How to Change the Cycle of Poverty, Malnutrition and Abuse in Bangladesh

A baby born into a poor rural community in Bangladesh has a lot of hurdles to overcome.

Surviving the birth is the first challenge — 8 out of 10 births in Bangladesh are at home, on a dirt floor, without a skilled health worker present, putting both the baby and the mother at risk.

Most mothers breastfeed, which provides infants with a healthy start, but after the first six months, nutrition becomes a big challenge. Poverty, high food prices and lacking knowledge about when and how to best introduce complementary foods, means that only 21% of children under two receive a minimum acceptable diet and 41% of children under the age of five are stunted (too short for their age, which impairs cognitive ability, and results in 20% lower earnings as an adult).

If the family doesn’t have enough food, when the child reaches school age, she will have to work to support the family (almost seven million children between five and 14 have to work to help their families survive). She may be sent away from her parents to be a child domestic worker in the home of another family in the city (there are around 400,000 child domestic workers between the ages of 6 and 17 in Bangladesh). Working in the home of a stranger who completely controls her life, the child would be hidden from public security, forced to work long hours for little or no pay, and subject to physical and sexual abuse (5% are raped by employers, 20% are physically tortured, and some are killed).

At around age 13 or 14, the child would be called back to her village and forced to marry (2/3 of girls are married before they turn 18). Soon after the wedding, she would be pregnant with her first child (60% of girls have their first baby before the age of 18) and she may not survive childbirth (girls who are married before the age of 18 are five times as likely to die during childbirth).

Once her baby is born, the cycle starts over again, repeating and multiplying with each short generation.

Uneducated, poor, young mothers in rural Bangladesh fear for their babies. But is there a way to change the cycle and allow these mothers to hope for a better future for their children? In September, I visited Bangladesh with Save the Children Canada and had the opportunity to visit their health, nutrition and education programs.

Read on to find out how they are working with communities to chart a new path…

Except where indicated via a link, all facts cited are from written or verbal materials from Save the Children.

Map Tracking Pregnancies in Bangladesh

Making Pregnancy and Childbirth Less of a Gamble

Many rural communities in Bangladesh do not have easy access to a qualified health worker.  To stop newborn babies, mothers and children dying, there is a need for a health worker in reach of every mother and child. That’s why Save the Children Canada is helping 400,000 of them around the world, including in Bangladesh.

On my trip, we spent a couple of days visiting the MaMoni project, which aims to improve maternal and newborn health and increase access to family planning services. It is being implemented in 15 upazilas (sub-districts) of Sylhet and Habiganj districts in northeast Bangladesh. The total population of the project area is 3.5 million. A major focus of the initiative is ensuring access to qualified health workers who can follow women through their pregnancy, assist in the delivery of their baby in a birth center, and provide easy access to public healthcare facilities and family planning services.

At the birth center we visited in Habiganj, health workers track women in the region from the identification of their pregnancy through to the birth, whether they choose to give birth in the birth center or at home. The large chart on the wall pictured above identifies where the pregnant women live, their expected due date and whether they are experiencing any complications or difficulties that need to be monitored.

Photo credit: Annie Urban

Photo Credit: Shafiqul Alam Kiron / Save the Children

Hands-on help with breastfeeding

Exclusive breastfeeding for the first six months is one of the most important things that a mother can do for her child’s health (nearly one million child deaths could be prevented globally each year if babies were exclusively breastfed for six months). Although most mothers in Bangladesh breastfeed (98% initiate breastfeeding and the average age of weaning is 33 months), they aren’t necessarily practicing the best techniques to ensure a healthy milk supply and well-nourished infants. Through 24/7 access to health workers, written materials, as well as community volunteers who visit mothers in their homes, new moms are taught proper breastfeeding technique and are helped with any problems they are facing.

Photo credit: Shafiqul Alam Kiron / Save the Children, Used with Permission

Easy Access to Health Care

If the mothers or their babies need medical attention, they can now go to the local health center. I was told that most patients are seen by a health worker within an hour of their arrival at the facility, which provides round the clock care. The waiting room has a television that plays a family drama with famous Bangladeshi actors. The show has been specifically scripted to reinforce important health messages. Many minor medical issues are diagnosed and treated in the center and, when complications arise, health workers can arrange for transfer to a larger facility.

Photo credit: Annie Urban

Introducing nutrient rich complementary foods after 6 months of age

Both tradition and poverty have led to infant feeding practices in Bangladesh that put some infants at risk. When food is scarce, some women continue to rely on breastfeeding as the sole source of nutrition for their babies well past the six month mark, which can lead to deficiencies in iron and other key nutrients. When food is introduced, mothers often give their babies something different than the family food, such as simple rice preparations, which would meet the baby’s hunger needs but not give them the nutrients that they need. Simple grains often end up accounting for the vast majority of a child’s diet. Since the first couple of years of the baby’s life are a critical time for health growth, brain development and protection of immune systems, a child that is malnourished during that time will suffer for life.

