Bangladesh
USAID’s Community Nutrition and Health Activity (CNHA) Report – Consultation (Meetings with Stakeholders, Households & Community People to Understand Information Sources, Media Access and Habits of CNHA Primary Target Groups to Inform CNHA SBC Strategy)
The USAID Community Nutrition and Health Activity (CNHA) is a five-year project (2023-2028) aimed at improving the nutritional status of women and children within the first 1,000 days of life in vulnerable communities across Bangladesh. Implemented in collaboration with CARE-Bangladesh and partners, the project spans 50 Upazilas in 14 districts and focuses on enhancing service delivery at the community level through health facilities and a strong Social and Behavior Change (SBC) strategy. The project aims to increase the adoption of family planning, maternal and child nutrition, and other health-related practices among its target population of 4 million direct and 10 million indirect participants. To inform its SBC strategy, CNHA conducted stakeholder consultations in February 2024, gathering data from various groups, including pregnant and lactating mothers, adolescents, and community health service providers, through individual and group consultations.
The consultations revealed key findings on the sources and trustworthiness of health-related information, with community health workers like CHCPs and FWAs emerging as the most trusted sources. Although many pregnant and lactating mothers received information on nutrition and family planning, adolescents and mothers-in-law were less informed. Common barriers to accessing accurate information included limited literacy, restricted access to health facilities due to poor transportation, and traditional beliefs that discouraged the adoption of new practices. Despite the widespread use of mobile phones, especially smartphones, media access was limited, with most women relying on family and community gatherings for information. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services, emphasizing the importance of targeted interventions to bridge gaps in knowledge and access within these vulnerable groups.
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The consultations revealed key findings on the sources and trustworthiness of health-related information, with community health workers like CHCPs and FWAs emerging as the most trusted sources. Although many pregnant and lactating mothers received information on nutrition and family planning, adolescents and mothers-in-law were less informed. Common barriers to accessing accurate information included limited literacy, restricted access to health facilities due to poor transportation, and traditional beliefs that discouraged the adoption of new practices. Despite the widespread use of mobile phones, especially smartphones, media access was limited, with most women relying on family and community gatherings for information. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services, emphasizing the importance of targeted interventions to bridge gaps in knowledge and access within these vulnerable groups.
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Rapid Gender Analysis on Power and Participation Shafiullah Khata, Ukhiya, Cox’s Bazar Bangladesh
The current Rohingya refugee crisis is regarded as one of the world's worst humanitarian crises of the twenty-first century. Myanmar's Rohingya Muslims are a stateless Muslim community that have faced systematic discrimination and targeted persecution in Myanmar’s Rakhine State for decades. As the Myanmar government refuses to give Rohingya any citizenship rights, the vast majority of Rohingya have no legal documentation which is effectively making them stateless and trying to escape from the military’s campaign of violence, killing, rape, arson, and other grave abuses.
Bangladesh has taken in the greatest number of refugees thus far. Since 25th August 2017 a large number of Rohingya people has fled into Bangladesh from Myanmar after facing statelessness, targeted violence and discrimination. As of February 2022, there are 923,179 people and 194,091 households in 33 camps in Kutupalong and Nayapara area of Cox’s Bazar District.
There is limited to no participation and/or influence of Rohingya women in decision making or leadership roles within the humanitarian response in Cox’s Bazar Refugee Camp. Societal and religious norms of the Rohingya are patriarchal and tend to favor men’s participation and leadership over that of women; however, there are opportunities identified to support greater participation and leadership of women in public life.
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Bangladesh has taken in the greatest number of refugees thus far. Since 25th August 2017 a large number of Rohingya people has fled into Bangladesh from Myanmar after facing statelessness, targeted violence and discrimination. As of February 2022, there are 923,179 people and 194,091 households in 33 camps in Kutupalong and Nayapara area of Cox’s Bazar District.
There is limited to no participation and/or influence of Rohingya women in decision making or leadership roles within the humanitarian response in Cox’s Bazar Refugee Camp. Societal and religious norms of the Rohingya are patriarchal and tend to favor men’s participation and leadership over that of women; however, there are opportunities identified to support greater participation and leadership of women in public life.
