HEALTHY FOOD PLATE (Draft)

 

AN EFFECTIVE TOOL FOR NUTRITION COUNSELLING IN BANGLADESH

 

BACKGROUND

The United States Agency for International Development (USAID) supported SHIKHA project (2013-2016), implemented by FHI360 in Bangladesh. FHI360 developed Healthy Food Plate - as a nutrition counselling tool for pregnant women to promote dietary diversity through a healthy and balanced diet.

SHIKHA project reviewed the study ‘Desired Dietary Patterns for Bangladesh’ developed by BIRDEM; various researches on nutrition and dietary practices of pregnant women; and its own baseline study to conceptualize the food plate, with support from the Food Planning and Monitoring Unit (FPMU), Ministry of Food (MoFood); and FAO.

It was then verified through a consultative process with experts from Government Organization (GO), Non-Government Organizations (NGOs), United Nations (UN) organizations and academia held in Dhaka on September 4, 2014, and June 10, 2015. The sample of the plates was also field-tested in SHIKHA project areas. The feedback from beneficiary women and community health workers from fields were considered and adapted in the final design with the consultation of the experts.

The various stakeholders are: FHI 360, Institute of Nutrition and Food Sciences (INFS), University of Dhaka; Food Planning and Monitoring Unit (FPMU), Ministry of Food, Institute of Public Health Nutrition (IPHN), Ministry of Health and Family Welfare (MoHFW); Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), BRAC, , United States Agency for International Development (USAID), and European Union (EU) and Food and Agriculture Organization of the United Nations. This design of the plate was also approved by the IEC technical Review Committee through IPHN, MoHFW.

SHIKHA project used this plate to counsel pregnant women by the project’s frontline workers. The tool was widely used by the nutrition workers, community health volunteers and the female beneficiaries.

For instance, a nutrition worker (Pushti Karmi) said that - “The plate helped us in explaining to the pregnant woman and her family members what she should eat, and they can see the food groups and the message and can remember them easily.” This was also echoed by a community health volunteer (Shasta Sebika): “When we ask pregnant women to eat more, they eat more rice, but after the introduction of the food plate we can demonstrate that they should fill half of their plate with rice and remaining half with foods from other varieties.” A pregnant beneficiary expressed: “This is very easy to understand and memorize what should I eat with rice.”

 

THE HEALTHY PLATE AND ITS KEY NUTRITION MESSAGES

The “Healthy Food Plate,” is a melamine plate with printed images of nutritious food in correct proportion; alongside pertinent nutrition messages. It is aimed to be used for nutrition education with mothers and children. The diagram below describes the salient features of the plate.

 

Healthy Food Plate

 

IMPACT OF HEALTHY FOOD PLATE

Endline evaluation of SHIKHA project suggested high acceptability and good perception of food plate (from qualitative findings at endline) and positive impact of nutrition counseling by using food plate for promoting dietary diversity (quantitative findings from surveys). The qualitative study conducted in SHIKHA project area also revealed that the plate was highly valued by the project’s frontline workers and beneficiaries. For example,

The SHIKHA endline survey clearly indicated that pregnant women from intervention areas did consume a diversified diet with proper amounts of starchy and fleshy foods, dairy products, leafy vegetables, and eggs. The mean dietary diversity score of pregnant women in the project area improved significantly to 4.76 in 2015–2016, from a baseline score of 4.28 in 2013–2014. About two-thirds or more of the respondents at baseline knew that pregnant women should eat these foods —dairy products (66%), leafy vegetables (73%), and eggs (65%). This increased significantly at the end line to 78%, 96%, and 90%, respectively.

 

PROGRAMMATIC IMPLICATION OF HELATHY FOOD PLATE

The Government of Bangladesh approved the healthy plate to use as an evidence-based counseling tool in improving diet quality of pregnant and lactating women through National Nutrition Services (NNS), MoHFW. Moreover, several other organizations had shown interest in using the food plate in their own nutrition education and counseling efforts. For instance, FAO used this plate for nutrition counselling in its “Integrated Agriculture and Health-based Interventions for Improved Food and Nutrition Security in Selected Districts of Southern Bangladesh” project”.

Even though the original plate was developed and approved to counsel pregnant and lactating women, it is also beneficial for improving nutrition for those who have high nutrient demands, such as adolescents and school-going children. Consequently, FPMU, MoFood and FAO disseminated a substantial amount of plates at national and sub-national level training, community women groups meetings, youth clubs, and nutrition education campaigns and events such as Nutrition Olympiad 2018, 2019, World Food Day, World Breastfeeding Week, etc. Key ministries of the Government of Bangladesh, training institutions, and other nutrition programmes have used the plate as a nutrition education tool to promote dietary diversity, to enhance nutrition awareness and improve diets.

 

PARTNERS AND CONTRIBUTORS

  • Original Contributors: Government of Bangladesh (GoB), FHI 360, University of Dhaka / INFS, BIRDEM, FAO
  • Donors: USAID, EU
  • Other Partners: IPHN, MoHFW, BRAC

 

CONDITION TO REPRODUCE THE PLATE

The logo of additional partner(s), if any, can be added with one of the following written statements:

  • If the organization reproduces the plate at its own cost, it will use the following text on the bottom border/rim of the plate:

“REPRODUCED BY (ORGANIZATION NAME)”

  • If the organization only distributes the plate produced by the original contributors, it will use the following text on the bottom border/rim of the plate:

“DISTRIBUTED BY (ORGANIZATION NAME)”

 

FOR FURTHER INFORMATION, PLEASE CHECK:

  1. Abu Ahmed Shamim, Kathrin Tegenfeldt, Kerry Aradhya, Tarana Ferdous, Nasrin Banu, Sumitra Roy, Raisul Haque, Saydur Rahman Siddiquee, Mosiqure Rahman and Nazma Shaheen (2016). Designing a food plate for dietary counseling of pregnant women in Bangladesh. Field Exchange 52, June 2016. p116. Available at  www.ennonline.net/fex/52/designingafoodplatebangladesh
  2. USAID SHIKHA Project. Designing a food plate for dietary counseling of pregnant women. USAID, FHI360. September 2015. Available at https://www.fhi360.org/sites/default/files/media/documents/resource-shik...
  3. USAID SHIKHA Project. Ministry of Health and Family Welfare endorses food plate as a counseling tool for pregnant and lactating women. USAID, FHI360.  June 2016. Available at https://www.fhi360.org/sites/default/files/media/documents/resource-shik...
  4. Project Final Report: AID-388-A-13-00003 SHIKHA: Oct-2013-Sept 2016. USAID, FHI360. November 2016. Available at https://www.fhi360.org/sites/default/files/media/documents/shikha-final-...
  5. Dietary guidelines for Bangladesh. June 2013. Government of Bangladesh, BIRDEM, USAID, EU, FAO BIRDEM, Dhaka. Available at http://www.fao.org/3/a-as880e.pdf
  6. Nahar Q, Choudhury S, Faruque MO, Sultana SSS, Siddiquee MA. 2013. Desirable Dietary Pattern for Bangladesh. Government of Bangladesh, BIRDEM, USAID, EU, FAO. Available at http://fpmu.gov.bd/agridrupal/sites/default/files/ToR%2015-%20Fial%20Rep...

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