Bangladesh

The impact of commodity price hikes on poor and extreme poor households – SHOUHARDO III

Between June and July month, the SHOUHARDOIII program conducted its annual Beneficiary Based Survey (BBS) and captured the impact of recent price hikes on the life of the program participants. The SHOUHARDOIII program reaches over 475,228 members of 168,535 poor and extremely poor households in Bangladesh. The findings of the annual survey confirm that households are experiencing an increase in the price of essential commodities over the last six months. Read More...

Harvesting the Outcomes of SHOUHARDO III’s Local Service Provision Model of Micro Seed Dealers and Micro Seed Retailers (MSD/MSR)

SHOUHARDO III aims to ensure sustainable agriculture and livelihood for its beneficiaries. Part of this entailed forming community groups consisting of both men and women farmers, as well as increasing their capability in terms of quality seeds, agricultural technology, input and output markets, and connections with public and private actors. Read More...

SHOUHARDO III – Capturing the changes and impacts of reformed Community Groups

SHOUHARDO III program established the Community-level Thematic Groups in the inception year of the program in 2016 to facilitate the large-scale program interventions on Agriculture and Livelihoods (Farmers’ Field Business School/FFBS), Health and Nutrition (Maternal Child Health and Nutrition/MCHN groups and Mother Groups), Women’s Empowerment (Empowerment Knowledge and Transformative Action/EKATA), and Governance (Village Development Committees) with additional components represented by the youth groups and Village Savings and Loan Associations (VSLA). These groups were reformed into gender and age-specific Community Groups (CG) following the midterm evaluation in 2018 that provided recommendations on putting in place a sustainability strategy. Read More...

Impact, Influence, and Innovation: Reflecting on 10 Years of the CARE-GSK Frontline Health Worker Initiative

In recognition of their critical role in health linkages and systems strengthening, CARE and GSK established a decade long strategic investment in frontline health workers (FHW) and community health workers (CHW) in 2011 called the Frontline Health Worker Initiative. Following 10 years of partnership and programming, this report explores the resulting impacts, influence, and innovation. It synthesizes reach and impact data from 13 programmes across the 9 countries included in the Frontline Health Worker Initiative between 2011 and 2021. The countries included in this initiative are Afghanistan, Bangladesh, Cambodia, Cameroon, Chad, Laos, Myanmar, Nepal, and Togo.
The data presented here is specific to the communities in which CARE delivered sexual and reproductive health, maternal and child health, nutrition, and sanitation programming with GSK’s support. The analysis is designed to identify the changes in overall health outcomes that occurred at a population level. While these findings do not necessarily imply causation, CARE’s efforts have likely reasonably contributed towards these changes within the specific communities.
The Frontline Health Worker initiative has achieved these results across multiple development and humanitarian contexts – including slow-onset and sudden shocks, conflict, and most recently the COVID-19 pandemic. Many of these results were only made possible through the long-term investment from GSK and scalable actions that were implemented across all nine countries. Critically, the Frontline Health Worker Initiative established platforms, networks and health service capacity-building that served as a catalyst for CARE to pivot towards the response to the COVID-19 pandemic quickly in the communities where these projects exist.
Learnings from this programme will serve to strengthen CARE’s private sector partnership models for future programmes to build resilience and achieve health impact in communities. Read More...

End line assessment of GSK supported Community Health workers (CHW) initiative in Sunamganj district, Bangladesh

In spite of improvement in maternal and child health, the Sylhet division continues to have the poorest indicators in Bangladesh. Higher mortality for both mother and child and poor utilization of healthcare services still exist in the Sylhet division. Sunamganj is one of the remotest areas in Bangladesh and belongs to the Sylhet division having the poorest maternal and child health status. Since December 2012, CARE Bangladesh together with GSK and other key stakeholders has been implementing a Community Health Workers (CHWs) Initiative, which aims to address the lack of skilled human resources in remote and underserved unions of Sunamganj district. The overall goal of the CHW initiative is to improve maternal and child health outcomes in underserved/remote and poor communities of Bangladesh by increasing their access to quality health care services. Through a unique model of Public-Private Partnership (PPP), the project developed 319 Private CSBAs who are providing maternal and child health services including primary treatment of Non-Communicable Diseases (NCDs) like diabetes and hypertension in the entire Sunamganj district. To do a robust measurement in terms of assessing maternal, neonatal and child health (MNCH) related knowledge and practices as well as documentation of learning of these innovative initiatives, icddr,b conducted a baseline study in 2012 and end-line assessment in 2018. Read More...