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Midline (monsoon flood) and baseline (flsh flood) study of SUFAL-!! project
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 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 flash floods and lightning hazards.
The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For 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 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.
The study further investigated the current and potential early actions that can be undertaken by communities and institutions to alleviate the impact of flash floods and lightning. These actions include seeking safe shelter, securing assets and livestock, and implementing strategies to cope with shocks and stress. Most significantly, there are no functional early warning systems in the targeted areas.
A total of 90.00% of the respondents from the treatment group and 50.80% of respondents from the control group areas said they were affected by flash floods within the previous three years. On the other hand, 69.30% of the respondents of treatment group and 50.80% of the respondents of control group areas admitted that their community members were affected by lightning in the past two years. Moreover, 74.40% of respondents of treatment group areas and 58.30% respondents of control group areas said that loss of human lives or major injury occurred due to lightning. Notably, Highest 81.90% of the respondents from both group areas said they did not get any early warning information regarding floods. FGD with respondents discovered that there is no functional early warning system in their areas for flash floods. Sometimes they got warnings through loudspeaker announcements when nearby areas got affected by the flood. In the case of lightning, 92.80% of the respondents from both group areas said they didn’t get any early warning information. Though there isn`t any early warning system for lightning, some respondents said in FGD that they occasionally identify symptoms by evaluating the cloud and notifying each other of the possibility of lightning which is considered as early warning for them. The respondents from both treatment and control group areas shared their opinions about different types of early warnings they received for different natural disasters. The highest 38.20% and 18.80% of the respondents received early warning (supposed to situation update) through television broadcasts from treatment and control group areas. The respondents from the treatment group and control group areas usually don’t get any functional early warnings. Hence, they consider flood situation updates and weather updates as early warnings. A total of 16.70% of the respondents admit that they won’t understand the early warning information due to language barriers, or technical jargon. From the treatment group areas, 61.50% of the respondents shared that due to a lack of clear instructions on severity and impact of the hazards, they won’t understand the warnings. Interestingly, a total of 17.90% of the respondents from both treatment and control group areas admitted some traditional beliefs and superstition might generate distrust against the early warnings. Read More...
The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For 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 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.
The study further investigated the current and potential early actions that can be undertaken by communities and institutions to alleviate the impact of flash floods and lightning. These actions include seeking safe shelter, securing assets and livestock, and implementing strategies to cope with shocks and stress. Most significantly, there are no functional early warning systems in the targeted areas.
A total of 90.00% of the respondents from the treatment group and 50.80% of respondents from the control group areas said they were affected by flash floods within the previous three years. On the other hand, 69.30% of the respondents of treatment group and 50.80% of the respondents of control group areas admitted that their community members were affected by lightning in the past two years. Moreover, 74.40% of respondents of treatment group areas and 58.30% respondents of control group areas said that loss of human lives or major injury occurred due to lightning. Notably, Highest 81.90% of the respondents from both group areas said they did not get any early warning information regarding floods. FGD with respondents discovered that there is no functional early warning system in their areas for flash floods. Sometimes they got warnings through loudspeaker announcements when nearby areas got affected by the flood. In the case of lightning, 92.80% of the respondents from both group areas said they didn’t get any early warning information. Though there isn`t any early warning system for lightning, some respondents said in FGD that they occasionally identify symptoms by evaluating the cloud and notifying each other of the possibility of lightning which is considered as early warning for them. The respondents from both treatment and control group areas shared their opinions about different types of early warnings they received for different natural disasters. The highest 38.20% and 18.80% of the respondents received early warning (supposed to situation update) through television broadcasts from treatment and control group areas. The respondents from the treatment group and control group areas usually don’t get any functional early warnings. Hence, they consider flood situation updates and weather updates as early warnings. A total of 16.70% of the respondents admit that they won’t understand the early warning information due to language barriers, or technical jargon. From the treatment group areas, 61.50% of the respondents shared that due to a lack of clear instructions on severity and impact of the hazards, they won’t understand the warnings. Interestingly, a total of 17.90% of the respondents from both treatment and control group areas admitted some traditional beliefs and superstition might generate distrust against the early warnings. Read More...
