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Promoting better nutrition in Bhutan

Izabela Leao's picture
 Izabela Leao / World Bank
School children singing and dancing in Samtse Dzongkhag. Photo Credit: Izabela Leao / World Bank

Bhutan is no ordinary place.

A landlocked Himalayan kingdom tucked in a mostly rugged mountainous terrain between India and China, it measures prosperity by assessing its citizens’ level of happiness by way of a Gross National Happiness index.

Equally striking, Bhutan’s constitution mandates that 60 percent of its national land be preserved under forest cover, making Bhutan the world’s only carbon-negative country.

Bhutan’s geography – with land rises ranging from 200 meters in the southern foothills to 7,000 meters in the high northern mountains – consists of three major agro-ecological zones that allow for a rich biodiversity and seasonal foods.

This natural wealth, however, comes with its caveats as Bhutanese living in isolated rural areas can’t access a reliable diverse diet throughout the year.

"Many families in rural Bhutan practice two meals rather than three meals a day," reports Ms. Kinley Bidha, Tarayana Foundation Field Officer in Samtse Dzongkhag. "Some for cultural reasons, others due to a shortage of food, others due to a shortage of land too farm," she adds.

Overall socio-economic development in the last three decades has led to a rapid improvement in health and nutrition outcomes in Bhutan – the country’s infant mortality rate declined to 30 per 1,000 live births in 2012 down from 90 per 1,000 in 1990; while the rate of stunting in children under 5 years declined 24 percent from 1986 levels.

Nonetheless, the lack of variety of foods in diet remains a key concern, especially for pregnant and nursing women as well as young children. And while most families feed their children complementary food, fewer than a quarter of parents provide them nutritious meals essential to their health.

In addition, 67 percent of Bhutanese adults consume less than the recommended five servings (or 400 grams) of fruits and/or vegetables per person a day [National Nutrition Survey (NNS) 2015].

When consumed, vegetables consist for the most part of two national staples, potatoes and chilies, which hardly provide essential vitamins and minerals.

Keeping regional variations in mind, between 16 and 34 percent of children under 5 are stunted—or too short for their age—seven percent of children are underweight, 35 percent of children of age 6-59 months and 44 percent of women of reproductive age are either anemic or iron deficient. Exclusive breastfeeding rates for six-month-old children remain at a low 50 percent (NNS, 2015).  

Damages caused by malnutrition during pregnancy and the first years of a child’s life are irreversible and contribute to stunting and lower immunological and cognitive development, and predispose to adult-onset diseases (including metabolic syndrome).

Thankfully, the negative impact of malnutrition on Bhutan’s economy is now better understood and has become a priority to promote its national development.

Empowering Indian women after a natural disaster hits

Hyunjee Oh's picture
In June 2013, a heavy deluge caused devastating floods and landslides in the state of Uttarakhand in India’s Himalayan foothills. Damyanti Devi, the mother of a young daughter, lost her home and livelihood. Her old house in Rudraprayag was completely washed away by the landslide.
In June 2013, a heavy deluge caused devastating floods and landslides in the state of Uttarakhand in India’s Himalayan foothills. Damyanti Devi, the mother of a young daughter, lost her home and livelihood. Her old house in Rudraprayag was completely washed away by the landslide.


This blog is part of a series exploring housing reconstruction progress in Uttarakhand, India.
  
In June 2013, a heavy deluge caused devastating floods and landslides in the state of Uttarakhand in India’s Himalayan foothills.
 
The disaster – the worst in the country since the 2003 tsunami—hit more than 4,200 villages, damaged 2,500 houses, and killed 4,000 people.
 
Damyanti Devi, the mother of a young daughter, lost her home and livelihood. Her old house in Rudraprayag was completely washed away by the landslide.
 
“The river was fast swelling up,” she said. “It had crossed the danger mark and reached close to our house. We just took our daughter and left with an umbrella and a lantern.”
 
She now owns a new house abuzz with music and her daughter’s laughs.
 
Like thousands of other people in Uttarakhand, Damyanti received support through the World Bank and the Global Facility for Disaster Reduction and Recovery (GFDRR) to rebuild her home.
 
This support channeled through the Uttarakhand Disaster Recovery Project (UDRP) also helped build better roads and mitigate future disaster risks in local communities.
 
A key component of the project was to rebuild 2,382 more resilient houses based on the owner-driven housing reconstruction model,  which allows families to rebuild according to their specific needs.
 
This community-driven approach is important as women are typically at greater risk from natural hazards than men, particularly those who are poor and live in low-income countries.
 
There is indeed strong evidence that disasters impact women differently and amplify gender inequalities.
 
Women and men have different perceptions of their surroundings and coping abilities, roles, responsibilities, and resources before or in the aftermath of a disaster.
 