Improved WASH Services to the Myanmar Refugees Population in camps 15 (Jamtoli) and 16 (Potibonia), Ukhiya Upazila, Cox’s Bazar

Applying both quantitative and qualitative tools and approaches, the end-line assessment was conducted in February 2022. It covers 415 respondents' households from camps 15 and 16—data collection done with tablets in KoBo. The samples were drawn systematically. First, the sample size was determined following the most common statistical formula. The objectives of the study are as follows: 1) To know the present situation context on WASH; 2) To identify the targeted respondent's current Knowledge, Attitude and Practice (KAP).

The study findings reveal the following:
Water
- The most commonly reported primary sources for drinking water were Piped water tap/Tap Stand, reported by 66% of households.
- In terms of water collection, male engagement has been increased. Overall, 86% of households reported women, followed by adult males (55%) and Children (6%). However, the male also helps them when they cook and cloth wash.
- Overall, only 2% of households reported a combined travel and waiting time of more than 30 Water containers.
- Females preferred to get 'Kolsi' (a pitcher) instead of Bucket or Jerrycan for carrying water. On the other hand, male and adolescent children preferred Jerrycan for carrying the water.
- 76% of respondents feel safe collecting enough water to meet their households' needs, such as drinking, cooking, laundry, bathing etc. However, women also reported that they feel unsafe because men go to water points to collect water.
- A significant proportion of households (88%) do not treat drinking water. Because they believe the drinking water source is safe—12% of households use the aqua tab to treat their water.
Sanitation
- The most-reported defecation (sanitation options) for household members five and above was communal latrines 86%, followed by shared latrines 14%, and single-household latrines 7%. Others places (2 %), bucket and open defecation was seldom reported 1%.
- The accessible latrine is one of the beauties of this project. This latrine is included: The railing on the way, The handle inside, The tap, The commode, The single-use.
- The community also thinks that these latrines will be equally helpful for elderlies.
- A significant 79% responded to the affirmative of privacy of latrine use. A significant number of
- 18% of the households' female members use the designated bathing facilities. However, this figure is low because of privacy concerns.
Hygiene
- All (100%) respondents mentioned that they cleaned every time they filled with fresh/clean water. While at the time of hurriedness, that type of cleaning activity has disrupted.
- 100% of households owned soap at the time of the interview. The study further explored other hand washing options/solutions households use when they do not have soap; because of CoVID-19, all respondents, even children, are aware of handwashing. They can recall the critical time of handwashing.
- Regarding the best way to receive health and hygiene messages, 45% stated Home visits by volunteers, and 2nd choice is by the local leaders. However, the study findings also revealed that only 7% of households said they do not know how to prevent diarrhea.
- 69% of females used reusable clothes, 16% used disposable pads. The reusable cloth is the most preferred for use during the menses.
- Most female respondents said they wash and reuse the MHM materials and dispose of way is Household/Trash bin, Throw in the open waste area/communal bins, In the latrine, Bury in the soil, and, Burn them
RECOMMENDATION
- Consideration of men, women and girls carrying water and provide water container that these particular groups prefer;
- The child-to-chid session needs to discuss the importance of Gender Marker because children remove the gender markers frequently, which causes a problem for the women;
- Need to keep attention to the elderly person in terms of WASH facilities along with Persons with Disabilities;
- Video documentaries for hygiene promotion may be more effective together; in this connection, CARE can collaborate with "shongjog" which is the open platform of CwC in Rohingya Camp. Read More...

Assessment on “Improving lives of Rohingya refugees and host community members in Bangladesh through sexual and reproductive healthcare integrated with gender-based violence prevention and response”

In response to the health and protection needs of the Rohingya refugees and the host communities in Cox´s Bazar, CARE is implementing the project “Improving lives of Rohingya refugees and host community members in Bangladesh through sexual and reproductive healthcare integrated with gender-based violence prevention and response” with funding support by German Federal Foreign Office. This is a two year project targeting Rohingya refuges of camp 11, 12, 15 and 16 and vulnerable host communities of Jaliapalong union for GBV and SRH services.

