2. Feeding Program
Feeding program is the most outreached solution
that we could offer to our society for proper
growth & maintenance.
Through feeding program we can able to help
those people who are suffering from food scarcity.
It also help the child in developing many
behaviors like socialization, sharing their foods, be
kind to all & cooperation.
3. Supplementary Feeding Program(SFP)
in BINP
A supplementary feeding program (SFP) was
implemented on the Bangladesh Integrated
Nutrition Project (BINP- the first large-scale
government intervention in nutrition) in response to
the high rates of low birth weight and malnutrition
among children and women of childbearing age.
4. Objectives/Aims/Purposes/Goals
The following are specific objectives of the
SFP:
Reduction of severe protein-energy malnutrition
(PEM) in Under 2 children by 50 percent
Reduction of moderate PEM among Under 2
children by one-third
Reduction of low birth weight (LBW) incidence by
50 percent
Improvement in weight gain to 7.0 kg in at least 50
percent of pregnant women
5. Targeted Areas
Supplementary feeding program in BINP covered
59 of a total of 464 Thanas (administrative units)
in Bangladesh. The approach is being scaled up
through the following National Nutrition Program
(NNP) to cover 105 of the country’s 464 Thanas;
further scaling up of nutrition action is planned
through the recently approved Health, Nutrition,
and Population Sector Program (HNPSP).
6. Program Duration
This supplementary feeding program (SFP) was
implemented between May 1995 and December
2002 and was followed by the National Nutrition
Program (NNP), whose implementation was just
begun in 2004.
7. Supplementary Nutrition per Day
Beneficiary Calorie
(Kcal)
Protein
(grams)
Growth faltered children under 2
years of age
800 20-25
Malnourished children under 2
years of age
500 12-15
Pregnant & lactating women 600 18-20
8. Supplementary Feeding Program
in BINP: Success relies on
For a better policy than welfare, following five conditions are
met:
1. The target groups have to enroll in the
program.
2. The criteria are correctly applied in selecting those to receive
supplementary feeding.
3. Those selected for supplementary feeding attend sessions to
receive the food.
4. There is no leakage (for example, selling of food supplements
or substitution (reducing other food intake).
5. The food is of quantity & quality to have a noticeable impact
on nutritional status.
9. Identified Percentage of Participants
Who Attended The SFP
Subgroups Both eligible & received population
for SFP
Both not eligible but
received population
for SFP
Malnourished, and
growth faltered children
under 2 years of age.
Eligible Received Not
Eligible
Received
70% Only 30% 30% 13%
Malnourished pregnant &
lactating women
Eligible Received Not
Eligible
Received
63% • 53% fully(at least 95%
of sachets)
•50% partially(less than
95% of sachets)
received
37% 37%
* Source of information comes from the study by Nahar (2003) in one BINP Thana.
10. Program Evaluations
All the available evidence from SFP in BINP does not show
that it improved growth in children, weight gain in pregnant
women, or birth weight in infants.
There are numerous potential explanations for this type of
negative results, including-
Mistargeting (especially errors of exclusion);
Sharing of supplementary food;
Substitution for other foods;
Inadequate ration size or incomplete participation;
Palatability issues;
11. Program Evaluations
Biological partitioning;
Inadequate feeding practices before, during, and after
illness;
Infection itself;
Restrictions on women’s mobility; and
High work and time demands placed on women.
All of these explanations, and others, are plausible and
have been offered in various evaluation reports.
12. Supplementary Feeding Program
in BINP: Program Disadvantages
To provide better nutrition to the selective, such type
of government-financed nutrition program is
probably not a permanent solution.
Require large amounts of time & effort.
Corruption has not been entirely prevented.
Lack of integration with other important local rural
NGOs.
13. Supplementary Feeding Program
in BINP: Program Advantages
The evidence of limited impact does not mean that the SFP in
BINP is not without its successes. The program has been shown in
numerous studies to be effective in improving child growth and
pregnancy outcomes.
i. First, the project has raised awareness of nutrition issues
amongst both government and non-government organizations.
ii. Secondly, there has been successful mobilization at the
community level, with high levels of participation in growth
monitoring
14. Supplementary Feeding Program
in BINP: Program Advantages
iii) Finally, as Sack et al. demonstrate, there have been benefits to
some target groups. They present data to show that
supplementary feeding for pregnant women has a beneficial
impact after enrolment. OED's analysis similarly finds that
supplementary feeding for children has a larger impact for
children attending on a regular basis, with a still larger impact
for the most malnourished children. As reported by Levinson
and Rohde, there is also a significant project impact on low
birth weight for children born to low-income women.
15. Conclusion
Inspite of the various problems faced by the SFP in
BINP and the inherent disadvantages of the program,
it has been quite phenomenal in helping the low birth
weight and malnourished children and women of
childbearing age. A great advantage of this program is
that it helps the participants from more than the well
off. And added to this is the political support that can
be easily garnered for this program. So, it can be
implemented quite efficiently in the poorer sections of
the community.
16. References
This study draws primarily on the following reports and analyses:
a) BINP Endline Evaluation, Final Report, September 2003 (Karim et al. 2003)
b) Thin on the Ground, 2003 (Save the Children Fund)
c) Baseline Survey of NNP: Initial Results, January 2005 (ICDDR,B)
d) Impact Evaluation of BINP, June 2004 (IMED, GOB)
e) Maintaining Momentum to 2015, February 2005 (OED, World Bank)
- Reanalysis of data from the endline evaluation report
- Reanalysis of SCF data
- Analysis of the 2000 Demographic and Health Survey (DHS) data
f) Nahar, S. Impact of Food Supplementation on Pregnancy Weight Gain and Birth Weight
in Rural Bangladesh. PhD thesis, Cambridge University, 2003.
g) Sack DA, Roy SK, Ahmed T, Fuchs G. 2005. Letter to the Editor. Health Policy and
Planning 20: this issue.
h) Levinson FJ, Rohde JE. 2005. Letter to The Editor. Health Policy & Planning 20: this
issue.