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USAID’s Improving Nutrition through Community-based

Approaches (INCA) Activity

Y2Q2 progress report

(January 1, 2018-March 31, 2018)

Implemented by:

Caritas Bangladesh (Awardee)

United Purpose (Sub-awardee)

Supported by: United State Agency for International Development (USAID)

Submitted to:

Office of Health, Population, Health, Nutrition and Education (OPHNE)

United States Agency for International Development (USAID)

Dhaka, Bangladesh

Submitted by:

Caritas Bangladesh

Dhaka, Bangladesh

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“This report is made possible by the support of the American people through the United States

Agency for International Development (USAID). The opinions expressed herein are those of the

author(s) and do not necessarily reflect the views of the U.S. Government or USAID or Caritas

Bangladesh the implementing agency.”

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Table of Contents List of Acronym ...................................................................................................................................... 4

Executive Summary ................................................................................................................................. 5

1. Training and orientation ..................................................................................................................... 6

1.1 Training on mobile app ................................................................................................................. 6

1.2 WIC Entrepreneur basic training on nutrition and WIC ................................................................ 7

1.3. Orientation for government health staff on nutrition and counseling ........................................ 7

1.4. Community Nutrition Support Group (CNSG) orientation ........................................................... 8

1.5. Organized training on LSPs engagement in nutrition services .................................................... 8

2. Community based activities ................................................................................................................ 9

2.1. 1,000 days’ household registration.............................................................................................. 9

2.2. Beneficiary Group formation ....................................................................................................... 9

2.3. Beneficiary group orientation on IYCF, maternal nutrition and group operation ....................... 9

2.3. 1,000 days’ household visit and counseling ............................................................................... 10

2.5. Promoting tippy tap ................................................................................................................... 10

3. Women Information Center level activities ...................................................................................... 11

3.1. Established Women Information Center ................................................................................... 11

3.2. 1,000 days HH and beneficiary registration, group formation and orientation under WIC ...... 11

3.3. Services from WIC ...................................................................................................................... 11

3.4 Orient UP on WIC and INCA ........................................................................................................ 11

4. Health center level activities ............................................................................................................. 12

4.1 Continue support to community based health facility ............................................................... 12

4.2 Annual Work Plan Preparation by Community Nutrition Support Group (CNSG) ...................... 12

5. Day observation ................................................................................................................................ 13

5.1. Observed community based nutrition day ................................................................................ 13

5.2. Observed international women’s day ........................................................................................ 14

6. Development and distribution of SBCC materials ............................................................................ 15

6.1 Approval of USAID’s INCA newly developed SBCC materials by IEC technical committee ......... 15

6.2. SBCC materials distribution and sharing .................................................................................... 15

7. Supportive supervision ..................................................................................................................... 17

8. Government High officials visit USAID’ INCA in Bhola ...................................................................... 18

9. INCA staff meeting ............................................................................................................................ 18

10. Challenges ....................................................................................................................................... 19

11. Annex .............................................................................................................................................. 19

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List of Acronym

ANC Ante Natal Care

CBHC Community based Health Care

CC Community Clinic

CG Community Group

CHCP Community Health Care Provider

CM Cluster Manager

CNP Community Nutrition Promoter

CNSG Community Nutrition Support Group

CSG Community Support Group

DGFP Directorate General of Family Planning

DGHS Directorate General of Health Services

DAE Department of Agriculture Extension

DLO District Livestock Officer

DLS District Livestock services

EPI Expanded Programme on Immunization

FS Field Supervisor

FWA Family Welfare Assistant

FWV Family Welfare Visitor

GMP Growth Monitoring and Promotion

HA Health Assistant

HH Household

IEC Information, Education and Communication

IPC Inter Personal Communication

IPHN Institute of Public Health nutrition

IT Information Technology

IYCF Infant and Young Child Feeding

LSP Local Service Provider

LW Lactating Mother

MIS Management Information System

MoHFW Ministry of Health and Family Welfare

NGO Non-Governmental Organization

NNS National Nutrition Services

PNC Post Natal Care

PW Pregnant Women

SAAO Sub Assistant Agriculture Officer

SBCC Social and Behavior Change Communication

UAO Upazila Agriculture officer

UP Union Parishad

USAID United States Agency for International Development

UzP Upazila Parishad

WIC Women Information Center

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Executive Summary

This quarterly report of “USAID’s Improving Nutrition through Community-based Approaches

(INCA) Activity” covers the period of January1, 2018 through March 31, 2018, which corresponds

to the second quarter of fiscal year (FY) 2017-18, Implementation Year One (IY1) and 4th milestone

of the project. The report highlights activities carried out under the USAID’s INCA by Caritas

Bangladesh (CB) and its sub-awardee, United Purpose (UP).