Gender-sensitive approaches to disaster prevention, mitigation, adaptation, relief, recovery, and reconstruction can save more lives and promote more gender-inclusive development.  

With that in mind, the  housing reconstruction component of UDRP helped empower women like Damyanti in the aftermath of a disaster in 4 different ways:

Indian agriculture at a crossroads: Smart solutions towards doubling farmers’ incomes

Martien van Nieuwkoop's picture
A few weeks ago, I felt a sense of déjà vu.  I was at a roundtable on agriculture in Delhi, in the same conference hall where, ten years ago, I participated in the consultations on the Bank’s World Development Report 2008 on Agriculture for Development
 
This time we were discussing how India can build a stronger agriculture sector without further harm to the environment or depletion of its natural resources.  The high-level dialogue was attended by senior representatives from India’s Niti Aayog, Ministry of Agriculture and Farmers’ Welfare, leaders of farmers’ associations from Punjab and Haryana, as well as by researchers, academics, and donors.

We focused on the ‘agriculture-water-energy’ nexus, achieving India’s second green revolution, making agriculture more climate resilient, as well as options to stop the burning of crop residue that is worsening air quality in much of northern India. It was heartening to see the torch bearers of India’s drive towards food security unhesitatingly debate a host of complex and sensitive issues.
 
Photo Credit: Alamy Stock Photo

Over the past six decades, India has come a long way from being a famine-prone country to comfortably producing food for 1.25 billion people from finite arable land. Food security firmly in hand, the government is now targeting to double farmers’ incomes by 2022.  Today, with rapidly growing urban food markets, India is emerging as a global agricultural powerhouse.

Face to face with Country Director for India, Junaid Ahmad

Nandita Roy's picture

The Lighthouse India is a platform to facilitate knowledge flows across states within India and to create strategic partnerships with other countries to share and transfer knowledge and experience, which would inform development policies, scale up good practices and innovations. We caught with our Country Director, Junaid Ahmad, for an in-depth understanding of this initiative of the World Bank.

What is Lighthouse India?

Development is best catalyzed when people learn by doing. The notion of lighthouse is that you are a beacon for someone. An Indian state innovating on how local government programs are run, say in West Bengal, can be a source of information for other states, say Madhya Pradesh or Karnataka, which are also trying to figure out how to strengthen local governments. In a federal system like India, the potential for learning from each other is vast especially where innovation is constantly happening. The problem is that the lessons from these innovations and the information about them is not moving smoothly across borders. Lighthouse India is based on the Bank's unique position to facilitate these exchanges and link them to actual implementation.

It is not only about exchanges between states in India. As India moves along the development trajectory towards high middle income, the nation itself is transforming. The lessons of this transformation are going to be critical for other countries. The Bank can also proactively broker these exchanges between India and other countries as India acts as a “lighthouse” for others.

It is important to stress that Lighthouse India is not just a passive exchange of best practices. It is an active exchange of practices and approaches where the expertise and experiences of India can be leveraged by another country. And as always, these exchanges are never one way: as India shares, it will gain from the development experiences of others.

Importantly, Lighthouse India will change the way we do analytical and advisory services.  The latter will be built around operational issues and offer the analysis to understand better implementation challenges.

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How is Lighthouse India important for Bank’s strategy in engaging with India?

First, Lighthouse India is essential in supporting the strategy of scaling up development impact. Let me take the example of livelihood programs. We’ve been working in Andhra Pradesh, Bihar, Odisha supporting the creation of self-help groups of women and facilitating their access to micro credit and economic activities. We could respond to every state that requests our assistance for this kind of activity. On the other hand, if we have worked in three or four States, we can then leverage their expertise and experience to support others. In this context, the World Bank can act as a broker of exchanges where states learn from the experience of each other. And this could be in any area such as local government strengthening or in solar power generation.

Second, Lighthouse India will play an important role in the delivery of global goods. For example, in the case of climate change, if we support the collective efforts of nations to de-carbonize their growth path, we may be able to achieve the objectives set out in COP18 in Paris. India has set for itself the aspiration of delivering 175GW of renewable energy in the coming years. Not only will India’s energy strategy help in delivering the global goal of sustainable development, its experience with scaling up renewable energy and energy efficiency will support the collective efforts of other countries to achieve their own objectives in the energy sector. This is where Lighthouse India can play an important role of leveraging India in the achievement of global goods.

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Managing climate risks in South Asia: A “bottom up” approach

Poonam Pillai's picture
Surma river between Bangladesh and India
The Surma River that flows between Bangladesh and India. Photo Credit: Poonam Pillai

Being from Kolkata, I have always been used to floods. Prolonged flooding typically meant schools and offices closed, traffic jams and a much-needed respite from the tropical summer heat. However, it was during a field visit to the flood prone northeastern border of Bangladesh, where rivers from India flow downstream into Bangladesh, that I fully appreciated the importance of disaster early warning systems and regional collaboration in saving lives, property, enabling communities to evacuate and prepare for extreme weather events.

