Report
Annual Evaluation (second year) for Joint Action for Nutrition
Outcome (JANO) Project
Submitted to:
CARE-Bangladesh
RAOWA Complex,
Level: 7-8, VIP Road,
Mohakhali, Dhaka-1206, Bangladesh
Submitted by:
Innovative Research & Consultancy (IRC) Limited
ABC Spring Flower, House # 52 (1st & 2nd Floor),
Road # 02, Block # L, Banani, Dhaka-1213
November 30, 2020
Table of Contents
Acknowledgement ....................................................................................................................................................... i
List of Tables ................................................................................................................................................................ ii
List of Graphs ............................................................................................................................................................. iii
Acronyms..................................................................................................................................................................... iv
Executive Summary .................................................................................................................................................... 1
1. Introduction ........................................................................................................................................................ 7
1.1 Overview of JANO project .......................................................................................................................... 7
2 Study Methodology ........................................................................................................................................... 8
2.1 Study Area and Target Group ...................................................................................................................... 8
2.2 Geographical Coverage and Sample size ................................................................................................... 9
2.3 Quantitative (Household and School) Sample Distribution ................................................................ 10
2.4 Qualitative Sample Distribution ................................................................................................................. 11
2.5 Survey Implementation ................................................................................................................................ 11
2.6 Quality Control Mechanism ....................................................................................................................... 12
2.7 Ethical considerations of the study ........................................................................................................... 13
3 Findings - JANO Annual Evaluation ............................................................................................................. 14
3.1 Household and Demographic Information .............................................................................................. 14
3.1.1 Household Information ........................................................................................................................ 14
3.1.2 Educational Status .................................................................................................................................. 14
3.1.3 Occupation of Household Head ........................................................................................................ 15
3.2. Women and Adolescent Girls Empowerment ...................................................................................... 15
3.2.1 Women’s decision making and access to markets to buy or sell products ............................ 16
3.2.2 Participation of Women in Formal and Informal Decision-Making Spaces ............................. 19
3.2.3 Functionality of Community Support Groups and School Management Committees ......... 20
3.3 Maternal Adolescent Child Health and Nutrition ................................................................................. 24
3.3.1 Assistance regarding maternal health and nutrition ...................................................................... 24
3.3.2 Antenatal and Postnatal Care ............................................................................................................. 24
3.3.3 Indicators of The National Plan of Action for Nutrition ............................................................. 25
3.3.4 Nutritional Status of Women of Reproductive Age ..................................................................... 26
3.3.5 Women and Adolescent Girls in Communities are Empowered to Demand and Utilize Both
Nutrition-Sensitive and Nutrition-Specific Services ................................................................................ 29
3.3.6 Students Apply Key Learning Points Regarding Nutrition, Health and Hygiene at Home .. 31
3.3.7 Nutritional Status in Children Under 5-years of Age ................................................................... 33
3.4 Nutrition Governance .................................................................................................................................. 34
3.4.1 Nutrition Specific Budgeting ............................................................................................................... 34
3.4.2 Nutrition Specific Safety Net Support .............................................................................................. 36
3.4.3 Meaningfully Participated of Women and Adolescent Girls in The Nutrition Action Plan . 38
3.4.4 Feedback Mechanisms .......................................................................................................................... 39
3.4.5 Tripartite Agreement ........................................................................................................................... 40
3.5 Food Security and Livelihood ..................................................................................................................... 40
3.5.1 Households Practicing Climate Smart Agricultural Techniques ................................................. 40
3.5.2 Households Involved in The Production of Higher Value Nutrition Products ...................... 42
3.6 Access to Information, Information and Communication Technology (ICT) Platform ................ 43
3.6.1 Access to information .......................................................................................................................... 43
3.6.2 Accessed or Received ICT Based Nutritional Information ......................................................... 46
3.6.3 Mobile Based Learning App are Used by Frontline Workers .................................................... 47
3.7 WATSAN & Hygiene Practice ................................................................................................................... 48
3.7.1 Safe Drinking water .............................................................................................................................. 48
3.7.2 Types of Latrine ..................................................................................................................................... 49
3.7.3 Hand Washing Practices ...................................................................................................................... 50
3.8. Outcome of Covid-19 Response and Impact of Covid-19 On JANO ............................................. 52
3.8.1 Knowledge about Covid-19 ................................................................................................................ 52
3.8.2 Outcome of Covid-19 response ........................................................................................................ 53
3.8.3 Hygiene Practices .................................................................................................................................. 56
3.8.4 Nutritional Practices ............................................................................................................................. 57
3.8.5 Students Faced problems in going to school during COVID-19 ................................................ 59
3.8.6 Help Needed to Continue Study for Students ............................................................................... 59
3.8.7 Satisfaction of Doing Classes Through Facebook from JANO .................................................. 60
3.8.8 Impact of Covid-19 on JANO Project .............................................................................................. 60
4. Logframe Review ............................................................................................................................................. 37
4.1. Process of Reviewing the Logframe ......................................................................................................... 37
1.1.1. Indicator 1 ....................................................................................................................................... 38
1.1.2. Indicator 2 ....................................................................................................................................... 39
1.1.3. Indicator 3 ....................................................................................................................................... 40
1.1.4. Indicator 4 ....................................................................................................................................... 41
1.1.5. Indicator 5 ....................................................................................................................................... 42
1.1.6. Indicator 6 ....................................................................................................................................... 43
1.1.7. Indicator 7 ....................................................................................................................................... 44
1.1.8. Indicator 8 ....................................................................................................................................... 45
1.1.9. Indicator 9 ....................................................................................................................................... 45
1.1.10. Indicator 10 ..................................................................................................................................... 46
1.1.11. Indicator 11 ..................................................................................................................................... 47
1.1.12. Indicator 12 ..................................................................................................................................... 48
1.1.13. Indicator 13 ..................................................................................................................................... 49
1.1.14. Indicator 14 ..................................................................................................................................... 50
1.1.15. Indicator 15 ..................................................................................................................................... 50
1.1.16. Indicator 16 ..................................................................................................................................... 51
1.1.17. Indicator 17 ..................................................................................................................................... 52
1.1.18. Indicator 18 ..................................................................................................................................... 52
4.2. Measures to Be Taken to Achieve Logframe Results in the Third year of Evaluation ................ 53
5. Conclusion and Recommendations ................................................................................................................. 54
Annex 1: Log frame .................................................................................................................................................. 58
Annex 2: Survey Area .............................................................................................................................................. 67
Annex 3: Other Tables ............................................................................................................................................ 68
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Acknowledgement
Innovative Research & Consultancy (IRC) Limited acknowledges and thanks all participants who
participated in this study. Without their time and input, this study would have been incomplete. The
study would not be possible without the dedication, commitment and hard work of the data collectors,
field supervisors and qualitative moderators.
We acknowledge the guideline and support of Mr. Aamanur Rahman, Director, Extreme Rural Poverty
Program, CARE Bangladesh. We also acknowledge the valuable inputs of Ms. Tania Sharmin, Senior
Team Leader, JANO for her support throughput the study.
Special thanks and appreciation to Md. Mahadi Hasan, M&E Coordinator, JANO for his contribution
toward tools development, active presence in training sessions at Rangpur and in the data collection
and analysis phases of the study. We also acknowledge the contribution of all local staffs and volunteers
of this project. Without their support, it would not have been possible to complete data collection
within the targeted time frame.
Via this study, we hope that the JANO project will strengthen its contribution to the development
and improvement of maternal and child nutrition in Nilphamari and Rangpur districts of Bangladesh.
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List of Tables
Table 1: Household and Demography Status ..................................................................................................... 14 Table 2: Education Level of Household members ............................................................................................ 14 Table 3: Occupation Status of Head of the Household members ................................................................ 15 Table 4: Key Learning points applied at School ................................................................................................. 32 Table 5: Key Learning points applied at Home .................................................................................................. 32 Table 6: Practice of CSA Technologies (% HH) ................................................................................................ 41 Table 7: HH Crops and vegetables cultivation during last 12 months ......................................................... 42 Table 8: Ways of vegetables cultivation .............................................................................................................. 43 Table 9: Awareness About Getting Information Related to Agriculture, Health & Nutrition............... 44 Table 10: Women or HH Received Information .............................................................................................. 44 Table 11: Types of agricultural extension service HH received during the last 12 months ................... 45 Table 12: Sources Service Providers: Agricultural Extension Service .......................................................... 45 Table 13: Whether Access Agricultural Extension Services when needed over the last six months .. 45 Table 14: Sources of Drinking Water .................................................................................................................. 48 Table 15: Person/ORG provided awareness services related to hygiene-safe water practices ............ 49 Table 16: Types of services Received .................................................................................................................. 49 Table 17: Types of Latrine used by HH .............................................................................................................. 50 Table 18 : Person provided awareness services related to hygiene-sanitation practices ........................ 51 Table 19 : Hand Washing Practices ...................................................................................................................... 51 Table 20: Source of hearing about COVID-19 .................................................................................................. 52 Table 21: Perception about the ways of attack by COVID-19 ...................................................................... 52 Table 22: Steps should be taken to stay away from COVID-19 ................................................................... 52 Table 23: Steps to take if anyone affected by COVID-19 ............................................................................... 53 Table 24: Received any service/relief during COVID-19 ................................................................................ 53 Table 25: Source of this support and information ............................................................................................ 53 Table 26: Support from JANO/JANO Volunteer (information about COVID-19/Hygiene Kit) ........... 54 Table 27: Persons who received support and information from JANO ..................................................... 54 Table 28: Benefits by taking support and information ..................................................................................... 54 Table 29: Usage of the information or knowledge or information related to nutrition about COVID-
19 .................................................................................................................................................................................. 55 Table 30: Causes of not getting support ............................................................................................................. 56 Table 31: Types of hygiene practice ..................................................................................................................... 56 Table 32: Whether use mask or not .................................................................................................................... 57 Table 33: Time of washing hands .......................................................................................................................... 57 Table 34: Any change of daily food habits of family during COVID-19 ....................................................... 57 Table 35: Source of giving suggestion about eating nutritious food ............................................................. 58 Table 36: Persons who take nutritious food ...................................................................................................... 58 Table 37: Benefits by eating nutritious food during COVID-19 .................................................................... 58 Table 38: Any problem for earning of family members during this COVID-19 ........................................ 58 Table 39: Steps taking for overcoming COVID-19 situation ......................................................................... 59 Table 40: Problems Faced During COVID-19 ................................................................................................... 59 Table 41: Types of Support Received During COVID-19 .............................................................................. 59
Annex:
Table 1: Household Sample Distribution by Village ......................................................................................... 68 Table 2: List of Selected School ............................................................................................................................ 70 Table 3: List of Qualitative Sample ....................................................................................................................... 71
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List of Graphs
Figure 1: Access to Basic Health Services ........................................................................................................... 18
Figure 2: Services received from different health service centers during last 12 months ...................... 18
Figure 3: Percentage of increased participation of community people, particularly women, in formal
and/ or informal decision-making spaces ............................................................................................................ 20
Figure 4: Incidence of receiving antenatal check-ups during pregnancy ...................................................... 25
Figure 5: Incidence of receiving postnatal check-ups after pregnancy ......................................................... 25
Figure 6: Percentage of women of reproductive age in the targeted districts who are consuming a
minimum dietary diversity (MDD) ........................................................................................................................ 27
Figure 7: The percentages of women consumed the number of food items in the previous 24 hours
....................................................................................................................................................................................... 28
Figure 8: Percentage of MDD food items consumed in the last 24 hours in women of reproductive age
....................................................................................................................................................................................... 29
Figures 9: Percentage of women and adolescents have claimed nutrition specific and sensitive services
from relevant service providers ............................................................................................................................ 30
Figure 10: Percentage of students disaggregated by sex who apply key learning points regarding
nutrition, health and hygiene at home ................................................................................................................. 31
Figure 11: Proportion of children 6–23 months of age who receive foods from 4 or more food groups
(based on the MDD-C methodology) ................................................................................................................. 34
Figure 12: Percentage of households practicing climate smart agricultural techniques (Baseline and
Annual evaluation) .................................................................................................................................................... 41
Figure 13: Satisfaction level after receiving support from JANO Volunteer (Information or knowledge
or Instruments/Hygiene kit) ................................................................................................................................... 55
Figure 14: Satisfaction level after receiving information or messages about nutrition ............................ 56
Figure 15: Satisfaction level of doing classes through Facebook ................................................................... 60
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Acronyms
ANC Antenatal Care
CARE Cooperative for Assistance and Relief Everywhere
CG Community Group
CSG Community Support Group
CSA Climate Smart Agriculture
DNCC District Nutrition Coordination Committee
EPI Expanded Program on Immunization
ESDO Eco-Social Development Organization
EU European Union
FGD Focus Group Discussion
HIES Household Income and Expenditure Survey
ICT Information and Communications Technologies
IDI In-depth Interviews
JANO Joint Action for Nutrition Outcome
KII Key Informants Interview
NGO Non-Government Organization
NPAN National Plan of Action for Nutrition
PLW Pregnant and Lactating Women
PNC Postnatal Care
SMART Specific, Measurable, Achievable, Relevant and Time-bound
SMC School Management Committee
UH&FWC Union Health & Family Welfare Centre
UDCC Union Development Coordination Committee
UNCC Upazilla Nutrition Coordination Committee
UNICEF The United Nations Children's Fund
VSLA Village Savings and Loan Association
WATSAN Water and Sanitation
WHO World Health Organization
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Executive Summary
Joint Action for Nutrition Outcome (JANO) project aims at reducing malnutrition and addressing
nutritional needs of pregnant and lactating women including adolescents. JANO also focuses on
capacity building of multiple levels of government bodies, especially enhancing capacities of Nutrition
Committees (NC) at the upazila and district levels in terms of developing nutritional plans, budget and
effective supervision. Funded by the European Union (EU) and implemented by CARE, Plan
International, including Eco Social Development Organization (ESDO). JANO collaborated with the
Government of Bangladesh (GoB) in implementing the National Plan of Action for Nutrition (NPAN)-
2) at the local, regional, and national levels selected all 65 unions of the seven most vulnerable upazilas
of Rangpur and Nilphamari (with a stunting rate of 42.1%) were selected for this project. These include
Gangachara, Kaunia, Taraganj, Domar, Jaldhaka, Kishorgonj and Nilphamari Sadar.
Approximately, 4.7 million people in Rangpur and Nilphamari were provided with knowledge and
training on health and nutritional practices in line with government priorities. The project’s
beneficiaries include 275,415 pregnant and lactating women and married adolescent girls aged between
15 to 49 years of age, 190,322 under five-year-old children, 421,425 unmarried adolescent girls and
boys aged 10 to 19 years of age.
The purpose of the annual evaluation was twofold:
1. To measure second year progress against given logframe indicators.
1.1. To measure the outcome (on health and nutrition) of COVID response project of JANO
2. To measure the impact of COVID-19 on the JANO project and recommend way forward.
In order to assess the annual year impact of the project, CARE Bangladesh collaborated with Innovative
Research and Consultancy (IRC) Limited to measure all 18 indicators that JANO project fixed as
outcome and expected results in the log frame.
Data for the annual evaluation was collected from 16-23 October 2020 through a mixed method, or
combination of quantitative and qualitative methods and techniques. A two-stage systematic random
sampling method was used to collect a representative quantitative sample from the household level.
The quantitative sample for the study covered a total of 430 respondents consisting of pregnant
women (n=103) and lactating women (n=327) from 35 villages across the 7 targeted project areas.
Following the same sampling approach, a total of 430 adolescents comprising of girls (n=262) and boys
(n=168) were also selected from 22 schools and madrashas. Moreover, 35 members of school
management committee, 71 community support groups, 100 female members of Community Group
(CG), Community Support Group (CSG), and District Nutrition Coordination Committee (DNCC)
were also interviewed.
Qualitative data was collected through Focus Group Discussion (FGDs), Key Informant Interviews
(KIIs), and In-Depth Interviews (IDIs) with CGs, CSGs, Pregnant and Lactating Women (PLW),
adolescent girls and boys, men, and other key stakeholders including local Nutrition Committees (NC),
service providers, local government bodies, and officials. In total, 10 FGDs, 35 KIIs and 10 IDIs were
conducted. In the data collection process, (21) female enumerators and three (3) supervisors were
engaged. In addition, relevant documents and literature were reviewed to evaluate the overall scenario
of the JANO project.
The second annual evaluation found that the average household size is 5. This is higher than the first
evaluation survey (4.30) and also higher than the national household size of 4.06. The majority (51.4%)
of households were female-headed as compared to the first annual evaluation (0.9%). The study
identified that the primary occupation of the household heads was agricultural daily wage laboring
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(crop/livestock) (22.1%) followed by non-agricultural daily wage laboring (20.5%). During the first
annual evaluation the primary occupation of the household heads was non-agricultural wage labouring
24%.
Major findings of the second annual evaluation are arranged into several subcategories, such as 1)
Women and adolescent girls’ empowerment; 2) Maternal, adolescent, child health and nutrition; 3)
Nutrition governance; 4) Food Security and Livelihood; 5) Access to information, Information and
communication technology (ICT), 6) WASH practice, and 7) Covid-19 response and impact of Covid-
19 on JANO.
1) Women and adolescent girls’ empowerment
During the second annual evaluation it was found that the overall participation of community people,
particularly of women in formal/informal (government-led and/or information, civil society-led, private
sector-led) decision making spaces is increasing since the first evaluation survey.
• Participation of the community people (particularly women) in formal (Govt. led forums: CG,
CSG, UP special committee, UP standing committee, adolescent group, student council)
bodies has increased from 0.93% during year evaluation to 2.79% during second annual
evaluation.
• Participation in informal groups (VSLA, FFS, Mothers group, youth group, women support
group) has increased from 3.49% during the first annual evaluation to 4.88% during the second
annual evaluation.
• In total, 41% (29 out of 71) of the CSGs were functional and active during second evaluation
survey. It is to be noted that during the first annual evaluation it was found that 612 CSGs
were newly formed by the JANO project which were non-existent/inactive during the
baseline.
• The second evaluation survey found that overall, 245 SMCs in the JANO project area raise
gender, nutrition, health, hygiene related issues in meetings, and action plan were accordingly
formulated. However, during the first evaluation survey 302 SMCs did the same. The apparent
decrease in number reflects the impact of COVID-19. It is still a significant and sustained
improvement compared with the baseline when only seven SMCs (7) did the same.
These findings suggest that the project needs to concentrate on women’s participation in the formal
decision-making spaces to sustain the project’s achievements. Moreover, SMCs will need
reenergization after the COVID-19 setback.
2) Maternal, adolescent, child health and nutrition
Safety-net programs such as maternity allowance, supplementary feeding, maternal health voucher,
etc. indicate availability of assistance for pregnant and lactating women and potential significant positive
impact on their nutrition and health conditions. The second annual evaluation study found that positive
changes exist regarding information about safety-net programs, and availability and access to healthcare
services during and after pregnancy, and nutrition level among PLW since the first evaluation study
started. The annual evaluation also indicates progress in nutrition, health and hygiene related practices
among students. Yet there are areas to be prioritized for further increasing access to healthcare and
enhanced nutritional level among these groups.
• The study findings show that percentage of pregnant and lactating women (PLW) receiving
nutrition specific safety net support (Maternal allowance, 1000 days, Supplementary feeding,
maternal health voucher, area based community nutrition scheme, VGF, VGD, iron folic acid
supplementation) is higher in second annual evaluation survey (10.64%) than first annual
evaluation study (10.2%) or the baseline (8.4%).
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• PLW mainly received safety net support like maternal allowance 3.3% (first evaluation 1.8%),
maternal health voucher 2.2% (first evaluation 2.9%), 1000 days 2.2% (first evaluation 1.4%),
VGD 2.2% (first evaluation 1.4%), etc. An improving trend is found except in the case of
maternal health voucher scheme.
• In the baseline study, it was found that pregnant women received ANC services mostly from
the Family Welfare Centre (FWC) (around 33%), whereas Community Clinic (CC) was found
to be the major providers of ANC (47%) during the first year annual evaluation. The trend
continued and CC was the major service provider in ANC (58.5%) during the second annual
evaluation survey.
• During the second annual evaluation survey 42.7% of the currently pregnant women took
more food than usual. This is a decrease from the first annual evaluation when 55.2% of
pregnant women took more food than usual during their pregnancy. Still this is improvement
considering the baseline information when 37.4% of pregnant women took more food than
usual.
• 68.9% of the pregnant women at the second annual evaluation reported that they were taking
additional rest whereas 65.7% and 41.7% of the pregnant women reported the same during
the first evaluation and baseline surveys, respectively.
• During the second annual evaluation 22.9% (n= 301) of the post-partum women reported
that they had received Postnatal Care (PNC). This is a significant increase as during the
baseline, “very few” mothers and children had received postnatal care and during the first
evaluation survey 19.6% (n= 342) reported the same.
• 38.4% of women of reproductive age in the targeted districts consumed a minimum dietary
diversity (MDD) during the previous 24 hours of the second annual survey; an increase of
1.4% percentage points compared to the first evaluation survey. Consumption of MDD thus
continued to increase from 34.9% since the baseline. Noticeably, consumption of MDD is
higher in Rangpur (44.3%) than Nilphamari (33.5%).
• In case of applying at least 5 key learning points (i) Food ingredients, food prepare and food
serving, ii) Health sciences and healthcare, iii) Adolescent health & Hygiene, iv) Hand wash
and v) Use of sanitary latrines.) at home, it was found that students from Rangpur (4.38%)
applied more than that of Nilphamari (2.22%) during the second evaluation survey. It is
identified that while progress is made in Rangpur, the numbers decreased in Nilphamari if
compared with first evaluation survey results, when, students in Nilphamari (2.54%) applied
their knowledge more than that of Rangpur (1.3%). Remarkably, girls were found to be
applying more learning points during the second annual evaluation survey (3.1%) than boys
(2.0%). This is an overall progress as during the baseline no female students had reported
about such practices.
• Minimum dietary diversity consumption by children (6-23 month) (who received foods from
4 or more food groups) is higher during the second evaluation survey (22.6%) compared to
the first annual evaluation (20.4%) and the baseline (17.8%).
3) Nutrition Governance
Even though different platforms such as DNCC, UNCC UDCC have started to operate in JANO
project areas, more emphasis is required to establish multi-sectoral plans and the installation of the
effective feedback mechanism. However, reach of safety-net programs is showing an increasing trend.
• The second annual evaluation found that DNCC, UNCC, UDCC platforms or forums are
initiated in both Rangpur and Nilphamari. In a KII session with JANO project staff it was
mentioned that 2 DNCC, 7 UNCC and 64 UDCC had spent budget on several purposes i.e.,
distributing foods, sanitary napkin, etc. this is a significant increase as during the first year
evaluation or baseline no such activities was recorded.
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• In total 73 plans were found (Two multi-sectoral plans (2019 -2020) at district level, seven at
UNCC/upazila and 64 at UDCC/union level) and thus budget was allocated to support
nutrition interventions in both districts. It is progress as during the first evaluation survey no
multi-sectoral plans at district, upazila, and union level were initiated and thus no budget was
allocated to support nutrition interventions.
• During the second evaluation survey, a significant progress was recorded in terms of
meaningful participation of women and adolescent girls in government forums (UDCC, CG,
CSG), i.e., raised issues during formulating the nutrition action plan and successfully
implemented those plans (overall 54.0% [Nilphamari 64.0% and Rangpur 45.5%]). During the
first evaluation “very few” did the same (overall 0.5% [Nilphamari 0.9% and Rangpur 0.0%]).
• During the second annual evaluation (as like the first year evaluation or the baseline), no
platforms/options such as availability of a complain box/ hotline number/or any other
mechanisms was found which would allow service receivers to engage into an effective
feedback mechanism.
4) Food Security and Livelihood
Application of Climate Smart Agriculture (CSA) techniques is increasing in the project area since the
baseline and first year evaluation survey.
• The prevalence of CSA techniques shows an increasing trend.
• Application of CSA techniques (minimum 3 out of 20) is showing a positive trend. During the
annual evaluation survey use of minimum 3 techniques was reported by 9.4% of the
households (Nilphamari 7.3% and Rangpur 12.9%). The same was reported by 8.3% of the
household during the first annual evaluation (Nilphamari 4.7% and Rangpur 10.6%). While
during baseline 5% of the households during did the same (Nilphamari 3% and Rangpur 8%).
• During the second annual evaluation survey, the prevalence of various CSA techniques was
measured. The farmers were found to be using various CSA techniques, such as use of short
duration varieties 10.7% (first evaluation: 6.5%), submergence-resistant varieties 7.7% (first
evaluation: 6.0%), disease-resistant varieties 8.2% (first evaluation: 5.1%), drought-resistant
varieties 9.2% (first evaluation: 7.4%), Alternative Wetting and Drying (AWD) methods 1.5%
(first evaluation: 1.6%), ribbon retting method 9.7% (first evaluation: 4.9%), growing creeping
vegetables on nets over ponds 0.5% (first evaluation: 1.4%).
5) Access to information, Information and Communication Technology (ICT)
This second annual evaluation reveals gender disparity in access to information and extension services,
including access to Information Communication Technology (ICT) to receive information about
nutrition. Gender disparity is eminent by the fact that during the second annual evaluation survey,
55.4% of women (first evaluation: 56.3%) owned mobile phone compared to 89.5% of men (first
evaluation: 81.7%).
• During the second annual evaluation, it was found that 61.2% of the total respondents
possessed knowledge about services that could be availed through smart technology (first
evaluation: 46.5%).
• In the project area, 66.3% of the households were visited by NGO health workers during the
last 12 months (first evaluation: 40.5%).
• During the second annual evaluation survey, it was found that 9.3% of the households
accessed or received nutritional information through text messages (first evaluation: 7.2%).
This indicates an increasing trend since the baseline when 4.2% of the households received
nutritional information though text messages.
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• No ICT based e-learning platforms was used by the frontline workers. Besides, no portal is
established for planning and decision making at district and upazila level. JANO’s next plan
may focus on developing and mainstreaming ICT based e-learning platforms at local level to
connect relevant government departments and increase awareness of the community people
about nutrition specific interventions.
6) WASH Practices
The second annual evaluation study explored the situation of access to safe drinking water, safe
sanitation, and prevalence of hand washing practices at critical times.
• Use of tubewell for drinking water is rising (second evaluation: 97.9%, first evaluation: 96.7%).
• Open defecation has decreased since the baseline (second evaluation: 1.9%, first evaluation:
6.3%, baseline: 7.8%).
• Second annual evaluation reveals a decreasing trend in percentage of households having water
facility and soap/detergent available near the latrines. The second evaluation survey identified
water facility near the latrines for washing hands in 43% of the cases (first evaluation 59%).
Further, soap/detergent near the water for washing hands was identified in 53% of the cases
in second evaluation as compared to 60% during first annual evaluation.
7) Covid-19 Response and Impact
The JANO project has proven to be pivotal in disseminating COVID-19 related. information.
Approximately, 90% of respondents in Nilphamari heard about the pandemic through JANO
Volunteers whereas the percentage in Rangpur was 69.1%. Other than this, the percentage of
alternative sources such as miking, media and gathering information from community people is above
50%. This indicates need for reaching out to these groups with correct information at the local level.
• 98.8% of the respondents reported to be washing hands frequently while 55.3% of the
respondents mentioned keeping social distance as a way to avoid COVID-19. Moreover, 9.5%
and 7.4% of the respondents mentioned “police would take the patients” and “keep it secret”,
respectively.