The activities undertaken during this quarter were intervention rolling out and continuation. In this

quarter training on mobile app has been conducted to track 1,000 day HH beneficiaries in two folds

i.e. TOT on key project staff followed by training to CNP, FS and WIC entrepreneurs. ToT on

mobile app has been provided to 27 staff which comprised of 3 FC, 3 PO-M&E, 11 CM, 3 WIC

coordinator and 7 central team members. The master trainer has provided training to 497 (male-25,

Female-472) participants on mobile app that includes, 380 CNP, 39 FS and 78 WIC entrepreneurs.

Followed by training on mobile app CNP started 1,000-day household tracking using mobile app. In

this reporting period, USAID’s INCA has newly registered 21,876 number of 1,000 day households

consisting 9,954 pregnant women, 14,754 children under two, 9,118 lactating mother and 3,123

adolescent girls. USAID’s INCA has formed 3,409 mothers, 2,899 fathers, 1,962 mothers in law and

836 number of adolescent girls’ groups among the registered 1,000 days HHs in Y2Q2. During these

beneficiary group formation, CNPs and FSs has given initial orientation to the all beneficiary groups

on IYCF, maternal nutrition, adolescent nutrition and group operation. CNPs also continuing SBCC

activities through household visit, counseling and courtyard session. During the reporting period a

total number of 106,084 households reached through SBCC activities where 32,013 pregnant

women 28,508 lactating mother, 56,609 mothers of 7-24 months’ children were received services. In

Y2Q2 a ToT on LSP engagement in nutrition services has provided to 26 project staff and among

them 20 were from field and 6 were from central team. The master trainers provide basic training to

LSP engagement in nutrition services training to 379 CNP and 39 FS. In this quarter, 902 (Male-458,

Female-444) GoB health staffs received orientation in 39 Batches. Total 4,543 CNSG members

(male-2,498, female-2,045) received orientation on nutrition and CNSG. For ensuring quality service

delivery at community level, the supportive supervision has been continued where 1364 supportive

supervision visits took place by FS to CNP and 298 visits took place by CM to FS. IEC technical

committee approved newly developed SBCC and following approval INCA has printed these SBCC

materials and distributing and sharing among the beneficiaries, stakeholders and staff. The project

also rolled out a targeted activity “Nutrition Day” and observed with the theme of “Measure to Know

Nutritional Status” in Kamalnagar Upazila under Lakshmipur district. About 1,000 of people reached

by this event and 300 beneficiaries like pregnant women, mothers and fathers of 7-24 month

children and adolescent girls participated in GMP and BMI measurement directly. USAID’s INCA

also observed international women day 2018 in 8 Upazila including WIC centres. During the

reporting period a team of Director IPHN and Line Director NNS along with Deputy Director,

IPHN and Program Manager, NNS, IPHN, Civil Surgeon of Bhola and others visited activities of

USAID’s INCA project in Bhola sadar Upazila and Monpura Upazila under Bhola district to observe

the progress.

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USAID’ INCA started implementing of project activities in full-swing manner in this reporting period

covering all interventions along with real time monitoring. It has achieved its 4th Milestone of project

during this quarter, please see annex 1 for summery of milestone 4 achievement. The accomplished in

Y2Q2 activities are in given details below:

