Nutrition assessment
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Bhutan

The lack of data in Bhutan makes a comprehensive overview of the national food and nutrition situation difficult.

According to the nationwide nutritional survey of 1986-88, the nutritional status of children (0-6 years) gave concern, as both the prevalence of underweight (37.9%) and the prevalence of stunting (56.1%) are considered to be serious public health problems according to the World Health Organization. The prevalence of wasting (4%), however, was less alarming. Regional comparison identifies the nutritional status of children in the Central and Western zones as better than in the Eastern and the Southern zones, which may be partly explained by the inaccessibility and remoteness of the latter zones. There is no recent national representative data available on the nutritional situation of pre-school children. The results of a survey in 1996 in one Central and two Eastern districts present the nutritional status of children under 5 similar to the 1986-88 results. Data derived from growth monitoring in the country, however, indicate a decrease in the prevalence of underweight in infants from 1992 to 1997.

Since 1983 the prevalence and severity of IDD have decreased, which is mainly due to a multi- sectorial IDD control programme including iodation of all salt in the late 1980's. The goitre rate of 6-11 year old children reduced from 59.7% in 1983 to 12.8% 1996.

Anaemia has been identified as the single most complication of pregnancy in Bhutan. Even in the urban population of Thimphu 96% of pregnant women attending antenatal care in the JDW National Referral hospital were classified as anaemic, 39 % as severely anaemic.

The 1988-89 nationwide nutrition survey classified 0.5% of children under 5 years with night-blindness, 0.1% with conjunctival xerosis and 0.1% with corneal ulcer with keratomalacia. The country launched, with success, a vitamin A supplementation programme in the late 1980's focussing on children and lactating mothers.

In general the diet in Bhutan consists mainly of cereals, with a low consumption of vegetables and fruits. The national average daily per caput energy intake was estimated to be 2,555 kcal. However, significant differences in the energy intake between different regions, urban and rural areas as well as between different socio-economic groups have been reported ranging from 1,647 kcal/day in Pemagatshel to 3,227 kcal/day in Punakha.

Morbidity in children is mainly attributed to Acute Respiratory Infections (15%), Intestinal Infections (10.6%) and skin diseases (10%). The unhygienic conditions in Bhutan pose a major threat to the health of young children.