• Major services provided by JANO included: idea and knowledge about COVID-19 (84.8%),
washing hands in a perfect way (59.3%), and wearing mask in a perfect way (57.0%).
• The average number of visits or contact with JANO volunteers from March to September is
7.
• More than 50% of the respondents specified that their family members received support and
information from JANO.
• Around 34% of the lactating mother and 28.9% of the pregnant women received support from
JANO.
• Respondents mentioned that they received knowledge about nutrition. More than 25% of the
respondents shared the learning/information with their family.
• Nearly 59% of the participants reported to be satisfied with the support regarding COVID-
19 received from JANO volunteer. The percentage of respondents who were very satisfied
varies across districts (Nilphamari 31% and Rangpur 12.8%). However, overall, 16.5% of the
respondents were dissatisfied.
• More than 50% of the respondents stated that they changed their food habits in their family
during COVID-19. Around 70% of them eaten decreased the amount of food.
• Around 60% respondents pointed that all their family members took nutritious food during
COVID-19. The percentage of lactating mother taking nutritious food was 23.9%.
• More than 55% respondents claimed that their income declined due to COVID-19.
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• Around 60% respondents took loan for overcoming this pandemic situation. More than 20%
of the respondents were taking low amount of food or food with good quality at the present
time during the second evaluation. Besides, 6.7% of the respondents have already sold their
land/ gold/ asset due this pandemic.
Recommendations and way forward
The following recommendations and guidance on the way forward for JANO to create sustainable
impact in the lives of target communities is presented below.
• Advocacy with stakeholders: In order to sustain gains from the Bangladesh National Plan
of Action for Nutrition (NPAN), JANO may consider advocacy with the Government and
other stakeholders going forward to improve the process of analyzing budget and expenditure
of nutrition Toward this end, JANO may focus on integrating the NPAN in various public
offices to strengthen effective interventions through adequate support from these
stakeholders.
• Communication, Coordination and Cooperation: JANO can create the position of
Nutrition Officer to identify barriers to effective communication and coordination among
different committees and commence advocacy at the governmental level. Through JANO,
CSG committee members could be encouraged to donate or contribute to the local nutrition
plan to more effectively integrate healthcare services at the community level. Each concerned
project committee member could align, collaborate and establish a platform to share and
expand cooperation between stakeholders at different levels.
• Monitoring and Evaluation: JANO could set up a robust system to plan and monitor
women’s participation in different forums. Adolescents’ and volunteers could be engaged in
this process.
• Awareness-raising Tools: Toll-free hotlines and community radio can be utilized as two
major awareness tools that links community people to essential nutrition information.
• Accountability: An active complaints and feedback mechanism should be established and
monitored under DNCC, UNCC, UDCC, CC level to strengthen the rights of beneficiaries
to have their voices heard.
• Education for All: JANO should continue its online classes with local school students and
also arrange online training for SMC members and school teachers.
• Upholding Income Generation: In order to cope with the effects of the Covid-19
pandemic, JANO can identify income-generating opportunities for beneficiaries
In Bangladesh’s evolving development landscape, the growing needs of vulnerable groups remains
paramount. Addressing malnutrition and boosting nutrition levels in children under 5 years, pregnant
women and lactating mothers remains a priority for the JANO project in future. Significant
commitment and buy-in from concerned stakeholders will contribute to ensuring value added,
accountable and sustainable service delivery to these groups in order to uphold their overall wellbeing.
Page | 7
1. Introduction
1.1 Overview of JANO project
“The Joint Action for Nutrition Outcome” (JANO) project implemented through a consortium of
CARE, Plan International and ESDO will work with the GoB) at the national, regional and local levels,
to support the effective implementation of the National Plan of Action for Nutrition (NPAN)-2. JANO
will work with multiple levels of the government, specifically with Nutrition Committees at the district,
upazila and union levels, building their capacity to better develop nutritional plans, implement and
allocate budgets for these plans, and provide effective oversight in project implementation. JANO has
intentionally selected Rangpur and Nilphamari as its coverage. districts. Under Rangpur division, these
regions are among the two most vulnerable areas in terms of poor nutrition levels, with a stunting
rate of 42.1%, according to the Multiple Indicator Cluster Survey of Bangladesh (2012-2013).
Government structures at the local and regional levels will act as key partners, where JANO will work
with the Nutrition Coordination Committees so that they implement effective nutritional programs
within their regions, which are inclusive of all citizens, and accountable to all. The private sector is also
seen as a major systemic partner, where JANO will motivate and encourage businesses to invest in
local markets, where they consider local populations to be a part of their core business. Throughout
all of JANO’s activities, women and girls will remain central. These activities will follow a gender-
transformational approach to develop capacity of women and girls to be informed decision makers,
better producers and income earners.
JANO intends to shift four domains of change:
Domain 1: Communities particularly adolescents and women are informed, engaged and empowered
to improve their nutritional status
Domain 2: Committed, capacitated and invested local government structures and systems
Domain 3: Responsive, engaged private sector and civil societies in co-creating innovative and
affordable solutions for improved nutrition
Domain 4: Well-coordinated multi-sectoral efforts to transform nutrition governance process
Overall Objective of JANO
The Overall Objective of JANO is to “contribute in ending malnutrition of children under five-years
of age, together.
Specific Objective of JANO
Specific Objective of JANO: Strategic objective is to “Improve maternal and child nutrition in
Nilphamari and Rangpur districts of Northwest Bangladesh.”
1.2 Purpose and Objectives of the JANO Annual Evaluation
JANO has recently completed its second year. Due to the COVID-19 pandemic JANO launched a
response program besides implementation of regular activities. Hence, in 2020, besides measuring the
results for the given log frame indicators, JANO has also intended to measure the impact of COVID-
19 on the project in a holistic way and also assess the progress and impact of COVID response
programs.
Page | 8
The purpose of the annual evaluation was to:
1. To measure annual (second year) progress against given logframe indicators.
1.1 To measure the outcome (on health and nutrition) of COVID response project of JANO
2. To measure the impact of COVID-19 on project and recommend way forward.
The study covered all indicators that the JANO project set for outcomes and expected results for the
log frame.
Please see Annex 1 Indicators List for full list of indicators and their baseline and annual
evaluation (first and second year) values.
2 Study Methodology
2.1 Study Area and Target Group The study was carried out by adopting a combination of quantitative and qualitative assessment
methods. Quantitative sample survey was adopted with pregnant and lactating women and adolescent
boys and girls at targeted schools. A face-to-face interview method was followed among the randomly
selected respondents including SMC members and Community Support Groups. A mostly structured
questionnaire was used. Also, telephone interviews were conducted to collect data from DNCC, CSG
CG members. The quantitative assessment enabled us to quantify the incidences of different activities
that were collected from either knowledge or habitual practices.
In-depth interviews, Focus Group Discussion and Key Informants Interviews under qualitative
assessment were carried out to encourage discussion, expression of differing opinions and points of
view regarding the study topic. In addition, desk research was carried out mainly to get a
comprehensive idea about relevant project documents and published results of the context at hand.
The qualitative assessment helped us to uncover prevalent trends in thought and opinion on nutrition-
-specific or nutrition-sensitive actions and plan.
The study reviewed the following documents provided by the JANO project:
• JANO Inception Report
• JANO Baseline Report
• JANO first year evaluation Report
• Baseline data collection tools
• Logical Framework of the JANO project
The survey was conducted in CAPI (Tab based), as preferred by the client. The SurveyCTO Platform
was used for data capturing. The following types of respondents were covered for the quantitative
study:
• Pregnant and Lactating women
• Adolescent girls & boys at school
• School Management Committees and
• Community Support Groups
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The following types of respondents were covered for qualitative study:
1. Community Support Groups
2. Community Groups CGs
3. Unmarried adolescents’ boys and girls (1 with boys and 1 with girls’ group)
4. Male head of the household
5. Sub Assistant Agriculture Officer (SAAO) – DAE
6. Community Health Care Provider
7. Family Welfare Assistant
8. Health Assistant
9. Representatives of UDCC
10. Representatives of UNCC
11. Representatives of DNCC
12. Livestock Officer
13. JANO Project staff
14. Public Health and Engineering Officers
2.2 Geographical Coverage and Sample size
The study covered the seven most vulnerable upazilas of Rangpur and Nilphamari districts:
Gangachara, Kaunia, Taraganj, Domar, Jaldhaka, Kishorgonj and Nilphamari Sadar. The survey
comprised results from 35 villages, selected as Primary Sampling Units across the above upazilas. The
survey selected a statistically representative sample to receive annual results of indicators across all
unions. The sampled households were selected from the sampled area equally applying a simple
random sampling method.
Since information on the number of pregnant, lactating women and adolescent boys and girls were
unknown at the time of the survey; the quantitative sample size for the study was calculated using the
following formula:
Deffe
Zppn
−=
2
2)1(
Where,
n= Required sample size
p= Estimated value of the parameter = 50%
e= Permissible Margin of error=5%
z= 1.96 which corresponds to the 95% confidence level
Deff. (Design Effect) = 1
Considering 50% as P value (which yield the maximum sample) with e set at 5%, z at 1.96, and design
effect 1 the sample size for the study becomes 384. Adding 12% non-response, the minimum sample
size of the study was calculated 430. The study covered 430 pregnant/lactating women. Using the same
formula and assumptions, the sampling size of adolescent girls and boys was 430 as well.
The achieved sample distribution and respondents of the quantitative samples for household and
school survey are:
Page | 10
Respondent Types Total Sample Distribution
Lactating and Pregnant women 430
Adolescent Girls & Boys at School 430
Members of (MCs 35
CSGs 71
Female members of CSG, CG, DNCC 100
2.3 Quantitative (Household and School) Sample Distribution
Household Selection
• All 35 villages were selected by the following systematic random sampling method.
− Step 1: Assigned a number to all of the
640 villages
− Step 2: Determined the sample size (in
this case, it is 35)
− Step 3: Divided 640 (the total number
of villages) by 35. This came to
18.28567 or 18 (when rounded off).
Then, a number in between 1 and 18
was drawn randomly. It came out as ‘2’.
That is, 2nd, [2 + (18.28567 X1)] or
20th, [2 + (18.28567 X2)] or 39th, and
other villages were chosen following
the same rule until 35 villages were
selected.
• A target beneficiary list was provided by CARE Bangladesh covering the stated 7 target upazilas,
which served as a sampling frame.
• Adolescent boys and girls were selected from the same household of adult respondents or from
nearby households as per their availability.
School Selection
In total 22 schools were selected from surrounding areas of the surveyed village.
Picture 1: Household Interviews being conducted
Picture 2: Interview with adolescent girls Picture 4: Interview with
adolescent girls
Picture 3: Interview with
adolescent boys
Page | 11
2.4 Qualitative Sample Distribution
Multiple techniques were employed for collecting qualitative data from target respondents and and
meet study’s objectives. These techniques are outlined below. Respondents were selected following
purposive sampling technique. Please see Annex 3 to see the list of participants and sample size of the
qualitative segment of the study.
• Focus Group Discussions were conducted with JANO beneficiaries and project stakeholders,
including Community Support Group, Community Group, unmarried adolescents’ boys and
girls, (1 with boys and 1 with girls’ group), Men (Head of the Household) and School
Management Committee. Two FGDs were taken with each of the categories in both Rangpur
and Nilphamari districts.
• Key Informant Interviews were taken from PNGOs, LGIs and other related government
officials, i.e., SAAO – DAE, Community Health Care Provider (CHCP), Family Welfare
Assistants, Health Assistants, Representatives of UDCC, Representatives of UNCC,
Representatives of DNCC, Livestock Officers, JANO Project staff, Public Health and
Engineering Officers of the project area.
• In-Depth Interviews were taken with Pregnant, Lactating women and married adolescent girls
in coverage districts.
2.5 Survey Implementation
The survey was implemented in several phases shown below.
i. Phase-I: Preparatory Phase
Field management and recruitment of interviewers: Experienced interviewers were recruited for
this project. Since the target respondents were female, only female interviewers were employed for
this study.
Finalize data collection instruments: A Pre-test of draft questionnaire was conducted and outcomes
were shared with CARE before finalization.
Training for data collection staff: A 4-day central training session was arranged in Rangpur (for
enumerators, supervisors, quality control officers and field management personnel. The objectives of
the project, introduction to respondents and code of conduct were discussed in addition to a
question/answer session. A mock test was also taken to ensure enumerators were well-prepared for
conducting interviews.
ii. Phase-II: Data Collection
A total of 21 female enumerators and 3 field supervisors collected data during this survey. 4
Qualitative Research Associates were appointed to cover the qualitative segment. The data collection
process took place between October 16 - 23, 2020.
Page | 12
iii. Phase-III: Data Management and Analysis
The collected data was processed by IRC’s in-house Electronic Data Processing (EDP) wing, which
ensured the strictest possible data checks and confidentiality, as per the global analysis practice. The
company’s senior programmers and researchers supervised data checking, coding, punching and
editing. After all the data was entered, it was cross-checked thoroughly with the corresponding
questionnaires. Required editing was completed as per need. Also, respondents were contacted when
required. For analysis purposes, IRC’s programmers and researchers jointly developed output formats,
wrote necessary programs and used advanced software. All outputs (tables, charts, and maps) were
thoroughly checked by a team of researchers before reporting An SPSS database was used to analyze
and present data.
iv. Phase-IV & V: Drafting Final Report and Presentation
The final report was prepared after receiving feedback and comments from CARE. This evaluation
report is a collaborative effort between IRC and CARE.
2.6 Quality Control Mechanism
The quality control measures taken at various stages of research projects are indicated below:
Field/Data Collection Level:
• Interviewer recruitment: Interviewers with experience who have worked with IRC were
recruited for the study.
• Survey control: Different levels of supervision (Managers, Quality Controllers and Team
Leaders) are all on our permanent payroll, are graduates and have relevant experience of more
than 5 years.
• Support with Interviews: Our Field Supervisor (FS) and Field Controller (FC) supported
more than 30% of the interviews. This helped us to closely monitor and maintain the quality
of data collection.
• Quality control and back-checking: The checking procedure was very stringent. All
completed questionnaires were scrutinized 100%. Then, 40% of all completed interviews were
randomly back-checked for respondent and response validity by team leaders, quality
controllers, field managers, research coordinators and senior researchers. Each high-level
authority checked the work of all others at lower levels.
Picture 5: Training Session at Rangpur
Page | 13
At Data Entry/Analysis:
• 100% punched data were re-checked and analyzed. Outputs were-checked by senior EDP
personnel and researchers.
2.7 Ethical considerations of the study
Maintaining research ethics is pivotal in conducting a study of this nature in a standard and bias-free
manner. While data collection from the field continued, the research team also maintained the ethical
standards that would provide the study with a more in-depth insight without compromising with the
freedom and confidentiality of respondents. Before conducting any of the FGDs and in-depth
interviews, written consent was collected from the respondents. For the respondents of FGDs verbal
consent was collected and for respondents of the in-depth interviews both verbal and written consent
were collected. The FGDs and interviews were recorded only after receiving permission from
respondents. Photographs were taken for research evidence; that too after receiving permission from
respondents. The hierarchical relationship between researcher and respondent were avoided and a
friendlier approach was undertaken while conducting the FGDs and In-depth Interviews. The research
team informed the respondents prior to the FGDs and interviews that they were free to leave or skip
any questions if they found it offensive or too sensitive Maintaining the confidentiality of the
respondents was the utmost priority of the research team. If any respondents were unwilling to publish
his/her name, pseudo names were used instead of their real names. The note keeper of the FGDs and
interviews read out the key findings to the respondents after the completion of every FGD and
interview. The respondents also incorporated their signature on these notes after listening to the
findings of the FGDs and interviews. In this way, the research team tried to maintain ethical standards
while collecting data from the field of study.
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3 Findings - JANO Annual Evaluation
3.1 Household and Demographic Information
The JANO project’s second annual evaluation collected basic household and demographic data on 430
(Rangpur: 194, Nilphamari: 236) sampled households. The sample was split into a 3:1 ratio between
pregnant and lactating women. The key findings from this data are presented below.
3.1.1 Household Information
The average household size in Bangladesh consists of4.06 members per household according to the
recently released Household Income and Expenditure Survey (HIES). From this study, it was found
that the average household size was 4 for Nilphamari and 5 for Rangpur. The average household size
of the second-year evaluation study was found to be greater (5) than the first annual evaluation (4).
Table 1 below highlights the household and demographic status of the study’s participants.
Table 1: Household and Demography Status
Response 2019 2020
Average Household Size 4.30 5
Sex of Household head
Male 99.1% 48.6%
Female 0.9% 51.4%
Educational Status of Household head
Educational Status of Household head (who had ever attended school) 73.3% 77.3%
N 430 430
3.1.2 Educational Status
The educational status of the household members shows that 28.9% completed primary education
during the first evaluation survey. However, this rate has decreased to 16.1% during the second
evaluation. Similarly, the rate of Masters/higher education degree holders has declined from 3.8% to
2.1% during the second evaluation. In addition, the proportion of discontinued completing
SSC/equivalents was 21% while it increased to 34.4% in the current study. In contrast, the percentage
of completing HSC/equivalent and graduates increased from 3.5% to 5.4% and 3.2% to 4.1%,
respectively. Table 2 shows the education level of household members.
Table 2: Education Level of Household members
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
0 Class 3.4% 0.7% 2.2% 2.3% 2.7% 2.5%
Primary incomplete
(less than class 5) 26.6% 17.4% 22.5%
26.2% 21.7% 24.3%
Primary complete (class 5 passed) 31.6% 25.4% 28.9% 17.2% 14.6% 16.1%
SSC/equivalent incomplete 17.5% 25.4% 21.0% 32.7% 36.7% 34.4%
SSC/equivalent complete 2.8% 12.3% 7.0% 7.6% 10.0% 8.7%
HSC/equivalent incomplete 6.8% 2.2% 4.8% 2.0% 2.4% 2.2%
HSC/equivalent complete 4.0% 2.9% 3.5% 6.3% 4.2% 5.4%
Graduate/equivalent 2.8% 3.6% 3.2% 3.8% 4.6% 4.1%
Masters/equivalent/higher 1.7% 6.5% 3.8% 1.6% 2.7% 2.1%
Informal/pre-school 0.0% 0.0% 0.0% 0.3% 0.4% 0.3%
Don’t know 2.8% 3.6% 3.2% 0.0% 0.0% 0.0%
N 177 138 315 236 194 430
Page | 15
Among target respondents, more than 85% are married and only 10% were never married. The study
found that the proportion of widows increased from 2.6% in 2019 to 3.1% in 2020. However, the rate
of divorces and those separated are negligible.
3.1.3 Occupation of Household Head
The second annual evaluation identified that the primary occupation of household heads was
agricultural daily wage laboring (Crop/livestock) (22.1%), followed by non-agricultural daily wage
labouring (20.5%). The prevalence of farm/crop production and sales as primary occupation increased
to 10% from 1.6%. However, salaried work (non-agricultural) decreased from 16.7% to 12.6% whereas
salaried work (agricultural) declined from 8.1% to 2.8%. Table 3 displays the occupational status of
household heads.
Table 3: Occupation Status of Head of the Household members
Response
Annual Assessment 2019 Annual Assessment 2020
Nil
phamari Rangpur All
Nil
phamari Rangpur All
Farm/crop production and sales 0.4% 3.1% 1.6% 12.7% 6.7% 10.0%
Agricultural daily wage labor
(crop/livestock)
17.1% 23.5% 20.0% 22.9% 21.1% 22.1%
Non-agricultural daily wage labor 27.4% 19.9% 24.0% 17.8% 23.7% 20.5%
Salaried work (agricultural) 10.3% 5.6% 8.1% 2.5% 3.1% 2.8%
Salaried work (non-agricultural) 15.4% 18.4% 16.7% 11% 14.4% 12.6%
Handicrafts 0.4% 0.0% 0.2% 0.0% 1% 0.5%
Household/domestic/housewife (unpaid) 0.4% 0.0% 0.2% 3.4% 2.1% 2.8%
Other self-employment/own business
(non-agricultural)
26.9% 27.6% 27.2% 25.8% 25.3% 25.6%
Retired/elderly 1.7% 2.0% 1.9% 2.1% 0.5% 1.4%
Other 0.0% 0.0% 0.0% 1.7% 2.1% 1.9%
N 234 196 430 236 194 430
3.1.3.1. Disability Status
Almost all respondents from Nilpahamari and Rangpur mentioned that they have no disabled members
in their families. The Annual Assessment rates on disability status among these groups remained the
same at 99.1% in both 2019 and 2020.
3.2. Women and Adolescent Girls Empowerment
This section discusses women and adolescent girls’ empowerment. Here, the annual progress of the
JANO project will be presented mainly focusing on women’s decision-making power that can impact
on nutrition and health care services. This section also follows some sub-themes that emerged from
the project, such as access to buying and selling products to market, participation in formal and
informal decision spaces, having said this, this segment looks at the level of empowerment women and
adolescent girls in communities hold in order to demand and utilize both nutrition-sensitive and
nutrition-specific services.
A UNICEF (2010) study finds that malnutrition is transferred from women to children and that
children grow up with the risk of being affected by different diseases and poses less immunity. Thereby,
women’s increased participation in decision making, agriculture and income generating capacities have
animpact on their household nutrition level (Sraboni et al., 2014). However, burdened by an age-old
patriarchal system, women and adolescent girls are still far from attaining a level of empowerment that
would contribute significantly to improving their nutritional status. Men are mostly decision makers
Page | 16
about agricultural activities and social participation limiting women’s equal participation on different
levels. Therefore, this project needs to concentrate on developing women’s decision-making power
and increasing their public participation as well as employment to have a direct impact on health and
nutrition.
3.2.1 Women’s decision making and access to markets to buy or sell products
In order to understand the major roles of both men and women in production and marketing of
household produces, it is important to note that there exists a huge gender difference in terms of
taking decisions about various types of products such as seeds, pesticides, fertilizers, livestock,
agricultural instruments, commodity production and market sales. The decision to maintain a
homestead garden with several crop varieties would be used as a production measure, the percentage
of adult males engaged in this activity is 54.5% and 63.7%, respectively. This trend has increased from
the first year’s evaluation where decisions were taken by men in 37.9% and presently in 44.0% cases,
respectively. Combining both Rangpur and Nilphamari districts, only14.2% (first year evaluation 5.6%)
women can decide to maintain the homestead garden, and 2.8% (first year evaluation1.9%) can
participate in choosing crops to grow for selling later on. This degree of participation by women
reveals their initial challenge toward accessing nutrition as they can rarely plant what they deem as
nutritious.
Seeds, pesticides, fertilizer: The study revealed that men play an important role in the production
of crops, seeds, pesticides and fertilizer. They also lead the decision-making process in purchasing
these items. In Rangpur, 64.7% (first year evaluation 59.7%) men took decisions on whether they would
buy improved seeds such as certified, Hybrid, HYV which is higher compared to women. 3.1% (first
year evaluation 2%) and In Nilphamari, this feature was also higher in men 68.2% (first year evaluation
30.8%) as compared to women 3.4% (first year evaluation 1.7%.
In terms of pesticides, 66.3% men (Rangpur: 62.4% and Nilphamari: 69.5%) (first year evaluation 43.7%,
Rangpur: 60.2% and Nilphamari: 29.9%) take decisions combining both districts, whereas women’s
participation rate is 2.8% (Rangpur: 2.6% and Nilphamari: 3.0%) (first year evaluation 1.6%; Rangpur:
2% and Nilphamari: 1.3%). The situation manifests that women are excluded and marginalized from
public spheres due to social norms such as Purdah1 and hampers their economic participation (Ahmed,
1992; Kashem & Islam, 1999). In fact, women are not considered as ‘farmers’, therefore, their decisions
regarding seed, pesticides and fertilizer production are challenged unless they belong to Female
Headed Households (Rosy & Haque, 2017). Both adolescent girls’ and boys’ participation in the above
decision-making processes are less than 1% in both districts. this means that men being the head of
the household are themselves decision makers, this reality not only excludes women but also young
girls and boys. Nonetheless, a many positive changes is noticeable, women have participated in diction-
making on a yearly basis.
Livestock: Livestock includes oxen, cattle, goats, sheep, chicken, ducks and turkeys. It is interesting
to note that the percentage of men’s roles in purchasing or selling oxen and cattle is relatively higher
than the rest of these animals. This trend has continued since the first year evaluation and men’s
control over this process increased from 40.7% of 66.7% during the second year of evaluation. In
contrast, women enjoy a higher level of participation in managing poultry, (10% combining both
districts) during the first year of the evaluation. This percentage increased to 18.6% in the second year
of evaluation. In the first year, women’s participation in decisions regarding purchase and sale of
livestock types was higher in Rangpur district compared to Nilphamari, this trend continued in the
second year of evaluation. Hence, these findings show that there are scopes to improve women’s
1 Wearing veil to cover body and face.
Page | 17
participation in the purchase and sale of livestock, especially in Nilphamari to increase of their
empowerment levels.
Farm tools: The use, purchase or rent of mechanized farm equipment such as hand tools, animal-
drawn ploughs, tractors, power tillers, and treadle pumps, are also determined by stereotypical gender
roles. It was revealed that 2.8% (first year evaluation 0.9%) women only participate in mechanized
farming related decision making compared to 61.2% (first year evaluation 41.6%) men. Women have
relatively more participation (3.0%) in dealing with non-mechanized farm equipment (first year
evaluation 1.4%). These results show that due to perceived social norms, women have limited scope
to use mechanized equipment (Chipande, 1987; Saito & Spurling, 1992). In addition, a study conducted
in Manikganj reveals that women find motorized techniques difficult to operate as they are not user-
friendly (Rosy & Haque, 2017). Similarly, to purchase or rent transformation equipment such as milling
machine, and food processing equipment, men take the lead, and the difference is 62.3% versus 2.6%
women (first year evaluation 43.0% men and 1.9% women). This difference remains visible in deciding
to invest in non-farming businesses, where men control how the money would be used. Therefore,
the project has great potential to increase women’s participation in decision making related to
production.
Control over income money2 The money earned from selling different produces and other sources
are mostly managed by men, which is 64.2% (first year evaluation 42.3%) compared to 3.0% (first year
evaluation 2.6%) women. The division in decision making power indicates that women also lack proper
control over their income, although women are extensively involved in livestock production
(Anderson & Eswaran, 2009). Moreover, women’s lack of access to information, market value chain
and men’s control over the market also plays a role in limiting women’s control over livestock or
related income (Paudel, ter Meulen, Wollny, Dahal, & Gauly, 2009).
About children: in terms of children’s education, marriage or medical treatment, men play a major
role in taking decisions. Only, in terms of children’s immunization do women play twice as much a role
as men (62.6% versus 28.4%). This is a significant increase in terms of women’s role play as during the
first year of evaluation where men and women played almost equal roles regarding children’s
immunization being primary caregivers. This feature is clearly absent in decisions regarding children’s
education public participation or marriage.
Access to basic health service: As shown in the below graph, 87.4% women have access to basic
health services across both coverage districts representing an increase from 73.5% during the first
annual evaluation. They mostly receive services from community clinics 57.8% (first year evaluation
49.1%) followed by UH&FWC 37.5% (first year evaluation 16.8%) and Upazila Health Complexes 8.7%
(first year evaluation 13.6%). Figure 1 shows access to basic health services across project areas for
target groups.
2 Access to and control over: Opportunity to receive and utilize information and ability to make approach to gain ownership.
Page | 18
Figure 1: Access to Basic Health Services
In this segment of the study, 92.6% of participants mentioned that they did not visit a healthcare centre
because it was ’’not required. A total of 5.6 people said that these services were of a “high expense”.