1. Training and orientation

1.1 Training on mobile app Following developed training manual on INCA apps the project has provided training to the project

staff including CNPs and Entrepreneur. The training on the mobile app has been organized following

two steps: 1. ToT on mobile the app and 2. Basic training on the app. A brief description of these

trainings has outlined below-

1.1.1 ToT on mobile App: ToT on mobile app has been held from 21-23 January, 2018 at

Padakhep Manabik Unnayan Kendra, Adabar,

Dhaka. Total 27 participants (male-18, female-09)

received ToT on the mobile app. Mr. Abu

Hamid, a Consultant of INCA mobile apps and

dashboard has facilitated the ToT. During this

training facilitators has been covered the

contents on installing and uninstalling of app,

signing in and setting the GPS and language,

registration of pregnant women, lactating

mother, 0-23 month children, adolescent,

beneficiaries group and non-service data entry,

uploading mobile data into dashboard,

uninstalling the app, introduction to dashboard,

user settings, exporting data into excel and

report generation. A table of participants attended

in this training is given in annex 2

1.1.2. Basic training on app to CNPs and

WIC entrepreneurs: After receiving ToT, the

master trainers organized a 2 days long basic

training on app for CNP and WIC entrepreneurs

and field supervisors (FSs). This training was led

by the Project Officer-M&Es and facilitated this

training with the assistance and co-facilitation of

the Field Coordinators and Cluster Managers.

The facilitators have followed the training manual

of apps for facilitating their session. The training

sessions includes installing and uninstalling of

app, signing in and setting the GPS and language, registration of pregnant women, lactating mother,

0-23 month children, adolescent, beneficiaries group and non -service data entry, monthly data entry

of beneficiaries after counselling, data view and edit uploading mobile data into dashboard,

uninstalling the app. Total 497 participant (male- 26, Female-471) received training on mobile app

and among them 380 were CNP, 39 were FS and 78 were WIC entrepreneurs. The Project

Director, Senior Expert M&E, Senior Expert Livelihood and LSP and other INCA central team

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member visited training to ensure quality of the training. Table of number of participants was attended

in app training present in annex 3

1.2 WIC Entrepreneur basic training on nutrition and WIC In Y2Q2 34 women entrepreneurs received a 2 days

long basic training on nutrition and WIC in 2 batches

in Charfassion, Bhola and Hatiya, Noakhali. This

training was led by WIC Coordinators and facilitated

the training with the assistance of others master

trainers of INCA. During this training, the facilitators

has been covered the topics on WIC concept and

operation strategy, activities of the WIC, IYCF,

Maternal Nutrition, Adolescent Nutrition, GMP, hand

washing, low-cost hand washing devices and water

filtering, homestead gardening, poultry rearing,

aquaculture and food processing etc. Trainers of the

local agriculture, livestock and fisheries of

government also facilitated different session of this

training on agriculture, fisheries and livestock as guest

facilitators. A summary of participants of this training is

in annex 4

1.3. Orientation for government health staff on nutrition and counseling In continuation of previous quarter, the project has

completed orientation for government front line

health staff in Y2Q2. Total 902 (Male- 458, Female-

444) government front line health worker were

oriented in this Y2Q2. The orientations held in

different training venue of the respective Upazila

Health Complex and Upazila Family Planning Office

and facilitated by the INCA master trainers along

with local government health and family planning

resource person who are Upazila Health and Family

Planning Officer (UH&FPO), Upazlila Family Planning

Officer (UFPO), Health Inspector (HI) etc. During

these orientations, Program Managers, NNS, IPHN,

Civil Surgeon of Bhola, Deputy Director of Family

Planning of Bhola, Deputy Program Managers, NNS,

IPHN and INCA central team has visited orientation

program as part of joint monitoring. Orientation

program were started in Y2Q1 but it have to

postponed due to nationwide strike of CHCP. After

withdrawn of the strike, the project resumed the

orientation for government health staff and completed in this quarter. The detail breakdown of the

participants of this orientation is provided in annex 5

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1.4. Community Nutrition Support Group (CNSG) orientation USAID’s INCA completed formation of

Community Nutrition Support Group and

oriented CNSG’s member on Nutrition and

CNSG operation in this reporting quarter.

Total 4,543 (male-2,498, female-2,045) number

of CNSG members were oriented in 287

batches. The orientations were held in the

Community Clinics and convenient places of

the respective community. The orientation

session was comprised of the objectives of

CNSG formation, roles and responsibilities of

CNSG members, nutrition scenario of

Bangladesh, food stuff and nutrition, nutrition

of pregnant women, 0-23 month children,

lactating mother, adolescent and role of CNSG

members to ensure nutrition status of 1,000

days household members within their

respective community. During these

orientations, Line Director, Program Managers,

NNS, IPHN, CS of Bhola, DDFP of Bhola and INCA central team has visited CNSG orientation for

observing orientation sessions as part of joint monitoring. The detail breakdown of the participants of

this orientation is provided in annex 6

1.5. Organized training on LSPs engagement in nutrition services Following training manual on LSP, the project

trained field staff and CNPs with a view to

engagement of LSP in nutrition services at

community level. Project organised one day

orientation for 26 project staff (20 field based

staff and 6 central team members) at Dhaka.

