Save the Children UK has released a report called “Thin on the Ground” claiming that the World Bank projects aimed at cutting children malnutrition in Bangladesh, Uganda and Ethiopia had failed to have any impact.
The charity’s cross-sectional survey “found no difference in the rates of malnutrition between Bangladesh Integrated Nutrition Project (BINP) upazilas and matched non-BINP upazilas after six years of project implementation [and that] growth monitoring charts were poorly understood by mothers and that supplementary feeding had limited effectiveness especially for very young children.” The survey compared the rates of malnutrition in three upazilas where the BINP had been implemented for six years (randomly selected from the six upazilas used in the baseline and MTE surveys) to three matched upazilas where there had been no major nutrition projects. There are some 460 upazilas in Bangladesh, each with a population of approximately 200,000 – 450,000 people.
The report says “resources may be being wasted on these large-scale community nutrition projects because they face major design and implementation limitations.” John Seaman, a health advisor at Save the Children, claims that the World Bank programmes are based on a “widely discredited” approach, which assumes “that the child is malnourished because the mother isn’t doing something right, because she doesn’t know how to feed or lacks the food to support the child”.
Save the Children suggests approaches that might have more of an impact: improving healthcare systems so that children get basic immunisation, or getting more children into school or improving sanitation and clean water supplies.
However, the Bank plans to expand the projects with a 10-year investment loan plan of $1bn which is under discussion with the Bangladeshi government. This will add to the $191 million spent in the first two years of the program, only for this country, worsening the debt problem.
According to Anna Taylor, author of the charity report, “what we seem to be observing is that the World Bank doesn’t really have adequate systems in place to ensure that decisions about multi-million dollar loans are based on evidence.” The World Bank has replied that their nutrition programs are based on experience and plans to release reports on the specific experiences in the next few months.