The health facilities that are available in the catchment areas are Union Health & Family Welfare Centre
(UH&FWC) (54.0%) and Community Clinics (90.2%), representing an increase from 22.3% and 72.6%,
respectively during the second year evaluation from the first year evaluation.
Figure 2: Services received from different health service centers during last 12 months
According to the pregnant women groups from IDIs, every
pregnant woman should be careful during her pregnancy
by eating nutritious food, avoiding heavy work and while
availing health services. A respondent from Gangachara,
Rangpur specified that she received health services from
BRAC. On the other hand, a respondent from Nilphamari
mentioned that she receives services from one service
provider each from both BRAC and the JANO project.
Both respondents mentioned that they received health
56.3%
65.7%59.4%
71.4%76.0% 73.5%
88.6% 86.1% 87.4%
43.8%
34.3%40.6%
28.6%24.0% 26.5%
11.4% 13.9% 12.6%
Nilphamari Rangpur All Nilphamari Rangpur All Nilphamari Rangpur All
Baseline Annual Assessment 2019 Annual Assessment 2020
Yes No
35.5%
15.7%9.2%
3.2%7.4%
49.1%
16.8% 13.6%
3.2% 5.4%
57.8%
37.5%
8.7% 6.9% 4.0%
Community Clinic UH&FWC Upazila Health
Complex
Other NGO Health
Service centre
Govt. Satellite Clinic
Baseline Annual Assessment 2019 Annual Assessment 2020
- “Not only I get the service of
measuring BP, iron tablets or
calcium, they also give
vaccines for the new born
baby”
- One pregnant woman,
Gangachara, Rangpur
Page | 19
services such as measuring blood pressure measurement, an ultrasound, prescribed medication
including advice for keeping fit.
According to participants, adolescent girls face different physical problems during menstruation such
as heavy bleeding body and chest pain. As they all attended the meetings of JANO program, they know
that they need to maintain personal hygiene, eat healthy and nutritious food and take rest during these
times on a monthly basis. Respondents also mentioned the services they received from Community
Clinics such as TT vaccines, Iron and Folic acid tablets. These groups also specified that they visited
the doctor from a local market if they faced any problems during menstruation as Community Clinics
would not always open.
According to the respondents, every pregnant
woman or lactating mother should receive
knowledge about avoiding heavy works eating
nutritious food, receiving health services from
doctors, taking steps for taking care of her new
born child and most importantly treatment for
her children. All of the project’s respondent’s received essential knowledge and information on these
issues through courtyard meetings conducted by the JANO program. All the respondents received
health services during their pregnancy such as measuring blood pressure, position of the baby, provide
iron, vitamin and calcium tablets ultrasound and medication. They added that service providers from
Community Clinics also provide health care services to children.
3.2.2 Participation of Women in Formal and Informal Decision-Making Spaces
The following section will explore the extent to which women participants engage in formal and
informal decision-making spaces.
Specific objective: Outcome
Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts
Indicators: % of increased participation of community people, particularly women, in formal
(government-led) and/ or informal (civil society-led, private sector-led) decision-making spaces
Definition Indicators:
•Govt. led forums: CG, CSG, UP special committee, Up standing committee, adolescent group,
student council,
•Informal group: VSLA, FFS, Mothers group, youth group, women support group
•Participation in the meeting and in the discussion Data disaggregation by sex
(Definition aligned with CARE global indicators.)
Formal Informal
Nilphamari Rangpur Overall Nilphamari Rangpur Overall
Baseline 1.79% 1.81% 1.79% 1.79% 1.81% 1.79%
Annual
Evaluation
2019
0.47% 0.47% 0.93% 2.33% 1.16% 3.49%
“We want to go to community clinics as there are female doctors there but they
are not always open. That’s why we have to visit the village doctor found in the local
market.”
- One adolescent girl, Nilphamari.
“Not only I get the service of measuring BP, iron
tablets or calcium, they also give vaccines for the
new born baby.”
-One pregnant woman, Gangachara, Rangpur
Page | 20
Annual
Evaluation
2020
1.16% 1.63% 2.79% 2.56% 2.33% 4.88%
Figure 3 show that participation of formal (Govt. led forums: CG, CSG, UP special committee, UP
standing committee, adolescent group, student council) and informal group (VSLA, FFS, Mothers
group, youth group, women support group) differs from baseline to the annual evaluation survey.
Participation of community people in formal groups has increased as compared to the baseline and
first annual evaluation survey (2019). This element has steadily increased in Nilphamari district in the
second annual evaluation survey.
Figure 3: Percentage of increased participation of community people, particularly women, in formal and/ or informal
decision-making spaces Figures in %
3.2.3 Functionality of Community Support Groups and School Management Committees
The CSG groups have been established since 2018. The main profession of CSG members are
homemakers, teachers, farmers and fishermen. approximately, 17 members were selected for the
CSG. In this group, 9 members are female including one adolescent girl and the remaining are male
including one adolescent boy
In both Rangpur and Nilphamari, the CSG members worked with CGs by checking family planning
vaccines, provided lists of pregnant women and old age allowances. In addition, these groups also
arranged courtyard meetings on health, nutrition and hygiene issues and recommended participants
go to CCs to avail treatment, regular checkups of pregnant women and also for adolescent health
issues.
1.79 1.79
0.93
3.49
2.79
4.88
Formal Informal
Baseline Annual Survey 2019 Annual Survey 2020
“If we see a girl sick for her
menstruation and she does not want
to go to school, we suggest her for
taking treatment from Community
Clinics. We also refer the community
people for the CC who are sick or
cannot go to hospital.”
-- CSG member
“Community Clinics provide medicine. Generally, they provide
30 different medicines but seldom one or two remain stocked
out. Besides, primary care for general health problems is
provided. We also provide PLW with iron, calcium
supplements, follow ups and encourage mothers to
exclusively breastfeed children up to 6 months. Similar
support regarding supplements is given to adolescents”
– KII with a HA
Page | 21
Meetings and decision-making process
According to the members of CSGs, meetings are arranged on a bi-monthly basis. Discuss about
planning and improvements for community people as well as the program are held at these sessions.
Community support groups organize coordination meetings (Shomonnoy Shova) every 6 months.
From 2018, members attended approximately 34 CSG meetings. They mentioned that their decisions
are normally recorded by the meeting’s President and that they always try to provide relevant
recommendations for all community member at these sessions.
Women and adolescent girl members of this CSG always make decisions about health and nutrition
related issues for adolescent, pregnant women, lactating mothers including disabled children visit CCs
for various kinds of treatment.
Problems and suggestions for improvement of CC services
Though the CSG members did not specify any problems, they suggested keeping CCs neat and clean,
improving their medical resources and providing more knowledge about their health services to the
community people.
According to the CSG members, these meetings are very effective for both CSGs and the community.
In addition, they mentioned the importance of providing nutrition- specific services for women and
adolescent girls.
Resource mobilization
The CSG respondents specified that they provide knowledge about the use of modern latrines,
improving nutrition by growing vegetables in front of community people’s homes and ask them to go
to CCs without hesitation.
The CSG members from the FGDs mentioned that they normally organize meetings and plan for their
upcoming work accordingly informing the community about their agendas. In addition, they arrange
courtyard-meetings providing information about the benefits of CCs. They also flagged areas where
they could support community people to improve their health and nutrition status.
A few of the male household heads from both Nilphamari and Rangpur are also members of CSGs.
They mentioned that they were selected for the CSGs through discussions on potential participants
who possess leadership skills. They added that if anyone is regularly absent for these meetings, they
would be denied membership. These participants also stressed that the CSG members knew their
responsibilities toward the community.
Along with the members, the Chairman and the Secretary of the Union Parishad, CG and CSG jointly
organize annual planning forums and make decisions by providing financial and technical support. The
One of the HA during a KII mentioned,
“Community Clinics has a group including UP members, schoolteachers, imams, etc any others then list,
do not use etc. In this group, 5-7 out of 17 members are women. [what is this bracket for…]?? only 1 or
2 women forward acceptable recommendations, if their recommendations are valuable, they are taken
into consideration. It was also mentioned, community groups hold meetings every month and so far,
almost 25-30 meetings have been held.”
Page | 22
respondents went on to mention that they
receive the support of some NGOs who provide
information about adolescent health during
courtyard meeting. They normally use the
method of route mapping to engage the demand
of community people with second year annual
plan program. Through this process, the
challenges and problems of the community
people are shared meetings.
According to the members of the CGs, they face
challenges in providing nutritious food, making sanitary latrines and building tube-wells in the
community as they do not have financial support. Though they collect very minimal amounts of money
from the patients of CCs, they use this fund to repair tube wells and/or sanitary latrines.
In total, 71 members of the CSGs were interviewed to evaluate their functionality during the second
year annual evaluation. As per survey data, out of 71 CSGs, 29 have been functionalized based on their
performance on seven indicators prescribed by the Institute of Public Health and Nutrition mentioned
below (from program personnel).
i) Mobilize and motivate the community people for taking health and nutrition services from
community clinic,
ii) Motivate and ensure the household members to taking additional food for women and
adolescent and taking rest of pregnant women,
iii) Motivate and ensure the household members to exclusive breast feeding,
iv) Motivate and ensure the household members to taking additional food to the child after 6
months age,
v) Assist to identify the malnourished child and women and arrange to send in community clinic,
vi) Taking action to protect child marriage and
vii) Motivate the adolescent women to taking Iron tablet and deworming tablet
Expected Result I: Output I
Results chain: Women and adolescent girls in communities are empowered to demand and
utilize both nutrition-sensitive and nutrition-specific services;
Indicators: % of CSGs in targeted communities are functional
Definition Indicators: Qualify five out of seven performance indicator prescribed by
government
Nilphamari Rangpur Overall
Baseline 0% 0% 0%
Annual Evaluation 2019 CSG (functional/Active)
414 198 612*
Annual Evaluation 2020* CSG (functional/Active)
37% 45% 41% (out of 71)
*Here values are calculated in percentage in the second year annual evaluation survey
It was found that, during the baseline survey, in total 7 SMCs had raised issues related to nutrition
specific and sensitive services for women and adolescents. In the first annual evaluation, 199 SMCs
from Nilphamari and 103 SMCs from Rangpur raised these issues during these meetings, set them in
the action plan and recorded them in the meeting minutes. In the second-year annual evaluation, face-
to-face interviews were conducted with SMCs, it was identified that monthly meetings were conducted
in 61.1% cases (Nilphamari 73.9% and Rangpur 38.5%), and 50% of them received training (Nilphamari
60.9% and Rangpur 30.8%). In those meetings, priority issues included discussion related to nutrition
“We take 5 TK from the CC patients. We use
them on repairing other problems. The amount for
improving nutrition of community people is very
negligible. For this reason, we need financial
support. If Govt. can implement the budget for this
project effectively, the project will see the success.”
-FGD with Community Group
Page | 23
awareness (100%), health issues (100%) and hygiene (97.1%), involvement of students in nutritional
activities (44.4%) including vegetable gardening at school (83.3%). However, the knowledge of SMC
members in gender sensitive hygiene issues was comparatively low at 42.9%.
Expected Result I: Output I
Results chain: Women and adolescent girls in communities are empowered to demand and
utilize both nutrition-sensitive and nutrition-specific services;
Indicators: # of School Management Committees set agenda for nutrition specific and sensitive
services for adolescents in the SMC meeting
Definition Indicators: SMCs will raise issues in the meeting, set them in the action plan and that
will be mentioned in the meeting minutes
Nilphamari Rangpur Overall
Baseline 6 1 7
Annual Evaluation 2019 199 103 302*
Annual Evaluation 2020* 157 88 245 *This indicator value was calculated based on the interview data (quantitative survey with 35 members of SMC)
The above findings from the survey indicates that 157 SMCs from Nilphamari and 88 SMCs from
Rangpur have raised issues on gender, nutrition, health and hygiene in corresponding meetings and
incorporated them in to action plans.
Role of SMCs
According to the SMC respondents from both Rangpur
Kaunia and Nilphamari, the President normally makes
decisions along with SMC members for leading school
development planning, increasing the attendance of
students, their academic performance and most
importantly their knowledge about gender, health,
nutrition and hygiene. They specified that the SMC teams
also select representatives from guardians whose children
attend these schools.
Selection for SMCs
The SMC respondents from both areas specified that they usually select the members of this group
through a voting process. They have separate positions for female candidate by which they follow
gender equality guidelines. They arrange meetings based on upcoming planning schedules and issues
related to health, student attendance and hygiene.
Planning for student development
According to the SMC participants of Kaunia Rangpur, they could not finalise any plans for the students
with the new committee as these schools are closed due to COVID-19.
Recommmendations:
The respondents from Kaunia Rangpur suggested trainingsbe providedon women and adolescent
health. They specified that theJANO program would help SMCs provide accurate knowledge about
nutrition, hygiene and academic development to students as well as to the community.
“We call the famous personality of our
area in this election. We have 4
candidates from parents’ section and
one separate position for female
candidates.”- One SMC respondent
from Nilphamari.
Page | 24
According to a JANO project staff, CSG will be functioned in the third year as these projects take
some time to be implemented properly. However, CSG members have actively participate in events
and meetings, made response plans for Covid-19 and delivered messages to the community. Required
training had been provided to the concerned team, meetings were held and planning was completed.
However, due to COVID-19, SMCs’ operations were paused. At this point, is anticipated that at least
5-6 months is needed to overcome this phase.
Moreover, the team expects that the project will reach its peak during the 5th year. In order to bridge
the gaps between the initial goal and actual results from CSGs, the plan is to incorporate the findings
of the first year going forward. Having said this, if major flaws are found, then training will be provided
and based on the situation, new modules will be created.
3.3 Maternal Adolescent Child Health and Nutrition
The following section discusses maternal, adolescent and child health, nutrition and the status of health
care facilities. Nutrition is a part of health and women’s empowerment, it’s crucial for advancing the
health and productivity of whole families and communities. Therefore, understanding the types of
assistance regarding ANC, PNC including nutritional levels is important to get an overall idea about
reproductive health and nutrition.
3.3.1 Assistance regarding maternal health and nutrition
In terms of assistance regarding maternal heath total of 3.2% women in Nilphamari and 3.4% in Rangpur
informed about having maternity allowance among the total number of 312 and 237 of these women
respectively. Similarly, 1.5% (decreased compared to first annual evaluation survey) women received
supplementary feeding and 2.2% received maternal health vouchers. This demonstrates a poor service
delivery from both the government and NGOs.
In case of area-based the Community Nutrition Scheme, (CNS) no service delivery was imparted in
the second annual evaluation compared to the first annual evaluation study. In the baseline study,
similar findings were identified varying from 1-2% for each category such as 1000-day assistance,
support (maternity allowance, Vulnerable Group Development (VGD), Valuable Group Feeding (VGF),
maternal health vouchers) and CBNS. There is a slight improvement in this percentage in terms of
1000-day assistance, maternity allowance and VGDs, yet it is an area where more focus must be given.
3.3.2 Antenatal and Postnatal Care
Antenatal care also known as prenatal care refers to the regular medical and nursing care
recommended for women during pregnancy. It begins from the early stages of pregnancy and aims to
provide care during pregnancy, at the time of delivery, and soon after delivery which is extremely
important for the survival and well-being of both the mother and her newborn baby.
Page | 25
From Figure 4, the survey results show that
approximately 79.6% of pregnant women (at least
received 2 check-ups during their pregnancy)
received antenatal checkups during pregnancy in the
second evaluation. District wise, the highest
percentage of pregnant women who sought at least 2
ANC support services was in Nilphamari, Thehe
lowest was found in Rangpur (76.t) in the second
evaluation. The percentage of pregnant women who
made 2 antenatal visits has increased, from 78.1% in
2019 to 79.6% in 2020 though this result was
unsatisfactory compared to the baseline (84.3%).
Those who had received ANC support, Of those
who received, more than half of them (58.5%) received it from CCs in the second annual evaluation,
which is higher than the first annual evaluation (47.6%). This result also shows that 20.7% of pregnant
women received ANC from FWCs and around 13.4% from UHCs during the second annual evaluation.
There is also a significant increase in the percentage of pregnant women taking more rest than usual
from 65.7% in 2019 to 68.9% in 2020. Pregnant women had also consumed more food during
pregnancy in the second annual evaluation (60%) than in the first annual evaluation (36.2%). However,
the ratio of husbands not accompanying wives outdoors during pregnancy has decreased compared to
the baseline study and first annual evaluation study. However, in both annual evaluations approximately
28% of pregnant women admitted that their husbands sometimes accompanied them to health centers.
In Figure 5, the incidence of receiving postnatal care
(immediately after the birth) and checkups after
pregnancy is recognized as an essential component of
maternal and newborn care. Interviewers asked each
mother if she had received a health checkup after
delivery and a PNC checkup within 42 days of her last
delivery. The graph shows that approximately 23%
(among 301 women) of mothers reported that they
have received PNC in the second annual evaluation
compared to the first annual evaluation (19.6%,
women said yes among 342 women) study. The survey
results show that the number of mothers receiving
PNC within the 42 days of their last child’s delivery has
increased during the second annual evaluation (36.2%) survey as compared to the first annual
evaluation (32.8%). The majority (more than 30%) of mothers received PNC services from
hospital/medical colleges in both annual evaluation surveys. They had also visited UHCs and CCs after
the birth of their children. Furthermore, 47.2% of mothers delivered their children at home as
compared to the first annual evaluation (55.6%). To facilitate their delivery, relatives, skilled birth
attendant (SBA), community based skilled birth attendants (CSBA), doctors and nurses played better
roles in both annual evaluations than in the baseline study.
3.3.3 Indicators of The National Plan of Action for Nutrition
The government, NGOs and some private sector organizations are focusing on poverty, education,
health and nutrition, water, and sanitation, as current development issues in Bangladesh. The National
Plan of Action for Nutrition has been adopted with different stakeholders to improve the nutritional
status in Bangladesh. National Nutrition Policy 2015 emphasizes ensuring proper nutrition of people
by identifying the causes of malnutrition. This policy focuses on the underlying causes of malnutrition
Figure 4: Incidence of receiving antenatal check-
ups during pregnancy
84.3% 78.1% 79.6%
Baseline Annual
Assessment
2019
Annual
Assessment
2020
Figure 5: Incidence of receiving postnatal check-
ups after pregnancy
19.6% 22.9%
Annual Assessment
2019
Annual Assessment
2020
Page | 26
and strengthening improvement areas to ensure the facilities and improve nutritional status in
Bangladesh. Mostly children and women suffer malnutrition in Bangladesh. National Nutrition Policy
2015 emphasizes several health points for children. Those are: breastfeeding be started within one
hour after birth; the baby be exclusively breastfed up to age 6 months (180 days); and after completion
of the 6 months the baby be given homecooked, nutritious complementary food up to 2 years of age
along with breastfeeding. The following paragraph discusses the status of child nutrition in Rangpur
and Nilphamari areas.
The second evaluation findings show that mothers with 0-23-month-old children were asked about
the initiation of breastfeeding within one hour of birth. The results revealed that 60.8% of mothers
began breastfeeding within 1 hour of their child’s birth. Nearly two-thirds (63%) of these mothers
(those have a child below 6 months) exclusively breastfed their children. Also, more than 80%of
mothers (those who have a child between 20 and 23 months) provided breast milk and they are still
breastfeeding their children. Nearly 98% of mothers gave Vitamin A capsules to their 6-59-month-old
child and 63.0% of the HH reported using iodized salt/packaged salt for cooking.
The series of FGDs held with the male head of the household found that these groups attend courtyard
meetings once a month. During these sessions, participants learned how to provide care for women
during their pregnancy such as regular checkups at CCs, ensuring that they avoid heavy work, take
rest and eat healthy food. The FGD respondents from Nilphamari specified that they take their
household’s female members to the CCs for various types of treatment including availing medicine.
“Not only we go to the Community Clinic for the checkups for our pregnant women, we also receive
medicines for different types of illnesses like fever, cough, headaches, itching and diarrhea. They are
very supportive. They also give iron and vitamin tablets for pregnant and adolescent girls.”
- One respondent from Nilphamari.
From the courtyard meetings, they also receive knowledge on saving money for the delivery of
newborns, various treatments, investing in nutritious food cultivation and emergency needs. In
addition, respondents from Rangpur talked about ‘Green Umbrella’ and UHC where they can access
health services for women.
According to CSG members (from the FGDs), female community people are not fully unaware of their
health, nutrition and hygiene, especially about their pregnancies and lactation. Hence, these members
provide knowledge to local women on CC based health services, particularly for malnutritional
children, pregnant women, and lactating mothers, doctor’s consultations, inform them including
adolescent girls about the importance of medical checkups, taking iron and calcium tablets. The
members also provide counselling services about the legal marriage age, adolescent and reproductive
health in addition to the negative effects of the dowry system.
3.3.4 Nutritional Status of Women of Reproductive Age
Specific objective: Outcome
Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts
Indicators: % of women of reproductive age in the targeted districts who are consuming a
minimum dietary diversity (MDD)
Definition Indicators: Women 15-49 years of age have consumed at least five out of ten
defined food groups the previous day or night. (FANTA-III)
Nilphamari Rangpur Overall
Baseline 30.9% 41.8% 34.9%
Page | 27
Annual Evaluation
2019
32.5% 42.3% 37.0%
Annual Evaluation
2020
33.5% 44.3% 38.4%
This was asked to women aged between15-49 years who have consumed at least five out of 10 defined
food groups the previous day or night. During the second year annual evaluation, a total of 430 women
(236 in Nilphamari, 194 in Rangpur) at reproductive age responded to this question on Minimum
Dietary Diversity (MDD). The below graph in Figure 6 shows that the stated food consumption is
slightly higher (38.4%, in the second year annual evaluation survey compared to 37% in the first year
evaluation and 34.9% in the baseline survey).
“MDD-W is a dichotomous indicator of whether or not women between 15–49 years of age have
consumed at least five out of 10 defined food groups the previous day or night. The proportion of
women 15–49 years of age who reach this minimum in a population can be used as a proxy indicator
for higher micronutrient adequacy, one important dimension of diet quality. The ten food groups are:
1. Grains, white roots and tubers, and plantains 2. Pulses (beans, peas and lentils) 3. Nuts and seeds 4.
Dairy 5. Meat, poultry and fish 6. Eggs 7. Dark green leafy vegetables 8. Other vitamin A-rich fruits and
vegetables 9. Other vegetables 10. Other fruits” http://www.fao.org/3/a-i5486e.pdf.Figure 6 displays
the percentage of women of reproductive age in coverage districts consuming a Minimum Dietary
Diversity. In the second-year evaluation, this percentage is 38.4%, a slight increase from both the
baseline (34.9) and first year’s evaluation (37.0%).
Figure 6: Percentage of women of reproductive age in the targeted districts who are consuming a minimum dietary
diversity (MDD) Figures in %
From the second year evaluation, it was revealed that most women (99% in Nilphamari and Rangpur)
consumed ‘Grains, white roots, tubers, plantains (rice, potatoes)’ over the previous 24 hours, other
Vitamin A rich fruits and vegetables (including ripe mangoes and papaya, carrots, pumpkins, sweet
potatoes)", other vegetables and fruits (including green mangoes and papaya)". It was found that
consumption of the above foods is higher in the women of Nilphamari, while pulses (beans, peas, lentils
and dairy (yogurt, cheese, milk), nuts and seeds, meat, poultry, fish (including dry fish), eggs and dark
green leafy vegetables were consumed more in Rangpur.
In addition, 56.5% women in the second year annual evaluation (48.5% in first year evaluation) took
Vitamin-A after the delivery of their child, and 31.2% (28.9% in the first year evaluation) took iron
30.9
41.8
34.932.5
42.3
37.033.5
44.3
38.4
Nilphamari Rangpur All
Baseline Annual Evaluation 2019 Annual Evaluation 2020
Page | 28
tablets while 26.2% (18.1% in the first year evaluation) took folic acid as well. It must be noted that
receiving of Vit-A, iron tablets and folic acid has increased in the second-year annual survey, when
comparing first year evaluation.
Figure 7 shows the percentage of women who consumed a selective number of food items in the past
24 hours of the survey period. In the second-year evaluation, dairy was the most popular food items
consumed as they were in the first-year evaluation 24%. This was not the case in the baseline with
only 4% preferring to consume dairy products. Similar consumption patterns can be observed in the
Nuts and seeds category ranked as the second most popular followed by eggs. Participants did not
prefer to eat other fruits or vegetative outside those highlighted in the below table.
Figure 7: The percentages of women consumed the number of food items in the previous 24 hours
Given that the main staple food item is rice in Bangladesh, 61% of women in the ‘better MDD’ group
consumed Grains but 38%% of women in the ‘no MDD’ group consumed this food. Other food items
that were commonly consumed were dark green vegetables, which were consumed by 32% of women
reporting improved MDD (i.e. having consumed 5 or more food items) and 32% of women in the no
MDD (i.e. having consumed 4 or fewer food items); Pulses (beans, peas and lentils), which were
consumed by 32% of women reporting better MDD (i.e. having consumed 5 or more food items) and
27% of women in the no MDD (i.e. having consumed 4 or fewer food items); meat, poultry and fish –
consumed by 30% of women reporting better MDD and 27% in the no MDD group; and other
vegetables – consumed by 26% of women reporting better MDD and 17% in no MDD group.
6%
11%
21%
25%
18%
9%6%
4%
0% 0%1%
9%
18%
34%
11% 11%9%
6%
1% 0%
1 2 3 4 5 6 7 8 9 10
Annual Assessment 2019 Annual Assessment 2020
Page | 29
Figure 8: Percentage of MDD food items consumed in the last 24 hours in women of reproductive age
3.3.5 Women and Adolescent Girls in Communities are Empowered to Demand and
Utilize Both Nutrition-Sensitive and Nutrition-Specific Services
Women and adolescents from the annual evaluation survey have claimed that they received more
nutrition-specific and sensitive-services from relevant service providers such as CCs for health services
and Extension services for agriculture and livelihood as compared to the baseline and first year annual
survey.
Expected Result I: Output I
Results chain: Women and adolescent girls in communities are empowered to demand and
utilize both nutrition-sensitive and nutrition-specific services;
Indicators: % of women and adolescent have claimed nutrition specific and sensitive services
from relevant service providers
Definition Indicators:
• Community Clinic (CC) for health services
• Extension services for agriculture and livelihood
Community Clinic Extension services
Nilphamari Rangpur Overall
Baseline 37.8% 30.7% 35.5% 3.98%
Annual
Evaluation
2019
39.7% 31.6% 36.1% 7.44%
Annual
Evaluation
2020
40.68% 32.99% 37.21% 8.84%
As per survey findings, women and adolescents claimed that they availed nutrition-specific and sensitive
services mainly from CCs and extension services for agriculture and livelihood from DAE, NGOs, and
the private sector. Women and adolescents get health services from community clinic but in adequate
manner. Figure 9 reflects the percentage of women and adolescents who claimed nutritious specific
and/or sensitive services from relevant service providers during the second annual evaluation survey.