Qualitative Monitoring Improvement Initiative Pilot for the SHOUHARDO III Program in Bangladesh
Strengthening Household Abilities to Respond to Development Opportunities (SHOUHARDO) III was a five-year multisectoral and integrated program implemented by CARE Bangladesh between 2015 and 2020 and funded by USAID and the Government of Bangladesh. The objective of the program was to improve the lives and livelihoods of 549,000 people living in poor and extreme poor communities in eight districts in the Deep Haor and Remote Char region of northern Bangladesh. The program focused on community-based asset development and women’s empowerment, building the capacity of local government and community-service organizations, increasing resilience to frequent shocks and stressors, and improving nutrition and health outcomes for mothers and children under two-years of age. SHOUHARDO III was extended for two years (2020 to 2022) and a second extension phase (SHOUHARDO III Plus) was funded for an additional two years (2022 to 2024). During this period the program will focus on engaging with and linking local service providers with the government and the private sector. Read More...
SHOUHARDO III Performance and Impact evaluation
This report evaluates the performance of the SHOUHARDO III project, which targets poor households in the char and haor (wetland) areas of Bangladesh and aims to address food and income insecurity, maternal and child health and nutrition, women’s and youth empowerment, as well as improve access to public services while building resilience capacities. This evaluation employs three methodologies: qualitative inquiry, pre-post comparison, and impact evaluation. The impact evaluation matches communities treated by SHOUHARDO III with untreated communities ex-post, using baseline stunting rates from the 2014 DHS dataset. The evaluation finds that the SHOUHARDO III project engaged more than 40% of households surveyed within target villages and successfully targeted poor and female-headed households. The analysis of baseline and endline statuses (pre-post analysis) of households in the SHOUHARDO III-targeted areas demonstrates that households from these areas improved across several indicators, including poverty levels, the nutritional status of women and children, women’s empowerment, and gender equity. From a qualitative standpoint, participants from areas where SHOUHARDO III appeared well-implemented offers insights into the potential of the interventions. The qualitative evaluation found mechanisms of change in several areas that can be built upon and enhanced. Qualitative findings show that the program succeeded in promoting multi-sectoral change at household and community levels. They also show that SHOUHARDO III effectively targeted services to the most food-insecure, Poor and Extremely Poor members of communities, and its multi-generational and gender-inclusive approach to its interventions facilitated community acceptance. From the impact evaluation, it is likely that we can credit SHOUHARDO III with improvements in women’s dietary diversity, women and children’s minimum acceptable diet, antenatal care access, and the increase in participation across several sectors. In addition, households in SHOUHARDO III villages experienced statistically significant differences in one resilience indicator, and households in program villages that experienced major shocks were better able to maintain their food consumption than similar households in comparison villages. However, the impact evaluation does not find meaningful differences between households in targeted communities and households in non-targeted communities in terms of women’s mobility and decision-making, children’s nutritional status (including child stunting and underweight status), children’s diarrhea, exclusive breastfeeding, household hunger, and improved use of health and nutrition services overall. Improvements in mostmeasured conditions in the SHOUHARDO III program areas appear to have been matched by similar improvements in non-program areas, suggesting broader forces may account for them. Ultimately understanding differences between program areas and non-program areas can help inform decisions about future chapters of the SHOUHARDO III program and other development food security programs to ensure the most effective programs for vulnerable populations. Understanding the dynamics and mechanisms of change and responses of participants to interventions can also inform future work. Salient findings are also important to highlight for action. The research team concludes this report with recommendations. Read More...
Baseline Study of SUFAL Project Funded by ECHO “Supporting Flood Forecast-based Action and Learning in Bangladesh” (SUFAL)
Supporting Flood Forecast-based Action and Learning in Bangladesh (SUFAL) is being studied in 4 unions (Chinadulli, Kulkandi, Noarpara, Shapdhari) of Islampur Upazila of Jamalpur district, 4 unions (Bhartkhali, Ghuridaha, Haldia, Saghata) of Sagatha Upazila of Gaibandha district and 4 unions (Begumganj, Buraburi, Hatia, and Saheber Alga) of Ulipur Upazila of Kurigram districts by BCAS with the support of Care Bangladesh and the consortium members including Concern Worldwide, Islamic Relief Bangladesh, and the Regional Integrated Multi-Hazard Early Warning System (RIMES) and financially supported by ECHO. SUFAL will set up a Forecast-based Early Action (FbA) system in three northern flood-prone districts: Kurigram, Gaibandha, and Jamalpur. There are many char land in the study area which are the propensities of disaster. The inhabitants of Char land are the most vulnerable and poorest community who are in search of livelihood. Their daily life is full of uncertainty. Read More...
