Bangladesh
Baseline Study Report Adaptation in Ecologically Critical Areas in Bangladesh (AECAB)
The Ecologically Critical Areas (ECAs) of Bangladesh, especially the Sundarbans and Hakaluki Haor natural resources and biodiversity are crucial for the ECA dependent communities. However, these ecosystems are experiencing many challenges due to human activities, economic pressure, poor governance and adverse effects of climate change. These factors disproportionately affect marginalised groups, including women, persons with disabilities, and ethnic communities in the two ECAs. In response to these challenges, the NABAPALLAB project, supported by the UK Government, aims to improve ecosystem-based protection and restoration and increase climate resilience of ECA dependent communities in the Sundarbans and Hakaluki Haor ECAs. During the inception period, the project has conducted three studies simultaneously: i) An Ecological Assessment and Detailed Scoping Study, ii) Political Economy Analysis, and iii) Baseline Study.
The baseline study serves to establish pre-project conditions, providing essential data for monitoring, evaluation, and learning. It aims to capture baseline data for outcome indicators, disaggregated by sex, disability, and geography, and validate assumptions mentioned in the project's Theory of Change (ToC).
The study scope encompasses:
•
Socio-economic conditions
•
Climate change perceptions
•
Awareness of ecosystem-based adaptation (EbA)
•
Locally led adaptation (LLA)
•
Nature-based solutions (NbS)
•
The current status of project intervention areas.
Methodology
The study has applied a mixed approach, integrating quantitative and qualitative approaches by incorporating household surveys (2622 household), Focused Group Discussions (FGDs) (2506 participants) and Key Informant Interviews (KIIs) (137 respondents). A multi-stage cluster sampling approach was applied to select the sampled households, while diverse community members and stakeholders were engaged through FGD and KII that provided comprehensive insights into local contexts, baseline situation and the needs of the communities in the six intervention areas of the project.
Key findings
1. There are high levels of poverty, landlessness, and climate vulnerability among target communities in both ECAs.
• Food is by far the highest expenditure for households - demonstrating a high proportion of expenditure is simply meeting basic needs.
•It is also the case that a relatively high proportion of expenditure is used on the servicing of debt, again demonstrating the impacts for poor households on having to use debt as a coping mechanism.
• Borrowing money and cutting expenditure are by far the most used coping strategies, with reliance on savings and migration also prevalent.
28% of households in the ECA are landless, while 72% possess land, averaging 5.58 decimals.1 In the Sundarbans ECA, the average landholding is 6.85 decimals, and in Hakaluki ECA, it is 4.18 decimals. This land is used for various purposes, including housing, agriculture, homestead gardening, cattle raising, and fish culture.
2.
Climate-induced disasters severely impact livelihoods and natural resources, with limited awareness of EbA, LLA, and NbS approaches.
• Household surveys reveal that around 91% of respondents were affected by climate hazards and disasters like floods, drought and cyclones in the last 5 years. FGDs participants also highlighted that the vulnerability of the communities is high due to the location of their settlement in a fragile area, with poor infrastructure, climate sensitive livelihoods and lack of access to government Social Safety Net (SSN) services and support.
• Among the households, 32% have incurred loss of income and 23% loss of livelihoods. Over 17% of the respondents mentioned that climate change has increased health risks and medical expenditures in recent years.
• In contrast to relatively high levels of negative coping mechanisms (e.g. borrowing money, or cutting expenditure), few households engaged in planned adaptation i.e. changing livelihood options, diversification of crops, changing types of crops.
• The survey results revealed that 94% of the ECAs respondents do not know about LLA and NbS, suggesting considerable scope to work with communities to increase their understanding of these key issues.
3. Access to climate information has been inadequate and there has been a low degree of anticipatory action.
• The survey revealed a low level of information on climate change and a lack of access to important climate information. The survey reveals that overall, 66% of the respondents do not know about the Early Warning System (EWS), around 23% have not received any early warning on floods, and only 11% got some early warning during the floods in the last five years
• When asked if they take measures to strengthen their household infrastructure before local climatic hazards, approximately 57% of respondents in the ECAs reported that they do not take such measures.
4. Access to clean and renewable energy, safe drinking water, and sanitation is inadequate, particularly among vulnerable groups including poor women and ethnic minority communities.