38%32%
7%
23%30% 26%
32%20%
26%
9%
61%
27%
2%13%
27%15%
32%
11%18%
2%
Grain
s, white
roots an
d
tubers, an
d p
lantain
s
Pulse
s (bean
s, peas an
d
lentils)
Nuts an
d se
eds
Dairy
Meat, p
oultry an
d fish
Eggs
Dark
green le
afy
vege
table
s
Oth
er vitam
in A
-rich
fruits an
d ve
getab
les
Oth
er ve
getab
les
Oth
er fru
its
Better MDD No MDD
Page | 30
Figures 9: Percentage of women and adolescents have claimed nutrition specific and sensitive services from relevant
service providers
The above results in Figure 9 show that few adolescent girls and women have received basic nutritional
services (such as growth monitoring) from CCs, UHs and FWCs in the last 12 months. However, they
did receive ANC, PNC, SBCC, EPI, LIM. Curative care curative care services from these service
providers. The evaluation also found that the overall level of accessibility to basic health care service
packages from the above service providers was satisfactory.
The FGDs conducted with married adolescent girls revealed that they face physical problems such as
heavy bleeding, headaches, body pain, acidity and chest pain during menstruation. One of these
respondents said that she stayed at home during her menstruation as she felt that it was a normal
problem. On the other hand, another respondent said that she went to the CC for treatment after
learning about their services from the JANO project through miking.
“I did not know that we could share about this heavy bleeding and headache problems during
menstruation to anyone. When I heard the miking of JANO program for going to Community Clinic
for taking treatments. I went there and got to know that if we eat healthy vegetables, these types of
problems won’t happen. They also gave suggestions on how we can keep our body healthy”. -- a
married adolescent girl.
The respondents also mentioned that they do not like to visit the doctor except when experiencing
major health problems. According to one of the participants, around 80% people in her community
visit the local hospital including her in-law’s family. The rest of them go to CCs. In contrast, a
respondent from Rangpur stated that she avails good quality services and treatment from CCs
These groups went on to state that they are very interested in availing knowledge about nutrition,
health and hygiene as it helps people to keep their bodies fit. One respondent specified that healthy
food and/or hygiene maintenance is merely not enough, physical exercise is also important to uphold
good health. Participants from Rangpur specified that they could not avail knowledge regarding
nutrition, health and hygiene from the CCs and courtyard meetings. According to a participant from
Nilphamari, newly married adolescents do not have knowledge about family planning. She
recommended that this information be provided in courtyard meetings. On the other hand,
participants from Rangpur recommended providing health related information through female
members of CCs.
37.80
30.70
35.50
3.98
39.70
31.60
36.10
7.44
40.68
32.9937.21
8.84
Nilphamari Rangpur All Extension services
Baseline Annual Survey Annual Evaluation 2020
Page | 31
3.3.6 Students Apply Key Learning Points Regarding Nutrition, Health and Hygiene at
Home
Expected Result I: Output I
Results chain: Women and adolescent girls in communities are empowered to demand and
utilize both nutrition-sensitive and nutrition-specific services;
Indicators: % of students disaggregated by sex who apply key learning points regarding nutrition,
health and hygiene at home
Definition Indicators: At least 5 learning of the below:
• Food ingredients, preparatoin and food serving
• Intake of diversified food
• Home gardening
• Safe drinking water
• Adolescent health & Hygiene
• Hand-washing in key times
• Use of sanitary latrines
• Information about health service providers
Boys Girls Nilphamari Rangpur Overall
Baseline 0.44% 0.0% 0.22%, 0% 0.15%
Annual Evaluation
2019 1.67% 2.26% 2.54%, 1.30% 2.09%
Annual Evaluation
2020 2.98% 3.05% 2.22% 4.38% 3.02%
School children/adolescents applied 5 key learning points on (i) Food ingredients, preparation and
serving, ii) Health sciences and healthcare, iii) Adolescent health & hygiene, iv) Hand-washing and v)
Use of sanitary latrines. The graph in Figure 10 shows that students of Rangpur (4.4%) applied most of
the highlighted learning points than did students from Nilphamari (2.2%). Also, girls followed slightly
more learning points in this annual evaluation survey (3.1%) than boys (3.0%). Overall, 3.0% of students
applied key learning points on nutrition, health and hygiene at home which is higher than both in the
first-year annual evaluation and baseline surveys. The results in this section were also consistently
higher for girls than for boys. Figure 10 showcases the percentage of students who applied key learning
points regarding nutrition, health and hygiene at home during the survey period.
Figure 10: Percentage of students disaggregated by sex who apply key learning points regarding nutrition, health and
hygiene at home Figures in %
0.2 0.4 0.2
2.5
1.31.7
2.3 2.12.2
4.4
3.0 3.1 3.0
Nilphamari Rangpur Boys girls All
Baseline Annual Evaluation 2019 Annual Evaluation 2020
Page | 32
Table 4 shows data from the second annual evaluation survey where 95.3% of 430 students considered
applying key learning points regarding nutrition, health and hygiene at home, and 95.6% were already
applying at least some of those key learning points at school. Table 4 shows the levels of application
Table 4: Key Learning points applied at School
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Apply learning on gender, health, hygiene
& nutritional knowledge at school
Yes 81.9% 95.5% 86.7% 96.7% 93.8% 95.6%
No 18.1% 4.5% 13.3% 3.3% 6.3% 4.4%
N 276 154 430 270 160 430
Learnings that apply at school
Concept of Gender equality & Equity 24.8% 17.7% 22.0% 12.3% 5.3% 9.7%
Nutrition 37.6% 45.6% 40.8% 55.2% 50.7% 53.5%
Food ingredients, food prepare and
food serving 8.8% 6.1% 7.8% 15.3% 4.0% 11.2%
Health sciences and healthcare 16.4% 11.6% 14.5% 14.2% 18.7% 15.8%
Hygiene 66.8% 91.8% 76.7% 83.5% 83.3% 83.5%
Puberty and reproductive health 32.3% 15.6% 25.7% 7.3% 11.3% 8.8%
Food & food nutrition management 10.6% 4.1% 8.0% 11.5% 11.3% 11.4%
Child Development, Family Relations and
personal safety 11.9% 2.7% 8.3% 5.7% 4.7% 5.4%
Adolescent health & Hygiene 28.8% 14.3% 23.1% 19.5% 15.3% 18.0%
Hand wash 69.0% 82.3% 74.3% 75.1% 52.7% 66.9%
Use of sanitary latrines 44.7% 38.8% 42.4% 43.7% 39.3% 42.1%
Child Marriage 16.8% 14.3% 15.8% 8.0% 4.7% 6.8%
N 226 147 373 261 150 411
The levels of application of learning points at home and at school has increased during the second
annual evaluation as compared with the first annual evaluation.
Table 5: Key Learning points applied at Home Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Apply learnings on gender, health, hygiene & nutritional knowledge at home
Yes 79.3% 87.7% 82.3% 97.0% 92.5% 95.3%
No 20.7% 12.3% 17.7% 3.0% 7.5% 4.7%
N 276 154 430 270 160 430
Learnings applied at home
Concept of Gender equality &
Equity 8.7% 14.8% 11.0% 9.5% 4.1% 7.5%
Nutrition 32.0% 37.0% 33.9% 60.5% 54.7% 58.4%
Food ingredients, food prepare
and food serving 4.6% 8.1% 5.9% 16.7% 4.7% 12.4%
Health sciences and healthcare 6.8% 6.7% 6.8% 14.4% 16.2% 15.1%
Hygiene 37.4% 40.7% 38.7% 84.0% 85.1% 84.4%
Puberty and reproductive
health 10.0% 9.6% 9.9% 11.8% 10.8% 11.4%
Food & food nutrition
management 6.8% 4.4% 5.9% 11.8% 10.1% 11.2%
Child Development, Family
Relations and personal safety 5.5% 3.7% 4.8% 6.8% 3.4% 5.6%
Adolescent health & Hygiene 16.9% 10.4% 14.4% 18.6% 14.2% 17.0%
Hand wash 37.9% 43.7% 40.1% 76.8% 52.7% 68.1%
Page | 33
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Use of sanitary latrines 29.2% 31.9% 30.2% 47.1% 41.9% 45.3%
Child Marriage 11.0% 10.4% 10.7% 7.2% 3.4% 5.8%
About Corona 3.8% .7% 2.7%
N 219 135 354 263 148 411
3.3.7 Nutritional Status in Children Under 5-years of Age
The following section explores the nutritional status in children under 5-years of age who constitute
the target population.
Specific objective: Outcome
Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts
Indicators: Proportion of children 6–23 months of age who receie food from 4 or more food
groups (based on the MDD-C methodology) by sex (Percentage)
Definition Indicators: Proportion of children 6–23 months of age who receive food from 4 or
more food groups (based on the MDD-C methodology) by sex (Percentage)
Boys Girls Nilphamari Rangpur Overall
Baseline 18.1% 17.4% 18.1% 17.2%. 17.8%
Annual Evaluation 2019 19.4% 21.2% 20.7% 20.2% 20.4%
Annual Evaluation 2020 21.8% 23.5% 22.7% 22.4%. 22.6%
The mothers of 239 children aged 6-23 months were asked about the proportion of food from 4 or
more food groups consumed by their children over the previous 24 hours. The data shows a minimum
dietary diversity consumption in these children which is slightly higher in the second year annual
evaluation as compared to the baseline and first year annual evaluation studies. Noticeably, the food
consumption rate is higher among girls than boys. (according to WHO standards).
Most of the children (responded by 64% mothers of Nilphamari and 62% by Rangpur) consumed
“Grains, white roots, tubers, plantains (rice, potatoes)” (47% in improved MDD and 16% in no MDD
groups) over the previous 24 hours. “Egg” (26% in improved MDD and 15% in no MDD groups) and
“Dairy (yogurt, cheese and milk)” (42% in improved MDD and 15% in no MDD groups). “Other
Vitamin A rich fruits and vegetables (including ripe mangoes and papaya, carrots, pumpkins, sweet
potatoes)” consumption is higher in children aged 6-23 months) of Nilphamari while in Rangpur,
consumption of “Dairy “in children of this age range is more widespread.
Figure 11 highlights the proportion of children aged between 6-23 months who received food from 4
or more food groups based on the MDD-CC methodology.
Minimum dietary diversity: Proportion of children 6–23 months of age who receive food from 4 or
more food groups was assessed using WHO guidelines for evaluating Infant and Young Child Feeding
(IYCF) practices among children 6-23 months old (WHO, 2010). The 7 food groups used for tabulation
of this indicator are: — grains, roots and tubers — legumes and nuts — dairy products (milk, yogurt,
cheese) — flesh foods (meat, fish, poultry and liver/organ meats) — eggs — Vitamin-A rich fruits and
vegetables — other fruits and vegetables.
https://apps.who.int/iris/bitstream/handle/10665/43895/9789241596664_eng.pdf;jsessionid=B2230551
772DCABDFE2AEDF1B9311059?sequence=1
Page | 34
Figure 11: Proportion of children 6–23 months of age who receive foods from 4 or more food groups (based on the
MDD-C methodology)
3.4 Nutrition Governance
The elements of nutrition governance include: an inter- sectoral mechanism for nutrition; having a
national nutrition plan/strategy; adoption of the nutrition plan/ strategy; nutrition in the
national nutrition plan and so on. Nutrition Governance is one of the core components of the JANO
project. This section will discuss nutrition governance, nutrition-based budgeting, safety net support,
nutrition action plans, feedback and a tripartite agreement between government officials. These efforts
will harness the drive to boost nutrition in target groups and structurally create more food secure
communities
3.4.1 Nutrition Specific Budgeting
Specific objective: Outcome
Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts
Indicators: # of DNCC, UNCC and UDCC spent budget effectively on nutrition-specific or
nutrition-sensitive actions
Definition Indicators: 50% of the fiscal year budget spent
Nilphamari Rangpur Overall
Baseline
0
DNCC, UNCC,
UDCC
0
DNCC, UNCC,
UDCC
0
DNCC, UNCC,
UDCC
Annual Evaluation 2019
0
DNCC, UNCC,
UDCC
0
DNCC, UNCC,
UDCC
0
DNCC, UNCC,
UDCC
Annual Evaluation 2020
2 DNCC,
7 UNCC,
64 UDCC
In the first annual evaluation it was found that District Nutrition Coordination Committees (DNCCs),
Upazila Nutrition Coordination Committees (UDMCs) and Union Development Coordination
Committees (UDCCs) are platforms or forums initiated in two target districts namely Rangpur and
Nilphamari. Until the first annual evaluation, two meetings were held by JANO. During the second
16% 17% 15% 14% 15% 13% 11%
47%
22%
42%
22% 26%
11% 13%
Grain
s, roots an
d
tubers (b
read
, rice,
noodle
s, porrid
ge, w
hite
pote
toes)
Lesu
mes an
d n
uts
(lentils, p
eas, n
uts)
Dairy p
roducts (m
ilk,
yogh
ut, ch
eese
)
Meat an
d fish
(inclu
din
g
dry fish
)
Eggs
Oth
er vitam
in A
rich
fruits an
d ve
getab
les
(inclu
din
g ripen m
ango
,
ripen p
apaya, carro
t,
pum
pkin
, sweet…
Oth
er fru
its and
vege
table
s (Inclu
din
g
green m
ango
, green
pap
ya and ve
getab
les )
Better MDD No MDD
Page | 35
annual evaluation, in a KII session with JANO project staff, it was mentioned that 2 DNCCs, 7 UNCCs
and 64 UDCCs had spent their allotted budgeted funds in several areas for instance, on distributing
food and sanitary napkins.
Though at the local level, these institutional budget funds were allocated for different nutrition related
activities, budget limitations remain a great challenge. This issue can be innovatively addressed, as one
Community Health Care Provider (CHCP) mentioned that though CGs and CSG members do not
receive funds from the government, they collect and maintain funding from those patients who can
afford to pay (BDT 2-5). These members donate and collect funding during agricultural seasons, they
collect what is produced by locals whatever possible. This fund is then used for local nutrition planning
activities for instance, planting fruit trees. However, this approach did not work everywhere, one FWA
mentioned, even though they tried to initiate a fund, people did not contribute much, and it did not
run well. This feature also indicates scope of further work to be done by JANO.
According to a JANO project staff, as an indicator of the performance of the project, Nilphamari had
completed it’s planning and budgeting. And, Rangpur has completed all of the process from CSG to
DNCC, which can be considered as a big achievement for second year.
The project was expected to formally be launched on December of first year, but due to some
administrative change and as well as for the impact of corona virus, the launching has been delayed to
second year. For the third year, the goal is to build operational capacity.
Expected Result 2: Output 2
Results chain: Coordinated and resourced sub-national and local
government structures recognize, respond and are accountable to demands of
poor and marginalized communities
Indicators: # of Multi-sectoral plans at district, upazila and union level have allocated budget to
support nutrition interventions in the two target districts
Definition Indicators: At least allocated budget to address one action in the multi-sectoral
nutrition action plan in each year
Nilphamari Rangpur Overall
Baseline 0 0 0
Annual Evaluation 2019 0 0 0
Annual Evaluation 2020 1 1 2 DNCC, 7 UNCC, 64 UDCC,
(73 plans)
Two multi-sectoral plans (2019 -2020) at district level, seven plans at union level and 64 plans at upazila
level were found and thus budget have allocated to support nutrition interventions in this area by
annual evaluation study. There is also an upcoming project of JANO, which will be implemented in
2020 – 2021 year. Here also, a progress is identified as during the first annual evaluation there was no
multi-sectoral plans at district, upazila and union level found and thus no budget was allocated to
support nutrition interventions in the two target districts.
However, the project is challenged by the fact that government officers are transferred to other areas,
thus, the project face challenge of orienting the incoming officers. One of the project managers
mentioned, “A lot of time and energy goes into establishing a working relationship but sometimes
office transfers go to vain”.
Page | 36
3.4.2 Nutrition Specific Safety Net Support
Expected Result 2: Output 2
Results chain: Coordinated and resourced sub-national and local government structures
recognize, respond and are accountable to demands of poor and marginalized communities
Indicators: % of increase of PLW people from the target population received nutrition specific
safety net support
Definition Indicators:
• Maternal allowance, 1000 days, Supplementary feeding, Maternal Health Voucher, Area based
Community Nutrition Scheme, VGF, VGD, Iron folic acid supplementation
Nilphamari Rangpur Overall
Baseline 8.0% 9.2% 8.4%
Annual Evaluation 2019 9.7% 10.7% 10.2%
Annual Evaluation 2020 10.26% 11.11% 10.64%
The study findings show that percentage of receiving nutrition specific safety net support (Maternal
allowance, 1000 days, Supplementary feeding, Maternal Health Voucher, Area based Community
Nutrition Scheme, VGF, VGD, Iron folic acid supplementation) is higher in second annual evaluation
survey (10.64%) than first year annual evaluation study (10.2%) among pregnant and lactating women
(PLW) in both program districts.
According to Health Assistant of Belagram,
“The basic health services for pregnant women are immunization, distribution of folic acid, regular health
check-up, weight check-up etc. For lactating mother, they have a separate breast-feeding corner in CC. Services
includes here is counselling about the importance of feeding breast milk, not to feed any other substance right
after birth like honey or sugar etc. Adolescent services in CC includes counselling about menstruation, personal
hygiene and knowledge about changing factors of their body. Also, they are provided IRON Tablets as it is very
common to have iron deficiency at this age. Medicines (during menstruation) and immunization is also available
for adolescents.
PLW mainly received safety net support like maternal allowance 3.3% (first evaluation 1.8%), maternal
health voucher 2.2% (first evaluation 2.9%), 1000 days 2.2% (first evaluation 1.4%), VGD 2.2% (first
evaluation 1.4%), etc. An improving trend identified except in the case of maternal health voucher
scheme.
According to them allowances are allocated from UP, some of them get these supports but some of
are not. Only relatives of chairman, member and other UP personnel get this opportunity. Some PLW
complained that those who can pay get the allowances. Every community clinic has their common drug
like folic acid, iron tablet, calcium tablet but in limited quantity. PLW people mainly visit community
clinic for regular health treatment, some of them visit the family planning center, private doctor, upazila
health complex for better treatment.
A SAAO mentioned, “we know and do many things on paper, but we have to make change practically”.
Similarly, a UDCC member suggested the same, “poorer segment needs material support so that
nutritional status is improved”. Therefore, extending coverage of allowances would benefit the people
to a larger extent. This does not really happen due to limitation of fund as different committee
members have indicated.
Page | 38
According to the FGD participants (head of the
households), the concept of pregnancy has been
changed after involving with this JANO program as they
have the scope to get any type of services from
Community Clinic. In addition, they also mentioned
allowance and medicines for mothers received from
CC. Few respondents even stated that they spent the
allowance money for buying nutritious food. The
respondents from Rangpur stated that they also get
disabled allowance.
The respondents from Nilphamari spent the allowance of pregnant women on their generating income.
One of them bought cow by taking few amounts of money from the allowance. The other respondents
shared that they discuss about their upcoming cultivation with known people at their local market. In
addition, they observe the demand of the crops and vegetables. They also received support from
agricultural and fisheries offices.
“We talk to our elders and known vegetable sellers about the demand of vegetables such potato,
cataract, corn etc. They also cultivate cauliflower, tomato, brinjal, chili, spinach etc. We also take
support from our agriculture office as we are known to them.”- One participants from FGD with men
from Rangpur. The participants from FGD (Nilphamari) also shared that they get the knowledge about
using technology, timeperiod and better ways for cultivation.
3.4.3 Meaningfully Participated of Women and Adolescent Girls in The Nutrition Action
Plan
Overall, 54% (Nilphamari 644%, Rangpur 45.5%) of women and adolescent girls of target population
in government forums (UDCC, CG, CSG) meaningfully participated (Raise issue in the forum and
incorporated raised issues in planning) in the nutrition action plan development and implementation
process.
Expected Result 2: Output 2
Results chain: Coordinated and resourced sub-national and local government structures
recognize, respond and are accountable to demands of poor and marginalized communities
Indicators: % of women and adolescent girls of target population in government forums (UDCC,
CG, CSG) meaningfully participated in the nutrition action plan development and implementation
process
Definition Indicators: Meaningful Participation:
• Raise issue in the forum
• Incorporated raised issues in planning
Nilphamari Rangpur Overall
Baseline 0 0.6% 0.2%
Annual Evaluation 2019 0.9% 0.0% 0.5%
Annual Evaluation 2020 64.4% 45.5% 54.0% (Source: Overphone Survey with (UDCC, CG, CSG) members)
FGD’s with adolescent revealed that they knew about the CG, CSG, Club for adolescent girls by which
they get the knowledge about taking care of their health, nutritious foods, maintaining hygiene and
many more like hand washing, taking services from Community clinic, stay clean during menstruation.
All of the respondents are involved with the adolescent girls’ club. They appreciated the services they
received from this program not only from Community clinic but also from their school. They visit to
the CC as they found it clean, its fresh environment and behavior of doctors and members. The
“We get money for the pregnant women.
We buy milk, banana, egg, fish with that
money. We all know that we cannot
expense too much for only food items.
Through these services, we are really
benefitted in case of taking nutritious food.”
- One respondent from Nilphamari.
Page | 39
respondents from Rangpur added that they also got the information from the adolescent girls’ club
about the bad impact of child marriage. They also found that this program arranges meetings for the
mothers for providing knowledge about good health, eating nutritious food, maintain hygiene.
The participants also mentioned about the different types of govt. offices like health, agriculture and
fisheries by where the community get services in their specific sector. In addition, they pointed about
School Committee where the elders take action plan for their educational and nutritional
development.
According to CSG (from FGD), the women and adolescent members play in decision making process
of the CSG in their health issues, hygiene practice during their menstrual time and important
information about nutritious food for their health specially in menstruation and pregnancy. They added
that they provide their level best and for this reason, they have not found any complain on their quality
of services.
3.4.4 Feedback Mechanisms
According to the DNCC, they do not have any platform by which they can get feedbacks on the
provided services to the service recipients. Also, UDCC from Kaunia mentioned that they don’t have
any separate platform for the service recipients yet. If they wish, they can convey their message to
Union Parishad Chairman.
Expected Result 2: Output 2
Results chain: Coordinated and resourced sub-national and local government structures
recognize, respond and are accountable to demands of poor and marginalized communities
Indicators: # of platforms in the target districts which allow effective feedback mechanisms for
service receivers
Definition Indicators:
• Availability of a complain box/hot line number/or any other mechanism
• Open complain box regularly for addressing in the monthly meeting.
• Register all submitted complain
• Public hearing meeting
• Discussed in the regular meeting about the submitted complains.
Nilphamari Rangpur Overall
Baseline Nilphamari 0 Rangpur 0 0
Annual Evaluation 2019 Nilphamari 0 Rangpur 0 0
Annual Evaluation 2020 Nilphamari 1 Rangpur 1 64 Upazila and 208 CCs
Overall, during the second annual evaluation 62.3% (Nilphamari: 56.4% and Rangpur 69.6%) HH
reported that they did not know that they can complain against issue related to services of Social
Safety Net, Health & Nutrition, Agriculture, Livestock/poultry and quality education. This increased
from 51.4% during the first annual evaluation. Further only 0.9% did complain to any office or
committee during the past 12 months of second annual evaluation. The percentage of complain
decreased from 1.9% (found during the first annual evaluation). It is still a priority area that community
people raise their issues in different platforms. One reason of not raising complaints is lack of
responses, it was found that only 25% complaint received a response (a decrease from 33.3% found
during the first annual study).
In response to the question, how do they receive and act upon service receivers’ feedback, response
from a service was “There was no opportunity before but now there is. However, the reality is do
not know much about nutrition so I am unable to say much”. Besides, a UDCC member mentioned
Page | 40
about existence of complain box. It appears though some mechanism is established both the service
providers and service receivers need sensitization about effective feedback mechanism that would
eventually enhance quality of the service.
3.4.5 Tripartite Agreement
Expected Result 3: Output 3
Results chain: Production and access to high value nutritious commodities and services are
increased
Indicators: # of initiative jointly taken as a result of tripartite agreement.
Definition Indicators:
Tripartite initiative (Govt.+JANO+Private sector) will be taken on agriculture, livestock, WASH,
micronutrient supplementation and financial inclusion as an outcome of tripartite MoU signing.
Nilphamari Rangpur Overall
Baseline 0 0 0
Annual Evaluation 2019 0 0 0
Annual Evaluation 2020 0 0 0
No tripartite agreement was signed or found in active in second annual evaluation study as during the
first evaluation study.
3.5 Food Security and Livelihood
3.5.1 Households Practicing Climate Smart Agricultural Techniques
According to the baseline study, a Climate Smart Agriculture (CSA) is considered as an agricultural
method that sustainably increases productivity, enhances resilience (adaptation), reduces/removes
GHGs (mitigation) where possible, and enhances achievement of national food security and
development goals.
Expected Result 3: Output 3
Results chain: Production and access to high value nutritious commodities and services are
increased
Indicators: % of households practicing climate smart agricultural techniques
Definition Indicators: Minimum 3 techniques have to be used out of 20 criteria
Nilphamari Rangpur Overall
Baseline 3% 8% 5%
Annual Evaluation 2019 4.7% 10.6% 8.3%
Annual Evaluation 2020 7.3% 12.9% 9.4%
Practicing and applying climate smart agricultural techniques has slightly increased in the second year
annual evaluation study (Nilphamari 7.3%, Rangpur 12.9%, Overall 9.4%) A minimum of 3 techniques
were used out of 11 criteria than the first year annual survey in Nilphamari 4.7%, Rangpur 10.6%,
Overall 8.3%).
In the second year annual evaluation, it was found that 50% of the households do not apply any climate
smart technologies which was lower than the first annual evaluation survey and the baseline study.
Notably, 50% of households used at least one climate smart technology in the second annual evaluation
as compared to the first annual evaluation (33%) and the baseline study (25%).
Page | 41
Figure 12: Percentage of households practicing climate smart agricultural techniques (Baseline and Annual evaluation)
The following table shows the types of climate-resilient techniques used by households during the
second annual evaluation. Out of twenty categories, 25.6% of respondents followed high efficiency
fertilizer applications, a total of 16.7% of respondents used disease-resistant varieties (blast) and 16.3%
engaged in crop diversification techniques.
Table 6: Practice of CSA Technologies (% HH)
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nil
phamari Rangpur All
Use of submergence-
resistant varieties
(BRRI 51, BRRI 52)
4.3% 7.7% 5.8% 15.3% 5.7% 10.9%
Use of drought-resistant
varieties
5.6% 9.2% 7.2% 14.4% 12.4% 13.5%
Use of short duration
varieties (BINA 7, BRRI
33, 43)
2.6% 10.7% 6.3% 9.7% 10.3% 10.0%
Zinc Enriched variety of
rice (BRRI Dhan 62, 72)
7.7% 7.1% 7.4% 3.8% 8.2% 5.8%
Ribbon retting method .9% 9.7% 4.9% 1.3% 0.5% 0.9%
High Yielding Variety
(HYV)
2.1% 8.2% 4.9% 11.9% 10.3% 11.2%
Growing creeping
vegetables on nets over
ponds
1.7% .5% 1.2% 5.1% 1.5% 3.5%
Use of disease-resistant
varieties (blast)
2.6% 8.2% 5.1% 15.3% 18.6% 16.7%
Conservation agriculture
(Zero/ Minimum tillage)
3.4%
1.9% 12.7% 10.3% 11.6%
Alternative Wetting and
drying (AWD) methods
1.7% 1.5% 1.6% 14.4% 4.6% 10.0%
High efficiency fertilizer
Application
.9% 5.1% 2.8% 28.0% 22.7% 25.6%
Crop diversification 4.3% 2.6% 3.5% 21.6% 9.8% 16.3%
74.1%12.9% 8.0%
2.4% 1.4% 1.0% 0.2%
65.6% 17.7%
6.5%
4.4%
2.3%2.1% 1.2% 0.2%
49.8% 9.8%
11.6%8.4%
8.1% 8.8%2.3%
1.2%
None 1 Tech 2 Tech 3 Tech 4 Tech 5 Tech 6 Tech 7 Tech
Baseline Annual Assessment 2019 Annual Assessment 2020
Page | 42
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nil
phamari Rangpur All
N 234 196 430 236 194 430
3.5.2 Households Involved in The Production of Higher Value Nutrition Products
Expected Result 3: Output 3
Results chain: Production and access to high value nutritious commodities and services are
increased
Indicators: % of households involved in the production of higher value nutrition products
Definition Indicators: Higher value nutrition products:
1. Is bio-fortified
2. Is a legume, nut, or some seeds
3. Is an animal source food, including dairy products
4. Is a dark yellow or orange-fleshed root or tuber
5. Is a fruit or vegetable
Nilphamari Rangpur Overall
Baseline 34.5% 41.0% 36.7%
Annual Evaluation 2019 32.9% 45.4% 38.6%
Annual Evaluation 2020 35.6% 46.9% 40.7%
The survey data depicts that among the respondents who were involved in the production of higher
value nutrition products, household involvement was slightly higher in the second-year annual
evaluation than baseline and first year evaluation studies.