Integrating Sexual and Reproductive Health and Gender Based Violence Programming
Learning brief on CARE's sexual and reproductive health (SRH) and gender-based violence (GBV) implementation programming in in Cox’s Bazar (CxB), Bangladesh, home to nearly a million refugees from Myanmar. Read More...
SUFAL II Baseline Report
The project “Scaling up Flood Forecast Based- Action and Learning in Bangladesh (SUFAL) – Phase II”, is aimed to strengthen resilience of communities to the impacts of frequent monsoon floods. SUFAL-II is being implemented in the districts of Kurigram and Gaibandha, Jamalpur and Bogura. In each district, two types of interventions (one intervention in one upazila) are being implemented. They are -
- Full scale implementation – Capacity development and support to communities to implement sector-specific early actions with extended lead times prior to monsoon floods.
- Partial scale implementation – Technical and capacity building support to the Disaster Management Committees (DMCs) and government officials, with the aim to demonstrate how the FbA mechanism can be operationalized in a district.
The selected areas in each district have ‘medium’ to ‘very high’ risk profiles as per INFORM Index on Risk Management. The risk profiles have been calculated based on the modelling of exposure to hazard, vulnerability and coping mechanisms in place.
Methodology
The baseline study uses a mixed method analysis. Thus, both quantitative and qualitative tools were administered to collect relevant data to assess the baseline status. The quantitative tool was administered to a sample of 1500 households, which were distributed across 60 wards. For the qualitative aspect of the study, a total of 28 Key Informant Interviews (KIIs) were conducted with DMCs and local government officials and 30 Focus Group Discussions (FGDs) were conducted with the community members.
Key Findings
Background of respondents
Under the household survey, a total of 1494 interviews were conducted, of which 1394 interviews were conducted in three treatment groups and 100 interviews were conducted in the control group. The majority of respondents were female (74%), Muslim (95.7%), and of Bangali (99.8%) ethnicity. Approximately 79% of households reported a monthly income that exceeded 5000 Taka.
Floods in 2022
Of all the respondents, 78.4% experienced floods in 2022, with the highest occurrence in the month of Ashar - Srabon. Treatment group 1 (64.7%) and the control group (70%) had a lower flood incidence compared to Treatment groups 2 (89.1%) and Treatment group 3 (86.8%).
Early warning
Of all respondents in the three treatment groups who faced floods in 2022, only 36.3% received early warnings. It was observed that a higher percentage of respondents from the treatment group 1 (69.4%) received early warnings as compared to treatment group 3 (35.4%) and treatment group 2 (11.8%). Overall, out of all the respondents who reported receiving early warning, 85.8% reported that they received it 1 to 5 days prior to the floods. Television (40.1%) and friends/relatives (29.7%) were the primary sources of early warning information. Among other sources, only 8.5% of respondents reported receiving early warning via Audio calls, 19.2% reported from community volunteers (miking or household visit) and 1.2% via digital boards. Among those who received early warnings, 60.3% had information about flood intensity/water level, and 52.9% had information about the lead time. However, only 36.2% received guidance on early actions, 24.7% received livestock advisory, and 13.0% received agromet advisory. This indicates a lack of agromet advisory, flood preparedness advisory, and health awareness across all treatment groups. Overall, 67.8% of respondents found the early warnings timely and understandable, and 98.8% expressed trust in the early warnings. Read More...
- Full scale implementation – Capacity development and support to communities to implement sector-specific early actions with extended lead times prior to monsoon floods.
- Partial scale implementation – Technical and capacity building support to the Disaster Management Committees (DMCs) and government officials, with the aim to demonstrate how the FbA mechanism can be operationalized in a district.
The selected areas in each district have ‘medium’ to ‘very high’ risk profiles as per INFORM Index on Risk Management. The risk profiles have been calculated based on the modelling of exposure to hazard, vulnerability and coping mechanisms in place.