Disaster early warning systems, along with other information services based on weather, water and climate data (sometimes known as “hydromet” or “climate services”) play a key role in disaster preparedness and improving the productivity and performance of climate sensitive sectors such as agriculture.  Along with investments in resilient infrastructure, risk financing strategies and capacity building measures, they are a key part of a toolkit for strengthening disaster and climate resilience.  Research shows that for every dollar spent on disaster early warning systems, the benefits range from $2-10.  In South Asia, these are particularly important given the region’s extreme vulnerability to climate risks and staggering socio-economic costs arising from extreme weather events.

জলবায়ু পরিবর্তনের সাথে কি সুন্দরবন এলাকায় মাছের প্রাপ্যতা কমবে?

Susmita Dasgupta's picture

  
মাতৃমৃত্যু বা শিশু মৃত্যু কমানোর মতো বাংলাদেশের স্বাস্থ্য খাতে বহু অর্জন থাকা সত্ত্বেও  দেশের অসংখ্য মানুষ অপুষ্টির শিকার। দেশের প্রায় ৩৩-৩৬ শতাংশ শিশু এবং ১৯ শতাংশ মহিলা অপুষ্টিতে ভুগছে।  অপুষ্টির হার স্বভাবতই দরিদ্র এবং নিম্নবিত্ত  পরিবারগুলোতে বেশি ।  ওয়ার্ল্ড ফিশ এবং বিভিন্ন গবেষণা সংস্থা জানিয়েছে অপুষ্টির সমাধান  রয়েছে বাঙালির চিরন্তন ঐতিহ্য "মাছে  ভাতে"। নানা ধরণের ছোট মাছ শরীরে ফ্যাটি এসিড, ভিটামিন ডি, এ, বি, ক্যালসিয়াম, ফসফরাস, আয়োডিন, জিঙ্ক, আয়রন এর ঘাটতি মেটায়। তাই অপুষ্টি এড়াতে নিম্নবিত্ত পরিবারের খাবারের তালিকায় নানা  রকমের টাটকা মাছ - বিশেষত ছোট মাছের পরিমান বাড়াতে হবে। 

পরিবেশ উষ্ণায়নের সাথে সাথে কিন্তু মাছের যোগান পাল্টাবে । 
পরিবেশ উষ্ণায়নের সাথে সাথে পৃথিবীতে সমুদ্রের উচ্চতা বাড়ছে - জানিয়েছে জলবায়ু পরিবর্তন বিষয়ে বিশেষজ্ঞ আন্তর্জাতিক প্যানেল (আই,পি, সি, সি). গত কয়েক দশক ধরেই প্রতি বছর অগ্রহায়ণ থেকে শুরু করে জ্যৈষ্ঠ মাস পর্যন্ত দক্ষিণ পশ্চিম উপকূলবর্তী  এলাকায়  নদী  নালায় নোনা পানির সমস্যা দেখা যাচ্ছে।  বিশ্বব্যাংক এবং ইনস্টিটিউট অফ ওয়াটার মডেলিং বাংলাদেশে তাদের গবেষণা প্রতিবেদনে (River Salinity and Climate Change: Evidence from Coastal Bangladesh) জানিয়েছে সমুদ্রের উচ্চতা বৃদ্ধির কারণে ইছামতি, বলেশ্বর, শিবসা, পশুর, আধারমানিক সহ বিভিন্ন নদী এবং সংলগ্ন খাল বিলে  নোনা  পানির সমস্যা শুকনো মৌসুমে আরো বাড়বে| ফলে, দক্ষিণ  পশ্চিম উপকূলবর্তী   অনেক উপজেলায় মিঠা  পানির মাছের প্রাকৃতিক আবাস কমে যাবে।  স্বভাবতই এর ফলে  মিঠা পানির মাছের যোগান কমবে।

Reviving Degraded Wetlands in India’s North Bihar

Pyush Dogra's picture

Kanwar Jheel is the largest in a series of 18 wetlands spread across the Ganges flood plains in India’s north Bihar. For generations, these wetlands have been the mainstay for this densely populated region, enabling families to farm the fertile soil and fish in nutrient-rich waters.

kanwar jheel, bihar


During the monsoon, when the River Burhi Gandak - a Ganges tributary - overflows its banks, the wetlands absorb the runoff, protecting this extremely flood-prone region. When the rains are over, the water shrinks to one tenth the size, exposing marshes and grasslands that create a mosaic of habitats for a wide variety of flora and fauna.

In winter, over 60 species of duck and waterfowl visit these wetlands on their annual migration routes along the Central Asian Flyway.