The findings in Table 7 shows that very few off the target population cultivated crops and vegetables
during the last 12 months. However, they cultivated bottle gourd and bean (26%), Indian Spinach and
lalshak (14%), eggplant and pumpkin (12%), potatoes (11%) mostly. The finding also show that only
used homestead land mainly used for vegetable cultivation (40%), livestock (58%), poultry (59%), pond
(13%), fruit Trees (60%), timber trees (36%).
Table 7: HH Crops and vegetables cultivation during last 12 months
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Sweet Potato 2.3% 0.0% 1.3% 11.1% 9.7% 10.5%
Cauliflower 2.7% 0.0% 1.6% 8.1% 6.7% 7.4%
Cabbage 2.3% 0.0% 1.3% 6.6% 4.8% 5.8%
Okra
2.0% 1.8% 1.9%
Raddish .9% .6% .8% 5.1% 1.8% 3.6%
Tomato 2.7% .6% 1.8% 6.6% 12.1% 9.1%
Bitter gourd 0.0% .6% .3% 7.1% 7.9% 7.4%
Cucumber .9% .6% .8% 1.5% 1.2% 1.4%
Eggplant 0.0% .6% .3% 10.6% 13.3% 11.8%
Pointed gourd
0.5% 0.0% 0.3%
Pumpkin 2.3% .6% 1.6% 15.2% 10.3% 12.9%
Chili 1.8% 1.2% 1.6% 3.5% 3.6% 3.6%
Nafa vegetables
2.0% 0.6% 1.4%
Bottle gourd 4.6% 4.2% 4.4% 30.8% 20.0% 25.9%
Tobacco .5% 6.6% 3.1% 3.5% 6.7% 5.0%
Mustard 0.0% .6% .3%
Potato 1.8% 9.6% 5.2% 12.1% 9.7% 11.0%
Onion 1.4% 1.8% 1.6% 3.5% 0.6% 2.2%
Page | 43
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Garlic .5% 1.8% 1.0% 2.5% 0.6% 1.7%
Pulses .5% 0.0% .3%
Ginger .5% .6% .5% 0.5% 0.6% 0.6%
Bean 2.7% 7.8% 4.9% 30.3% 20.6% 25.9%
Carrot
0.5% 0.0% 0.3%
Palong shak 2.7% 2.4% 2.6% 10.1% 6.1% 8.3%
Napa vegetables 1.8% 3.0% 2.3% 12.6% 3.6% 8.5%
Lalshak 1.8% 4.8% 3.1% 18.2% 8.5% 13.8%
String Bean 0.0% 1.8% .8% 1.5% 1.8% 1.7%
Snake gourd .5% 2.4% 1.3% 1.0% 0.6% 0.8%
White gourd 0.0% .6% .3% 1.0% 0.0% 0.6%
Wax gourd .5% 4.2% 2.1% 3.0% 3.6% 3.3%
Indian Spinach .9% 4.8% 2.6% 19.2% 8.5% 14.3%
Kang Kong 0.0% 2.4% 1.0% 4.0% 1.8% 3.0%
Papaya 0.0% 2.4% 1.0% 1.5% 1.2% 1.4%
Not Cultivated 79.0% 71.3% 75.6% 42.9% 53.9% 47.9%
N 219 167 386 198 165 363
For cultivating vegetables, participants used the pit/hip method and plain methods. Most of them used
following practices (compost and biogas production, livestock fattening, fodder production, artificial
insemination, vaccination, de-worming, disease management, recommended feeding practices,
improved housing) for their livestock/poultry during the past 12 months.
Table 8: Ways of vegetables cultivation
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Pit /Hip method 38.6% 67.4% 52.9% 77.3% 82.0% 78.9%
Bed method 13.6% 2.3% 8.0% 10.9% 9.8% 10.5%
Plain method 47.7% 30.2% 39.1% 38.2% 31.1% 35.7%
N 44 43 87 110 61 171
3.6 Access to Information, Information and Communication Technology (ICT)
Platform 3.6.1 Access to information
This second annual evaluation study intends to reveal the gender differences in many areas emphasizing
on nutrition, where access to information is also an indicator that is connected to health, hygiene,
nutrition and other services. A toal of 55% women own mobile phones compared to 89% of men.
However, there is no separate data on how many women or men know about the services they can
avail through smart technology, although the combined percentage is 61% who have some idea of
these services.
Married adolescents girls (from FGD) mentioned that most of the male members of households use
mobile phone rather the female ones. In addition, health app would be effective for them. The other
respondent from Rangpur added that they would get the information through text messages on the
mobile phone.
Page | 44
“Through mobile phone, we get the information about nutritious food for health, what should
be done when we become sick and where would we get the treatment for this illness.”
- One married adolescent from Rangpur
Also lactating mothers are very interested to receive the information through text messages. They did
not receive this information over mobile phone during this COVID-19 as they could not be outside
with their children.
Table 9: Awareness About Getting Information Related to Agriculture, Health & Nutrition
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Self-Knowledge
Yes 49.6% 42.9% 46.5% 56.8% 66.5% 61.2%
No 50.4% 57.1% 53.5% 43.2% 33.5% 38.8%
N 234 196 430 236 194 430
HH members knowledge
Yes 47.9% 39.3% 44.0% 44.5% 60.3% 51.6%
No 22.6% 13.8% 18.6% 25.0% 12.4% 19.3%
Don’t know 29.5% 46.9% 37.4% 30.5% 27.3% 29.1%
N 234 196 430 236 194 430
Types of Information household received during last 12 months
Agriculture 38.6% 14.8% 28.8% 30.9% 27.1% 29.1%
Livestock 2.4% 1.1% 1.9% 5.1% 3.9% 4.5%
Health 66.1% 61.4% 64.2% 79.4% 67.4% 73.6%
Nutrition 11.8% 18.2% 14.4% 14.0% 16.3% 15.1%
Information on feeding infants 29.9% 9.1% 21.4% 10.3% 4.7% 7.5%
Don't know 21.3% 34.1% 26.5% 14.7% 20.9% 17.7%
N 127 88 215 136 129 265
Information related to health: A total of 72% women of Nilphamari and 62% women of Rangpur
have received knowledge about feeding infants during the last12 months. Meanwhile, 69.3% women
(total 430 women) have received information on feeding children under 5 during the last 12 months.
In both cases, Nilphamari is in a better position to provide information; however, the overall rate is
still poor to ensure children’s improvied health. To improve their health, hygiene and nutrition, so far
NGO health workers have contributed the most as 40.5% households are visited by NGO health
workers in both districts.
Table 10: Women or HH Received Information
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Whether women of HH received information on feeding infants during last 12 months
Yes 32.1% 16.8% 25.1% 72.9% 61.9% 67.9%
No 67.9% 83.2% 74.9% 27.1% 38.1% 32.1%
N 234 196 430 236 194 430
Whether any women of HH received information on feeding of children under 5 years during
last 12 months
Yes 41.9% 20.9% 32.3% 73.7% 63.9% 69.3%
No 58.1% 79.1% 67.7% 26.3% 36.1% 30.7%
N 234 196 430 236 194 430
Whether you or any household member access any service from UP information Centre
during last 12 months
Yes 29.5% 14.8% 22.8% 33.5% 21.1% 27.9%
No 47.4% 54.1% 50.5% 56.4% 64.9% 60.2%
Don't know 23.1% 31.1% 26.7% 10.2% 13.9% 11.9%
Page | 45
N 234 196 430 236 194 430
Extension services: This project has greater scope to focus on extension services as the extent of
providing extension services is very low in both districts. Livestock/Poultry extension services mostly
given by DLS, NGOs, Private sector/business organization and LSP. They advise on Input use, disease
management, vaccinations, feed, artificial insemination etc.
In addition, people hardly visit Upazila Veterinary hospital to ask for services. Only 2.6% people (N
430) went to veterinary hospital during last 12 months. Many of them think it is not necessary to avail
the service – 85% in Nilphamari and 86% in Rangpur. However, almost 82% visit to hospital was for
treatment. It is to be noted that 9% visit was to get vaccination and extension service.
Table 11: Types of agricultural extension service HH received during the last 12 months
Response
Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Advice on input use 3.4% .5% 2.1% 5.1% 2.1% 3.7%
Training 3.8% .5% 2.3% 2.5% 3.1% 2.8%
Practical Demonstration .9% .5% .7%
Application of Input
(Fertilizer, Pesticide,
Fungicide, Herbicide)
0.0% 1.0% .5% 4.2% 1.0% 2.8%
Disease and pest control 0.0% 1.5% .7% 4.7% 1.5% 3.3%
Irrigation management 3.0% 2.6% 2.8%
Introduce new variety .9% .5% .7% 2.5% 1.5% 2.1%
Crop harvest technique 0.4% 1.5% 0.9%
Soil Test 1.7% 1.0% 1.4%
Post-harvest
management 1.7% .5% 1.2% 1.7% 1.0% 1.4%
No service received 89.7% 95.9% 92.6% 91.1% 91.2% 91.2%
N 234 196 430 236 194 430
Agricultural extension service is mostly given by DAEs, NGOs and Private sector/business
organization. They advise on ‘Advice on input use’, ‘Application of Input (Fertilizer, Pesticide, Fungicide,
Herbicide)’, ‘Disease and pest control’, ‘Irrigation management’ and ‘Introduce new variety’.
Table 12: Sources Service Providers: Agricultural Extension Service
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
DAE 16.7% 62.5% 28.1% 47.6% 47.1% 47.4%
NGOs 75.0% 37.5% 65.6% 19.0% 29.4% 23.7%
Private sector/business
organization
8.3% 0.0% 6.3% 33.3% 23.5% 28.9%
N 24 8 32 21 17 38
The reasons behind no using various agricultural extension services were: shortage of extension
worker, extension workers did not visit regularly, extension center was far away, poor
communication, financial problem, quality of extension services is very poor and Family member does
not allow women to contract with Extension service.
Table 13: Whether Access Agricultural Extension Services when needed over the last six months
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Yes 2.1%
1.2% 2.5% 2.6% 2.6%
No 67.9% 59.2% 64.0% 82.6% 78.4% 80.7%
Page | 46
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Don’t know 29.9% 40.8% 34.9% 14.8% 19.1% 16.7%
N 234 196 430 236 194 430
3.6.2 Accessed or Received ICT Based Nutritional Information
Expected Result 4: Output 4
Results chain: Information and communication technology (ICT) platform is established at local
level to connect relevant govt. departments and increase awareness of community people on
nutrition interventions’
Indicators: % of community members who have accessed or received ICT based nutritional
information
Definition Indicators: community members will have access nutritional information from the
mobile based learning apps and receive text messages
Male Female Nilphamari Rangpur Overall
Baseline 4.1% 8.3% 2.4% 7.8% 4.2%
Annual
Evaluation
2019
5.3% 4.7% 6.4% 8.2%
7.2%
(% of community member
received text messages on
nutrition. No learning apps
found)
Annual
Evaluation
2020
9.7% 10.5% 8.1% 10.8% 9.3%
7.2% households in first annual evaluation study, 6.4% in Nilphamari and 8.2% in Rangpur accessed or
received nutritional information from mobile based learning apps. While, overall, 9.3% households in
second annual evaluation study received text messages on nutrition, no portal has made yet.
From a FGD discussion with adolescent found that they watch videos on YouTube about nutrition
and hygiene. They suggested for providing health, nutrition and hygiene related information through
text messages along with courtyard meeting with projectors as community people learn any kind of
issues through any kind of meetings. They felt that it is an easy way for community people to get the
knowledge about health, nutrition and hygiene. On the other hand, respondents from Nilphamari
specified that mothers of adolescent girls should get the information from these kinds of projects.
A pregnant mother from Rangpur pointed that receiving knowledge about health, nutrition and hygiene
through mobile phone would be easier for community people. Additionally, she suggested for providing
knowledge to the husbands so that they could motivate their spouses. However, pregnant mother
from Nilphamari pointed that as everybody do not have mobile access, they would never get
information through text messages. In addition, pregnant mother from Domar stated that mass people
could not read the texts. They can also get the information through courtyard meeting.
“We do not have mobile phone for every person in our house. Only my husband has one phone. If anyone
gives information about health, nutrition and hygiene, I would never get that as my husband stays outside for
his work. It would be better if we get these types of information from courtyard meeting.”
- One Pregnant mother, Nilphamari
“It would be easier if we get phone calls for free from Govt. to get the information about health, nutrition and
hygiene.”
- One pregnant woman from Rangpur
Page | 47
3.6.3 Mobile Based Learning App are Used by Frontline Workers
Expected Result 4: Output 4
Results chain: Information and communication technology (ICT) platform is established at local
level to connect relevant govt. departments and increase awareness of community people on
nutrition interventions’
Indicators: % of frontline workers using the ICT based e-learning platform to support the
community based on needs
Definition Indicators: Mobile based learning app are used by frontline workers
Nilphamari Rangpur Overall
Baseline 0% Frontline workers
Annual Evaluation 2019 Monitoring reports
Annual Evaluation 2020 0
The study found no ICT based e-learning platforms to support community-based needs were being
used by frontline workers and no portals have been established for planning and decision-making at
district and upazila levels eiher.
Expected Result 4: Output 4
Results chain: Information and communication technology (ICT) platform is established at local
level to connect relevant govt. departments and increase awareness of community people on
nutrition interventions’
Indicators: # of government forums (UNCC, DNCC,) utilizing Nutrition Information Portal for
planning and decision making at district and upazila level
Definition Indicators: One web-based platform established
Nilphamari Rangpur Overall
Baseline
There is no Nutrition Information Portal for planning and
decision making at district and upazila level
(February-19)
Annual Evaluation 2019 0
Annual Evaluation 2020 0
An FGD was conducted among male household heads. They recommended providing information
about health, nutrition and hygiene through TV or courtyard meetings as the female members of their
household would not get enough time to check mobile phone texts. Additionally, the respondents
from Rangpur recommended providing more information about women and adolescent health along
with nutritious food and taking necessary steps during menstruation through text messages.
The pregnant women (from FGDs pointed out that receiving knowledge about health, nutrition and
hygiene through mobile phones would be easier for community people. However, respondents from
Nilphamari stated that as nobody hsa mobile phone access, they would never receive information
through text messages. However, they can also receive this information through courtyard meetings.
“We do not have mobile phone for every person in our house. Only my husband has one phone. If anyone
gives information about health, nutrition and hygiene, I would never get that as my husband stays outside for
his work. It would be better if we get these types of information from courtyard meeting.”
-One Pregnant mother, Nilphamari
Page | 48
3.7 WATSAN & Hygiene Practice
Accesss to safe drinking water is a human right and a basic requirement for good health (Multiple
Indicator Cluster Survey 2012-2013). This following section describes the situation of Safe water
including drinking water sources, safely managed drinking water, safely managed sanitation, water
treatment, type of sanitation facility, hand-washing practices and waste management.
3.7.1 Safe Drinking water
According to the JANO baseline report safe drinking water means: water sources considered as being
safely managed including tube-wells, dwellings with piped water, yard/lot piped water, public taps,
protected wells and pond sand filters. In the annual evaluation, it was found that the main drinking
water source of the household were tube wells and few of them used piped connections into a
dwelling. Usually, water is collected by adult women (20 years and above) and the household builds it
on its own. They had received awareness related services concerning hygiene-safe water practices
from NGOs and Community Clinics and health-related services such as arsenic testing including
knowledge on the recommended depth of tube wells.
Table 14: Sources of Drinking Water
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Source of Drinking Water
Tube-well 98.7% 94.4% 96.7% 99.2% 96.4% 97.9%
Piped into dwelling 1.3% 5.6% 3.3% 0.8% 3.6% 2.1%
Place of drinking water source
Own Homestead Area 98.7% 87.2% 93.5% 99.6% 99.0% 99.3%
Neighbors .4% 1.0% .7% 0.4% 1.0% 0.7%
Common place .9% 11.7% 5.8% 0.0% 0.0% 0.0%
N 234 196 430 236 194 430
The FGDs conducted with these groups explored that adolescents in both Rangpur and Nilphamari
who shared that they always drink safe water from tube-wells. Specifically, the adolescent girls in
Nilphamari stated that the source of their drinking water are tube-wells though they use water from
direct lines for cooking. On the other hand, participants from Rangpur stated that drinking safe water
keeps the body healthy. They also pointed out that brining water from far away is very difficult as it
takes a lot of time and requires great effort from women and girls.
“We should drink safe water. We learned it from our school. If our drinking water is pure, we can prevent the
waterborne diseases.” -One adolescent girl, FGD, Rangpur
Also, pregnant women mentioned from the IDIs that they Both respondents have tube-well in their
own house. The respondents mentioned that government. officers checked their tube-wells and
marked them arsenic-free. One of them from Rangpur mentioned that they also drink water from
motorized machines. In contrast, respondents from Nilphamari mentioned that they had extreme iron
but now they receive safe water supplies. One of them also mentioned that they too drink water from
motorized machines.
.
Page | 49
Table 15: Person/ORG provided awareness services related to hygiene-safe water practices
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
DPHE 28.2% 6.1% 18.1% 10.2% 8.8% 9.5%
UP 9.4% 5.1% 7.4% 13.1% 6.2% 10.0%
NGO 15.8% 16.8% 16.3% 50.0% 46.9% 48.6%
Community Clinic 18.8% 20.4% 19.5% 43.6% 26.3% 35.8%
Did not received 17.5% 45.9% 30.5% 16.1% 26.8% 20.9%
JANO 0.0% 0.0% 0.0% 15.3% 6.2% 11.2%
Don’t know 17.1% 19.4% 18.1% 3.4% 5.2% 4.2%
N 234 196 430 236 194 430
According to all lactating mothers, most of the people in their communities have tube-wells in their
house as they are conscious about drinking safe water. One mother from Rangpur mentioned that
they drink water from motorised machines. They also use water from tube-wells for daily household
activities. They too a mentioned that government officers had checked their tube-wells and marked
them arsenic-free. In contrast, respondents from Nilphamari mentioned that they had extreme iron
but now they receive safe water supplies.
Table 16: Types of services Received
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Recommended depth of tube well 24.9% 2.8% 17.1% 20.7% 17.6% 19.4%
Arsenic testing 26.9% 7.5% 20.1% 18.2% 30.3% 23.2%
Coliform testing 0.0% 0.0% 0.0% 2.5% 4.9% 3.5%
Distance maintaining with latrine 6.2% 3.8% 5.4% 31.8% 28.2% 30.3%
Health related service 30.1% 49.1% 36.8% 74.7% 65.5% 70.9%
Didn't receive any service 11.9% 36.8% 20.7% 2.0% 6.3% 3.8%
N 193 106 299 198 142 340
3.7.2 Types of Latrine
Flush to septic tanks (40.2%) was commonly used by both households of Nilphamari and Rangpur
districts in the second annual evaluation. They also use “Pit latrines with slab/ (water sealed intact)”
(26%), “Flush to piped sewer system” (14.4%) and Flush to pit latrine (13.3%) Regarding hygiene
practices, 99.3% family members notably use sandals while using latrine. A slightly lower percentage
of households in the annual evaluation (1.9%) reported that they followed open defecation systems
as compared to the first annual evaluation (6.3%) and the baseline surveys (8%).
The FGD participants with men found that they have knowledge about sanitary latrines, hygiene, and
nutritious food through several courtyard meetings. This group also shared that they did not have
sanitary latrines but they all have it in the present-day including soap, water and bleaching powder in
their current latrines. The participants stated that they share this information with their family
members as they learnt those ideas from their communtieis. In addition, they received the service
from the project organized by JANO by attending courtyard meetings. Participants from Nilphamari
pointed out that people are now more conscious about hygiene because of COVID-19. On the other
hand, the participants from Rangpur stated that they received BDT 150 from BRAC for the purpose
of making modern sanitary latrines.
Adolescent girls from the FGDs specified that they have knowledge about sanitary latrine. They added
that they have soap and water in front of their toilets. The respondent from Rangpur pointed out that
Page | 50
“We need to keep our toilet clean. We should wear sandals during entering the toilet. We have Harpic for
cleaning our toilet. Through this, we always try to maintain our hygiene in sanitation.” -One adolescent girl,
FGD, Nilphamari
According to a pregnant woman from Rangpur, their
modern latrines are hygienic as they always keep those
clean. She marked that they always have tissue,
bleaching powder and a commode-brush for their
latrine. In contrast, respondents from Nilphamari
mentioned that they do not have hygienic latrines as it
is surrounded by tin-sheds. Both groups have
knowledge about washing hands with soap and water.
They even pointed that mothers should wash their
hands properly as they need to feed their children.
During interviews with mothers, they specified that they always keep their latrines clean. They added
that they use sandals for using latrines. Due to this COVID-19 pandemic, they are now more conscious
about cleanliness such as washing hands with soap for 20 seconds. they do not forget to wash their
hands before touching their children or feeding them.
Table 17: Types of Latrine used by HH
Response Baseline Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Flush to piped sewer
system 0.4% 16.2% 3.1% 10.2% 11.4% 18.0% 14.4%
Flush to septic tank 8.8% 20.9% 38.8% 29.1% 38.6% 42.3% 40.2%
Flush to pit latrine 16.5% 50.0% 33.7% 42.6% 15.7% 10.3% 13.3%
Flush to somewhere
else 0.4% 0.9% 0.5% 0.7% 0.8% 1.0% 0.9%
Flush, don’t know
where 0 0.4% 0.5% 0.5% 0.0% 0.0% 0.0%
Ventilated improved
pit latrine 0.4% 2.1% 1.5% 1.9% 0.8% 0.5% 0.7%
Pit latrine with slab/
(water sealed intact) 32.7% 0.9% 15.3% 7.4% 28.4% 23.2% 26.0%
Pit latrine without
slab/open pit (water
sealed broken)
26.7% 0.4% 1.0% 0.7% 1.7% 2.6% 2.1%
Open defecation/ No
toilet facility/bush/field 7.8% 7.7% 4.6% 6.3% 2.5% 1.0% 1.9%
Advanced offset pit
closet 1.6% .4% 0.0% .2% 0.0% 0.5% 0.2%
offset pit closet 3.4% 0.0% .5% .2% 0.0% 0.0% 0.0%
Refused to observed
toilet 0 0.0% .5% .2% 0.0% 0.5% 0.2%
N 234 196 430 236 194 430
3.7.3 Hand Washing Practices
During the second annual evaluation, nearly 43% (59%, in first evaluation) of the household members
mentioned that they have water facilities and 53% (60%, in the first evaluation) of the household
members have soap/detergent available near their latrines for washing hands. Hand -washing practices
with water and soap before eating is well maintained by adult males (98%), adult females (96%), boys
(23%) and girls (34%).
“There is a link between washing hands and
eating nutritious food. If we eat nutritious
food but do not wash hands, germs would
affect our stomach. We need to maintain
the hygiene also, otherwise nutrition would
never keep our body healthy.”
- One pregnant woman from Gangachara,
Rangpur.
Page | 51
Table 18 : Person provided awareness services related to hygiene-sanitation practices
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
DPHE 2.6% 2.6% 2.6% 0.0% 0.5% 0.2%
UP 12.0% 5.6% 9.1% 13.1% 9.3% 11.4%
NGO 27.4% 24.5% 26.0% 55.1% 53.1% 54.2%
Community Clinic 26.9% 25.0% 26.0% 46.6% 26.8% 37.7%
None 38.0% 53.1% 44.9% 17.8% 27.3% 22.1%
JANO 0.0% 0.0% 0.0% 12.7% 6.7% 10.0%
N 234 196 430 236 194 430
Survey results show that NGOs and CC provided awareness services related to hygiene-sanitation
practices (e.g. hand washing, use of hygienic latrines etc.). However, 22% of the HH reported that
they didn’t get any on the same. In baseline HH members reported that water facility is not near to
the latrines for washing hands (87.5%), soap/detergent not available near to the water for washing
hands (83.3%). Table 19 : Hand Washing Practices
Response Annual Assessment 2019 Annual Assessment 2020
Nilphamari Rangpur All Nilphamari Rangpur All
Before food preparation ((Use of
materials) 97.0% 81.6% 90.0%
95.8% 92.8% 94.4%
Before eating 97.4% 94.9% 96.3% 98.7% 100.0% 99.3%
Before feeding of Children 89.3% 91.8% 90.5% 89.4% 91.8% 90.5%
After defecation 95.7% 98.5% 97.0% 98.7% 96.9% 97.9%
After cleaning baby’s defecation 88.9% 90.8% 89.8% 88.6% 89.7% 89.1%
N 234 196 430 236 194 430
They wash their hands before food preparation (94%), before eating (99%), before feeding their
children (91%), after defecation (98%) and after cleaning their baby’s defecation (89%). They usually
use soap and water for cleaning hands. The frequency of hand-washing practice among adult males
and females (20 years and above) was found to be higher than respective households. The incidence
of hand-washing was found to be higher in this annual evaluation survey than the baseline survey.
FGD with newly married adolescent mentioned that they live in their in-law’s house and the source
of drinking water is safe as the tube-well is arsenic free. One of them specified that she saw when
the water of tube-well has checked.
“We get safe water but not all the tube-well in this area is safe for drinking. Out of 10 tube-
wells, 3 or 4 tube-wells would be found unhygienic.”
One participant specified that women face problems of back and hand pain for using tube-wells. The
respondent claimed that it is difficult for the adolescent girl to take water from far away as they have
to maintain a line and need some time for that. The adolescent married girls specified that they use
modern toilet which is surrounded by tin and have soap and water in front of the toilet.
Page | 52
3.8. Outcome of Covid-19 Response and Impact of Covid-19 On JANO
3.8.1 Knowledge about Covid-19
All the respondents from both Rangpur and Nilphamari have heard about COVID-19. Approximate
90% of respondents in Nilphamari heard about this pandemic through JANO Volunteers and
while69.1% respondents in Rangpur heard about the same from volunteers. Alternatively, over 50%
received this source of information through miking, media and by receiving information from the
community. other
Table 20: Source of hearing about COVID-19
Response Nilphamari Rangpur All
JANO Volunteer 90.7% 69.1% 80.9%
Miking 70.3% 58.8% 65.1%
Media (Facebook/Radio/TV) 65.3% 58.8% 62.3%
from community people 58.5% 63.9% 60.9%
Mosque 28.0% 36.1% 31.6%
Courtyard meeting 34.7% 17.5% 27.0%
Newspaper/Magazine 19.5% 26.3% 22.6%
Leaflet 23.3% 11.9% 18.1%
Community Clinic/FWC (Through the service provider) 14.8% 9.8% 12.6%
Poster 11.9% 12.9% 12.3%
CSG Members 9.7% 3.6% 7.0%
N 236 194 430
More than half of the respondents mentioned that people would get infected by COVID-19 if they
came from abroad. Approximately, r 30-45% of respondents in both Nilphamari and Rangpur stated
that everyone can get infected (41.2%participants) by going outdoors (39.3% participants) and not
washing their hands with soap (38.4% participants).
