planning services. The role of the journalists and the mass media is magnanimous and unique in creating a positive attitude towards expected behavior change in relation to health, family planning and malnutrition through innovative ideas, constructive criticism, reporting, supporting, writing, forming interest groups, etc. In this modern era, the ‘key to success’ in the social sector is largely in the hands of the journalists and the mass media along with the sincere devotion of the persons involved in the implementation of nutritional activities. Under the umbrella of SDG- sustainable development goals, a new nutrition program / project should be developed, and implemented with the support and supervision of national and international experts. The managers of the program must have sufficient educational back-up knowledge and qualifications to handle the situation. The nation is already on the highway of development, and there is no way to accept that malnutrition has become one of the hindering points of development.
Although, latest data depicts that the extent and magnitude of malnutrition has reduced significantly from that of the previous surveys (surveys undertaken in last 43 years), nevertheless, the percentage of malnutrition level is still unacceptably high. In the developing countries, about 50% deaths among children under 5 years of age are attributable to malnutrition. About 60% pregnant women and children less than 5 years of age have been suffering from nutritional anemia (iron deficiency anemia). About 25% populations have iodine deficiency and almost 20% population have goiters of various grades. The incidence and prevalence of night blindness and blindness due to Vitamin-A deficiency are also noticeably high, but within acceptable range amongst the under five children.
Among all the manifestations of malnutrition, LBW (birth weighing equal or less than 2.5 kg) is the most visible stigma of poor maternal health and nutritional status before and during pregnancy. The more the incidence of LBW, the more the women are deprived of their rights – safe motherhood, decision making power and gender equity. The weight of a newborn basically reflects the quality of its intrauterine development, respect for women in the society, and the health care including the services the woman received during pregnancy. Adolescent marriage and adolescent pregnancy is universal in this country, which is associated with poverty, lack of social empowerment, different types of health problems including UTI etc. The other immediate causes of LBW are also an integral part of their life – lack of food, lack of caring practices, lack of health services including lack of environmental sanitation.
In normal physiological state, a healthy mother gives birth to a child weighing usually about 3 to 3.3 Kg. The rate of growth of children since birth should be at least 3.3 Kg at birth, 6.0 kg at three months, 7.8 kg at five months, 9.2 kg at nine months, 10.2 kg at 12 months, 11.5 kg at 18 months and 12.6 kg at 24 months. Birth weight is an important parameter which could be indicative of (1) the immediate viability of the neonate, (2) the state of maternal health and nutrition before and during pregnancy, (3) respect for the women (4) women’s rights and most importantly (5) the future quality of life of the baby.
Every child since the beginning of the journey of life should have the best possible start, every child should receive a stimulation of connectivity, every child should get good quality of basic education, every child should have the opportunities to develop his or her full potential and contribute to society in meaningful ways. Most of the brain development happens before a child reaches three years of age. In a short span of 36 months of time, children develop their abilities to think and speak, learn and reason, and lay the foundation for their values and social behavior as adults. Choices made and actions taken on behalf of children during this critical period affect not only how a child develops but also how a country progresses. In reality, the future of a country depends on the quality of early childhood. This aspect of national growth and development must be recognized.
When infants are held and touched in soothing ways, they tend to thrive. The brain’s malleability during these early years also means that when children do not get the care they need, or if they experience starvation, malnutrition, abuse or neglect, their brain development may be compromised. Early childhood period starts from fertilization of ovum in the uterus. The effects of what happens during the prenatal period and during the early months and years of a child’s life can last a lifetime. It affects all the key ingredients of emotional intelligence, confidence, curiosity, intention, self-control, relatedness, capacity to communicate and cooperativeness that determine how a child learns and relates in school and in life. It is, of course, never too late for children to improve their nutrition, health and development, to learn new skills, overcome fears or change their beliefs.
In the first three years of life, brain connections proliferating explosively, and children discover new things in every sphere of their life. At birth, a baby has about 100 billion brain cells (neurons). Most of these cells are not connected to each other and cannot function on their own. They must be organized into networks that require trillions of connections or synapses between them. These connections are miracles of the human body, depending partly on genes and partly on the events of early life. Many kinds of experiences affect: how young brains develop, but nothing is more important than early care and nurturing.
The uniqueness of the human brain lies not only in its size and complexity but also in the properties that make it extraordinarily interactive with experience. Every touch, movement and motion is translated into electrical and chemical activity that shifts the genetic momentum. Human interactions are as important to the development of brain connections as having food to eat, sounds to hear and light to see. There are periods in life when the brain is particularity open to new experiences and especially able to take advantage of them. If these sensitive periods pass by without the brain receiving the stimulation for which it is primed, opportunities for various aspects of development may be substantially reduced.
When children do not get the care they need during developmental prime times, or if they experience starvation, abuse or neglect, their brain development may be compromised. Many children living in emergency, displaced or post-conflict situations experience severe trauma and are under exceptional and unresolved stress or conditions that are particularly debilitating for young children. Only a few synapses fire, while the rest of the brain shuts down.
Malnutrition is a cross-cutting issue, and thus, should be tackled from multiple directions. The core importance lies in the efficient management of BCC (behavioral change communication) activities at all levels of intervention with optimum services utilizing the experts of the country. There should be a separate set of medical professionals and paramedics under the health services headed by a separate DG or ADG (Nutrition). Similarly, new positions should be created in the family planning services. The role of the journalists and the mass media is magnanimous and unique in creating a positive attitude towards expected behavior change in relation to health, family planning and malnutrition through innovative ideas, constructive criticism, reporting, supporting, writing, forming interest groups, etc. In this modern era, the ‘key to success’ in the social sector is largely in the hands of the journalists and the mass media along with the sincere devotion of the persons involved in the implementation of nutritional activities. Under the umbrella of SDG- sustainable development goals, a new nutrition program / project should be developed, and implemented with the support and supervision of national and international experts. The managers of the program must have sufficient educational back-up knowledge and qualifications to handle the situation. The nation is already on the highway of development, and there is no way to accept that malnutrition has become one of the hindering points of development.
(PID UNICEF Feature)