Through the MaMoni project, Save the Children and its partners have been implementing programs that teach mothers to start feeding their infants a variety of complementary foods, including rice, vegetables and animal protein, starting at six months of age. Community volunteers show mothers how to prepare a plate for the baby that is based on the family’s menu (instead of preparing separate baby food). They are taught to ensure that their baby’s access to protein is prioritized when food is scarce — adults and older children will not suffer as much from inadequate protein as babies will.

Photo credit: Annie Urban

Combining Work and Education

As children grow up, they may have to work to support their family’s income. Although Bangladesh does hope to eliminate child labor, the process has to be gradual. Banning child labor outright and intervening to remove children from their jobs puts them at risk of starvation, homelessness and being sold into the sex trade.

As the government and NGOs work towards their goals on the elimination of child labor, education programs being put in place by Save the Children are helping more and more children get an education while also helping to support their families. The children pictured above are in a Grade 4 class with an adapted schedule that allows them to go to school for several hours per day and then also spend time working in their family embroidery or car repair businesses. As they get older, they can participate in apprentice programs in skilled trades such as embroidery, mobile phone servicing, computer word processing and more.

In the case of child domestic workers, Save the Children approaches employers and convinces them to send the children to school for a couple of hours per day. The employers are pressured to “do the right thing” by letting the child go to school, but are also promised that the child will learn skills that will help with their tasks in the home, such as cooking.  The education and skills that these children get help them to earn a better salary and have greater opportunities in life. It also gives children an opportunity to report any abuse in the home to their teachers, which increases their safety.

The more educated these children are, the greater their economic opportunities will be in life. The more money they make, the less likely they are to have to force their children to work one day. Education is the key to breaking this cycle.

Photo credit: Annie Urban

Strong Community Engagement is Key to Sustainability

One of the most amazing things about the MaMoni project was the way that the community was engaged. Participation by both men and women who volunteer their time to learn about healthy pregnancy and health babies and to share their knowledge with others is allowing these communities to take charge of their own health and their future. In addition to one-on-one visits with individual mothers, the community also organizes community action groups that identify the key health problems facing mothers and children in their community and develop plans to address those through interventions and education.

In Dhaka, we visited a youth club, where young volunteer leaders (teenagers) developed and ran programs for children and youth to keep them off the streets and give them opportunities to develop and express themselves. The responsibility and pride that they took in improving the outlook for youth in their urban slum was impressive.

The engagement of the community and volunteers is key to ensuring these initiatives are appropriately and strongly integrated into local culture and that the practices are sustainable.

Photo credit: Annie Urban

What a Difference It Makes

An educated, well-nourished child has many more opportunities than an uneducated, stunted child that has been abused and forced to work long hours in dangerous conditions. Programs like the ones I visited with Save the Children Canada mean that girls like these two can dream about their future education and careers, instead of preparing for marriage and childbirth and poverty. They give children the chance to be children, while also giving them the chance to grow up to be adults with choices and agency. They’re changing the cycle from one of poverty, abuse and death to one of hope, dreams and choices.

What changes would you like to see in your community to break harmful cycles that are preventing youth from reaching their potential?

Learn more about the programs being implemented by Save the Children Canada and read more about my trip to Bangladesh on the PhD in Parenting blog. Want to help? Canadians can send Stephen Harper an e-mail and take other actions to help end child hunger.

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Iranian Parliament Wants to Legalize Marriage for Girls as Young as 9 Years Old

Photo credit: Annie Urban

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Wanda Forrest
Wanda Forrest2 years ago

What a sad event people lost lives..

Naomi A.
Naomi A.2 years ago

I love hearing about these types of programs!
Thank you Annie Urban for posting it.

Elizabeth Sowers
Liz Sowers2 years ago

Sounds like the Mamoni Project and Save the children are making huge differences in the lives of many, and this will make a profound difference in the future of these communities.

Rachael Pappano
Rachael Pappano2 years ago

Thanks for the article, great ideas, gives me hope that things like this where it's really needed can change for the better and things like poverty, malnutrition and abuse will someday be a thing of the past.

Jink Huge
Jink H.2 years ago

It's a shame that these practices go on in the "modern world". It goes to show the mindset of poverty and survival of the "fittest". I always thought that if I were destitute that I wouldn't bring a child into this world but I was raised in a country where we are educated. Impoverished countries lack education so they follow tradition of marying young and starting families.

Sarah Hill
Sarah Hill3 years ago

What will change the cycle of poverty is education and good paying jobs, not hand outs.

jenny H.
jenny H.3 years ago

Thank you for this interesting and informative article. I'm currently studying for a degree in Childhood studies which touches on the issues raised here. It is hard not to feel overwhelmed when faced with the enormity of the issues at stake. Hearing positive stories of change is encouraging.

Areba P.
Areba P.3 years ago

Annie good job on highlighting the work of MaMoni. I just want to add that MaMoni is a USAID funded program that is implemented by Save the Children in Bangladesh along with local NGOs FIVDB and Shimantik.

Heidi H.
Past Member 3 years ago

Education and birth control and the awareness of sexual equality is of utmost importance for developing and underdeveloped nations. This is an admirable effort.

sandra g.
sandra g.3 years ago

we all should open our hearts , we read this reality and continue to our daily life as every other day, it is a must to make a change , beginning in ourselves, being generous, kind and peaceful., at least .