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Bangladesh

Bangladesh-Community Mobilization

Duration: Phase 1: May 2009 to November 2014 | Phase 2: September 2014 to mid 2017

From 2009 to November 2014, Alive & Thrive implemented a comprehensive program in Bangladesh to improve breastfeeding and complementary feeding practices and to reduce stunting and young child anemia. Read about the program approach and results in phase 1. In phase 2, Alive & Thrive is undertaking a feasibility study of the integration of maternal nutrition in maternal, neonatal, and child health (MNCH) programs. Read about phase 2 program activities.

Download the Bangladesh country profile brief.

Phase 1: Scaling up infant and young child feeding

May 2009 to November 2014

The comprehensive program was built on partnerships with the Institute of Public Health Nutrition and other government agencies, nongovernmental organizations (NGOs), UNICEF, bilateral donors, journalists, medical associations, and a national infant and young child feeding (IYCF) alliance of 25 partners. BRAC implemented community-based interventions in Alive & Thrive program areas.

Program Approach

  • Advocacy to raise the profile of nutrition and the importance and urgency for action through advocacy materials, a capacity building program for journalists, and national and district-level meetings and workshops for opinion leaders
  • Interpersonal communication and community mobilization to address barriers and promote priority actions during home visits, antenatal care sessions and postnatal care visits, health forums, and community mobilization sessions for influential community members
  • Mass communication to reach large audiences throughout the country through professional media campaigns based on rigorous concept testing and pretesting and a sophisticated mix of scientific and marketing data
  • Strategic use of data for advocacy, program design, implementation, and mid-course adjustments

Results

  • 1.7 million mothers of children under 2 counseled on IYCF in program areas by more than 10,000 frontline workers of BRAC, the NGO responsible for implementing the interpersonal communication and community mobilization component in 50 subdistricts.
  • Improved practices. Changes in exclusive breastfeeding were close to 25 percentage points higher than in comparison areas, and the percentage of children who had minimum dietary diversity almost doubled. (2013 process evaluation)
  • Scale achieved through mass media, multiple platforms, and leveraged resources. Alive & Thrive broadcast seven TV spots nationwide. Features of the Alive & Thrive interpersonal and community mobilization approach introduced by BRAC in 50 subdistricts spread to 172 additional subdistricts through BRAC’s Essential Health Care Program and Maternal, Neonatal, and Child Health Program. IYCF programs were modeled after Alive & Thrive in USAID-funded Feed the Future sites and DFID-funded nutrition and poverty reduction programs.
  • Systems strengthening with support for training of master trainers for three national training institutes, a regional training institute, and 16 BRAC training venues facilitated scaling up infant and young child feeding programs by the government and NGOs. 

Phase 2: Demonstrating the feasibility of integrating maternal nutrition in MNCH

Sept.  2014 to Sept. 2016

Inadequate maternal nutrition is likely to undermine the potential impact of IYCF improvements made in Alive & Thrive’s first phase because it is linked to poor fetal growth leading to small for gestational age and preterm newborns. These babies do not respond to growth promoting feeding practices as well as normal newborns do. In this second phase of program activities, Alive & Thrive is working with BRAC to integrate an intensified package of nutrition interventions in BRAC’s Maternal, Neonatal, and Child Health Program (MNCH).

Objectives

  • To increase dietary diversity and intake of energy, iron, folic acid, and calcium in 80 percent of pregnant women over two years in Alive & Thrive program areas
  • To test the operational feasibility of integrating a package of maternal nutrition interventions in a large scale MNCH program through the adaptation of Alive & Thrive’s behavior change approach and tools) that proved effective in improving infant and young child feeding practices

Program Approach

  • Advocacy with stakeholders at the national and district levels to raise the priority given to maternal nutrition (in addition to IYCF) in MNCH programs
  • Interpersonal communication in BRAC’s MNCH program focused on an intensified maternal nutrition package that includes iron-folate and calcium supplementation and an emphasis on dietary diversity
  • Expanded community mobilization and local media coverage to generate demand for improved practices, services, and products
  • Strategic use of data to develop a scalable program and demonstrate the feasibility of integrating maternal nutrition interventions