Bangladesh has made great strides in the fight against poverty. Nevertheless, over a quarter of its population of 150 million still lives below the national poverty line of $2 USD a day. The country continues to face numerous obstacles including high rates of stunting and acute malnutrition in children, the constant threat of natural disasters, and uneven distribution of health and hygiene services. Approximately 85 percent of Bangladeshis live in rural areas and depend largely on agriculture for their livelihoods. Despite steady increases in food production, the growing population continues to remain dependent on costly food imports.
Since 2010, PCI and prime partner ACDI/VOCA have been collaborating on a five-year USAID-funded Multi-Year Assistance Program which seeks to increase food security among vulnerable households in the Khulna Division of south-western Bangladesh. The Program for Strengthening Household Access to Resources (PROSHAR) is utilizing an integrated approach to empower communities by addressing maternal and child health issues, providing assistance to farmers, and strengthening the country’s ability to manage and recover from disasters. PCI serves as the SO2 and SO3 lead, responsible for implementing activities to improve the health and nutrition of pregnant and lactating women and children under the age of five, and ensure institutions and households are prepared to respond effectively to shocks.
IMPROVED HEALTH AMONG PREGNANT WOMEN & YOUNG CHILDREN
In alignment with PCI’s focus on preventing malnutrition, PROSHAR’s health and nutrition interventions for women and children are focused on the first “1,000 days”, the period of time between when a woman becomes pregnant up through the child’s second birthday. Proper nutrition during this critical window has a profound impact on a child’s cognitive and physical development and potential for a healthy, productive future. To this end, PCI is preventing and treating child malnutrition by expanding integrated clinical health services and providing nutritional supplementation for children under two years of age and pregnant and/or breastfeeding mothers.
CARE GROUP TRIOS: PCI has designed a unique, community-based behavior change approach, Care Group Trios, to promote health and nutrition education and the uptake of related services. Traditionally, care groups focus on sharing key concepts within a group of mothers who then share the information with ten of their peers, creating a cost- effective, community-wide impact. However, PCI found that in Bangladesh, fathers and mothers-in-law had the strongest influence on behavior related to maternal and child care. With this, the Care Group Trio approach expands upon the traditional Care Group model by utilizing mothers-in-law and father groups to implement behavior change from their particular roles. To date, 249 Care Group Trios have been formed under PROSHAR.
Key achievements include:
- The prevalence of overall stunting for children aged 6-59 months declined 25%.
- The prevalence of underweight children (0-59 months) and overall wasting (6-59 months) declined 40% and 46% respectively.
- The household huger scale declined 43% for all households sampled. The proportion of mothers taking vitamin A supplements increased 66% to 57%, and mothers taking folic acid during pregnancy almost
doubled to 74%.
- Antenatal care service utilization by pregnant women increased from 68% to 90%, and the percent of mothers attending four or more antenatal care visits increased from 17% to 46%.
- The percentage of households with access to water at hand-washing facilities increased from 54% to 89%.
HELPING BANGLADESH BECOME MORE DISASTER RESILIENT
PCI is building the capacity of local communities and government institutions at the ward, union and upazila levels to reduce their vulnerability to cyclones and other food security threats through effective disaster risk management. Based on extensive research conducted on vulnerabilities and coping mechanisms and the reinforcement of proven local strategies, PCI has developed five innovative solutions:
Risk Atlas: PCI developed a series of maps that include schools, hospitals, and churches and overlaid them with maps of flood plans, erosion areas, and drought patterns. Armed with this information, and supplemented by local knowledge, PCI figured out which areas were at greatest risk and helped communities determine what to do in the case of a disaster. When cyclones and tidal surges strike, families now have a shelter plan if the river rises, and know which roads to avoid to keep them safe, secure, and out of harm’s way.
Cyclone – The Movie: Recognizing that films are an effective way to get important messages to people in rural areas with low literacy skills, PCI produced short films to reinforce disaster response and mitigation messages and further educate vulnerable communities. The films highlight the importance of being ready for a disaster and are presented prior to the screening of popular Bollywood or Hollywood blockbusters in Bengali.
Shelter Assessment: PCI has assessed over 100 shelters in Bangladesh to determine their safety, their potential effectiveness during disasters, and what improvements should be made for the safety and comfort of the community. PCI uses these assessment results to support community efforts to build and/or improve shelters and to help communities advocate to their local government for improved, or properly constructed, shelters and facilities.
Disaster Simulations: PCI brings communities together to simulate the stress and dynamic challenges of an actual disaster and educates participants on what to do and where to go in case of an emergency. Each simulation is run by the community’s PCI-trained disaster management committee, and thousands of community members join in, pretending to be injured, lost, or in need of help after a disaster.
Disaster Pocketbook: The pocketbook was designed with two goals: to reduce stress of people in an emergency and to keep people alive in an emergency. Using clear language and vivid illustrations, the pocketbook provides tips about what to do before, during, and after a disaster, such as teaching girls and boys how to swim to save their own and others’ lives during floods and tidal surges.
CURRENT FUNDING PARTNER: U.S. Agency for International Development (USAID)