• 97% of surveyed households have access to grid electricity in the ECAs, with 5.3% using solar energy and 0.2% relying on biogas. However, the grid electricity supply is unreliable, with about 63% of these households experiencing load shedding for more than 4 hours daily.
• There is also a significant reliance on traditional fuels (i.e. wood, twigs, cow dung, kerosine etc.) which is likely to have an impact on the broader sustainability of ECAs.
• 41% of respondents collect drinking water from tube wells, followed by Rainwater Harvesting System (RWHS) (22%), pond and dug wells (17%).
• Around 67% of the respondents use pit latrines with ring slabs (a type of improved sanitary latrine), whereas 20% use pit latrines without slabs.
5. Despite some positive trends in joint economic decision-making, women were not systematically included in decision-making around agricultural production.
In key measures women appeared to have moderate levels of inclusion in household decisions. Participation in decision-making on household purchases the surveys demonstrated that on average, across both regions, 68.1% reported having moderate or high levels of participation in these decisions.
•
Nearly three-quarters of the female respondents lacked the right to participate in decision-making in agricultural decision-making. Most female respondents in both regions (around 70.6% - 79.1%) did not share decision-making with their husbands about agricultural land use.
6.
There is little engagement of LGIs in conservation of natural resources, promoting resilient livelihoods. Participation of the community in formal and informal institutions is low.
• Around 93% of ECAs respondents reported that they have no membership and affiliation with the local conservation committees and groups such as Community Patrol Groups (CPG) or Village Conservation Forums (VCF). About 96% of the ECAs respondents have no participation in the decision-making of the Local Government Institutions (LGIs). Participation of vulnerable groups in decision-making is higher (10%) in the Sundarbans ECA than that of Hakaluki Haor (0.2% only).
• The participation of the study population in formal (government-led) and informal (civil society-led, private sector-led) climate-relevant decision-making spaces is also very low in the ECAs. About 6% of the households’ members participated in the decision-making spaces where 98% were male. The project must put more emphasis on the empowerment of people living in poverty and women for their effective participation in local decision processes that may benefit people living in poverty and women for adaptation and resilience building.
• Whilst community members felt that local authorities and committees had an important role to play in supporting farmers and forest-dependent communities, this support is currently inadequate due to constraints like insufficient human resources and capacity. Read More...
The baseline study serves to establish pre-project conditions, providing essential data for monitoring, evaluation, and learning. It aims to capture baseline data for outcome indicators, disaggregated by sex, disability, and geography, and validate assumptions mentioned in the project's Theory of Change (ToC).
The study scope encompasses:
•
Socio-economic conditions
•
Climate change perceptions
•
Awareness of ecosystem-based adaptation (EbA)
•
Locally led adaptation (LLA)
•
Nature-based solutions (NbS)
•
The current status of project intervention areas.
Methodology
The study has applied a mixed approach, integrating quantitative and qualitative approaches by incorporating household surveys (2622 household), Focused Group Discussions (FGDs) (2506 participants) and Key Informant Interviews (KIIs) (137 respondents). A multi-stage cluster sampling approach was applied to select the sampled households, while diverse community members and stakeholders were engaged through FGD and KII that provided comprehensive insights into local contexts, baseline situation and the needs of the communities in the six intervention areas of the project.
Key findings
1. There are high levels of poverty, landlessness, and climate vulnerability among target communities in both ECAs.
• Food is by far the highest expenditure for households - demonstrating a high proportion of expenditure is simply meeting basic needs.
•It is also the case that a relatively high proportion of expenditure is used on the servicing of debt, again demonstrating the impacts for poor households on having to use debt as a coping mechanism.
• Borrowing money and cutting expenditure are by far the most used coping strategies, with reliance on savings and migration also prevalent.
28% of households in the ECA are landless, while 72% possess land, averaging 5.58 decimals.1 In the Sundarbans ECA, the average landholding is 6.85 decimals, and in Hakaluki ECA, it is 4.18 decimals. This land is used for various purposes, including housing, agriculture, homestead gardening, cattle raising, and fish culture.
2.
Climate-induced disasters severely impact livelihoods and natural resources, with limited awareness of EbA, LLA, and NbS approaches.
• Household surveys reveal that around 91% of respondents were affected by climate hazards and disasters like floods, drought and cyclones in the last 5 years. FGDs participants also highlighted that the vulnerability of the communities is high due to the location of their settlement in a fragile area, with poor infrastructure, climate sensitive livelihoods and lack of access to government Social Safety Net (SSN) services and support.
