Child - Centred Approaches to Preventable Disability - the Case of Nutritional Rickets in Bangladesh
Overview
An estimated 300,000 people suffer from rickets in the three districts in Bangladesh where the project is operating. If addressed in the early stages of a child's life, rickets can be cured without any long-term effects. If neglected, it can cause permanent disability, which may subject the individual to lifelong poverty.
Treating a child with rickets before the age of 10 means (s)he has an 80 per cent chance of living a life free from disability. Rickets was virtually unknown in Bangladesh before the 1970's but since then, reported incidents of the disease have been increasing.
SARPV first identified rickets as an important health issue in 1991 in the Chakaria area after the great cyclone. It has since campaigned to raise the profile of the issue and carried out research on rickets. SARPV is a founder member of the Consortium on Rickets in Bangladesh and held the first International Rickets Congress in 2006. It has undertaken field studies to determine rickets prevalence at household level. Rickets is primarily caused by Vitamin D and/or calcium deficiency, both of which are required for proper bone development. The rising prevalence of rachitic children in Bangladesh is due to an unbalanced diet that relies heavily on crops grown in calcium-deficient soil. Intensive agricultural methods, over-farming, population pressure and the misuse of chemical fertilizers contribute to reduced levels of essential soil nutrients. Failure to recognise rickets as a problem at policy level and within the medical community has meant an overall rise in the incidence of rickets in Bangladesh over the years and a growing number of children who are disabled for life as a result.
The goal of this three-year project is to improve health outcomes for children in Bangladesh regardless of their poverty levels. It aims to develop awareness at household and community level around the prevention of rickets through three major components - nutritional knowledge and awareness, recognition of the symptoms, and access to treatment. To achieve this, family planning health workers and local CBOs in three districts will be trained on rickets prevention, diagnosis and care. Through child-centred outreach work, they will help communities identify the early symptoms of rickets, understand how to prevent them and provide appropriate support to children and carers affected by the condition. Training to strengthen CSOs and communities will also be included so that they can better advocate for child rights and appropriate policies to support child health and disability.
Importantly networks will be developed to support sharing of information and advocacy for rickets prevention at local, district and national levels.
Expected outcomes:
CSOs and health service providers are better able to advise and educate families and communities about rickets and diagnose and treat existing cases; households are better able to recognise the early symptoms of rickets and understand how to prevent them; CSOs and communities are better able to advocate for appropriate social policies to support child health and disability issues; local CSOs are better able to engage with international dialogue on disability prevention and nutrition. The primary beneficiaries include 36,000 children and adults already affected with rickets; 150,000 children between 1-15 years who have a high risk of developing rickets; 600,000 community members in identified at-risk areas; and 400 family planning health workers.