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]]>Purpose
Mukhe bhaat is conducted when the baby is ready to make the transition from a liquid diet to solids. It is performed after the baby has completed six months and before the first birthday. The purpose of mukhe bhaat in ENICAPLW project is to introduce solid food/complementary food in a timely manner that will help the baby achieving a good nutrition status and prevent malnutrition.
Where it will be conducted?
Mukhe bhaat will be conducted at the Mother Baby Area of different camps. The beneficiaries who will be the resident of respective camps will participate in the ceremony.
How it will be conducted?
The mukhe bhaat will be conducted thrice in a month. The date will be 10th, 20th and 30th of the month. If those days are not available due to holiday or other reason, the mukhe bhaat will be organized on the next official working day. The children along with, who will complete their 6 months from 1st to 10th of the month, will be the participants of the Mukhe bhaat ceremony on 10th . Those who will complete their 6 months from 11th to 20th of the month will be the participants of the Mukhe bhaat ceremony on 20th. And those who will complete their 6 months from 21st to 31st of the month will be the participants of the Mukhe bhaat ceremony on 30th . During mukhe bhaat, mothers will bring their babies to the BFSC/MBA on mentioned time. At first, there will be a cooking demonstration which will be facilitated by the counselor. She will demonstrate the process of cooking nutrient rich food such as khichuri in a proper manner for the children. The mothers will learn the process and will follow the techniques to prepare foods in their respective homes for their baby. After preparing the food, the children will be fed the food.
What kind of foods can be offered to the baby?
Food for the baby’s first bite may be rice, pulse, mixed khichuri, kheer, payash (if to offer baby something sweet). Or it is plain mashed rice with a pinch of well-cooked dal although a variety of food will be better to be served in the baby’s bowl.
Some attentive measures should be taken during mukhe bhaat:
It is best to limit the gathering to just the selected participants to conduct the program properly and to avoid feeling baby overwhelmed.
Hands and all the utensils should be washed well before feeding the baby.
Baby’s food must be prepared fresh and maintaining all kind of hygienic measures.
A small towel/soft tissue should be kept handy to wipe the excess food around baby’s mouth.
The mother will feed their baby first.
Emergency Nutrition Intervention for Children under 5, Adolescents, Pregnant & Lactating Women | Social Assistance & Rehabilitation for the Physically Vulnerable (SARPV)
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]]>Methodology: Mineral analyses were done on samples of whole blood and foods collected from the Chakaria region in October 1997. Blood was obtained from children aged 36-98 months identified by their families as either rachitic (n=11) or unaffected (n=8), who were each given physical and radiographic examinations (results reported separately). Samples of drinking water from tubewell, cooking water (pond), and cooked and uncooked rice were collected from three households, one of which had rachitic children. Samples of other foods likely to be sources of Ca and other limiting nutrients (mungbean, grasspea, chickpea, Indian chickpea, cowpea, lentil, black gram, amaranth, red chillies, taro, a sea-fish, churie, shrimp, and faishya) were purchased from the market at Chakaria. Water pH was measured at the point of sampling; samples were held frozen (blood) or at ambient temperature (water), or dried (food) prior to analysis. Samples were digested with nitric-perchloric acids and analyzed for 20 elements (Pb, Cd, Cu, Zn, Co, P, K, Na, Mg, Fe, B, Mo, Ni, V, As, U, Cr, Al, Sr, and Ba) by inductively coupled plasma emission spectrometry.
Results: The results of the study showed blood mineral values for rickets cases and controls to be similar with the exception of P (serum: cases, 43 mg/L vs. control, 52mg/L, p>.05; whole blood: cases, 216 mg/L vs. control, 235 mg/L,p>.05). All values in both pond and well water samples were within normal limits. All elements in the rice samples were within safe limits reported for plant foods; rice was very low in Ca (86 mg/kg as eaten). All elements in the local foods were within the normal ranges reported for these elements with two notable exceptions: amaranth and shrimp, both containing high concentrations of almost all elements (amaranth, mg/kg dry weight: Ca, 26,947; Al, 1455; Pb, 1.5; Sr, 129; Ba, 32; Cr, 9.8; V, 3; As, 0.2; shrimp, mg/kg dry weight: Ca, 37,278; Al, 209; Pb, 0.3; Sr, 322; Ba, 34; V, 0.5; As, 4.3).
Conclusion: The results do not indicate wide exposure to antagonists of Ca use, but point to a food supply generally low in Ca.