• Among the households, 32% have incurred loss of income and 23% loss of livelihoods. Over 17% of the respondents mentioned that climate change has increased health risks and medical expenditures in recent years.
• In contrast to relatively high levels of negative coping mechanisms (e.g. borrowing money, or cutting expenditure), few households engaged in planned adaptation i.e. changing livelihood options, diversification of crops, changing types of crops.
• The survey results revealed that 94% of the ECAs respondents do not know about LLA and NbS, suggesting considerable scope to work with communities to increase their understanding of these key issues.
3. Access to climate information has been inadequate and there has been a low degree of anticipatory action.
• The survey revealed a low level of information on climate change and a lack of access to important climate information. The survey reveals that overall, 66% of the respondents do not know about the Early Warning System (EWS), around 23% have not received any early warning on floods, and only 11% got some early warning during the floods in the last five years
• When asked if they take measures to strengthen their household infrastructure before local climatic hazards, approximately 57% of respondents in the ECAs reported that they do not take such measures.
4. Access to clean and renewable energy, safe drinking water, and sanitation is inadequate, particularly among vulnerable groups including poor women and ethnic minority communities.
• 97% of surveyed households have access to grid electricity in the ECAs, with 5.3% using solar energy and 0.2% relying on biogas. However, the grid electricity supply is unreliable, with about 63% of these households experiencing load shedding for more than 4 hours daily.
• There is also a significant reliance on traditional fuels (i.e. wood, twigs, cow dung, kerosine etc.) which is likely to have an impact on the broader sustainability of ECAs.
• 41% of respondents collect drinking water from tube wells, followed by Rainwater Harvesting System (RWHS) (22%), pond and dug wells (17%).
• Around 67% of the respondents use pit latrines with ring slabs (a type of improved sanitary latrine), whereas 20% use pit latrines without slabs.
5. Despite some positive trends in joint economic decision-making, women were not systematically included in decision-making around agricultural production.
In key measures women appeared to have moderate levels of inclusion in household decisions. Participation in decision-making on household purchases the surveys demonstrated that on average, across both regions, 68.1% reported having moderate or high levels of participation in these decisions.
•
Nearly three-quarters of the female respondents lacked the right to participate in decision-making in agricultural decision-making. Most female respondents in both regions (around 70.6% - 79.1%) did not share decision-making with their husbands about agricultural land use.
6.
There is little engagement of LGIs in conservation of natural resources, promoting resilient livelihoods. Participation of the community in formal and informal institutions is low.
• Around 93% of ECAs respondents reported that they have no membership and affiliation with the local conservation committees and groups such as Community Patrol Groups (CPG) or Village Conservation Forums (VCF). About 96% of the ECAs respondents have no participation in the decision-making of the Local Government Institutions (LGIs). Participation of vulnerable groups in decision-making is higher (10%) in the Sundarbans ECA than that of Hakaluki Haor (0.2% only).
• The participation of the study population in formal (government-led) and informal (civil society-led, private sector-led) climate-relevant decision-making spaces is also very low in the ECAs. About 6% of the households’ members participated in the decision-making spaces where 98% were male. The project must put more emphasis on the empowerment of people living in poverty and women for their effective participation in local decision processes that may benefit people living in poverty and women for adaptation and resilience building.
• Whilst community members felt that local authorities and committees had an important role to play in supporting farmers and forest-dependent communities, this support is currently inadequate due to constraints like insufficient human resources and capacity. Read More...
Systems-Level Impact through the 2018 U.S. Farm Bill
In a global context of rising numbers of people affected by increasingly frequent and severe food security crises, CARE advocated for essential amendments in the 2018 Farm Bill to strengthen critical international food aid programs. CARE's advocacy for the 2018 Farm Bill was rooted in its focus on gender equality and systems change, which in this case meant advocating for a shift away from monetization in support of CARE’s long-term goals for transforming food aid from a commodity-centric model to one that enhances effectiveness, efficiency, and focus on systems change.
Central to CARE’s asks in the 2018 Farm Bill were efforts to end the mandate of monetization and provide greater certainty in the use of the Community Development Funds. Both of these asks would strengthen Food for Peace, a program authorized in the Farm Bill that provides in-kind food aid directly to communities and supports community self-sufficiency. CARE recognized the 2018 Farm Bill reforms, including ending mandatory monetization and expanding Community Development Funds, could strengthen local food systems, empower farmers, and build community resilience by prioritizing sustainable and effective food aid delivery. Read More...