Indicator 1: %of targeted refugee and host community report an improved environment for women and girls following the implementation of SRH and GBV prevention measures
i. 93% respondents have good and very good understanding on available SRH service
ii. Proportion of women who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care. 17% of interviewed women can make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care.
iii. 32% of interviewed female from both host community and refugee community received both Anti-natal Care (ANC) and Post Natal Care (PNC).
So, we can say that, 47% (average of result of three proxy indicator) of targeted refugee and host community report an improved environment for women and girls following the implementation of SRH prevention measures.
iv. 49% of women and girls reporting feeling safe following the implementation of GBV prevention measures
v. 63% respondents (male 21`% and female 42%) go to community leaders for seeking help when they face any form of violence both in their home and also outside of their home
Here, “56% of targeted refugee and host community report an improved environment for women and girls following the implementation of GBV prevention”
Considering the average result of above GBV and SRH indicators, we can say that, 51.5% of targeted refugee and host community reported an improved environment for women and girls on SRH and GBV prevention measures at the baseline of the project.
Indicator 2: # of people (m/f) accessing services and information on SRH services and GBV prevention and response
Indicator 3: % of refugees and host population who report satisfaction with GBV and SRH assistance
i. 70% respondents from refugee and host community reported full satisfaction with GBV assistance
ii. 87% female and 65% male from refugee and host community reported full satisfaction with SRH assistance. (Among them 67% female from refugee and 20% female from host community, 45% male from refugee community and 20% male from host community)
Indicator 4: % of staff members with improved knowledge on SHR and GBV
Inicator 5: 45% of men and boys who report rejecting intimate partner violence and domestic violence
80% of staff members with improved knowledge on SHR and GBV
Indicator 5: # of women and adolescent girls having received MHM kit
i. Most of the respondents (85%) use reusable clothes
ii. 90% respondents wash and use the cloth again
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AHP DFAT III-COVID-19: A Visit to OXFAM livelihood project in Teknaf

This joint monitoring visit was conducted in the Oxfam- MUKTI implemented project, part of the DFAT AHP III consortium. As per the agreed decision of the MEAL Working Group (MWG), the visit date was 27 February 2022. The activity was covered: 1) Homestead Gardening & Pit Composting, 2) Tailoring, 3) Goat Rearing, and 4) IGA of People with Disabilities. The visit location was Rasullabad, Dargapara, and Lichuaprang villages. A convenient sample was used in this visit, so generalizing is a limitation. Read More...

POST PROJECTSUSTAINABILITYSTUDY OF SETU (SOCIAL AND ECONOMIC TRANSFORMATION OFTHE ULTRA POOR)

POST PROJECT SUSTAINABILITY STUDY OF SETU09CARE Bangladesh implemented (2009-2015) Social and Economic Transformation of the Ultra Poor (SETU), under the EEP/SHiREE program funded by former UKaid from the Department for International and the Swiss Agency for Development Cooperation in four districts: Ranpur, Gaibandha, Lalmonirhat and Nilphamari of the Northwest region of the country that is severely affected by seasonal food insecurity. The design of SETU was structured around CARE's Criteria and threshold of calculating multidimensional poverty livelihood opportunities; social inequalities playing out different forms of exploitation, dependence, discrimination, and marginalization; and weak governance at all levels resulting in lack of participation of extreme poor and poor people in Union Parishad and local development processes.This PPS study of SETU aims to assess how and to what extent the graduation model sustains in later years; and the factors that determine sustainability or lack thereof in the same population group. The study followed the same area and sample (418) households of SETU’s end evaluation study and included 95% of households who graduated and 5% of HH who have not graduated. Read More...

Sustainability of impact-strengthening the Dairy value Chain (SDVC) Final Report

Strengthening Dairy Value Chain (SDVC) Project was one of the first Value Chain Development (VCD) programmes of CARE Bangladesh, it had its roots in focusing extensively in supporting farmers through provision of organizing, training and technically supporting farmers. SDVC-II had a more market led focus and a more facilitative approach. It worked across the dairy value chain, ranging from Livestock Health Workers (LHWs), Input sellers, Milk Collectors, BRAC Dairy, and others. This study aimed to measure long-term sustainability of impacts through Market Systems Development Approach. The study focused on capturing the sustainability of the project’s interventions, 5 years after the project had closed.
SDVC built household resilience, improved livelihoods, and helped chronically food insecure households increase their income and dairy consumption. The project focused on implementing change through a set of interventions namely:
• Improving Productivity
• Increasing Access to Inputs
• Increasing Access to Markets
• Improving the Policy Environment
• Supporting Use of Technology and Data
The study adopted the AAER (Adopt, Adapt, Expand, Respond) framework1 for capturing systemic change. The study found that after five years of project completion, substantial linkages remain, and functions continues to serve the poor in a systematic manner. Where we found that market actors such as Livestock Health Workers, Retailers, Collection points continue to function strongly. Similarly, we found that BRAC dairy continues to source milk from collection points, where smallholders supply roughly 70-80% of the milk. Other processors were also found to utilise the collection points in terms of sourcing milk. BRAC intends to replicate the dairy hub model with the use of Digital Fat Testing Devices in the southern part of Bangladesh as well. All processors like PRAN, Milk Vita, Rangpur Dairy were also found to have been sourcing from the established collection points.
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