Table 21: Perception about the ways of attack by COVID-19
Response Nilphamari Rangpur All
Those who come from abroad 56.4% 55.2% 55.8%
Those who were close to the effected patients 46.6% 51.0% 48.6%
Everyone can get attacked 39.0% 43.8% 41.2%
Those who are going outside 36.0% 43.3% 39.3%
Those who do not wash hands with soap 41.1% 35.1% 38.4%
Child & oldest 10.6% 5.7% 8.4%
N 236 194 430
More than 90% respondents shared that people should wash their hands with soap frequently and
wear masks. Half of the respondents mentioned maintaining social distance and eating nutritious food,
drinking water and other liquids.
Table 22: Steps should be taken to stay away from COVID-19
Response Nilphamari Rangpur All
Wash hands with soap frequently 99.2% 98.5% 98.8%
Wear Masks 93.2% 93.3% 93.3%
Maintain social distance 53.0% 58.2% 55.3%
Eat nutritious food, drink lots of water and take liquids 50.8% 45.4% 48.4%
Make the hands disinfected by washing hands with sanitizer 45.3% 42.8% 44.2%
Keep distance from the effected people 44.5% 40.7% 42.8%
N 236 194 430
Page | 53
Nearly 90% respondents recommended taking treatment if anyone were to get affect by COVID-19.
In addition, they marked that people should stay alone at their home for this disease. Below 10%
mentioned that police would take the patients and keep the news secret.
Table 23: Steps to take if anyone affected by COVID-19
Response Nilphamari Rangpur All
Take treatment 88.1% 88.7% 88.4%
Stay home alone 65.7% 64.4% 65.1%
To call the govt. number 22.9% 20.1% 21.6%
Police would take the patients 12.7% 5.7% 9.5%
Keep it secret 6.8% 8.2% 7.4%
N 236 194 430
3.8.2 Outcome of Covid-19 response
According to approximately 67% of respondents, they received services/relief during COVID-19 like
knowledge about this virus, hygiene kit and financial support as well. Most of them (86.8%) got the
information about idea and knowledge about COVID-19. Around 50% received advices and learnt
how to wash hands and use masks in a perfect way.
Table 24: Received any service/relief during COVID-19
Response Nilphamari Rangpur All
Yes 75.0% 57.2% 67.0%
No 25.0% 42.8% 33.0%
N 236 194 430
Type of services received for COVID-19
Idea and knowledge about COVID-19 89.3% 82.9% 86.8%
Advices 64.4% 42.3% 55.9%
learnt how to wash hands in a perfect way 65.5% 35.1% 53.8%
learnt how to wear mask in a perfect way 61.0% 34.2% 50.7%
Information about nutrition 25.4% 22.5% 24.3%
Any kit for safety from COVID-19
(Mask, Gloves, Hand Sanitizer, soap) 21.5% 21.6% 21.5%
Food 2.3% 11.7% 5.9%
Trainings 6.2% 1.8% 4.5%
Financial Support 3.4% 5.4% 4.2%
Medicine 1.7% 3.6% 2.4%
N 177 111 288
Above 90% respondent received the information about COVID-19 from JANO Volunteer. Very few
of them mentioned that the source of getting knowledge about COVID-19 is community people
(34.7%), Community clinic (22.6%), CSG members (10.4%) and Government (7.3%). The percentage
of getting the news from NGOs is negligible.
Table 25: Source of this support and information
Response Nilphamari Rangpur All
JANO Volunteer 96.0% 83.8% 91.3%
From the community people 37.9% 29.7% 34.7%
Community Clinic/FWC (Through the service provider) 26.6% 16.2% 22.6%
CSG Members 13.6% 5.4% 10.4%
Govt. support 7.9% 6.3% 7.3%
NGO 0.0% 2.7% 1.0%
N 177 111 288
Page | 54
According to the respondents, they received support from JANO Volunteers for COVID-19. Above
50% of them got support about the learning of washing j\hands and wearing masks perfectly. More
than 20% of them stated that they also received hygiene kit like mask, gloves, hand sanitizer and soap
from JANO.
Table 26: Support from JANO/JANO Volunteer (information about COVID-19/Hygiene Kit)
Response Nilphamari Rangpur All
Idea and knowledge about COVID-19 85.3% 83.9% 84.8%
learnt how to wash hands in a perfect way 68.8% 41.9% 59.3%
learnt how to wear mask in a perfect way 62.9% 46.2% 57.0%
Advices 62.4% 37.6% 53.6%
Any kit for safety from COVID-19
(Mask, Gloves, Hand Sanitizer, soap) 24.1% 23.7% 24.0%
Information about nutrition 22.9% 19.4% 21.7%
Give information by miking 18.8% 6.5% 14.4%
Leaflet/promotion form 5.9% 1.1% 4.2%
Medicine 2.4% 6.5% 3.8%
Trainings 3.5% 3.2% 3.4%
N 170 93 263
The average number of visits or contact with JANO Volunteers from March to September is 7. More
than 50% specified that their family members received support and information from JANO. Around
34% lactating mother and 28.9% pregnant women also received the support from JANO.
Table 27: Persons who received support and information from JANO
Response Nilphamari Rangpur All
Average number of visits or contacts of
JANO Volunteers (March to September) 8 6 7
N 170 93 263
All family members 51.2% 57.0% 53.2%
Lactating mother 39.4% 25.8% 34.6%
pregnant women 32.4% 22.6% 28.9%
Adult men 18.2% 14.0% 16.7%
Mother of child aged under 5 (Who do not take breast milk) 17.6% 7.5% 14.1%
Adolescents 14.7% 6.5% 11.8%
Children aged under 5 11.8% 4.3% 9.1%
N 170 93 263
The respondents mentioned they appreciated the way they received support from JANO for COVID-
19. Around 27% stated that their family members are healthy and they become more aware about this
virus.
Table 28: Benefits by taking support and information
Response Nilphamari Rangpur All
Everyone is healthy still now 26.0% 30.6% 27.8%
Became more aware 27.7% 26.1% 27.1%
Learned a lot 10.7% 8.1% 9.7%
Was able to stay clean 7.9% 8.1% 8.0%
Increased knowledge about health 5.6% 6.3% 5.9%
Enhance carefulness 6.2% 2.7% 4.9%
Learned about Corona 5.1% 2.7% 4.2%
learned about the correct rules 3.4% 5.4% 4.2%
Was able to live a normal life 1.7% 3.6% 2.4%
Food shortages have been reduced .6% 3.6% 1.7%
Page | 55
Response Nilphamari Rangpur All
Got advice 2.8% 0.0% 1.7%
Financial crisis has subsided 1.1% 1.8% 1.4%
Protected from the virus .6% .9% .7%
No problem .6% 0.0% .3%
N 177 111 288
Not only about COVID-19 information, the respondents mentioned that they also received knowledge
about nutrition related to COVID-19. They are using the information everywhere. More than 25%
share the information with their family. In Rangpur, people share the information in outside rather in
Nilphamari.
Table 29: Usage of the information or knowledge or information related to nutrition about COVID-19
Response Nilphamari Rangpur All
Everywhere 34.5% 23.4% 30.2%
With family 30.5% 21.6% 27.1%
At home 27.1% 26.1% 26.7%
At outside .6% 11.7% 4.9%
To stay healthy 3.4% 1.8% 2.8%
With neighbors 1.1% 5.4% 2.8%
Nearby .6% 3.6% 1.7%
At work 0.0% 2.7% 1.0%
From JANO 0.0% 2.7% 1.0%
In cooking 1.1% .9% 1.0%
In eating 1.1% 0.0% .7%
N 177 111 288
Figure 13 reflects that more than half of the participants were satisfied after receiving support from
JANO volunteers about COVID-19. The percentage of respondents who are very satisfied are from
Nilphamari (31%) as opposed to Rangpur (12.8%). The percentage of dissatisfied participants is 16.5%.
Figure 13: Satisfaction level after receiving support from JANO Volunteer (Information or knowledge or
Instruments/Hygiene kit)
Nearly 45% participants satisfied as they received information messages about nutrition related to this
pandemic. More than 25% respondents are very satisfied whether the percentage of dissatisfaction is
26.3%.
13.5%
55.5%
31.0%
20.9%
2.3%
64.0%
12.8%16.2%
.8%
58.5%
24.5%
Very dissatisfiedNeither satisfied nor
dissatisfied
SatisfiedVery satisfied
Nilphamari Rangpur All
Page | 56
Figure 14: Satisfaction level after receiving information or messages about nutrition
Out of 142 respondents, half of them claimed that no one helped them during this COVID-19. Nearly
30% participants mentioned that no one visited to their house for providing any kind of support. Only
6.3% respondents stated that they felt no need of this support.
Table 30: Causes of not getting support
Response Nilphamari Rangpur All
No one helped 59.3% 50.6% 54.2%
No one came 27.1% 31.3% 29.6%
Don't know 10.2% 9.6% 9.9%
There was no need 3.4% 8.4% 6.3%
N 59 83 142
3.8.3 Hygiene Practices
Around 90% respondents stated that they wash their hands for 20 seconds with soap frequently
because of hygiene practice. Half of them marked that they use hand sanitizer outside and coming back
to home. Almost all the participants have soap or hand sanitizer in their home.
Table 31: Types of hygiene practice
Response Nilphamari Rangpur All
Wash hands with soap frequently for 20 seconds 94.1% 87.1% 90.9%
Use hand sanitizer outside 57.6% 57.7% 57.7%
Use other things for hand wash 55.1% 59.3% 57.0%
Use hand sanitizer after coming from outside 52.5% 53.6% 53.0%
Keep house and latrine clean by
using Bleaching powder/detergent 27.1% 25.8% 26.5%
Maintain the hygiene during cold or cough 17.4% 8.2% 13.3%
Used a mask 8.9% 5.2% 7.2%
do not wash hands 2.1% 3.1% 2.6%
Do not have soap or hand sanitizer .4% 1.5% .9%
N 236 194 430
More than 95% respondents agreed that they use mask when they go outside. Only 0.9% use mask all
the time. However, the percentage of not using mask is very tiny (1.4%).
30.8%
0.0%
43.6%
25.6%
16.7%
5.6%
44.4%
33.3%
26.3%
1.8%
43.9%
28.1%
Very dissatisfiedNeither satisfied nor
dissatisfied
SatisfiedVery satisfied
Nilphamari Rangpur All
Page | 57
Table 32: Whether use mask or not
Response Nilphamari Rangpur All
Yes, only in outside 98.3% 96.9% 97.7%
No, do not use mask 1.3% 1.5% 1.4%
Yes, all the time .4% 1.5% .9%
N 236 194 430
Almost all the participants wash their hands after using bathroom, before and after cooking and
eating. Only 26.5% respondents mentioned that they wash their hands after touching anything. They
are also conscious about preparing food for children as they (71.2%) wash their hands before and
after the work.
Table 33: Time of washing hands
Response Nilphamari Rangpur All
After using bathroom 96.2% 97.9% 97.0%
Before and after cooking 96.6% 93.3% 95.1%
Before and after eating 95.3% 94.8% 95.1%
Before preparing food for children 68.6% 74.2% 71.2%
Before and after meeting with effected person 53.8% 55.7% 54.7%
After giving bath to the children 46.2% 45.4% 45.8%
After touching anything 31.4% 20.6% 26.5%
N 236 194 430
3.8.4 Nutritional Practices
More than 50% respondents stated that they changed their food habits in their family during COVID-
19. Around 70% of them decreased the amount of food. Only 35.1% increased their amount of
nutritious food for this pandemic. They also specified the cause of changing food habits.
Table 34: Any change of daily food habits of family during COVID-19
Response Nilphamari Rangpur All
Yes 57.2% 61.9% 59.3%
No 42.8% 38.1% 40.7%
N 236 194 430
Type of changes
Decrease the amount of taking food 71.7% 71.2% 71.4%
Increase the amount of nutritious food 37.8% 32.2% 35.1%
Keep the food in store 0.0% 2.5% 1.2%
N 127 118 245
Cause of changes
Financial problem 43.7% 54.2% 48.6%
Try to stay healthy 20.0% 17.5% 18.8%
Because of Corona 16.3% 8.3% 12.5%
There was no job 12.6% 10.0% 11.4%
Poverty 4.4% 5.0% 4.7%
Business was closed .7% 3.3% 2.0%
Nutrition 1.5% 1.7% 1.6%
For baby .7% 0.0% .4%
N 135 120 255
Nearly 90% respondents marked that they received the knowledge about nutritious food from JANO
Volunteers. In addition, other family members (42%), neighbors (39.6%) and members of Community
Clinic (26.7%) has also informed the respondents about eating nutritious food.
Page | 58
Table 35: Source of giving suggestion about eating nutritious food
Response Nilphamari Rangpur All
JANO Volunteer 95.6% 81.7% 89.0%
Family 39.3% 45.0% 42.0%
Neighbor 37.8% 41.7% 39.6%
Member of Community Clinic 32.6% 20.0% 26.7%
FWC 7.4% 0.0% 3.9%
N 135 120 255
Around 60% respondents pointed that all their family members take nutritious food during COVID-
19. The percentage of lactating mother for taking nutritious food is 23.9%. However, the percentage
of adult men and adolescents are very low.
Table 36: Persons who take nutritious food
Response Nilphamari Rangpur All
All family members 59.3% 60.0% 59.6%
Lactating mother 22.2% 25.8% 23.9%
Children 20.7% 15.0% 18.0%
pregnant women 13.3% 15.0% 14.1%
Adult men 7.4% 5.8% 6.7%
Adolescents 5.9% 5.8% 5.9%
N 135 120 255
More than 80% respondents felt that they are benefitted by taking nutritious food during COVID-19.
As their family members are still healthy and strong (65.7%). They also mentioned about increasing
immunity, less illness and their children of any family are healthy.
Table 37: Benefits by eating nutritious food during COVID-19
Response Nilphamari Rangpur All
Whether get benefits by eating nutritious food during COVID-19
Yes 85.9% 80.8% 83.5%
No 14.1% 19.2% 16.5%
N 135 120 255
Benefits by eating nutritious food during COVID-19
Everyone in the family is still healthy 63.8% 68.0% 65.7%
Increased immunity 13.8% 3.1% 8.9%
Got less ill 6.9% 9.3% 8.0%
Didn’t got infected in Corona 4.3% 10.3% 7.0%
Baby was healthy 7.8% 2.1% 5.2%
Consumed nutritious food for betterment 3.4% 4.1% 3.8%
Don’t know 0.0% 3.1% 1.4%
N 116 97 213
More than 55% respondents claimed that their income declined due to COVID-19. However, 18.4%
respondents mentioned that they have no incoming problems during this COVID-19.
Table 38: Any problem for earning of family members during this COVID-19
Response Nilphamari Rangpur All
Decrease the income 53.4% 61.3% 57.0%
Income is off 25.4% 23.7% 24.7%
No problem 21.2% 14.9% 18.4%
N 236 194 430
Page | 59
Around 60% respondents took loan for overcoming this pandemic situation. More than 20% are now
taking low amount of food or food with good quality at the present time. Very few (6.7%) respondents
have already sold their land/ gold/ asset for this pandemic.
Table 39: Steps taking for overcoming COVID-19 situation
Response Nilphamari Rangpur All
Take loan 59.7% 58.8% 59.3%
Take low amount of food or the quality of food 19.1% 25.8% 22.1%
Nothing 18.2% 12.4% 15.6%
take help for mental support 14.8% 10.3% 12.8%
Sell the land/gold/asset 5.9% 7.7% 6.7%
N 236 194 430
3.8.5 Students Faced problems in going to school during COVID-19
More than 80% students faced problems during COVID-19 in both Nilphamari and Rangpur. Around
92% respondents specified that they are now facing problems in understanding their study. Few of
them (13.3) mentioned that they could not get food from school in this pandemic. Half of the
respondents are unhappy as they have to stay at home and could not see their friends from school.
Table 40: Problems Faced During COVID-19
Response Annual Assessment 2020
Nilphamari Rangpur All
Faced problems 87.8% 82.5% 85.8%
N 270 160 430
Type of Problems
Friends are not seen due to school being closed 51.9% 54.5% 52.8%
Having to study at home 51.1% 62.1% 55.0%
There has been / is a problem in understanding education 95.4% 87.1% 92.4%
The food I got from school stopped 13.1% 13.6% 13.3%
Can't play sports 27.0% 18.2% 23.8%
N 237 132 369
3.8.6 Help Needed to Continue Study for Students
Out of 430 students, only 19.5% respondents got online classes on Facebook through the help of
JANO volunteer. The majority (40.9%) took help from their friends for study. More than 20%
respondents went to teachers’ house for taking help on study.
Table 41: Types of Support Received During COVID-19
Response Annual Assessment 2020
Nilphamari Rangpur All
I took a class on Facebook (with the help of JANO volunteer) 23.3% 13.1% 19.5%
Heard from friends 37.0% 47.5% 40.9%
Went to the teacher's house 30.4% 23.1% 27.7%
No help was received 22.2% 32.5% 26.0%
From family members 13.0% 8.8% 11.4%
From Television 8.5% .6% 5.6%
N 270 160 430
According to a JANO project staff, as the schools are closed, the team arranged a total of 64 facebook
live classes with the teachers of the schools. The volunteers ensured the participation and motivation
of both teachers and students through monitoring. And, since the government has also arranged TV
Page | 60
sessions of class, the team also ensured that the students were reached. And for the online classes,
the link was also provided.
3.8.7 Satisfaction of Doing Classes Through Facebook from JANO
Half of the respondents are happy for doing classes on Facebook by taking the help of JANO program.
More than 30% are very satisfied for that. In contrast, the proportion of being dissatisfied for this
classes are below 10% (Very dissatisfied-9.5% and dissatisfied-2.4%).
Figure 15: Satisfaction level of doing classes through Facebook
Causes of Dissatisfaction: The students shared the causes of their dissatisfaction for doing classes
on Facebook through JANO project. Half of them marked that they did not find anyone during the
class. They also mentioned that lack of communication, not having smartphone and Facebook account,
facing problems on study and so on.
3.8.8 Impact of Covid-19 on JANO Project
Because of this pandemic, the staffs of this project could not work properly except the volunteers.
The volunteers visited to the community people and provided awareness about this COVID-19 which
is the main challenge as they need to be very careful and maintained the social distance. Their regular
meetings have also stopped as they had to provide awareness about COVID-19. As the schools has
also stopped, they could not work in the school premises. In addition, the vegetable gardens have
destroyed during this COVID-19 period. The project staffs work from home while the volunteers
needed to visit their project areas. They started using PPE and visit door to door. On the other hand,
the project started providing information about awareness to the school going children like the online
classes.
According to the community people, they had to stay at home because of this lockdown. They could
not take medicines if they felt sick. They could not even get treatments by going to the community
clinic. They received the medicines from the JANO program staffs at home. They also received masks,
hand sanitizer and awareness about COVID-19.
33.30%
51.20%
3.60%
2.40%
9.50%Very satisfied
Satisfied
Neither satisfied nor
dissatisfied
Dissatisfied
Very dissatisfied
Page | 37
4. Logframe Review
4.1. Process of Reviewing the Logframe
In order to adopt the JANO project Logframe, the IRC team carefully reviewed the context of the
COVID-19 pandemic situation and the project’s performance. In addition, it examined relevant
government approaches, different service delivery options and the way forward to adopt the Logframe
in future. The IRC team tested required indicator definitions, actions and approaches and conducted
context analysis as per the current Bangladesh and geographical aspects in north Bengal as well. The
team further reviewed all project processes documentation, monitoring and progress reports, events
reports including other key stakeholder mapping reports to identify the future direction of the project.
The outcome indicators or expected results of the JANO project are segregated into 4 sections below.
They intend to improve maternal and child nutrition in Nilphamari and Rangpur districts.
1. Women and adolescent girls in communities are empowered to demand and utilize both
nutrition-sensitive and nutrition-specific services;
2. Coordinated and resourced sub-national and local government structures recognize, respond
and are accountable to demands of poor and marginalized communities;
3. Production and access to high value nutritious commodities and services are increased; and
4. Information and communication technology (ICT) platform is established at local level to
connect relevant govt. departments and increase awareness of community people on nutrition
interventions’
The logframe has been reviewed on the basis of the JANO project goal and targets. The following
segments have been reviewed by using SMART criteria3.
SMART Indicators
• Specific: The indicator should accurately describe what is intended to be measured, and should
not include multiple measurements in one indicator.
• Measurable: Regardless of who uses the indicator, consistent results should be obtained and
tracked under the same conditions.
• Attainable: Collecting data for the indicator should be simple, straightforward, and cost-
effective.
• Relevant: The indicator should be closely connected with each respective input, output or
outcome.
• Time-bound: The indicator should include a specific time frame.
3 George T. Doran, developed the concept of S.M.A.R.T. goals in the discipline of project and program management
Specific Measurable Achievable Relevant Time-bound
Page | 38
The Logframe has been reviewed by considering each of the above SMART points and addresses
several assumptions that may support and encourage the project to determine whether a project is
on track.
Following color codes are used to assess the performance of the indicators based on their
achievements and targets.
1 On track
2 Marginally behind target
3 Lagging behind
1.1.1. Indicator 1
% of women of reproductive age in the targeted districts who are consuming
a minimum dietary diversity (MDD)
Def. Women 15-49 years of age have consumed at least five out of ten defined food groups
the previous day or night. (FANTA-III)
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari
30.9%
Rangpur 41.8%
Overall 34.9%
(February-19)
Nilphamari
32.5%
Rangpur 42.3%
Overall
37.0%
(October-19)
+1% over
baseline
Nilphamari 33.5%
Rangpur 44.3%
Overall 38.4%
(October-20)
+3% over
baseline
(37.9%)
+6% over
baseline
(40.9%)
46.9%
(2023)
“MDD-W is a dichotomous indicator of whether or not women 15–49 years of age have consumed
at least five out of ten defined food groups the previous day or night.” (http://www.fao.org/3/a-
i5486e.pdf). The ten food groups are: 1. Grains, white roots and tubers, and plantains 2. Pulses (beans,
peas and lentils) 3. Nuts and seeds 4. Dairy 5. Meat, poultry and fish 6. Eggs 7. Dark green leafy
vegetables 8. Other vitamin A-rich fruits and vegetables 9. Other vegetables 10. Other fruits”
This indicator was able to explain how women’s’ diet or food consumption has influenced their
micronutrient intake levels. This indicator was measured through the % of women reporting
consumption of at least five (5) out of 10 defined food groups the previous day or night during the 2nd
year annual assessment, which is 38.4% (slightly lagged behind from the second-year target).
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Can be a major challenge to deliver
adequate nutrient in women’s diet if
COVID-19 continue to rise until the next
annual assessment. Hence, COVID-19
could lead to further changes in food
security.
• Current trend shows that this indicator is
achievable but JANO needs to continue its
training and awareness program on nutrition.
• Women (of reproductive age) consumed more
dairy, eggs, dark green leafy vegetables, vitamin
A-rich fruits & vegetables, and fruits during the
Page | 39
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
second evaluation as compared to the first
annual evaluation. Therefore, Program can
encourage the community to focus more on
homestead production and consumption of
agricultural products and rearing of livestock to
cope up with the pandemic situation.
• Alternative employment creation through
various local government committees to
mitigate income losses due to pandemic.
Comments: Also, JANO program can review the similar nature of the program to establish guidelines
for monitoring dietary diversity levels and assess targets for the next year.
1.1.2. Indicator 2
Proportion of children 6–23 months of age who receive foods from 4 or more
food groups (based the MDD-C methodology) by sex (Percentage)
Def. Children 6-23 months age who received four food groups out of seven (WHO standard)
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Boys 18.1%
Girls 17.4%
Nilphamari
18.1%
Rangpur 17.2%.
Overall 17.8%
(February-19)
Boys 19.4%
Girls 21.2%
Nilphamari
20.7%
Rangpur 20.2%.
Overall
20.4%
(October-19)
2% over
baseline
Boys 21.8%
Girls 23.5%
Nilphamari 22.7%
Rangpur 22.4%.
Overall 22.6%
(October-20)
4% over
baseline
(21.8%)
10 over
baseline
(27.8%)
(Assuming
10 means
+10%)
37.8%
(2023)
This indicator calculated the percentage of Children 6-23 months of age who received four food
groups out of seven following WHO guidelines for assessing infant and young child-feeding (IYCF)
practices among children 6-23 months old (WHO, 2010). A total of 7food groups have been used
for tabulation of this indicator including grains, roots and tubers, legumes and nuts, dairy products
(milk, yogurt, cheese), flesh foods (meat, fish, poultry and liver/organ meats), eggs, Vitamin-A-rich fruits
and vegetables, including other fruits and vegetables.
This indictor measured the percentage of children 6–23 months of age whose mothers reported that
they have consumed food from 4 or more food groups, which is 22.6%.
Page | 40
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Like MDD-W, there will be a major
challenge to deliver adequate nutrients in
children’s diet/consumption if COVID-19
continues to rise until the next annual
assessment Hence, COVID-19 could lead
to further changes in food security.
• Project can review and adjust the 3rd year and
overall target.
• JANO needs to provide separate training and
continue courtyard meeting, and awareness
program focusing MDD to the mothers of the
children.
• Program can encourage the community to focus
more on homestead production and
consumption of agricultural products and
rearing of livestock to cope up with the
pandemic situation.
• Need a linguistic change for the third year target
(10 over baseline). We are assuming this as
‘+10% over baseline value’.
Comments: Also, JANO program can review the similar nature of the program to establish guidelines
for monitoring dietary diversity levels and assess targets for the next year.
1.1.3. Indicator 3
# of DNCC, UNCC and UDCC spent budget effectively on nutrition-specific
or nutrition-sensitive actions
Def. 50% of the fiscal year budget spent
Baseline
(incl.
reference
year)
February 2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari 0
Rangpur 0
Overall 0
(February-19)
Nilphamari 0
Rangpur 0
Overall 0
(October-19)
2 DNCC,
7 UNCC,
64 UDCC
(73 plans)
(October-20)
1 DNCC
4 UNCC
10
UDCC
2 DNCC
7 UNCC
30 UDCC
2 DNCC,
7 UNCC
65 UDCC
(will be
monitored
from 2nd
year to
5th year)
(2023)
As reported by stakeholders of the JANO project, 2 DNCCs, 7 UNCCs and 64 DNCCs have spent
their respective budgets in various areas, but were not limited to nutrition-specific or nutrition-
sensitive actions. They spent money to distribute relief during the Covid-19 lockdown, they distributed
sanitary napkins among community people and to repair CCs. They also spent funds on Nutrition and
Breastfeeding week activities during Covid-19.
Page | 41
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Regular activities have been impacted by
COVID-19.
• According to the definition of the indicator, it
was difficult to measure by third party. It doesn’t
measure whether these budgets are actually
spent on nutrition-specific or nutrition-sensitive
actions.
• Require monitoring system to ensure that what
portion of the budgets are spent on nutrition-
specific and nutrition-sensitive actions by the
project.
