Scientific Seminar Highlights Nutri-CAP Study’s Impact on Urban Health in Bangladesh
A recent scientific seminar organized by icddr,b focused on the findings of the Nutri-CAP study, which examined the effects of an integrated nutrition and hygiene program in urban slums. The event took place at the Sasakawa Auditorium in Mohakhali and was part of the AdSEARCH dissemination series.
The study, conducted in the Bauniabadh slum of Dhaka, provides strong evidence that a locally led initiative can significantly improve the health and well-being of vulnerable groups such as pregnant women, adolescent girls, and young children in informal urban settlements. This is particularly important given the challenges posed by rapid urbanization in Bangladesh.
Urbanization and Health Challenges
Over the past two decades, Bangladesh has made significant progress in improving public health. However, the country’s urban population has grown rapidly, increasing from 8% in 1973 to 40% in 2022. With over 62 million people now living in urban areas, this number is expected to double by 2035, putting immense pressure on already strained urban health systems.
Although cities generally offer better health outcomes than rural areas, disparities persist within urban populations. In slum communities, more than half of households face food insecurity, and up to 50% of children are stunted. Only 40% of women in slums receive the recommended four or more antenatal check-ups, compared to over 53% in non-slum areas.
Slums also have a disproportionately young population, with more than 30% of residents under 15 years old. This highlights the urgent need for targeted investments in maternal, adolescent, and child health.
The Nutri-CAP Intervention
The Nutri-CAP program targeted three key groups: pregnant women, adolescent girls, and children under two. It introduced a comprehensive package of services, including monthly home-based counseling, nutritional supplements, and regular health monitoring.
Pregnant women received support through regular weight, blood pressure, and haemoglobin checks, along with guidance on antenatal care and adequate rest. The results showed measurable improvements, with intervention group women gaining an average of 8.9 kilograms during pregnancy, compared to 7.5 in the control group.
Facility-based deliveries and positive pregnancy outcomes were more common among the intervention group, while adverse events such as abortion, stillbirth, and neonatal death were lower. The risk of babies being born small for gestational age was reduced by 16%.
Adolescent girls in the intervention group saw a significant increase in haemoglobin levels, rising from 12.0 to 12.8 g/dL. Although dietary diversity remained unchanged due to rising food prices, there was improved awareness of health and nutrition issues. Prevalence of thinness and overweight among this group aligned with national urban trends.
For young children, the study found meaningful reductions in growth faltering in terms of height-for-age and weight-for-age. Improvements in gut health were also observed, with lower intestinal inflammation and more responsive immune activity among adolescents in the intervention group.
Economic Benefits and Scalability
The program also brought economic benefits. Out-of-pocket health expenditure was consistently lower among intervention households, especially for pregnant women and children. While indirect costs such as time spent accessing services were slightly higher, total healthcare spending was lower compared to the control group.
Medicines and diagnostic costs were reduced, and although human resources remained the largest component of provider costs, the study found that these could be optimized over time as the model is integrated into existing systems.
Expert Perspectives
Dr Mustafa Mahfuz, principal investigator of the study, emphasized that the program’s success stemmed from its locally rooted approach. “This model worked because it listened to the community, trained local women, and addressed multiple barriers at once,” he said. “The results are a testament to what is possible when evidence meets empathy.”
Dr Tahmeed Ahmed, executive director at icddr,b, highlighted the potential for scaling the Nutri-CAP model in other informal settlements in Bangladesh and similar settings elsewhere. He noted that the program’s adaptable and locally driven design makes it both effective and ready for expansion.
Broader Implications
The seminar featured insights from various stakeholders, including government officials, development partners, NGOs, and researchers. A representative from Global Affairs Canada shared reflections on Canada’s commitment to supporting community-based nutrition programs.
Mr Edward Cabrera, first secretary – Development (Health), Canada’s International Development – Global Affairs Canada, emphasized the importance of understanding the critical nutrition challenges affecting vulnerable groups in urban areas. He stated that the project would provide concrete evidence on effective interventions that can lead to better decision-making at the policy level.
Overall, the Nutri-CAP study demonstrates the potential of integrated, community-driven approaches to address pressing health challenges in urban slums. Its findings offer valuable lessons for policymakers and practitioners seeking to improve health outcomes for marginalized populations.