The main objective of the orientation program

was to firstly, to develop a field based resource

team, so that they can organise training for field

based staff and CNPs; secondly to develop a

central resource team, so that they can ensure

quality of training through monitoring and

accompaniment support. The methodologies of

the training were; presentation, questions and

answers, participatory discussion, group work

and mock session etc. Detailed status of

participants in this training is provided in annex 7.

The master trainers of INCA has organised 18

batches day long training for CNP and FS across

the project. Total 419 participants (379 CNP and 39 FS) were trained on LSP in this quarter and

among the participants 393 are female and 25 male. During the training, each CNP develop LSP

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orientation plan and following their orientation plan, they provided initial orientation to their listed

LSP through Inter Personal Communication (IPC) at their locality. Detailed status of participants in this

training is provided in annex 8

2. Community based activities

2.1. 1,000 days’ household registration Community Nutrition Promoters (CNPs)

continued registration their targeted

beneficiaries across the project area using the

beneficiary registration tools and guideline. A

total number of 21,876 one thousand days

household were newly registered during this

reporting period with 36,949 numbers of

individual beneficiaries. The individual

beneficiaries comprised of 9,954 Pregnant

Women, 9,118 Lactating Mother, 14,754

Children of 0-23 months and 3,123 Adolescent

girls. Following basic training on mobile app in

this quarter, CNP also started 1,000 days household registration and tracking using mobile app. Field

Supervisors and Cluster Managers are supervising the beneficiaries’ registration. Project Officer-M&E

has been supervising and verifying the beneficiaries and registration process through household visit

as sample basis from filed office level. Project Director, Nutrition Specialist and Senior Expert-M&E

also are verifying beneficiary’s registration through household visit and cross check collection data

through logical check from central office. A synopsis of number of 1,000 days’ household and

beneficiaries’ registration has been provided in annex 9 and annex 10.

2.2. Beneficiary Group formation

As part of continuation of beneficiary group formation, the project has formed a total number of

3,409 mothers, 2,899 fathers, and 1,962 mothers in law and 836 number of adolescent girls’ groups

among the registered 1,000 days HHs in this reporting period. A summary of number of groups has

given in annex 11

2.3. Beneficiary group orientation on IYCF, maternal nutrition and group

operation During

beneficia

ry group

formatio

n, CNPs

and FSs

oriented

the

respectiv

e beneficiary group members on IYCF, maternal nutrition and group operation through a formal

courtyard session. During this reporting period, USAID’s INCA has provided orientation to a total

number of 3,409 mothers, 2,899 fathers, 1,962 mothers in law and 836 number of adolescent girls’

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groups. After completing this beneficiary group orientation, CNPs also are conducting courtyard

sessions with the beneficiary groups as their regular activities. USAID’s INCA has organized

courtyard session in a total of 3,409 mothers, 2,899 fathers, 1,962 mothers in law and 836 number

of adolescent girls’ group. A summary of number of groups orientation and court yard session has given in

annex12 and annex13

2.3. 1,000 days’ household visit and counseling

Comm

unity

Nutriti

on

Promo

ters

(CNPs)

are

visiting

1000

days’ household according to their work plan in their assigned working area and providing counseling

to the pregnant women and lactating mothers, mothers of 7-23 month children and their family

members. A total of 106,084 no. of 1,000 days households were visited and provided counseling

during the reporting period. The CNPs are carrying SBCC materials and using it in their counseling

and through SBCC activities 32,013 pregnant women 28,508 lactating mother, 56,609 mothers of 7-

24 months’ children were received services in Y2Q2. Field supervisors are providing supportive

supervision to the CNPs for ensuring quality counseling. From this quarter, CNPs also started 1,000

days household tracking and input their service data using mobile app. please see the annex 13 for

details.