• Need to define the unit of measure as
Percentage.
• New definitions can be added as a measurement
of nutrition-specific or nutrition-sensitive
actions separately.
• JANO can revise or update the overall target for
2023 (numbers of UDCC). (since the target has
been changed according to the program
officials).
Comments: This indicator can be measurable if it is clearly defined as a separate ‘budget expenditure
head’ for nutrition-specific or nutrition-sensitive actions. In addition, it is recommended that the
meaning of ‘effectively’ needs to be properly defined.
1.1.4. Indicator 4
% of increased participation of community people, particularly women, in
formal (government-led) and/ or informal (civil society-led, private sector-
led) decision-making spaces
Def. • Govt. led forums: CG, CSG, UP special committee, Up standing committee, adolescent
group, student council,
• Informal group: VSLA, FFS, Mothers group, youth group, women support group
• Participation in the meeting and in the discussion Data disaggregation by sex
(Definition aligned with CARE global indicators.)
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari
30.9%
Rangpur 41.8%
Overall 34.9%
(February-19)
Nilphamari
32.5%
Rangpur 42.3%
Overall 37.0%
(October-19)
+1% over
baseline
Nilphamari 33.5%
Rangpur 44.3%
Overall 38.4%
(October-20)
+3% over
baseline
(37.9%)
+6% over
baseline
(40.9%)
46.9%
(2023)
Here, in order to calculate the above indicator, the project will consider the following aspects to
measure the participation of community people, particularly women, in formal (government-led) and/
or informal (civil society-led, private sector-led) decision-making spaces.
Page | 42
• Government-led forums: CG, CSG and UP special committee, Up standing committee,
adolescent group, student council,
• Informal group: VSLA, FFS, mothers’ groups, youth groups, and women support groups
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Project's regular activities have been
impacted by COVID-19.
• This indicator needs to be separated by the
participation of ‘only women’ or ‘only
community people’. Also, Disaggregate by type
of groups, i.e., formal and informal.
• It will be challenging to achieve the 3rd year
target of 'Formal' session. JANO can review the
target of 'formal' sessions.
• 'Informal' session needs effective monitoring
system.
Comments: This indicator needs to be measured through monitoring processes and needs to be
empowered women for their active participation.
1.1.5. Indicator 5
% of students disaggregated by sex who apply key learning points regarding
nutrition, health and hygiene at home
Def. At least 5 learning of the below:
• Food ingredients, food prepare and food serving
• Intake of diversified food
• Home gardening
• Safe drinking water
• Adolescent health & Hygiene
• Hand wash in key times
• Use of sanitary latrines
• Information about health service providers
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari
0.22%,
Rangpur 0%,
Boys 0.44%,
Girls 0.0%,
Overall: 0.15%
(February-19)
Nilphamari
2.54%,
Rangpur1.30%
Boys 1.67%,
Girls 2.26%,
Overall:
2.09%
(October-19)
Nilphamari
2.22%, Rangpur
4.38%,
Boys 2.98%,
Girls 3.05%,
Overall: 3.02%
(October-20)
3% over
baseline
(3.15%)
5% over
baseline
(5.15%)
20.15%
(2023)
Page | 43
This indicator was calculated by the percentage of School children/adolescents who applied 5 key
learning points (i) Food ingredients, food preparation and food, ii) Health sciences and Healthcare, iii)
Adolescent Health & Hygiene, iv) Handwashing and v) Use of sanitary latrines.
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
The COVID-19 pandemic has had a severe
impact on students.
• Since schools are shut down over the
pandemic situation, this indicator can be
challenging to achieve.
Needs to adopt new methods for teaching and learning
aligned with the education board and Jano project.
1. Online class
2. Awareness campaigns
3. Regular Assessment /assignment
4. Video/Audio learning tools
Comments: The COVID-19 pandemic has had a severe impact on education system. Hence, since
schools are shut down over the COVID-19 pandemic, this indicator will be challenging to estimate. If
this situation continues, the overall target and/or definition needs to be revised.
1.1.6. Indicator 6
% of women and adolescent have claimed nutrition specific and sensitive
services from relevant service providers
Def. • Community Clinic (CC) for health services
• Extension services for agriculture and livelihood
Baseline
(incl.
reference
year)
February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target Total
2023 Achievement
Target
(Y1) Achievement
Target
(Y2)
CC:
Nilphamari
:37.8%
Rangpur
:30.7%
Overall
:35.5%
Extension
services:
3.98%
(February
2019
CC:
Nilphamari
:39.74%
Rangpur
:31.63%
Overall
:36.05%
Extension
services: 7.44%
(October
2019)
CC:
Nilphamari
:40.68%
Rangpur
:32.99%
Overall
:37.21%
Extension
services: 8.84%
(October
2020)
CC=5%
over
baseline
(42.8%)
Extension
services=5%
Over
baseline
(8.98%)
CC=8%
over
baseline
(45.8%)
Extension
services=8%
over
baseline
(11.98%)
CC=53.5%
Extension
services=23.9%
(2023)
Page | 44
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Women and adolescents in the project
area have faced difficulties getting the
services they need (during pandemic)
• These target indicator needs to be segregated
for the different groups since the project is
targeting multiple groups.
• Especially the target for extension service
needs to be revised
Comments: There should be separate indicators for women and adolescent groups. The method
operationalize and measure these nutrition specific and sensitive services also needs to be determined.
1.1.7. Indicator 7
% of CSGs in targeted communities are functional
Def. Qualify five out of seven performance indicator prescribed by government
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
0% (February-
19)
Rangpur - 198
Nilphamari -
414
Total – 612*
(Source –
Project
Manager KII)
(October-19)
Nilphamari 37 %
Rangpur: 45 %
Overall: 41%
(October-20)
20% 60% 60%
(2023)
During the second annual evaluation, it was revealed that a total of 624 CSGs are currently working
in project areas. This indicator provides information about whether CSGs are qualified based on five
performance indicators prescribed by the Government.
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Difficult to arrange face-to-face meetings;
organize events and regular activities of
CSG
• This indicator provides subjective data rather
than quantifiable or measurable data.
• Also, needs to define the unit of measures:
Percentage or Numbers
• To avoid bias in evaluation, this indicator needs
clear instructions on how to be measure in
terms of functionality.
• Need to focus on documentation, meeting
minutes, etc.
Comments: It is recommended that the meaning of functionality be further defined and revised to
be aligned with project goals. It will otherwise be time consuming to measure this indicator according
Page | 45
to the definition set in in the log frame. They are functional but lack of documentation may decreases
the percentage.
1.1.8. Indicator 8
# of School Management Committees set agenda for nutrition specific and
sensitive services for adolescents in the SMC meeting
Def. SMCs will raise issues in the meeting, set them in the action plan and that will
be mentioned in the meeting minutes
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari-6
Rangpur-1
Overall -7
(February-19)
Nilphamari :
199
Rangpur: 103
Overall -302*
(Source SMC
members)
Monitoring
reports
Nilphamari 157
Rangpur: 88
Overall: 245
(Source: Survey
with SMC
members)
(October-20)
50 SMCs 150 SMCs
330
SMCs
(2023)
This indicator is calculated from data gathered during the quantitative survey, in which the number of
SMC members are recorded who set agenda for nutrition specific and sensitive services for
adolescents during SMC meetings. Project staff will then convert these numbers into percentages by
considering the total number of SMCs (330) and segregating them by districts.
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
The COVID-19 has restricted school
activities to a larger extent. • Recommend to define the unit of measures as
Percentage.
• It was challenging for third party to measure
this indicator.
Comments: It will be time-consuming to measure the indicator according to the definition set in the
log frame. This indicator can use a percentage indicator to track results in a percentage format. Besides
this, indicators can be measured on a monitoring basis. Event reports, meeting records, monitoring
reports and annual reports can be the means of verification in this context.
1.1.9. Indicator 9
# of Multi-sectoral plans at district, upazila and union level have allocated
budget to support nutrition interventions in the two target districts
Def. At least allocated budget to address one action in the multi-sectoral nutrition action plan
in each year
Page | 46
Baseline
(incl.
reference
year)
February 2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari 0
Rangpur 0
Overall 0
(February-19)
Nilphamari 0
Rangpur 0
Overall 0
(October-19)
2 DNCC,
7 UNCC,
64 UDCC
(73 plans)
(October-20)
74 74
74 plan
with
allocated
budget
(65unions,
7 upazilas,
2 districts
in each
years)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
• Along with interviews with key officials, Budget
records, Monitoring reports and Annual reports
need to checked regularly to capture this
information.
• Need to update yearly and overall target for this
indicator (since the target has been changed
according to the program officials) in the
logframe (74 or73?).
Comments: In 2021’s annual assessment, along with interviews with key officials, budget records,
regular monitoring reports and annual reports can be the means of verifications to capture this
information.
1.1.10. Indicator 10
% of increase of PLW people from the target population received nutrition
specific safety net support
Def. • Maternal allowance
• 1000 days
• Supplementary feeding
• Maternal Health Voucher
• Area based Community Nutrition Scheme
• VGF
• VGD
• Iron folic acid
Page | 47
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari 8.0%
Rangpur 9.2%
Overall 8.4%
(February-19)
Nilphamari
9.7%
Rangpur 10.7%
Overall
10.2%
(October-19)
Nilphamari 10.26%
Rangpur 11.11%
Overall 10.64%
(October-20)
2% over
baseline
(10.4%)
5% over
baseline
(13.4%)
18.4%
(2023)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
PLW in the project area may have faced
difficulties getting the safety net services
they need.
• Need to establish a system to track this
indicator.
Comments/Assumptions: This indicator is well specified and measurable.
1.1.11. Indicator 11
% of women and adolescent girls of target population in government forums
(UDCC, CG, CSG) meaningfully participated in the nutrition action plan
development and implementation process
Def. Meaningful Participation:
• Raise issue in the forum
• Incorporated raised issues in planning
Baseline
(incl.
reference
year)
February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target (Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement Target (Y2)
Nilphamari 0
Rangpur 0.6%
Overall
0.2%
(February-19)
Nilphamari
0.9%
Rangpur 0.0%
Overall 0.5%
(October-19)
(conducted
interview with
community
people)
Nilphamari:
64.4%
Rangpur: 45.5%
Overall:
54.0%
(October-20)
(Source:
Overphone
Survey with
(UDCC, CG,
CSG)
members)
(October-20)
Representation:
100% of CSGs
Participation:
30 % of CSGs
Representation:
100% of CSGs
Participation:
40 % of CSGs
60%
(2023)
Page | 48
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Difficult to arrange face-to-face meetings;
organize events and regular activities
related to project.
• Need to establish a system to monitor what
specific issues are incorporated in the planning
process.
• Need to revisit the definition and target and
fix the calculation of this indicator.
Comments: This indicator calculated the percentage of women and adolescent girls of target
population in government forums (UDCC, CG, CSG) meaningfully participated in the nutrition action
plan development and implementation process in the second-year evaluation. There should be a
separate indicator for women and adolescent groups, there also needs to be a clear definition of the
term ‘meaningful participation’. These efforts will require identifying key practices that are consistent
with project goal that can be easily observed in this survey. This process could be effectively assessed
through document review. A system also needs to be established to monitor the specific issues that
are incorporated in the planning process.
1.1.12. Indicator 12
# of platforms in the target districts which allow effective feedback
mechanisms for service receivers
Def. • Availability of a complain box/hot line number/or any other mechanism
• Open complain box regularly for addressing in the monthly meeting.
• Register all submitted complain
• Public hearing meeting
• Discussed in the regular meeting about the submitted complains.
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari 0
DNCC-
UNCC-
UDCC-
CC-
Rangpur 0
DNCC-
UNCC-
UDCC-
CC-
Overall 0
(February-19)
Nilphamari 0
DNCC-
UNCC-
UDCC-
CC-
Rangpur 0
DNCC-
UNCC-
UDCC-
CC-
Overall 0
(Ocotober-
19)
64 Unions and
208 CCs
(Ocotober-20)
74
(unions
65,
Upazila 7
and
District
2)
and 211
CCs
74 (unions
65, Upazila 7
and District
2) and 211
CCs
73
(unions
64,
Upazila
7 and
District
2) and
208
CCs
Page | 49
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Difficult to arrange face-to-face meetings;
organize events and regular activities
related to project.
• There should have a specific definition of
indicator to reflect what will be considered as
an effective feedback mechanism.
• Need to monitor the indicator (according to the
def.). It was difficult to measure for third party.
• Need to update yearly target for this indicator
(since the target has been changed according to
the program officials) in the logframe.
Comments/Assumptions: This indicator will be required to check availability and functionality of
complaints boxes. and, whether complaints registers have all been submitted during public hearing
meetings and discussed in regular meetings at Union, Upazila, District and CC levels to capture
complaints and community feedback comprehensively. A specific definition of this indicator should
also be provided to reflect effective feedback mechanisms.
1.1.13. Indicator 13
% of households involved in the production of higher value nutrition products
Def. Higher value nutrition products:
1. Is bio-fortified
2. Is a legume, nut, or some seeds
3. Is an animal source food, including dairy products
4. Is a dark yellow or orange-fleshed root or tuber
5. Is a fruit or vegetable
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari
34.5%
Rangpur 41.0%
Overall 36.7%
(February-19)
Nilphamari
32.9%
Rangpur 45.4%
Overall
38.6%
(October-19)
Nilphamari 35.6%
Rangpur 46.9%
Overall 40.7%
(October-20)
10% over
baseline
(46.7%)
15% over
baseline
(51.7%)
56.7%
(2023)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
The pandemic has been affecting the entire
agricultural production and food security. • New/Alternative techniques relevant to the
indicators could be developed
• Need to review yearly target for this indicator,
it would be challenging to implement in this
pandemic situation.
Page | 50
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
• JANO can revise or update the
target/definition of indicator considering the
pandemic situation.
Comments: This indicator is well specified and measurable.
1.1.14. Indicator 14
% of households practicing climate smart agricultural techniques
Def. Minimum 3 techniques have to be used out of 20 criteria
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari 3%
Rangpur 8%
Overall 5%
(February-19)
Nilphamari
4.7%
Rangpur 10.6%
Overall 8.3%
(October-19)
Nilphamari 7.3%
Rangpur 12.9%
Overall 9.4%
(October-20)
10% over
baseline
(15%)
15% over
baseline
(20%)
25%
(2023)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
The pandemic has been affecting the entire
agricultural production and food security. • New/Alternative techniques relevant to the
indicators could be developed.
• JANO can revise or update the target/definition
of indicator considering the pandemic situation.
Comments: In this case, we calculated the percentage of households who used a minimum of 3
techniques out of 20 criteria.
1.1.15. Indicator 15
# of initiative jointly taken as a result of tripartite agreement.
Def. Tripartite initiative (Govt.+JANO+Private sector) will be taken on agriculture, livestock,
WASH, micronutrient supplementation and financial inclusion as an outcome of tripartite
MoU signing.
Baseline
(incl.
referenc
e year)
February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target (Y3)
Mid term
review
Target Total
2023 Achievemen
t
Targe
t (Y1)
Achievemen
t
Target
(Y2)
Nilphamar
i 0
Rangpur 0
Nilphamari 0
Rangpur 0
Overall 0
Nilphamari 0
Rangpur 0
Agriculture
-1 (crop)
Education
Agriculture-1
(livestock)
Wash and
At least 2
initiatives will
be taken on
Page | 51
Baseline
(incl.
referenc
e year)
February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target (Y3)
Mid term
review
Target Total
2023 Achievemen
t
Targe
t (Y1)
Achievemen
t
Target
(Y2)
Overall 0
(February-
19)
(Ocotober-
19)
Overall 0
(Ocotober-20
department
-1
hygiene-1
Micro nutrient
supplementation
-1
Financial
institution 1
each of the
following
thematic areas;
agriculture,
livestock,
WASH,
micronutrient
supplementatio
n and financial
inclusion as an
outcome of
tripartite MoU
signing.
Reference year:
2023
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
• Need joint efforts with JANO consortium.
• JANO may consider bipartite instead of triparty
or other types of efforts to achieve this
indicator.
Comments: This indicator is well specified and measurable but It needs to be measured through
monitoring processes.
1.1.16. Indicator 16
# of government forums (UNCC, DNCC,) utilizing Nutrition Information
Portal for planning and decision making at district and upazila level
Def. One web based platform established
Baseline
(incl.
reference
year) February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
There is no
Nutrition
Information
Portal for
planning and
decision making
at district and
upazila level
(February-19)
0
(October -19)
0
(October -20)
2 DNCC
7 UNCC
2 DNCC
7 UNCC
9 govt.
forums
(2
DNCC,
7
UNCC)
(2023)
Page | 52
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
• Need program efforts
Comments/Assumptions: This indicator is well specified and measurable. It too needs to be
measured through monitoring processes.
1.1.17. Indicator 17
% of frontline workers using the ICT based e-learning platform to support the
community based on needs
Def. Mobile based learning app are used by frontline workers
Baseline
(incl.
reference
year)
February 2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
0% Frontline
workers
(February-19)
0
(October -19)
0
(October -20)
10% over
baseline
25% over
baseline
50%
relevant
govt.
front
line
workers
(2023)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
Difficult to arrange face-to-face meetings;
organize events and regular activities
related to project.
• JANO can revise indicator, results and target
by reviewing reports, consultation with
partners.
• Can add “Government frontline workers’ in the
definition of the indicator.
Comments: This indicator needs to have a clear definition of the term ‘community based needs’.
1.1.18. Indicator 18
% of community members who have accessed or received ICT based
nutritional information
Def. community members will have access nutritional information from the mobile based
learning apps and receive text message
Page | 53
Baseline
(incl.
reference
year)
February
2019
Annual Assessment
2019 (Y1)
Annual Assessment
2020 (Y2) Target
(Y3)
Mid term
review
Target
Total
2023 Achievement Target
(Y1) Achievement
Target
(Y2)
Nilphamari
2.4%
Rangpur 7.8%
Male: 4.1%
Female: 8.3%
Overall 4.2%
(February-19)
Nilphamari
6.4%
Rangpur 8.2%
Male: 5.3%
Female: 4.7%
Overall 7.2%
(October-19)
Nilphamari 8.1%
Rangpur 10.8%
Male: 9.7%
Female: 10.5%
Overall 9.3%
(October-20)
10% of
community
members
20% of
community
members
60% of
community
members
(2023)
How and at what extent COVID-19
impacted on JANO in the second
year (project year)
Measures that JANO immediately need to
take to achieve the results/ Suggestions on
logframe
During pandemic, Community people may
have received health/nutrition-related
messages
• This indicator needs to have a clear definition.
Whose message/texts will be included?
Comments: As the government sends text messages in order to spread health/nutrition-related
messages to people through mobile operators, this process makes it difficult to monitor/track the
results of this activity by JANO under this category.
4.2. Measures to Be Taken to Achieve Logframe Results in the Third year of
Evaluation The IRC team is strongly recommended to undertake more awareness related activities keeping in
mind the COVID-19 pandemic situation and the lograme for quick recovery from subsequent shocks
potentially created by the pandemic. It will need to engage community people through using more
people sensitive and social distancing measures as per WHO guideline. Stronger referral systems are
also needed to achieve the project’s goal and objectives.
In order to monitor this entire process, the JANO project can undertake the following approaches:
• A short check list could be developed to review meeting minutes and relevant registers
• Some additional observations along with general meeting observations could be effective
• Year wise specific targets (for the remaining years) can be set after every annual review. This
will show which indicators are on track for 2023.
• Year wise targets and activities/indicators related to Covid-19 can be incorporated into the
logframe.
• Definition of the indicator can be revised or update considering the results of the first year
and second year annual evaluation.
Page | 54
5. Conclusion and Recommendations
Women’s increased participation in education, income generating activities, credit programs, and
public life can be considered as the development of women’s position that directly links with
empowerment. Moreover, the intervention of JANO have brought changes in terms of women and
adolescent girls’ knowledge about nutrition and reproductive healthcare services. However, there are
many structural and ideological barriers against sustainable transformation in a society. Thus, it is also
important to explore the socio-cultural norms, poverty, religious barriers, lack of education, violence
against women, health risk, and inequality in economic and political spheres to identify the causes of
limited changes in different sectors. Considering the overall project activities, the followings are
possible way forwards:
i. Advocacy for integrating NPAN as a major component of public and private
intervention
During the second annual evaluation, it was identified that many service providers are aware of NPAN
and they have different ideas about how to improve nutritional status of the people. One of the HAs
perceived NAP as follows: “Our responsibility as part of the NAPN is to identify and aware mothers
and children about nutrition. We also refer them to the health complex if needed.” He also,
mentioned, nutrition action plan is part of their overall action plan in terms of providing healthcare
services. However, one of the drawbacks is that they could only aware the people but cannot support
materially to establish changes. Similarly, a SAAO mentioned, “we know and do many things on paper,
but we have to make change practically”. Similarly, a UDCC member suggested, “poorer segment
needs material support so that nutritional status is improved”. Therefore, extending coverage of
allowances would benefit the people to a larger extent. This does not really happen due to limitation
of fund as different committee members have indicated. Therefore, JANO should strive to make
nutrition action plans a major component of overall action plans of different public offices.
Initiatives can be taken for increasing nutrition specific and nutrition sensitive budgets and need to
classify the expenditure into two categories as well. JANO can record the spending on nutrition
activities by monitoring both planned and executed proportion of the budget in regular interval.
ii. Functionality of committees to develop and implement nutrition based action plans
In Total 73 multi-sectoral plans at district, upazila or union level were found during the second annual
evaluation survey. However, the project is challenged by the fact that government officers are
occasionally transferred to other areas, thus, the project face renewed challenge of orienting the
incoming officers. One of the project managers mentioned, “a lot of time and energy goes into
establishing a working relationship but sometimes all go to vain”. Thus, it is highly recommended to
active the co-ordination committee for the development of multi-sectoral nutrition action plan for its
proper functioning. Possibly an advocacy program could be designed for a dedicated post that would
coordinate multi-sectoral nutrition action plans.
Possibly JANO could start advocacy initiatives at the government level for creating an active post of
Nutrition officer at the district/ upazila level.
Page | 55
iii. Poor Coordination, Communication and Cooperation Between Nutrition Based
/Development Committees at Different Levels
One of the Health Assistants in the study mentioned, CSGs do not have opportunity to work together
with UNCC or DNCC, he mentioned “we just follow instructions given from the Upazila level”. It is
also attested by the fact that National Nutrition Portal is rarely used as mentioned by many service
providers. Moreover, many never used the national portal and as a reason, they mentioned that “we
are always under various kinds of pressure, so these sorts of things are not done”. In the same vein,
in response to a question of what new initiatives were taken at the catchment area a Upazila Women
Affairs Officer said, “we follow the guidelines designed for upazilas. Instructions come from above”.
Members of different committees repeatedly mentioned, they do their work following instructions
from higher authorities. Additionally, a UDCC member said, “DNCC and UNCC never gave financial
or other supports except some suggestions”. Overall, a strict hierarchical system limits possibility of
innovation to take form from the grassroots. Therefore, JANO project should aim to develop a
bottom-up approach in terms of policy formulation and implementation.
JANO can arrange a sharing platform for the active corporation, involving CSG and other committees.
Regular meetings, events, role play activities may be used to gather feedback and suggestions for
increasing engagement of CSGs.
One of the Project Managers of JANO stated that, “the nature of this project is different. Unlike other
projects here, we do not have any input support. Besides, working with UNCCs and DNCCs is a
major challenge. In these committees, many government officers are included because they are
incumbents of particular offices. However, when they are occasionally transferred to other areas, we
face challenges of orienting incoming officers. A lot of time and energy goes into establishing a working
relationship with these stakeholders but, sometimes these efforts go all in vain”. Yet another issue that
was raised was challenges faced in coordination between different public offices, for instance: when
arranging a meeting of the UNCC or DNCC. The administrative process takes a lot of uncalled for
time. Though COVID-19 has halted much of JANO’s project activities (especially in schools), JANO
project officials continued working by following government guidelines.
iv. Barriers in women’s participation at various forums
Participation of the community people (particularly women) in formal (Govt. led forums: CG, CSG,
UP special committee, UP standing committee, adolescent groups, student councils) bodies has
increased from 0.93% in first annual evaluation to 2.79% during second annual evaluation. Though the
number shows an increase, the project should consider sensitizing relevant stakeholders. If deemed
suitable their opinion is taken into consideration.” The statement reveals reservations about women
and their competence, which needs to be changed for a sustainable and meaningful participation of
women in public forums.
Increase number of women and adolescents, possibly introduce adolescents’ volunteers and JANO
could establish a separate group for women to aware, monitor, and ensure their participations.
v. Lack of Awareness on Feedback Mechanism
During the second annual evaluation 62.3% (Nilphamari: 56.4% and Rangpur 69.6%) HHs reported that
they did not know that they can complain against issue related to services of Social Safety Net, Health
& Nutrition, Agriculture, Livestock/poultry and quality education. This increased from 51.4% during
the first annual evaluation. Further, only 0.9% did complain to any office or committee during the past
12 months of second annual evaluation. One reason for not raising complaints was “lack of responses”,
Page | 56
it was found that only 25% complaint received a response (a decrease from 33.3% found during the
first annual study). These statistics represent needs of improving the feedback mechanism.
On this similar issue, in response to the question, how do they receive and act upon service receivers’
feedback, a service provider stated that “there was no opportunity before but now there is. However,
the reality is do not know much about nutrition so I am unable to say much”. Another UDCC member
mentioned about the existence of complain boxes. It appears that though some mechanism is
established both the service providers and service receivers need sensitization about effective feedback
mechanism that would eventually enhance quality of the service.
JANO can continue to advocate at DNCC, UNCC, UDCC, CC level to focus or maintain proper and
formal feedback mechanism. JANO needs to set up the system, raise awareness among communities,
local members of the committee for their active participation and also need to receive and register
complaints and take action in response to feedback.
vi. Funding Limitations
In a KII session with a JANO project staff it was mentioned that 2 DNCC, 7 UNCC and 64 UDCC
had spent budget on several purposes i.e., distributing food and sanitary napkins this is a significant
increase as during the first annual evaluation or baseline no such activities were recorded. Though
some local level budget has been allocated for different nutrition related activities, budget limitations
remain a great challenge. This issue can be innovatively addressed, as a Community Health Care
Provider (CHCP) mentioned that their CGs and CSGs do not receive funds from the government,
but they collect and maintain their own funds (BDT 2-5) from those patients who can afford to pay.
These members donate and collect funds during agricultural harvesting seasons; they collect a portion
of income from the local produce as regularly as possible. This fund is then used for local nutrition
planning for instance, planting fruit trees and improved maintenance of CCs. This approach could be
mainstreamed to engage local people more into the project/ ensuring better healthcare of the
community. However, the above approach did not work well everywhere, a Family Welfare Assistant
(FWA) mentioned that even though they tried to initiate a similar scheme in their area, people did not
contribute much to the fund resulting in this initiative performing poorly. This indicates the scope of
further work to be done by JANO in this area.
Encourage CSG members to donate and collect funds/contributions for implementing the local
nutrition action plan. It will create an ownership mentality among them and it will help to promote
substantiality practice over time.
vii. Women’s Access to Technology
During the second annual evaluation survey, it was found that 9.3% of households accessed or received
nutritional information through text messages. This indicates the that 7.2% of the households received
nutritional information though text messages during the first annual evaluation survey. Further, gender
disparity is imminent by the fact that during the second annual evaluation survey, 55.4% of the women
owned mobile phone (first evaluation: 56.3%) compared to 89.5 of men (first evaluation: 81.7%). This
reflects, women are at great need of digital extension services which could improve both nutrition
level and economic empowerment of women. Moreover, married adolescent girls recommended it
would be better if they could receive family planning and other health related information through
mobile phone.