Central to CARE’s asks in the 2018 Farm Bill were efforts to end the mandate of monetization and provide greater certainty in the use of the Community Development Funds. Both of these asks would strengthen Food for Peace, a program authorized in the Farm Bill that provides in-kind food aid directly to communities and supports community self-sufficiency. CARE recognized the 2018 Farm Bill reforms, including ending mandatory monetization and expanding Community Development Funds, could strengthen local food systems, empower farmers, and build community resilience by prioritizing sustainable and effective food aid delivery. Read More...
Ecological Assessment and Detailed Scoping Study in the Sundarbans and Hakaluki Haor Ecologically Critical Areas (ECA) for Nature-based Solutions (NbS) and Locally Led Adaptation (LLA)
The Ecologically Critical Areas (ECAs) in Bangladesh, notably the Sundarbans and Hakaluki Haor are vital for biodiversity and livelihoods. The UK government’s Adaptation in Ecologically Critical Areas known locally as NABAPALLAB- (Nature Based Adaptation towards Prosperous and Adept Lives & Livelihoods in Bangladesh) project aims to enhance resilience of the ecosystem and livelihoods through Nature-based Solutions (NbS) and Locally Led Adaptation (LLA). The project has conducted three separate assessments (Ecological Assessment and Detailed Scoping study; Stakeholder Mapping and Political Economy Analysis; and Baseline Study) simultaneously during its inception stage. This report synthesizes findings from the ecological assessment and detailed scoping study. Insights were gathered to understand ecological status, community needs, and intervention opportunities in the Sundarbans and Hakaluki Haor. The report further highlights current and emerging threats, drivers and complexities in both ECAs. The status of the natural resource base, degradation pattern and ecosystem health were also analysed and documented using physical data and recent satellite imagery.
In the Sundarbans, the study found different ecosystems, including wetlands, low-lying lands, riverside areas, homesteads, croplands, and coastal embankments. All of these ecosystems are affected by various climatic stressors such as salinity, tidal inundation, erratic rainfall, and cyclones. They are also impacted by anthropogenic drivers such as shrimp farming, water logging, overharvesting, illegal fishing, deforestation, poaching. For example, the study shows that shrimp cultivation has a profound effect on agriculture with changes in land use and intrusion of saline water, which lead to decreased soil fertility, crop failure and lower productivity. Shrimp cultivation also contributes to surface water pollution, leading to scarcity of drinking water and negative impacts on WASH. The study also highlights significant threats to important endangered wildlife species in the Sundarbans ECA, including the Masked Finfoot and White-Rumped Vulture. In addition to the anthropogenic threats, the study has identified other problems such as fishing with poison, bird hunting, use of illegal fishing equipment, canal siltation, and intrusion of saline water into freshwater wetlands. These issues result in decreased fish population, depletion of wildlife and reduced agricultural productivity.
The Hakaluki Haor, encompassing 276 interconnected beels (wetland lakes) over an area of 18,000 hectares, faces significant threats from both anthropogenic and climate change stressors. Extensive sedimentation and agricultural expansion have led to the conversion of over 20 beels to agricultural production, impacting wetland productivity, aquatic vegetation, fish populations, and local livelihoods. Degradation of rivers, canals, and hill streams within the Haor has further exacerbated these problems and challenges, affecting crop production, fish yields, and biodiversity. Encroachment on protected swamp forest areas after phase-out of previous projects, wide-ranging deforestation, and conversion of raised land (Kandas) for agriculture have negatively impacted the habitats of fish and birds, and other wetland-dependent wildlife as well as waterfowl migratory routes. Furthermore, elite capture excludes poor fisher folk and landless individuals from fishing and accessing natural resources, while agricultural expansion in Kanda areas raises concerns about increased use of chemical pesticides and fertilizers that pollute wetlands. Read More...
