By Steve Godfrey, Director, Policy & External Relations
Rallies and marches evoke great causes; for equality and rights, employment, the environment – you can add to the list. But the idea that better nutrition could be the trigger for youth action via a rally? Unlikely, I agree, but read on…
Several years ago, a charismatic Bangladeshi TV presenter, Farzana Brownia, took to the airwaves to talk about her experiences in pregnancy – courageous in a socially modest culture. Her programme on Bangladesh’s third largest TV channel, Channel i, helped spark the creation of the Shornokishoree (translated literally as “golden adolescent girls”) Network Foundation (SKNF), a movement which today numbers around 50,000 adolescents girls and boys across the country.
This network of school-based clubs is recognised by the Ministry of Education. Members are selected from classes, typically discussing topics such as unemployment, early marriage at school – issues that matter to young people. These groups mirror the demographics of the school: either mixed, all boys, or all girls). They are taught self-confidence, self-reliance and social responsibility and have to organise meetings in their own communities on the topics discussed at school. The Foundation also supports scholarships for the most disadvantaged and advocacy. The members are active in identifying child marriages and then get these reported and stopped by the authorities.
Why might a movement of adolescents matter for nutrition? The malnutrition statistics in Bangladesh speak for themselves:
- Among 29.5 million adolescents, 26 percent rural adolescent girls are underweight
- Anemia is 49 percent among 15 to 19 years old adolescent girls
- 59 percent of girls are married before 18, exposing millions to the risks associated with early pregnancy, doubling the rate of maternal mortality
- Almost one third of the adolescents aged between 15 and 19 years old are already mothers or pregnant with their first child
On the plus side, the Government is committed to addressing these challenges through its National Strategy for Adolescent Health. Also, Bangladesh has made some important progress – for example, overall stunting of children under 5 years of age has been steadily falling in the country, and early marriage has fallen by 6 percent points since 2011.
But adolescent nutrition is a big challenge to Bangladesh and us all. The nutrition community has come late to the issue. Our galvanising and important focus on the first 1000 days somewhat overshadowed the significance of health status preconception to tackling stunting, to the critical dangers associated with early pregnancy and of poorly nourished mothers. Added to this, adolescents are not, unlike new mothers and babies, automatically reached via the public health system. They sit outside regular channels.
So how to address a critical constituency which is hard to reach, in rapid growth and dramatic physical changes, undergoing the transient adulthood?
Under the leadership of Directorate General of Family Planning (DGFP), Ministry of Health & Family Welfare, GAIN prepared “Turning the Future: Landscape Analysis on Adolescents and Nutrition in Bangladesh” in 2017 in collaboration with partners and supported by the Ministry of Foreign Affairs, Netherlands. The landscape analysis (to be published soon) sheds light on adolescent nutrition and also highlights the fact that there are gaps in data related to adolescents and their diet. In addition, GAIN has also carried out a Consumer Insight Study (CIS) in selected districts that revealed human side of nutrition, of poverty and of limited choices. For example, when girls marry, they move to their in-laws home, where the social pressure to eat lightly, not to appear selfish, reinforces dietary inadequacies.
In nutrition we have made a slow but important shift from seeing those who are malnourished mainly as potential recipients of services or interventions to “fix” the problem, to putting them at the centre of solutions – agents choosing better eating practices, better and more nutritious diets, pushing for a food system which can make those kinds of food more available.
But adolescents are a particularly difficult group to see as agents – their choices are constrained by their families/carers, they are notoriously immune to advice, self-willed, and heavily peer influenced – not by “authorities”.
So when I attended and shared GAIN’s 15th anniversary in Dhaka with a group of forty 13-15 year old “golden girls”, the State Minister in the Ministry of Women and Children Affairs and a host of dignitaries, I was intrigued. Was this a way to bring young people into action to improving their own nutrition? To be agents not subjects, actors not beneficiaries?
It is still too early to answer that question but the experience was impressing. Listening to these very young women discussing what they eat, why and how it is connected to their health and development was spellbinding. The reports back from the four working groups were concise, succinct and the more amazing for being done in front of TV cameras and VIPs . Frankly, so much clearer than hundreds I have heard in development meetings! And covered repeatedly on the evening TV news.
And it hit home that, if representative of their peer group, almost 25 of these 40 girls would be married with a child within a couple of years.
Back to the march: the start of the journey is on 18 and 19 of December, when 5,000 golden girls from across the country will rally in Dhaka to launch a national “Adolescent Nutrition Campaign” with very high level policy makers and leaders. Under the guidance of the Government of Bangladesh, SKNF with Channel i will lead the launch, with support from GAIN. Could it be a game changer in thinking about this problem and identifying new ways to tackle it?
The model has an unusual potential – the Government has come forward with its support. It is based on an organised and successful nascent movement of young people. It has a big media channel behind it. Most importantly, it sees the girls as future leaders and shapers of a prosperous Bangladesh. Surely we should all rally to the cause!
Published 22 November 2017