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]]>The post Apparent efficacy of food-based calcium supplementation in preventing rickets in Bangladesh appeared first on SARPV.
]]>The post Rickets in Bangladeshi children: a small focus or a widespread problem ? appeared first on SARPV.
]]>The post Rickets in Bangladeshi children: a small focus or a widespread problem ? appeared first on SARPV.
]]>The post Rapid assessment of the prevalence of lower limb clinical rickets in Bangladesh appeared first on SARPV.
]]>Full Article: http://www.publichealthjrnl.com/article/S0033-3506%2802%2900017-3/pdf
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]]>The post Rickets in Bangladesh appeared first on SARPV.
]]>Realizing the threats of disability, I shared this with Dr. John E. Bullock of Malumghat Christian Hospital (MCH), and he told me that name of this deformity was rickets but happens due to lack of vitamin D. Why it was happening it was unknown. I then consulted with Julian Franics who advised me to do a survey in one village to see the prevalence of this disease in the children. SARPV then did a survey in one village named Baraitali with support of one social worker name Maruf at that time we found about 1% children with these deformities in that time.
At that time SARPV sent 25 children to MCH hospital consulting with Dr. John E for operation as per advice of Dr. John E Bullock whether it is curable by operating or not to see and we found that 99% of them has got back their straight leg. That was the first time operation of Rickets children in Bangladesh .
In 1993 I got an opportunity to share about rickets with an organization named AEM of France, and then they came with a group of multi-disciplined professionals to come and practically see in late 1994 through one doctor named Jean Paul Cimma.
Rapid assessment of the Rickets in 1995 to 1997
In 1995 Dr. Cimma with other colleagues did a rapid assessment from Chittagong to Mhoheskhali where rickets was found near about 4.5% of the children. Then we informed UNICEF, DFID, Medical Association, and WHO. Brigadier M.A. Hafiz issued a letter from WHO to all medical concern to take care of this issue and to see what it was, but there was no response at all at that time.
In 1997 one day Dr. Craig Meisner and Dr. Jerry Combs came to SARPV and asked me about rickets. They had been contacted UNICEF local office about this disease and were further interested.
Current ApprehensionsRickets is not a problem of coastal belt only as the entire Bangladesh is at risk.
The most affected area of rickets are in the following divisions. This has been identified with the support of one our consortium member name HKI.that in all 6 Divisions Rickets has bee found but what is the prevalence of this it is not known to us till today.
1. Chittagong , 2.Syllhet, 3.Dhaka, 4.Rajshahi, 5.Khulna, 6. Barisal
These are the divisions where rickets has been found gradually increasing and from this picture in no way it can be said that it is the problem of only in the coastal belt. This is the problem of whole Bangladesh and it is an alarming factor for the overall development of the nation. Still we don’t know for sure the causes of rickets and probable prevention strategies Rickets is a Problem of ,Environment,People’s Food-habit ,Nutrition- child and parents, Health, and Disability. Rickets is a multi-dimensional social problem with grave aspects of concerns. I strongly disagree with this statement.We DEFINITELY now know that it is lack of Ca in The diet. We know that supplemental Ca in the diet alone can prevent and cure! Don’t reinvent the wheel here.
A quick rapid assessment survey was conducted on 35 households in the ethnic groups and 35-house hold in the plain land to see the prevalence of Rickets in the tribal community as already we have found rickets children in the plain land household in previous studies. This 35 household of the tribe has been selected randomly from two district and 7 villages and rest 35 household of the plain land has been selected nearest plain land community of the tribal community what was in our sample. Out of total 13 tribes, 7 tribes were sampled randomly from Banderban District and Cox’s Bazaar District. After the recruitment of necessary staff, a training of 3 days was conducted in the local SARPV office at Chakaria about the purpose and procedure of the study. To identify and collect the children, the workers took the help of an identification slip to a particular place used Geographical Reconnaissance Sheets. Interview of the parents were taken and the children were examined for evidences of rickets and wherever it has been necessary a medical doctor has been taken to justify the rickets cases. In this study we have followed our methodology and talked to the parents and also we have seen the children of the sample households and referral house holds too. In addition we met the community leaders and elder persons of the community, Social Worker of each community. We tried to know the food habit of each house hold both in tribal and plain land household (in the previous study it is found that rickets is more common in low-socioeconomic group where dry fish is commonly used. Dry fish is preserved with some chemicals. So there might me some correlation with these two). Out of 35 tribal households we did not get any Rickets Children on the other hand and of 35 plain land houses hold we have got in the sample households 17% of rickets children and referral 11% of Rickets Children. Major difference in the food among the tribal and plain land household it has been found that tribal people takes maximum vegetables than the Plain land household (47%). Dry fish is also less among the tribal people (26%). The tribal people in comparison to the plain land household take less chilies and spices (36%). Finally their cooking time is less than the plain land people. Mostly tribal people eat most of the wild animal and all types sea fish, snail, snake, shark etc 100%. Another observation is that tribal people use less dress than the plain land people, it means more exposed to sunlight. Birth spacing in tribal is more, as result children get maximum time to have the breast milk (%). It is also has been observed that tribal People spent only 6% in education, 68% to the food and to the health17% sector from their income. On the other hand Plain land people spent 57% for the food, 16% for education and for health 17%.