In the Sundarbans, the study found different ecosystems, including wetlands, low-lying lands, riverside areas, homesteads, croplands, and coastal embankments. All of these ecosystems are affected by various climatic stressors such as salinity, tidal inundation, erratic rainfall, and cyclones. They are also impacted by anthropogenic drivers such as shrimp farming, water logging, overharvesting, illegal fishing, deforestation, poaching. For example, the study shows that shrimp cultivation has a profound effect on agriculture with changes in land use and intrusion of saline water, which lead to decreased soil fertility, crop failure and lower productivity. Shrimp cultivation also contributes to surface water pollution, leading to scarcity of drinking water and negative impacts on WASH. The study also highlights significant threats to important endangered wildlife species in the Sundarbans ECA, including the Masked Finfoot and White-Rumped Vulture. In addition to the anthropogenic threats, the study has identified other problems such as fishing with poison, bird hunting, use of illegal fishing equipment, canal siltation, and intrusion of saline water into freshwater wetlands. These issues result in decreased fish population, depletion of wildlife and reduced agricultural productivity.
The Hakaluki Haor, encompassing 276 interconnected beels (wetland lakes) over an area of 18,000 hectares, faces significant threats from both anthropogenic and climate change stressors. Extensive sedimentation and agricultural expansion have led to the conversion of over 20 beels to agricultural production, impacting wetland productivity, aquatic vegetation, fish populations, and local livelihoods. Degradation of rivers, canals, and hill streams within the Haor has further exacerbated these problems and challenges, affecting crop production, fish yields, and biodiversity. Encroachment on protected swamp forest areas after phase-out of previous projects, wide-ranging deforestation, and conversion of raised land (Kandas) for agriculture have negatively impacted the habitats of fish and birds, and other wetland-dependent wildlife as well as waterfowl migratory routes. Furthermore, elite capture excludes poor fisher folk and landless individuals from fishing and accessing natural resources, while agricultural expansion in Kanda areas raises concerns about increased use of chemical pesticides and fertilizers that pollute wetlands. Read More...
Community Nutrition and Health Activity Equity Gap Analysis
The Community Nutrition and Health Activity (CNHA) conducted an equity gap analysis to investigate the existing inequities in health and nutrition outcomes within its target areas in Bangladesh. This analysis aimed to identify not only the current inequities but also the underlying reasons for these disparities. Using USAID’s Unofficial Guidance to an Equity Gap Analysis, the CNHA team defined desired outcomes, assessed differential health and nutrition outcomes among various population groups through secondary data, and conducted stakeholder consultations with marginalized groups to understand the reasons behind these inequities. The findings highlighted that individuals in the two lowest wealth quintiles face significant barriers to accessing health care services, with persons with disabilities particularly excluded. Stakeholder consultations revealed issues such as lack of respectful care from community health care providers, restrictions on women's mobility, and inadequate participation in government safety net programs.
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Baseline Study Report of Flash Flood and Lightning
The baseline study concerning the impact of flash floods and lightning on the SUFAL-II project aims to analyze the context of flash floods and lightning, assess the scopes of the Early Warning System, and examine current trends of of hazard-specific responses taken by individual, community, and institutional levels. The objective of this project is to bolster the capabilities of vulnerable communities and institutions in Bangladesh to implement forecast-based early actions. The study employed a mixed-method approach, amalgamating both quantitative and qualitative data collection and analysis techniques. This was done to assess the context, accessibility, usage, and potential of early warning systems and early actions for mitigating the risks associated with the flash floods and lightning hazards.
The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For the treatment group areas, the selected Upazilas were Gowainghat, Dharmapasha, and Khaliajuri and for control group areas, the selected areas were Sylhet Sadar, Sunamganj Sadar, Madan.
Data was collected from 502 households, 12 focus group discussions, and 19 key informant interviews. The study's findings indicate that flash floods and lightning are recurrent and severe hazards that pose significant threats to the communities lives, assets, and livelihoods. These hazards are disproportionately affect women, individuals with disabilities and farmers. The study also identified several shortcomings in the existing early warning systems, including issues related to timeliness, quality, coverage, accessibility, comprehension, and trust.
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The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For the treatment group areas, the selected Upazilas were Gowainghat, Dharmapasha, and Khaliajuri and for control group areas, the selected areas were Sylhet Sadar, Sunamganj Sadar, Madan.
Data was collected from 502 households, 12 focus group discussions, and 19 key informant interviews. The study's findings indicate that flash floods and lightning are recurrent and severe hazards that pose significant threats to the communities lives, assets, and livelihoods. These hazards are disproportionately affect women, individuals with disabilities and farmers. The study also identified several shortcomings in the existing early warning systems, including issues related to timeliness, quality, coverage, accessibility, comprehension, and trust.