However, challenges exist as women do not have the access to phones. As one woman commented,
“We do not have mobile phone for every person in our house. Only my husband has one phone. If
anyone gives information about health, nutrition, and hygiene, I will never get that as my husband stays
Page | 57
outside for his work. It would be better if we get these types of information from courtyard meetings.”
The cost of a mobile phones call is another challenge for poorer communities as reflected by a
pregnant woman from Rangpur, “It would be easier if we make phone calls for free to get the
information about health, nutrition and hygiene”. In this regard, toll free hotlines could be a solution.
In addition, during the second evaluation survey no ICT based e-learning platforms to support the
community were used by frontline workers. The statistics indicate that there is an enormous possibility
and need to develop this sector. Hence, development of a nutrition-focused portal could be very
effective as it will store all relevant information and deliver it to target communities in project areas.
JANO could introduce toll free hotlines, use community radio platforms to disseminate knowledge.
viii. Rolling back school interventions
Through interviews with SMC members, it was identified that monthly meetings were conducted in
61.1% cases (Nilphamari 73.9% and Rangpur 38.5%), and 50% received some form of training
(Nilphamari 60.9% and Rangpur 30.8%). Moreover, capacity of SMC members in gender sensitive
hygiene issues was comparatively low at 42.9%. Thus, initiatives must be emphasized more in schools
and Rangpur needs to catch up with Nilphamari. Besides, the COVID-19 has restricted school activities
to a larger extent. Therefore, initiatives should be taken to restart nutrition focused activities in
schools.
JANO can continue the online class and create a schedule to keep track of student's regular learning
activities and tasks. Also, the project can arrange online competitions, games, and other activities for
their social and mental development in this pandemic. Training of teachers is also essential under the
National Curriculum and Textbook Board (NCTB).
ix. Constraints to Income Generation
More than 55% respondents claimed that their income declined due to the COVID-19 pandemic.
Approximately 60% of respondents took loans to overcome this situation. The strain on their
economic situation will have a direct detrimental effect on the nutritional status of these people as the
survey indicates that more than 20% of respondents consumed less food or food of lower quality
during the pandemic as compared to earlier times. This trend will in turn severely affect the JANO
project’s aim of ending malnutrition and addressing the nutritional need of pregnant, lactating women
and adolescent girls.
In order to reduce the impact of the pandemic on the wellbeing of beneficiaries’ during this time,
JANO provided information about how to maintain hygiene and social distance, mapped people’s
movement and COVID-19 infection, distributed relief including sanitizers, soaps, and cleaning
products. Moreover, innovative activities were supported by JANO such as mask manufacturing by
the local community.
Page | 58
Annex 1: Log frame
4 If not indicated otherwise, to be achieved by the end of the project.
Results
chain
Indicators4
Definition Indicators
Baseline
(incl.
reference
year)
Annual
Assessment
2019
Annual
Assessment
2020
Targets
(incl.
referen
ce year)
Sources
and means
of
verification
Assumptions
Overa
ll o
bje
cti
ve: Im
pact
To contribute
in ending
malnutrition
of children
under five
years of age,
together with
addressing
the
nutritional
needs of
Pregnant and
Lactating
Women
(PLW) and
adolescent
girls;
Prevalence of
stunting among
children under 5
years of age
Nilphamari and
Rangpur districts
height for age < –2 SD of
the WHO Child Growth
Standards median (WHO
guideline)
Nilphamari
34.1%
Rangpur 36.1%
Overall 34.8%
(February-19)
24.8 %
(2023)
Baseline
Midline
evaluation
Final
Evaluation
No disaster
and long-time
pandemic
(COVID-19)
situation
persist
(for mid term)
Prevalence of
wasting among
children under 5
years of age
Nilphamari and
Rangpur districts
weight for height < –2 SD
of the WHO Child Growth
Standards median (WHO
guideline)
Nilphamari 7.5%
Rangpur 12.3%
Boys 10.1%,
Girls 8.2%
Overall 9.2%
(February-19)
4.2%
(2023)
Baseline
Midline
evaluation
Final
Evaluation
Prevalence of
underweight women
age 15-49 years in
Nilphamari and
Rangpur districts
BMI is a simple index of
weight-to-height (WHO
guideline)
Nilphamari
10.2%
Rangpur 7.3%
Overall 9.3%
(February-19)
4.3%
(2023)
Baseline
Midline
evaluation
Final
Evaluation
Sp
ecif
ic
ob
jecti
ve:
Ou
tco
me Improved
maternal and
child nutrition
in Nilphamari
% of women of
reproductive age in
the targeted districts
who are consuming a
Women 15-49 years of age
have consumed at least five
out of ten defined food
groups the previous day or
night. (FANTA-III)
Nilphamari
30.9%
Rangpur 41.8%
Overall 34.9%
Nilphamari 32.5%
Rangpur 42.3%
Overall 37.0%
(October-19)
Nilphamari
33.5%
Rangpur 44.3%
Overall 38.4%
(October-20)
46.9%
(2023)
Annual
report
Baseline,
midline &
No major
catastrophes
and natural
disasters such
as floods,
Page | 59
and Rangpur
districts
minimum dietary
diversity (MDD)
(February-19)
final
evaluation
pandemic
situation.
Political
environment
remains
conducive,
especially after
elections in
2018, to
project
implementatio
n
Nutrition
remains high in
the
development
agenda of the
Government
Ministries and
departments
are supportive
to
operationalize
multi-sectoral
approaches to
nutrition
programming
% reduction of
anaemia among
pregnant women in
Nilphamari and
Rangpur districts
Pregnant women as a
haemoglobin concentration
< 110 g/l at sea level.
(WHO guideline)
Nilphamari
55.7%
Rangpur 60.0%
Overall 57.3%
(February-19)
45.3%
(2023)
Baseline &
final
evaluation
Proportion of
children 6–23 months
of age who receive
foods from 4 or
more food groups
(based the MDD-C
methodology) by sex
(Percentage)
Children 6-23 months age
who received four food
groups out of seven (WHO
standard)
Boys 18.1%
Girls 17.4%
Nilphamari
18.1%
Rangpur 17.2%.
Overall 17.8%
(February-19)
Boys 19.4%
Girls 21.2%
Nilphamari 20.7%
Rangpur 20.2%.
Overall 20.4%
(October-19)
Boys 21.8%
Girls 23.5%
Nilphamari
22.7%
Rangpur 22.4%.
Overall 22.6%
(October-20)
37.8%
(2023)
Annual
report
Baseline,
midline and
final
evaluation
# of DNCC, UNCC
and UDCC spent
budget effectively on
nutrition-specific or
nutrition-sensitive
actions
50% of the fiscal year
budget spent
Nilphamari 0
DNCC
UNCC
UDCC
Rangpur 0
DNCC
UNCC
UDCC
Overall 0
(February-19)
Nilphamari 0
DNCC
UNCC
UDCC
Rangpur 0
DNCC
UNCC
UDCC
Overall 0
(October-19)
2 DNCC,
7 UNCC,
64 UDCC
(73 plans)
(Source: KII)
(October-20)
2
DNCC,
7 UNCC
65
UDCC
(will be
monitore
d from
2nd year
to 5th
year)
(2023)
Annual
reports
Action plan
documents at
district and
upazila level
Baseline
Midterm and
final
evaluation
Page | 60
% of increased
participation of
community people,
particularly women,
in formal
(government-led)
and/ or informal (civil
society-led, private
sector-led) decision-
making spaces
• Govt. led forums: CG,
CSG, UP special
committee, Up
standing committee,
adolescent group,
student council,
• Informal group: VSLA,
FFS, Mothers group,
youth group, women
support group
• Participation in the
meeting and in the
discussion Data
disaggregation by sex
(Definition aligned with
CARE global indicators.)
Participation in
meeting
discussion
Formal:
Nilphamari:
1.79%
Rangpur: 1.81%
Overall 1.79%
Informal:
Nilphamari:
1.79%
Rangpur: 1.81%
Overall 1.79%
(February-19)
Participation in
meeting
discussion
Formal:
Nilphamari:
0.47%
Rangpur: 0.47%
Overall 0.93%
Informal:
Nilphamari:
2.33%
Rangpur: 1.16%
Overall 3.49%
(October-19)
Participation in
meeting
discussion
Formal:
Nilphamari:
1.16%
Rangpur: 1.63%
Overall 2.79%
Informal:
Nilphamari:
2.56%
Rangpur: 2.33%
Overall 4.88%
(October-20)
Formal
11.79%
Informal
11.79%
(2023)
Monitoring
reports
Annual
reports
Baseline,
midline &
final
evaluation
(Social audit)
Page | 61
Exp
ecte
d R
esu
lt I
Ou
tpu
t I
Women and
adolescent
girls in
communities
are
empowered
to demand
and utilize
both
nutrition-
sensitive and
nutrition-
specific
services;
% of students
disaggregated by sex
who apply key
learning points
regarding nutrition,
health and hygiene at
home
At least 5 learning of
the below:
• Food ingredients, food
prepare and food
serving
• Intake of diversified
food
• Home gardening
• Safe drinking water
• Adolescent health &
Hygiene
• Hand wash in key
times
• Use of sanitary latrines
• Information about
health service
providers
Nilphamari
0.22%, Rangpur
0%
Boys 0.44% Girls
0.0%
Overall: 0.15%
(February-19)
Nilphamari
2.54%, Rangpur
1.30%
Boys 1.67% Girls
2.26%
Overall: 2.09%
(October-19)
Nilphamari
2.22%, Rangpur
4.38%
Boys 2.98% Girls
3.05%
Overall: 3.02%
(October-20)
20.15%
(2023)
Monitoring
reports
Annual
reports
Baseline
Midterm and
final
evaluation
Pandemic
situation will
not be
continued.
Schools will be
open and
SMCs are
functional.
% of women and
adolescent have
claimed nutrition
specific and sensitive
services from
relevant service
providers
• Community Clinic
(CC) for health
services
• Extension services for
agriculture and
livelihood
CC: Nilphamari
:37.8%
Rangpur :30.7%
Overall :35.5%
Extension
services: 3.98%
(February 2019)
CC: Nilphamari
:39.74%
Rangpur :31.63%
Overall :36.05%
Extension
services: 7.44%
(October 2019)
CC: Nilphamari
:40.68%
Rangpur :32.99%
Overall :37.21%
Extension
services: 8.84%
(October 2020)
CC=53.5
%
Extensio
n
services=
23.9%
(2023)
Service
record book
of the
respective
service
providers
Monitoring
reports
% of CSGs in
targeted communities
are functional
Qualify five out of seven
performance indicator
prescribed by government
0%
(February-19)
Rangpur - 198
Nilphamari - 414
Total – 612*
(Source – Project
Manager KII)
(October-19)
Nilphamari 37 %
Rangpur: 45 %
Overall: 41%
(October-20)
60%
(2023)
Monitoring
reports
Annual
reports
Baseline
Midterm and
Page | 62
final
evaluation
# of School
Management
Committees set
agenda for nutrition
specific and sensitive
services for
adolescents in the
SMC meeting
SMCs will raise issues in
the meeting, set them in
the action plan and that will
be mentioned in the
meeting minutes
Nilphamari-6
Rangpur-1
Overall -7
(February-19)
Nilphamari : 199
Rangpur: 103
Overall -302*
(Source SMC
members)
Monitoring
reports
Nilphamari 157
Rangpur: 88
Overall: 245
(Source: Survey
with SMC
members)
(October-20)
330
SMCs
(2023)
Event Report
Meeting
records
Monitoring
reports
Annual
reports
Exp
ecte
d R
esu
lt I
I
Ou
tpu
t II
Coordinated
and
resourced
sub-national
and local
government
structures
recognize,
respond and
are
accountable
to demands
of
poor and
marginalized
communities
# of Multi-sectoral
plans at district,
upazila and union
level have allocated
budget to support
nutrition
interventions in the
two target districts
At least allocated budget to
address one action in the
multi-sectoral nutrition
action plan in each year
Nilphamari 0
Rangpur 0
Overall 0
(February-19)
Nilphamari 0
Rangpur 0
Overall 0
(October-19)
2 DNCC,
7 UNCC,
64 UDCC
(73 plans)
(October-20)
(Source: KII)
(October-20)
74 plan
with
allocated
budget
(65union
s, 7
upazilas,
2
districts
in each
years)
Budget
records
Monitoring
reports
Annual
reports
Government
of Bangladesh
continues
efforts to
implement the
NPAN stays
high
No political
and/or
economic
crisis
(especially due
to elections)
% of increase of PLW
people from the
target population
received nutrition
specific safety net
support
• Maternal allowance
• 1000 days
• Supplementary feeding
• Maternal Health
Voucher
• Area based
Community Nutrition
Scheme
• VGF
• VGD
• Iron folic acid
supplementation
Nilphamari 8.0%
Rangpur 9.2%
Overall 8.4%
(February-19)
Nilphamari 9.7%
Rangpur 10.7%
Overall 10.2%
(October-19)
Nilphamari
10.26%
Rangpur 11.11%
Overall 10.64%
(October-20)
18.4%
(2023)
Participant
list from UP
Project MIS
Monitoring
reports
Annual
reports
Page | 63
% of women and
adolescent girls of
target population in
government forums
(UDCC, CG, CSG)
meaningfully
participated in the
nutrition action plan
development and
implementation
process
Meaningful Participation:
• Raise issue in the
forum
• Incorporated raised
issues in planning
Nilphamari 0
Rangpur 0.6%
Overall 0.2%
(February-19)
Nilphamari 0.9%
Rangpur 0.0%
Overall 0.5%
(October-19)
Nilphamari:
64.4%
Rangpur: 45.5%
Overall: 54.0%
(October-20)
(Source:
Overphone
Survey with
(UDCC, CG,
CSG) members)
(October-20)
60%
(2023)
Meeting
minutes
Annual
reports
# of platforms in the
target districts which
allow effective
feedback mechanisms
for service receivers
• Availability of a
complain box/hot line
number/or any other
mechanism
• Open complain box
regularly for addressing
in the monthly
meeting.
• Register all submitted
complain
• Public hearing meeting
• Discussed in the
regular meeting about
the submitted
complains.
Nilphamari 0
DNCC-
UNCC-
UDCC-
CC-
Rangpur 0
DNCC-
UNCC-
UDCC-
CC-
Overall 0
(February-19)
Nilphamari 0
DNCC-
UNCC-
UDCC-
CC-
Rangpur 0
DNCC-
UNCC-
UDCC-
CC-
Overall 0
(Ocotober-19)
64 Unions and
208 CCs
(Ocotober-20)
73
(unions
64,
Upazila 7
and
District
2) and
208 CCs
Project MIS
Meeting
minutes of
different
platforms
Annual
reports
Page | 64
Exp
ecte
d R
esu
lt I
II
Ou
tpu
t II
I
Production
and access to
high value
nutritious
commodities
and services
are increased
% of households
involved in the
production of higher
value nutrition
products
Higher value nutrition
products:
1. Is bio-fortified
2. Is a legume, nut, or some
seeds
3. Is an animal source food,
including dairy products
4. Is a dark yellow or
orange-fleshed root or
tuber
5. Is a fruit or vegetable
Nilphamari
34.5%
Rangpur 41.0%
Overall 36.7%
(February-19)
Nilphamari 32.9%
Rangpur 45.4%
Overall 38.6%
(October-19)
Nilphamari
35.6%
Rangpur 46.9%
Overall 40.7%
(October-20)
56.7%
(2023)
Annual
reports
Baseline
Midterm and
final
evaluation
Opportunities
for pro-poor
market exist
Private
companies
recognize the
potential of
last mile
marketing
% of households
practicing climate
smart agricultural
techniques
Minimum 3 techniques have
to be used out of 20
criteria
Nilphamari 3%
Rangpur 8%
Overall 5%
(February-19)
Nilphamari 4.7%
Rangpur 10.6%
Overall 8.3%
(October-19)
Nilphamari 7.3%
Rangpur 12.9%
Overall 9.4%
(October-20)
25%
(2013)
Annual
reports
Baseline
Midterm and
final
evaluation
# of initiative jointly
taken as a result of
tripartite agreement.
Tripartite initiative
(Govt.+JANO+Private
sector) will be taken on
agriculture, livestock,
WASH, micronutrient
supplementation and
financial inclusion as an
outcome of tripartite MoU
signing.
Nilphamari 0
Rangpur 0
Overall 0
(February-19)
Nilphamari 0
Rangpur 0
Overall 0
(Ocotober-19)
Nilphamari 0
Rangpur 0
Overall 0
(Ocotober-20)
At least
2
initiatives
will be
taken on
each of
the
following
thematic
areas;
agricultur
e,
livestock,
WASH,
micronut
rient
Project
Monitoring
report
Baseline
Midterm and
final
evaluation
Page | 65
suppleme
ntation
and
financial
inclusion
as an
outcome
of
tripartite
MoU
signing.
Referenc
e year:
2023
Exp
ecte
d R
esu
lt I
V
Ou
tpu
t IV
VG
F
Information
and
communicatio
n technology
(ICT)
platform is
established at
local level to
connect
relevant govt.
departments
and increase
awareness of
community
people on
nutrition
interventions’
# of government
forums (UNCC,
DNCC,) utilizing
Nutrition Information
Portal for planning
and decision making
at district and upazila
level
One web based platform
established
There is no
Nutrition
Information
Portal for
planning and
decision making
at district and
upazila level
(February-19)
0
(October -19)
0
(October -20)
9 govt.
forums
(2
DNCC,
7
UNCC)
(2023)
Meeting
minutes
Final
evaluation
Sufficient
internet
facilities in the
targeted
locations
Limited
fluctuation of
front line
workers
Government
continues
efforts in ICT
solutions
Community
members use
data from ICT
platforms
% of frontline
workers using the
ICT based e-learning
platform to support
the community based
on needs
Mobile based learning app
are used by frontline
workers
0% Frontline
workers
(February-19)
Monitoring
reports
0
(October -20)
50%
relevant
govt.
front line
workers
(2023)
Monitoring
reports
Annual
reports
Final
evaluation
% of community
members who have
community members will
have access nutritional
Nilphamari 2.4%
Rangpur 7.8%
Nilphamari 6.4%
Rangpur 8.2%
Nilphamari 8.1%
Rangpur 10.8%
60% of
communi
Monitoring
reports
Page | 66
accessed or received
ICT based nutritional
information
information from the
mobile based learning apps
and receive text messages
Male: 4.1%
Female: 8.3%
Overall 4.2%
(February-19)
Male: 5.3%
Female: 4.7%
Overall 7.2%
(October-19)
Male: 9.7%
Female: 10.5%
Overall 9.3%
(October-20)
ty
members
(2023)
Annual
reports
Final
evaluation
Page | 67
Annex 2: Survey Area
Page | 68
Annex 3: Other Tables
Table 1: Household Sample Distribution by Village
District Upazila/Thana
Name Union/Ward Name Area/Village Name
MZ
/
MH
Village RMO
Name
RMO
Code Both Male Female
Nilphamari Domar Upazila Bhogdabari Union 1 *Nij Bhogdabari 762 1 RURAL 1 11784 5865 5919
Nilphamari Domar Upazila Gomnati Union 2 *Purba Ambari 825 1 RURAL 1 2738 1353 1385
Nilphamari Domar Upazila Ketkibari Union 3 *Dakshin Ketakibari 317 1 RURAL 1 4272 2130 2142
Nilphamari Jaldhaka Upazila Balagram Union 4 *Chhit Mirganj 235 1 RURAL 1 1820 888 932
Nilphamari Jaldhaka Upazila Golmunda Union 5 *Paschim Golmunda 693 1 RURAL 1 9957 4989 4968
Nilphamari Jaldhaka Upazila Kaimari' Union 6 *Talukbadi 942 1 RURAL 1 831 418 413
Nilphamari Jaldhaka Upazila Mirganj Union 7 *Mirganj 615 1 RURAL 1 1986 1091 895
Nilphamari Jaldhaka Upazila Saulmari' Union 8 *Taluk Saulmari 955 1 RURAL 1 12558 6217 6341
Nilphamari Kishoreganj Upazila Chandkhana Union 9 *Saranjabari 881 1 RURAL 1 1606 810 796
Nilphamari Kishoreganj Upazila Kishoreganj Union 10 *Pushna 795 1 RURAL 1 4922 2481 2441
Nilphamari Kishoreganj Upazila Putimari' Union 11 *Kalikapur 369 1 RURAL 1 13042 6664 6378
Nilphamari Nilphamari Sadar
Upazila Chapra Saramjani Union 12
*Beradanga 169 1 RURAL
1 6831 3363 3468
Nilphamari Nilphamari Sadar
Upazila Gorgram Union 13
*Dhobadanga 318 1 RURAL
1 8627 4442 4185
Nilphamari Nilphamari Sadar
Upazila Khokshabari Union 14
*Dakshinpara 288 1 RURAL
1 373 188 185
Nilphamari Nilphamari Sadar
Upazila Kunda Pukur Union 15
*Patkamuri 786 1 RURAL
1 2813 1383 1430
Nilphamari Nilphamari Sadar
Upazila Palashbari Union 16
*Kismat Kanaikata 606 1 RURAL
1 589 308 281
Nilphamari Nilphamari Sadar
Upazila Ramnagar Union 17
*Char Charabari 228 1 RURAL
1 3384 1713 1671
Page | 69
District Upazila/Thana
Name Union/Ward Name Area/Village Name
MZ
/
MH
Village RMO
Name
RMO
Code Both Male Female
Nilphamari Nilphamari Sadar
Upazila Sonaroy Union 18
*Chak Dublia 208 1 RURAL
1 3729 1898 1831
Nilphamari Nilphamari Sadar
Upazila Tupamari Union 19
*Nilphamari Bazar
(Part)B 829 1 RURAL
1 5173 2666 2507
Rangpur Gangachara Upazila Alam Biditar Union 20 *Saragandha Ismail 867 1 RURAL 1 3552 1758 1794
Rangpur Gangachara Upazila Betgari Union 21 Chhayani Aldadpur 27 3 RURAL 1 1185 607 578
Rangpur Gangachara Upazila Gangachara Union 22 *Bhutka 163 1 RURAL 1 2629 1300 1329
Rangpur Gangachara Upazila Gajaghanta Union 23 *Umar 954 1 RURAL 1 3683 1855 1828
Rangpur Gangachara Upazila Lakshmitari Union 24 Paschim Ichli 449 2 RURAL 1 2237 1164 1073
Rangpur Gangachara Upazila Marania Union 25 *Alal 13 1 RURAL 1 868 442 426
Rangpur Gangachara Upazila Marania Union 26 *Kismat Marania 572 1 RURAL 1 1035 551 484
Rangpur Gangachara Upazila Nohali Union 27 *Madhya Kachua RURAL 1 1233 639 594
Rangpur Kaunia Upazila
Kaunia ' Bala Para'
Union 28
*Arazi Khorda
Bhutchara 62 1 RURAL 1 807 397 410
Rangpur Kaunia Upazila
Kaunia ' Bala Para'
Union 29
*Panjarbhanga 708 1 RURAL 1 1436 732 704
Rangpur Kaunia Upazila Kursha Union 30 *Mahesha 634 1 RURAL 1 2694 1337 1357
Rangpur Kaunia Upazila Sarai Union 31 *Kachu 534 1 RURAL 1 4593 2279 2314
Rangpur Kaunia Upazila Tepa Madhupur Union 32 *Baje Mazkur 111 1 RURAL 1 2178 1022 1156
Rangpur Taraganj Upazila Alampur Union 33 *Fazilpur 373 1 RURAL 1 2779 1417 1362
Rangpur Taraganj Upazila Hariarkuti Union 34 *Khalea Nandaram 547 1 RURAL 1 2120 1080 1040
Rangpur Taraganj Upazila Sayar Union 35 *Baidyanathpur 74 1 RURAL 1 1167 595 572
Page | 70
Table 2: List of Selected School
Sl. No. Name of School Village Union Upazila District
1 Chor Eshorkol Junior school Char Eshokol Lakshmitari Gangachara Rangpur
2 Uday Narayon Mashari High School Udaynarayon Mashari Sarai Kaunia Rangpur
3 Shamolgonj Junior High School Shamgonj Sayar Taraganj Rangpur
4 Rajballav High School Rajballav Gajaghanta Gangachara Rangpur
5 Aldadpur BL High School Aldadpur Betgari Gangachara Rangpur
6 Fazilpur BL High School Fazilpur Alampur Taraganj Rangpur
7 Bazamuskur Girls Dakil Madarasha Bazamuskur Tepa Madhupur Kaunia Rangpur
8 Dhormeshwar Mohesha BL high School Mohesha Kursha Kaunia Rangpur
9 Kalikapur High School ( Kalikapur School and College) Kalikapur Putimari Kishoreganj Nilphamari
10 Ambari Bangobondhu High School Purbo Ambari Gomnati Domar Nilphamari
11 Doxminpara Girls High School Doxminpara Khoksabari Nilphamari Nilphamari
12 Dhobadanga High School Dhobadanga Gorgram Nilphamari Nilphamari
13 Chorchorabari High School Chorchorabari Ramnagar Nilphamari Nilphamari
14 Uttorpatkamuri High School Patkamri Kundapukur Nilphamari Nilphamari
15 Talukbodi High School Talukbodi Koimari Jaldhaka Nilphamari
16 Shoulmari ML High School Taluk Shoulmari Shoulmari Jaldhaka Nilphamari
17 Shoulmari Girls School & College Taluk Shoulmari Shoulmari Jaldhaka Nilphamari
18 Golmunda ML High School Paschim Golmunda Golmunda Jaldhaka Nilphamari
19 Chalk dublia Govt. Primary School Chokdublia Sonaroy Nilphamari Nilphamari
20 Doxmin Ketkibari Telipara Govt. Primay School Dakhin Ketkibari Ketkibari Domar Nilphamari
21 Fokirgonj Chalkbera Dakhil Madrasha Chokdublia Sonaroy Nilphamari Nilphamari
22 Khankaye Keramotia Dakhil Madrasha Neej Bhogdaburi Bhogdaburi Domar Nilphamari
Page | 71
Table 3: List of Qualitative Sample
Respondents Type
Rangpur Nilphamari
Total
Gan
gach
ara
Kau
nia
Tar
agan
j
Dom
ar
Jald
hak
a
Kis
horg
onj
Nilp
ham
ari
Sadar
Focus Group Discussions (FGDs)
Community Support Group 1 1 2
Community Group 1 1 2
Unmarried Adolescents boys and girls
(1 with boys and 1 with girls’ group) 1 1 2
Men (Head of the Household) 1 1 2
School Management Committee 1 1 2
Total FGDs 10
Key Informant Interviews (KIIs)
SAAO – DAE 1 1 2
Community Health Care Provider (CHCP) 1 1 2
Family Welfare Assistants 1 1 2
Health Assistants 1 1 2
Representatives of UDCC 4 1 1 1 1 8
Representatives of UNCC 4 1 1 1 1 8
Representatives of DNCC 2 1 3
Livestock Officer 1 1
JANO Project staff 5 5
Public Health and Engineering Officers 1 1 2
Total KIIs 35
In-depth Interviews (IDIs)
Pregnant women 2 2 4
Lactating women 2 2 4
Married adolescent girls 1 1 2
Total IDIs 10
