Despite a 'slight' decline in the last four years, preliminary results of Bangladesh Demographic and Health Survey (BDHS) show child malnutrition still remains high.
The findings released on Tuesday in Dhaka also 'shocked' experts as the 'vital' vitamin-A intake fell from 88 percent four years back to 62 percent, apparently due to low campaign coverage.
Underweight children under-5 declined from 41 percent in 2007 to 36 percent while 41 percent children were found stunting, too short than they should be at their age, which was 43 percent in 2007.
Sixteen percent children, only one percent less than 2007, are still considered wasted or too thin for their height.
Although exclusive breastfeeding rate in the first six months leapt from 43 percent in 2007 BDHS to 64 percent, proper feeding practices of children under two years of age have fallen from 42 percent to 37.
"It is only 21 percent if we count the percentage following more stricter definition of infant and young feeding practices," said Dr Shams El Arifeen, an ICDDR,B director who presented the survey finds.
If the current trends continue, government will be able to achieve its 'conservative' nutrition target of HPNSDP, reducing stunting to 38 percent and underweight to 33 percent by 2016.
But experts say much needs to be done to achieve an optimum goal in Bangladesh, home to one of the largest malnourished children in the world.
The findings have upset nutritionist Dr Tahmeed Ahmed like many others as combating malnutrition is seen as the key to economic development.
"The progress (cutting malnutrition rate) is very little. It's nothing extraordinary," the director of ICDDR,B nutrition programme said, adding new approaches should be taken based on the findings.
He said the fall of vitamin-A supplementation 'disappointed' him since a third of women and children suffer from deficiency of this vitamin in Bangladesh.
Vitamin-A deficiency can cause childhood blindness in developing countries. It also increases the severity of infections like measles and diarrhoeal diseases in children and can slow the recovery from illnesses.
He said only breastfeeding is not enough to combat malnutrition, homemade food should be provided properly.
Dr Ahmed said apart from scaling up direct nutritional interventions like feeding practices and vitamin-A supplementation, there should be some indirect approaches to improve the situation.
"We should focus on women empowerment, health-seeking practices, agriculture, livestock, sanitation and hygiene practices to get better results," he said. It has been proved that these factors can improve nutritional status, he added.
"We found it in our study results which were published in British medical journal The Lancet," he said.
Dr Ahmed also suggested campaigns on appropriate feeding practices as at least one in four children of rich families was found malnourished, despite abundance of food.
Public health specialist Dr Khairul Islam of Wateraid Bangladesh said due to lack of proper hand washing practices, food do not get absorbed properly.
"Lack of hygiene causes chronic infections that eat away nutrition of a person," he told bdews24.com.
However, the decline in vitamin-A coverage has worried policymakers as the HPNSDP target is to achieve 90 percent by 2016 which seemed achievable until Tuesday.
In 2011, vitamin-A has been provided in the first immunisation campaign on Jan 8, exactly 6 months prior to the start of the 2011 BDHS data collection on July 8.
The second campaign was held on May 29.
Since BDHS data collection continued until Dec 27, 2011, at least the last month of the survey was more than 6 months after the campaign.
"It seems that the coverage achieved in the May vitamin-A campaign may not have been optimal," said Dr Arifeen.
The interviewers asked mothers if their children under age five had taken a vitamin-A capsule in the six months prior to the survey.
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