2.5. Promoting tippy tap

USAID’s INCA

has been

promoting

Tippy Tap

among the

1,000 days HH

through

counselling,

demonstration

and setting-up it

at HH level

whose has not

hand washing

fac ilities at their

house. The project also has promoting Tippy Tap at community based health facilities and

institutions like community clinic, schools, madrasa and mosque etc. During this reporting period,

total 4,409 tippy taps has established at 1,000 days household across the project area. The number of

tippy tap established is given in annex 15

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3. Women Information Center level activities

3.1. Established Women Information Center In the continuation of WIC establishment, rest of 4 out of 40 WICs has been established in this

quarter. These 4 WIC also equipped and furnished as like as other 36 WICs which established in last

quarter. The details Field office wise newly establish WIC provided in the Annex 16

3.2. 1,000 days HH and beneficiary registration, group formation and orientation

under WIC Assigned Women Entrepreneurs of each WIC has been started 1,000 days HH and beneficiary

registration. During this reporting period, total 3,613 number of 1,000 day’s households registered

under 40 WIC across the project area. Entrepreneurs also have started formation of beneficiaries

groups along with beneficiary registration. Total 37 mothers group and 18 adolescent girls group has

been formed in this quarter among the registered pregnant women, lactating mother and adolescent

girls under the WICs.

During beneficiary group formation, WIC entrepreneurs oriented the respective beneficiary group

members on IYCF, maternal nutrition and group operation through a formal courtyard session. In

Y2Q2, 14 adolescent groups were oriented on nutrition and personal hygiene. Courtyard session

organized with mother and adolescent was 29 and 13 respectively.

3.3. Services from WIC WIC has started

providing services

among the beneficiaries

at 1,000 days HH level

and WIC level. During

this reporting period,

WICs were performed a

total 29 courtyard

session with mothers

groups, 13 courtyard

session with adolescent

girls, referred total 26

PW to the nearest

community based health

facilities for ANC and

nutrition services and a

total 37 under 2 years

children referred to satellite clinic, EPI centre and UHFWC for immunization and nutrition services.

WICs also started promoting and demonstration nutrition sensitive activities among the

beneficiaries, during this reporting period a total 11 model homestead gardening, 3 poultry rearing

shade, 119 tippy-tap and 6 low-cost water has demonstrated and set-up.

3.4 Orient UP on WIC and INCA For engagement of local UP in WIC operation, the project

has started coordination and liaison with the UP and

Upazila Parishad. The WIC Coordinators were attending

in the UP monthly meeting and taken scopes to orient UP

on WIC an INCA. A total 12 UP were orient on WIC and

INCA during these reporting period. The WIC

Coordinators has discussed on USAID’s INCA, USAID,

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Caritas, United Purpose, WIC formation, operation and its activities briefly. Chairman of the

respective Union Council were committed support to implementing WIC in their locality and also

showing their interest for visiting WICs mostly.

4. Health center level activities

4.1 Continue support to community based health facility The project

has

continuing

health

center level

activities

according

to the

project

plan. CNPs

and FSs are

developing

their quarterly work plan consisting community based health center level activities and spending

their working hour for attending at the community based health and nutrition service point regularly.

The CNPs are assisting community based health service providers like CHCP, FWA and HA in

counselling, conducting GMP, ANC, PNC, early detection and registration of pregnant women,

immunization etc. for ensuring health and nutrition services. A total of 4,223 no. of CNP man-days,

1,230 FS man-days and 245 CM man-days have been spent to assist health facility. A detail is given in

Annex 17

4.2 Annual Work Plan Preparation by Community Nutrition Support Group

(CNSG) Following

formation

and

orientation

of

Community

Nutrition

Support

Group

USAID’s

INCA

facilitated preparation of Annual Work Plan of CNSG. USAID’s INCA has developed a formative

guideline for work plan preparation consisting of inform members about work plan, identifying key

nutrition problem in the community, grading problem according to severity, exercise on key solution

for the problem, preparation of draft work plan for CNSG and display final work plan at community

clinic. During this reporting quarter, 4 CNSGs has established their work plan. The work plan

preparation workshops were hampered by nationwide strike of CHCP and have to shift in next

quarter. Rest of the CNSG will prepare their annual work plan in this upcoming quarter.

