Assignment Name: Baseline and Knowledge, Practice and Coverage (KPC) Study of the Collective Responsibility, Action and Accountability for Improved Nutrition (CRAAIN) Project

Country: Bangladesh

Client Name: Concern Worldwide

The Collective Responsibility, Action and Accountability for Improved Nutrition (CRAAIN) project, a three-year initiative from January 2020 to December 2022, aimed to address food insecurity and malnutrition in Bagerhat District, particularly in the coastal regions of Mongla, Sharonkhola, Kachua, and Mollahat. Funded by European Union (EU), this project aligned with the EU-funded Food and Nutrition Security Programme for Bangladesh 2015 and the National Food Policy of Bangladesh, contributing to the reduction of malnutrition, particularly among maternal and child nutrition.

The project was designed to improve nutrition through an integrated, multi-sectoral approach that strengthens the capacity of government bodies, private sector, civil society, and local communities to deliver effective nutrition services. The project’s goal was to enhance nutrition governance at the local level by focusing on maternal, infant, and young child nutrition (MIYCN), improving access to nutritious food, promoting Water, Sanitation, and Hygiene (WASH) practices, and establishing pro-poor nutrition-sensitive interventions.

Key objectives of the project included:

• Improve nutritional knowledge and practices among households, with a focus on extreme poor populations in the target areas.
• Strengthen public-private sector relationships for pro-poor, market-based solutions to improve access to nutritious foods and WASH services.
• Enhance coordination and accountability of government departments and local institutions in providing nutrition-sensitive services.
• Mobilize civil society to engage with communities and stakeholders in the fight against malnutrition, focusing on reducing stunting among children.

DM WATCH was assigned to provide baseline data and assess the current knowledge, practice, and coverage (KPC) among mothers/caretakers of children, household heads, School Management Committee members, adolescent girls’ and boys’ groups in four Upazilas of Bagerhat, namely, Mongla, Sarankhola, Kachua, and Mollahat.

Objective 1: To capture baseline information against each outcome and output indicator from different sources as outlined in the agreed logframe.

Specific objectives under this objective included:

• To provide a brief overview of the current context which the CRAAIN project will be implemented in with particular attention given to the external environment risks (e.g. COVID19, climate change, and natural disasters).
• To provide essential information on the key CRAAIN logframe indicators for the population in the target area, results to be disaggregated by gender, age and location as needed.
• To examine the current allocation of government resources for nutrition services, social safety nets, and nutrition sensitive agriculture, education and health services.
• To assess the current functionality, responsiveness and capacity of targeted government departments, and the targeted populations perception of these.

Objective 2: To understand the current knowledge, practice, and coverage (KPC) among mothers/caretakers of children 0-59 months, household heads, schoolteacher/SMC members, adolescents and male groups.

Specific objectives under this objective included:

• To provide essential baseline information on the knowledge, practice and coverage related to key MIYNC, WASH and food security related behaviours.
• Assess cultural beliefs or behavioural patterns and practices that create barriers to infant and young child feeding and care practises.
• To explore the status and condition of women’s access to resources, time use and control over decision-making, productive resources and opportunities and how these relate to MIYNC, WASH and food security.
• Map and quantify the strength the drivers and bottlenecks in adopting the improved behaviours and access services specific to nutrition, water, sanitation, hygiene and food security
• To formulate and provide practical and sustainable recommendations for both short and long term SBCC programmes of Concern Worldwide in the coastal region.
• To assess and identify communications processes and sources important for programme implementation and effectiveness. Including mapping and quantifying the strength of information channels available to households in the rural areas.

The study team of DM WATCH was responsible for conducting the baseline study and the Knowledge, Practice, and Coverage (KPC) study for the CRAAIN project. Below is a detailed account of the services provided by the team:

Planning and Consultation:

• Conducted comprehensive desk review of the project and relevant documents.
• Conducted detailed consultations with key project stakeholders, including Concern Worldwide, Jagrata Juba Shangha (JJS), Rupantar, and WaterAid, to finalize the study’s design, methodology, and sampling framework.
• Engaged with the CRAAIN Project Steering Committee to align the baseline and KPC study with the project’s objectives, ensuring the data collection tools were tailored to capture information relevant to nutrition, WASH, and food security in Bagerhat District.

Methodology Design and Tool Development:

• Developed and refined the study’s methodological framework, integrating quantitative surveys and qualitative interviews.
• Designed data collection tools, including household surveys, focus group discussion (FGD) guides, and key informant interview (KII) templates, all aligned with the project’s logframe indicators.
• Conducted a pre-test of the tools in a non-project site to ensure cultural appropriateness and clarity.

Training and Data Collection:

• Recruited and trained enumerators, ensuring they were well-versed in the Digital Data Gathering (DDG) system, data privacy protocols, and the project’s Code of Conduct.
• Led field mobilization and supervised the data collection process, including household surveys with 500 beneficiaries, 22 FGDs, and 30 KIIs with various stakeholders such as local government officials, healthcare providers, and community leaders.
• Monitored the data collection in real-time, ensuring that enumerators adhered to quality control measures, including plausibility checks and data validation.

Data Analysis and Reporting:

• Conducted data analysis to calculate key indicators on maternal and child nutrition, WASH, food security, and gender-based decision-making.
• Developed two comprehensive reports on the baseline findings and the KPC study, which included both quantitative and qualitative analysis. Key findings were provided on the level of knowledge and practices regarding exclusive breastfeeding, minimum acceptable diet (MAD) for children, and handwashing behaviors.
• Presented findings with disaggregated data by gender, age, and location, in line with the CRAAIN logframe.

Dissemination and Stakeholder Engagement:

• Organized a consultation workshop where the preliminary findings of the baseline and KPC study were shared with stakeholders, including the CRAAIN Consortium, local government officials, and civil society organizations.
• Delivered PowerPoint presentations summarizing the findings and discussed actionable recommendations for Social Behavioural Change Communication (SBCC) and improving service delivery.
• Final reports, including the baseline report and KPC report, were shared with Concern Worldwide, the European Union, and other relevant stakeholders for evidence-based advocacy and programmatic adjustments.

These services contributed to providing a clear understanding of the current knowledge, practices, and coverage regarding maternal and child nutrition, WASH, and food security, as well as an evaluation of the government’s capacity to deliver nutrition services. The findings were instrumental in shaping future interventions and policy adjustments aimed at improving nutrition outcomes in the coastal region of Bangladesh.