Nov 2015 – Aug 2017
Improving mother & child nutrition in Bangladesh
Bangladesh – South Asia
To design and test an improved communications approach for community- and facility-based health workers, so they can effectively support families to feed their children better.
$1,200,000 Multi-Year Grant Value
Recent studies in Bangladesh have shown that improved feeding of children aged 6-24 months can contribute to lower rates of malnutrition.
However, questions remain about how to translate these encouraging findings into large-scale health promotion activities such as those run by the world’s largest NGO, BRAC.
This project will generate the knowledge and tools needed to support BRAC's thousands of community health workers to provide effective counselling on the safe and appropriate feeding of young children.
This will include direct observation of families exposed to previous health promotion efforts, to better understand how they have engaged with the messaging directed at them and what constraints they face in turning this knowledge into improved feeding practices.
It will also involve working with food scientists to work out what recipes for children in this age group are both feasible for poor families to make at home and could lead to better nutritional outcomes.
Finally, the project will incorporate the findings from both of these efforts into new job aids for BRAC’s tens of thousands of community health workers, so that in the future they will be able to more effectively counsel families on improved child feeding. It will also actively share learnings with the management of Bangladesh’s “Community Clinics” in selected districts.
Because CIFF and BRAC understand that the poorest household may have difficulty in accessing the resources they need to implement optimal complementary feeding, this project was approved alongside another grant to the World Bank to evaluate an income support programme for the poorest.
Between February and June 2016, BRAC completed a comprehensive survey in 10 upazilas of five districts of Bangladesh. This included interviewing 119 mothers through focus group discussions, 74 mothers through in-depth interviews, and 10 fathers and 11 grandmothers though informal discussions. The age of mothers ranged from 17 to 37.
This formative research revealed insights on:
- The mothers’ perception of their child’s growth - particularly the importance given to weight as a predictor of good health and the ignorance about height as a sign of good health
- Breastfeeding practices – mothers being aware of the colostrum feeding but still feeding sweets just after birth due to tradition; good knowledge of mothers on exclusive breastfeeding and practising it, except some who initiate complementary feeding early due to inadequate breastmilk
- Dietary habits of children and provision of dietary diversity - found to be good in most areas, with mothers feeding the recommended number of food groups and adequate meal frequency for the age
Based on the existing complementary feeding practices of the study areas, four major food recipes have also been developed for three different age groups of children.
BRAC will now be rolling out the suggested recipe, together with appropriate messaging, and testing it for its uptake and impact on growth (while taking seasonality into account).