SARPV strongly feel that there is a need to again have a national survey to see the current prevalence of rickets in Bangladesh and root cause of this lack of calcium in food what has been identified now.
Second also to see the difference of food behave of the tribal people and cooking pattern and Environmental difference what has been push the people in to threat for he future generation to be affected by rickets and to turn their life as physically disabled. SARPV also feel that Nutritional Program can be redesigned to prevent the rickets disease from Bangladesh .
SARPV also feel that there is a real need to set up Rickets Research Institute so that in near future we can take proper action. We do feel we need a solution permanently to free this country from any further rickets’ epidemics and to save our future generations.
Shahidul Haque/ SARPV
26 January, 2006
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]]>The post Rickets: An Overview and Future Directions, with Special Reference to Bangladesh appeared first on SARPV.
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]]>On 26th January, 2010 a Dissemination of National Rickets Survey in Bangladesh was held at BRAC INN Centre, Dhaka. The survey was conducted by Rickets Interest Group (RIG) with the leadership of Dr. S K Roy, Senior Scientist, ICDDR, B and in collaboration with SARPV, UNICEF, CARE Bangladesh, National Nutrition Programme, BRAC and Plan Bangladesh. The aim of the National Rickets Survey was to determine the prevalence of the disease in Bangladesh in children 1 to 15 years of age and to determine the association with their nutritional status and dietary intake of calcium and other nutrients.
The aim of the survey was to determine the prevalence of the disease in Bangladesh in children 1 to 14 years of age and to determine the association with their nutritional status and dietary intake of calcium and other nutrients.
16,000 children in rural areas and 4000 children in urban areas irrespective of their sex and socio-economic status from six divisions were randomly selected. After enrolment they were examined for the presence of features of rickets and their parents /guardians were interviewed to record their age, sex and socio-economic data. With the presence of rickets featuresparent/guardians were asked about the feeding practice of the child and representative food was sampled to assess calcium content. Qualitative and quantitative data were collected through anthropometrical measurement (weight, height) and in-depth interviews.
In clinically suspected cases, radiological examination was done to identify radiological signs of active rickets and blood was taken for biochemical tests. This survey included both current patients and new cases were identified through case-finding strategy among their family members. The results were analyzed to determine the relationship of Rickets with nutritional status of the children and their dietary (calcium, phosphorus, protein) deficiencies, and dietary and environmental inhibitors (phytates, oxalates).
The result of the survey showed high prevalence of rickets in 1% children aged 1-15 years of which 76.6% were from Chittagong Division. Districts like Cox’s Bazar, Chokoria, Maheshkhali and other upazilas of Chittagong reported for high endemic rickets. About 47.4% children were deficient in calcium and vitamin D. In these areas UNICEF is supporting SARPV to identify rickets and have undertaken community based programs for its prevention.
The session was Chaired by Professor Dr. Shah Monir Hossain, Director General, Directorate General of Health Services, MOHFW, who said that over the next 5 years starting in July 2011 the Government should take initiative to merge Health and Nutrition programme to resolve these problems, which at present runs individually. He suggested to investigate the causes of differences of incidence of rickets in different geographical areas and ethnic groups and stressed on awareness building to reduce the chances of those children being physically disabled and finally becoming burden of their families as well as in the society Dr. Shah Monir Hossain also mentioned that complementary feeding for children after six months of age should be focused and communicated to the parents to avoid chances of rickets. He also mentioned that, Rickets can be prevented just with nutritional advice if detected early and must be taught at the primary level. Behavior change is very important and with appropriate communication and dissemination of information it is possible to make Bangladesh a ricket free country.
Source:http://www.icddrb.org/news_detail.cfm?ID=263
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