Methodology
The baseline study uses a mixed method analysis. Thus, both quantitative and qualitative tools were administered to collect relevant data to assess the baseline status. The quantitative tool was administered to a sample of 1500 households, which were distributed across 60 wards. For the qualitative aspect of the study, a total of 28 Key Informant Interviews (KIIs) were conducted with DMCs and local government officials and 30 Focus Group Discussions (FGDs) were conducted with the community members.
Key Findings
Background of respondents
Under the household survey, a total of 1494 interviews were conducted, of which 1394 interviews were conducted in three treatment groups and 100 interviews were conducted in the control group. The majority of respondents were female (74%), Muslim (95.7%), and of Bangali (99.8%) ethnicity. Approximately 79% of households reported a monthly income that exceeded 5000 Taka.
Floods in 2022
Of all the respondents, 78.4% experienced floods in 2022, with the highest occurrence in the month of Ashar - Srabon. Treatment group 1 (64.7%) and the control group (70%) had a lower flood incidence compared to Treatment groups 2 (89.1%) and Treatment group 3 (86.8%).
Early warning
Of all respondents in the three treatment groups who faced floods in 2022, only 36.3% received early warnings. It was observed that a higher percentage of respondents from the treatment group 1 (69.4%) received early warnings as compared to treatment group 3 (35.4%) and treatment group 2 (11.8%). Overall, out of all the respondents who reported receiving early warning, 85.8% reported that they received it 1 to 5 days prior to the floods. Television (40.1%) and friends/relatives (29.7%) were the primary sources of early warning information. Among other sources, only 8.5% of respondents reported receiving early warning via Audio calls, 19.2% reported from community volunteers (miking or household visit) and 1.2% via digital boards. Among those who received early warnings, 60.3% had information about flood intensity/water level, and 52.9% had information about the lead time. However, only 36.2% received guidance on early actions, 24.7% received livestock advisory, and 13.0% received agromet advisory. This indicates a lack of agromet advisory, flood preparedness advisory, and health awareness across all treatment groups. Overall, 67.8% of respondents found the early warnings timely and understandable, and 98.8% expressed trust in the early warnings. Read More...
PROHORI: Combating Intimate Partner Violence in Bangladesh in the Context of COVID-19
In July 2021, CARE Bangladesh and its local partner GBK launched the Prohori project to prevent intimate partner violence (IPV) and respond to survivors of violence through safe spaces, behavior change communication and capacity building approaches that address gender norms and practices. The 12-month project was generously funded by Voices Against Violence: The Gender-Based Violence Global Initiative, a public-private partnership led by Vital Voices and funded with support from the State Department and the Avon Foundation. The project targeted female garment workers and their male partners in Gazipur District, and female agricultural workers and their male partners in Rangpur District. CARE implemented activities in four locations in Gazipur, a peri-urban industrial area in central Bangladesh, and GBK implemented activities in five locations in Rangpur in northwest Bangladesh. Prohori used a blend of community-based, participatory approaches to prevent IPV, improve IPV survivors’ linkages to post-GBV referral services, and strengthen the capacity of first responders to respond empathetically to people who disclose they have experienced GBV. The project built 9 Women and Girls’ Safe Solidarity Spaces (WSSSs, adding to the 18 that CARE had already established in Gazipur) and strengthened GBV services through capacity building and referral service coordination. Read More...
Building Resilience of the Urban Poor Baseline Report
CARE Bangladesh, with the support from C&A Foundation, has been implementing a project titled ‘Building Resilience of the Urban Poor (BRUP)’ through CARE’s partner organization- Village Education Resource Center (VERC) in two wards (Tongi and Konabari) of Gazipur City Corporation. The overall goal of the project is to achieve enhanced resilience of targeted urban communities and targeted institutions to prepare for, mitigate, respond to, and recover from shocks and stresses. NIRAPAD (Network for Information, Response And Preparedness Activities on Disaster) has been commissioned to conduct the baseline study and to develop a Monitoring and Evaluation (M&E) framework for the project. This report describes the current situation of the project area in Gazipur as well as presents a Monitoring and Evaluation (M&E) framework based on the finding of the study. Read More...