The Effects of Mainstreaming Nutrition and Early Childhood Development Under BRAC’s MNCH Programme
A Mixed-methods Impact Evaluation in Bangladesh
Malnutrition is one of the most serious global health problems. BRAC Bangladesh has attempted to combat malnutrition, a serious global health problem, by mainstreaming nutrition and early childhood development (ECD) under BRAC’s Maternal, Newborn, and Child Health (MNCH) Programme since 2010. Stunting, wasting, and micronutrient deficiencies contribute to nearly 3.1 million child deaths annually. In addition, more than 200 million children are not fulfilling their potential in cognitive development due to the high prevalence of stunting and the number of people living in absolute poverty.
The nutrition component of the MNCH programme is designed to reduce malnutrition among pregnant-lactating women and young children. In some trial areas, the mainstreaming of nutrition is complemented with a comprehensive ECD intervention to improve knowledge of caregivers on how to stimulate the cognitive and physical development of children. The MNCH program employs several strategies that focus on building the capacity of community health workers, establishing an effective community based integrated nutrition service delivery, and raising awareness and empowering communities to improve infant and young child feeding and breastfeeding practices.
To determine the impact of the mainstreaming of nutrition, a propensity score matching design that includes 1,600 households with children under two years old in 40 beneficiary mouzas (administrative districts that correspond to specific land areas in Bangladesh) and 40 comparison mouzas was used. To identify the impact of the ECD programme on children’s cognitive and motor skills and nutrition outcomes, a cluster randomized controlled trial was used that includes 3,120 households with children under two years old in 78 treatment mouzas and 78 control mouzas.