PHOTOS: FABI HUDA

FABI HUDA

This was the first time I was visiting Lalmonirhat, excited to see how the urban/peri-urban living structure differed from what I was used to seeing in Dhaka city, with a goal of examining whether the children in the region are eating well. The first two years of a child’s life, along with the time spent in the womb, constitute the critical first 1000 days of a child’s life, as they determine the foundation for the child’s cognitive growth into adulthood. The nutritional status during this period is assessed using Infant and Young Child Feeding practice indicators globally, looking at exclusive breastfeeding (only for 0–6-month-old children), minimum acceptable diet, and overall dietary diversity for children aged 0–23 months. While there are a total of 17 recommended indicators according to WHO/UNICEF recommendations, these do not include Minimum Dietary Diversity for Women (MDD-W).

Despite its ability to positively impact childhood malnutrition indicators, societal and scientific priorities have sidelined MDD-W as a complementary indicator. When you ask the average Bangladeshi mother if she is aware of what she needs to feed her children, she often demonstrates awareness of the child’s protein and vitamin needs from various sources, underscoring the importance of calorie-rich foods for development as well. She might also be aware of the types of foods she needs to eat during pregnancy and while breastfeeding, but the chances are that her knowledge does not directly translate into practice.

During the fieldwork, we visited many homes, particularly during lunch times. We saw plates of food assembled for a child placed in front of the mother, while her own sat beside it, almost neglected as she fed her child. Whether it was a breastfeeding mother or one introducing new foods to her 6–8-month-old child, the women often neglected their own sustenance for their child. A common sight, even in households in urban Lalmonirhat, was heaped plates of rice, accompanied by a small green chilli and some salt. You see the same in the slums of Dhaka city: mothers who return after hours of domestic work end their days with a plate of white rice and maybe some daal, considering it sufficient sustenance for themselves.

“Why are you only eating rice?” I’ve asked many women, and received a similar answer from most: “Etai baki chilo… Ki aar korbo.” (This is all that was left… What more can be done?) Always coupled with a dejected laugh, as if this were the norm—as a mother and the wife of the household. And while the children in these households were eating well, with plates decorated with eggs and a side of vegetables, it was striking to see the mothers resign themselves to a simple plate of carbohydrates.

Bangladesh’s nutrition policies have reduced child stunting impressively but have largely failed to confront the gender dynamics that keep mothers malnourished. Nearly three-quarters of Bangladeshi women of reproductive age are deficient in more than one essential micronutrient, even as the country celebrates dramatic reductions in visible underweight. While caloric hunger is no longer a concern, deficiency in essential micronutrients is the main culprit behind detrimental health outcomes for women and the children they bear. This deficiency, or “hidden hunger”, persists because its root causes are deeply gendered: women eat last, eat least, and eat the poorest-quality food in their own households, because patriarchal norms present maternal self-sacrifice as a virtue.

Moreover, food taboos strip protein from pregnant women’s plates during pregnancy. As studies note, many women report at least one food restricted by family elders during pregnancy, with nearly half being forced to adhere to these taboos. White carp is avoided because it supposedly causes convulsions in the baby. Trout is believed to cause speech disorders. Duck meat will give the baby a “harsh voice”. Eggs will make the baby too large, necessitating a caesarean section the family cannot afford. Mrigal fish is believed to cause epilepsy. Even traditional beliefs mirroring those of other cultures, such as the Chinese medicine hot/cold classification system, persist. Pregnancy is considered a “hot” condition requiring avoidance of “hot” foods, which can raise the body’s temperature. This leads to families avoiding protein-rich items, including fish, fowl, and lentils. In fact, amongst certain indigenous communities in Khagrachari, studies have identified 64 distinct food items classified as taboo during pregnancy.

The gender order, as Levay et al. write, “disadvantages women through gendered food allocation that often privileges males, which results in an inequitable distribution that can begin in childhood and leads to women’s lifelong poor nutritional status.” One of the factors that forces the persistence of this gender order is the economic depravity faced by many families, which leads to unequal distribution of food. Food inflation reached 12.56% in October 2023, driven by the aftershocks of the Russia-Ukraine war, currency depreciation, and supply disruptions. WFP monitoring found that 30% of low-income households were food insecure in late 2023, with more than six in ten households adopting harmful coping strategies. In fact, during food crises, mothers absorbed the shock: they reduced both the quantity of their food intake and the quality and diversity of what they consumed in order to feed their children and husbands.

So, the question arises: who is responsible for Bangladesh’s maternal malnutrition crisis? Is it just a crisis of food availability, or is it our negligence of its gendered origins? The country produces enough food to feed its population, but patriarchal household dynamics ensure that mothers absorb the deficit in times of crisis. Unless Bangladesh confronts the gendered power structures within its own households, its impressive nutrition gains will continue to leave mothers behind. There needs to be a stronger push from technical experts as well as policymakers to dismantle these beliefs systematically. Incorporating the expectation of gender equity within family dynamics into our education system and the daily lives of our youth will encourage children to look after their mothers, and to learn to respect family members who have generationally sacrificed their own well-being.

Fabi Huda is a health policy researcher, currently working with climate change & public health in Bangladesh. She can be reached at fabi.s.huda@gmail.com.