Staff Correspondent
Experts have suggested working towards full integration of nutrition into the primary healthcare system through stronger public-private collaboration to address Bangladesh's evolving nutrition challenges and accelerate the progress towards Universal Health Coverage (UHC).
The made the suggestion at a national roundtable titled "Integration of Nutrition Actions in Primary Healthcare Systems through Public-Private Platforms in Bangladesh," organised by Max Foundation Bangladesh in the capital on Monday.
Senior government officials, representatives of development partners, UN agencies, research organisations, academia, civil society, and the private sector joined the event to engage in a multi-sectoral conversation regarding practical approaches to mainstreaming nutrition within routine primary healthcare services.
Dr. S.M. Ziauddin Hyder, Special Assistant to the Prime Minister on Health Affairs, spoke at the programme as the chief guest while Prof. Dr. Pravath Chandra Biswas, Director General of the Directorate General of Health Services (DGHS), was present as the special guest. The keynote paper was presented by Saiqa Siraj, a public health nutrition specialist, and the session was chaired by Dr ATM Tariqul Islam, Country Director of Max Foundation Bangladesh and Regional Director of Max Foundation South Asia.
Dr. Hyder highlighted the pitfalls in historical efforts of the nation’s nutrition policies, explaining that such initiatives have long lacked strong government ownership, and largely remain donor-driven with sustained changes being slow to witness.
“We have achieved gains in tackling malnutrition and stunting, though progress has been slow. We need a stronger, government led and coordinated approach,” he added.
Expressing the government’s plans to build a healthier Bangladesh, Dr Hyder laid emphasis on a lifecycles approach where individuals are receiving community-based preventative care from birth to adulthood through extensive primary healthcare systems.
He explained the plan for union sub-centres, each of which will be staffed by nine community health workers. According to him, an inter-sectoral approach to nutrition, health and food safety is essential for success of primary healthcare and to strengthen coordination, the government is considering a National Food and Nutrition Authority Commission to oversee policies, implementations, and collaborations.
Prof Dr Pravath Chandra Biswas linked the micronutrient deficiency persisting in society to the disease burden, noting that 70 per cent of deaths in Bangladesh are now non-communicable diseases. He explicitly mentioned that chronic issues such as hypertension and kidney disease are closely tied to these deficiencies, since a child denied nutrition in the womb carries reduced nephron function and chronic disease into adulthood.
Dr Mohammed Eunus Ali, Director of the Institute of Public Health Nutrition, said nutrition is routinely left at the edge of health services rather than placed at their centre.
Following up with Dr Ali, Dr Rawshan Zahan Akhter Alo, Deputy Director of IPHN, added on an additional focus on the golden 1000 days: 270 days of pregnancy plus the following two years.
Dr Tahmeed Ahmed Executive Director of icddr,b, discussed hallmarks in understanding nutrition and child health globally. Through extensive clinical studies, icddrb has been able to identify the causal mechanism for stunting -- poor water, sanitation and hygiene, he said.
Dr Iqbal Kabir, a public health nutrition specialist, raised the unresolved question on how to operationalise public-private partnership for nutrition and regulate the private-public platform and what role the private sector plays in doing so.
BRAC James P Grant School of Public Health Professor Prof Kaosar Afsana argued that systems-thinking, and systems linkage are essential, pointing out that nutrition is currently parcelled out between ministries — health, WASH, early childhood development, environment — while agriculture, fisheries and livestock matter just as much yet sit outside the conversation.
In the keynote speech, Saiqa Siraj, highlighted that nutrition services remain fragmented despite a substantial policy architecture with an estimated 60 to 70 per cent of rural care-seeking flowing to informal and private providers sitting outside public protocols.
In his closing, Dr ATM Tariqul Islam, emphasised the importance of bringing together the public sector, private sector, and civil society to strengthen nutrition and primary healthcare.
Faria Shabnam, NPO—Food & Security of WHO, Dr Rudaba Khondker, Country Director of GAIN, Tahmina Ferdous, Nutrition Specialist at UNICEF, Dr Santhia Ireen, Deputy Director of Education & Research at BRAC JPGSPH, Kazal MM Ahidul Islam Head of Programme Design & Quality at Max Foundation, Shihab Uzzaman, Country Director of Bopinc, Mohammad Solaiman Rasel, Chief Technology Officer & Chief Business Officer at Grameen HealthTech Limited (Shukhee), Mohammad Soeb Iftekhar, Associate Director of Programs at iDE (International Development Enterprises) and A S M Shahidul Alam, Team Leader, MMS project on behalf of SMC, also spoke.
