Association for Public Policy Analysis & Management

This paper estimates the impact of BRAC’s nutrition programme on breastfeeding and complementary feeding practices, healthseeking behavior, and nutrition and early childhood development outcomes in Bangladesh. BRAC’s nutrition program is designed to reduce malnutrition among pregnant-lactating women, and young children. The nutrition program aims to fulfill its objectives by building the capacity of community health workers, establishing an effective community based integration nutrition service delivery, and raising awareness and empowering communities to improve feeding practices. Specifically, community health workers will provide age-appropriate home visits, and will be on call to handle feeding problems and give recommendations on antenatal care and dietary allowances during pregnancy.

BRAC’s Nutrition Program is a four year program that started in 2012 and will be continued up to 2016. In some trial areas, the nutrition intervention is complemented with a comprehensive early childhood development (ECD) intervention to improve knowledge of caregivers on how to stimulate the cognitive and physical development of children, for example by emphasizing the importance of exclusive breast feeding and complementary feeding practices. The ECD program also stimulates nutrition directly by antenatal and postnatal care as well as nutrition for infants and toddlers through home visits.

We used a propensity score matching approach in which we match geographic areas, specifically 40 Moujas, that benefit from BRAC’s nutrition program to 40 Moujas in surrounding areas that do not benefit from BRAC’s nutrition program on the basis of Census data. This matching approach resulted in a comparison group that is statistically equivalent to the beneficiary areas in terms of observable characteristics. Following the propensity score matching we collected household-level data on breastfeeding and complementary feeding practices, stunting, wasting, and early childhood development outcomes that are based on the ages-and stages questionnaire from 20 households in each of the 118 Moujas.

Our preliminary findings suggest that the nutrition program may have a positive effect on the likelihood and frequency of antenatal care and reduce the likelihood of stunting. However, it appears as if the program does not have an effect on wasting.

In some trial areas, the nutrition intervention is complemented with a comprehensive ECD intervention to improve knowledge of caregivers on how to stimulate the cognitive and physical development of children by, for example, emphasizing the importance of exclusive breastfeeding and complementary feeding practices. The ECD program also stimulates nutrition directly by antenatal and postnatal care as well as nutrition for infants and toddlers through home visits. The ECD program is a pilot program and BRAC wishes to experiment with it to understand how to effectively scale the intervention to maximize the impact on nutrition outcomes and cognitive development.

Therefore, we conduct a cluster-randomized controlled trial of the early childhood development program. Our preliminary findings suggest that the randomization was successful. We find only very few statistically significant differences between the beneficiaries and non-beneficiaries of the early childhood development program.