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Evaluation intermédiaire du projet « Féministes en Action » 2021-2023
Description of the document:
L’évaluation intermédiaire du projet « Féministes en Action » intervient près de trois ans après le début du projet et deux après le démarrage effectif des financements aux organisations féministes. Couvrant la période 2021-2023, elle poursuit plusieurs objectifs :
∇ Un objectif d’apprentissage et de capitalisation, alors que Féministes en Action est le premier consortium financé au titre du FSOF, l’un de ceux cherchant à atteindre directement les OSC féministes les plus fragiles et celui ayant le périmètre thématique le plus large (les autres sont construits en général autour d’une thématique d’intervention). Le consortium constitué, avec la présence d’ONG internationales et de fonds des « Suds » est lui aussi inédit.
∇ Un objectif stratégique et prospectif, avec une réflexion portant à la fois sur les changements visés et l’architecture globale du projet alors que le projet devrait disposer de nouveaux fonds à mettre en oeuvre après 2023. L’évaluation doit notamment permettre d’accompagner une réflexion sur les objectifs du cadre logique du Projet dans l’optique d’une redéfinition afin d’assurer la cohérence avec les objectifs réellement visés par le Projet et les indicateurs prévus difficilement renseignables.
∇ Un objectif de redevabilité, tourné avant tout vers les sociétés civiles féministes que Féministes en Action cherche à renforcer. Il s’agit de s’assurer que l’action menée apporte une valeur ajoutée (« do not harm ») et que les conditions de mise en oeuvre sont cohérentes avec les valeurs féministes promues tout en tenant compte des exigences d’un bailleur de fonds publics.
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L’évaluation intermédiaire du projet « Féministes en Action » intervient près de trois ans après le début du projet et deux après le démarrage effectif des financements aux organisations féministes. Couvrant la période 2021-2023, elle poursuit plusieurs objectifs :
∇ Un objectif d’apprentissage et de capitalisation, alors que Féministes en Action est le premier consortium financé au titre du FSOF, l’un de ceux cherchant à atteindre directement les OSC féministes les plus fragiles et celui ayant le périmètre thématique le plus large (les autres sont construits en général autour d’une thématique d’intervention). Le consortium constitué, avec la présence d’ONG internationales et de fonds des « Suds » est lui aussi inédit.
∇ Un objectif stratégique et prospectif, avec une réflexion portant à la fois sur les changements visés et l’architecture globale du projet alors que le projet devrait disposer de nouveaux fonds à mettre en oeuvre après 2023. L’évaluation doit notamment permettre d’accompagner une réflexion sur les objectifs du cadre logique du Projet dans l’optique d’une redéfinition afin d’assurer la cohérence avec les objectifs réellement visés par le Projet et les indicateurs prévus difficilement renseignables.
∇ Un objectif de redevabilité, tourné avant tout vers les sociétés civiles féministes que Féministes en Action cherche à renforcer. Il s’agit de s’assurer que l’action menée apporte une valeur ajoutée (« do not harm ») et que les conditions de mise en oeuvre sont cohérentes avec les valeurs féministes promues tout en tenant compte des exigences d’un bailleur de fonds publics.
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USAID’s CNHA Health Facility Readiness and Functionality Assessment, 2024
The Community Nutrition and Health Activity (CNHA), funded by the United States Agency for International Development (USAID), is dedicated to enhancing the nutritional status of women and children within vulnerable 1000-day households in Bangladesh—those with pregnant and lactating women and/or children under two years. This assessment, conducted between March and June 2024, evaluated the readiness and functionality of 1,336 community clinics (CCs) and 354 Union Health and Family Welfare Centers (UH&FWCs) across 14 districts. It aimed to identify strengths and weaknesses in key operational areas, including governance and management, health workforce presence, service delivery, logistics, and information systems. The findings revealed a significant presence of community groups in CCs but highlighted operational gaps in regular meetings and management practices. While the availability of maternal and child health services was generally high, discrepancies existed in the provision of family planning methods and comprehensive nutritional services. The assessment serves as a foundational tool for CNHA to target interventions, enhance health systems, and improve overall community health outcomes by integrating these findings into local government improvement plans.
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Total Page No: 62 Read More...