Protecting wetlands: Lessons from Sri Lanka and Maldives

Mokshana Wijeyeratne's picture
Sri Lanka and Maldives are home to rich wetlands that are habitats for a variety of fauna and flora but also benefit the ecosystem
Sri Lanka and Maldives are home to rich wetlands with a variety of fauna and flora that benefit the ecosystem.


Sri Lanka and Maldives share much more than the tag of tourism hot spots, beautiful beaches, and similar cultural traits. Both island nations have a range of unique environments that are rich in biodiversity and serve a myriad of ecosystems functions.

Both countries are home to rich wetlands with a variety of fauna and flora that benefit the ecosystem, including flood protection, water purification, and natural air conditioning and provide food and support to local communities.

Sri Lanka has actively been working to ensure these essential ecosystems are protected. The Maldives has too commenced such great work. This work has produced a wealth of knowledge and innovations on how to manage and conserve wetlands. 

Managing wetlands in Sri Lanka and Maldives

The wetland management and land use planning effort undertaken in Colombo under the World Bank-financed Metro Colombo Urban Development (MCUDP) project showcases resilience in urban land use planning and highlights how a city can become more livable by intermingling green spaces to its urban fabric. All this, while protecting wetlands and reaping the benefits of their natural ecosystem functions.

The MCUDP used robust strategies and sustainable economic models, such as wetland parks, to help save urban wetlands from threats such as encroachment and clearing. Through the Climate Change Adaptation Project (CCAP), funded by the European Union and the Government of Australia, Maldives has also taken steps to manage threats to its largest wetlands.

While the approaches to wetland management in both countries have been different there are many key lessons that can be shared.

Rebuilding houses and livelihoods in post-earthquake Nepal

Mio Takada's picture
When the 2015 earthquake hit Nepal, Fulmati Mijar lost her home and livelihood. Now, she has turned her life around, learned carpentry and quake-resistant techniques, and started a business
When the 2015 earthquake hit Nepal, Fulmati Mijar lost her home and livelihood. Now, she has turned her life around, learned carpentry and quake-resistant techniques, and started a business. Credit: World Bank.

 
Fulmati Mijar, a mother of three living in Nuwakot district in Nepal, used to earn her living from daily wage labor along with her husband.
 
On April 25, 2015, their lives took a turn for the worse when a magnitude 7.8 earthquake struck Nepal, killing 8,790 people and affecting 8 million more—or nearly a third of the country’s population.
 
The catastrophe destroyed Fulmati’s house and made her family more vulnerable.
 
Yet, it did not dent her resolve.
 
When housing reconstruction started through the Earthquake Housing Reconstruction Project (EHRP), Fulmari joined her village’s Community Organization (CO), supported by the Poverty Alleviation Fund (PAF) and learned carpentry and earthquake-resistant techniques for housing reconstruction.
 
She initially received a NPR18,000 ($176) loan to invest in a small furniture enterprise. With the funds, her family started making windows, doors, and kitchen racks, which were in high demand. After repaying the loan, she received another loan to upgrade their furniture enterprise, where today she and her family make their living.
 
At the time of the 2015 earthquake, full recovery was estimated to cost $8.2 billion, with the housing recovery component amounting to $3.8 billion. The World Bank immediately pledged $500 million to support the emergency response. During the reconstruction phase, the most urgent—and largest—need was to rebuild nearly 750,000 houses.
 
More than two years since the earthquake, restoring lost or affected livelihoods has become more important.

What does risk management have to do with Sri Lankan families?

Ralph van Doorn's picture
While the number of Sri Lankans living under the poverty line has decreased tremendously, many still live right above it and can fall back into extreme poverty if they experience a shock such as a natural disaster. Photo Credit: Lakshman Nadaraja 


Imagine there is a small fire in your house: someone forgot to put out a cigarette stub and accidentally set your rubbish bin on fire. You will need just one bucket of water to put it out.
 
But up the ante, and it is no longer possible for an individual to handle it. For instance, if your entire house was on fire, you would need to call your local fire station for help.
 
Now, go up one more level. You live in a thickly wooded part of a district like Badulla, and a forest fire covering hundreds of acres is threatening homes and businesses—then it would take the resources of the country, and maybe even aid and support from international allies, to battle the fire and help people recover.
 
I am telling you this story to illustrate how there are levels of risks—and responses—to consider when discussing a subject like integrated risk management.
 
As part of our work on the recently released Sri Lanka Development Update (SLDU) we considered the risks and opportunities facing Sri Lanka, beginning from the smallest unit of the household and building up to the country, as represented by the public sector.
 
There’s been a lot of talk about the macro-economy and national level reforms and policy initiatives. However, in this blog I wanted to focus on your families. What does integrated risk management mean for households?
 
The poorest Sri Lankan families are vulnerable to shocks

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