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5. Day observation

5.1. Observed community based nutrition day To create mass

awareness in the

community

people USAID’s

INCA activity

organized

community based

nutrition day on

March 29, 2018 at

Charfalcon Union

Parishad

Premises,

Kamalnagr upazila

under Lakshmipur

district. The

theme of the

nutrition day was

“Measure to

know nutritional

status” in Bangla

"gvc‡j Z‡eB †evSv

hv‡e, cywó Av‡Q mwVKfv‡e".

With the assistance of Community Nutrition Support Group (CNSG), the event was scheduled in

three sessions. First was the inauguration and technical discussion on the theme of Nutrition Day.

UP chairman of Charfalcon Union was chief guest in this occasion. The respective UP member,

CHCP, CNSG members, FPI, HI, some journalist of print and electronic media, NGO workers were

also present in this event. Next session was growth monitoring promotion for the children and BMI

calculation to the adult. GMP and BMI was very new information among the participants. It was

observed that most of the mothers don’t know about the GMP. They were informed where to get

the services. During this session BMI of 100 mothers and 20 adolescents were calculated. GMP of 40

children was done and moderate to severe malnourished 10 children were referred to nearby health

service center. The third and final session was open discussion and quiz competition. Participants

were asked on the discussed topics and winner was given token prize. Through this event total 300

(20 male, 280 female) people were reached directly from 1000 days household and about 800

general people were reached indirectly through this event. USAID’s INCA also prepare plan to

observe nutrition day in smaller scale with different quarterly theme to reach larger community.

Next quarter Nutrition Day Event will be observe integrating with the National Nutrition Week

2018.

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5.2. Observed international women’s day USAID’s INCA has celebrated International

Women’s Day 2018 across the project through

different events incorporating with the government.

The theme of International Women’s Day 2018 is

“The Time is Now: Rural and Urban Activities

Transforming Women’s Lives”. This day was

celebrated in 8 out of 11 Upazilas with Department

of Women Affairs jointly at Upazila level through in

rally, human chain, and discussion meeting and

women development fair and cultural programs at

Upazila level. Beside of these activities, the project

also organized rally, discussion meeting and

conducted courtyard session with the engagement

of CNSG and community leaders on the theme of

IWD with pregnant and lactating mother, husbands,

mothers in law and adolescent girls. Total 353

courtyard sessions were conducted by the

Community Nutrition Promoters (CNP) and Field

Supervisors on the theme of IWD 2018 and

covered 4,220 pregnant and lactating mothers,

husbands, mothers in law and adolescent girls

directly and about 23,000 community people were

reached through the rally and discussion session of

this day. See annex 18 for women day celebration

status

WIC and its entrepreneur also celebrate the

International Women Day 2018 by organizing

different events like rally, discussion sessions and

human chain, video show, BMI campaign at the

WICs and community level. The rallies were

rounded in the villages led by local UP chairman

and members and gathered in WICs for discussion.

Following celebration of this day, the assigned

entrepreneur also conducted courtyard session

with the mothers and adolescent girls group in their

villages on the theme of IWD 2018. Through

these events, WIC has reached about 6,000 remote

villagers including pregnant and lactating women,

adolescent girls, male and female, local elites and

religious leaders.

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6. Development and distribution of SBCC materials

6.1 Approval of USAID’s INCA newly developed SBCC materials by IEC technical

committee In Y2Q1 4

types of

SBCC

material has

been

developed

through a

consultation

workshop

followed by a

draft review meeting and submitted to IEC technical committee of MoHFW for approval. The IEC

Technical Committee meeting was held on January 17,2018 for final review and approval at

Bangladesh Secretariat. Ms. Roxana Quader, Addl. Secretary, MOH&FW chaired the IEC Technical

Committee meeting. USAID’s INCA presented final draft SBCC materials i.e. nutrition calendar for

pregnant women, food bowl for children (under 2 years), and nutrition ludo game for adolescent

girls and bill board in this meeting with the collaboration of NNS, IPHN. After reviewing the

materials, the committee has given written approval for printing and use.

6.2. SBCC materials distribution and sharing 6.2.1. Food plate distribution among pregnant women: As part of continuation of food plate

distribution,

the project

has

distributed

total 20,566

of food plate

among the

registered

pregnant

women

during this

reporting quarter. This food plate has adopted from the NNS, IPHN and reprinted for distribution

among the registered pregnant women once in this project duration. CNPs are distributing the food

plate among the pregnant women during their household visit, counselling and demonstration by

using this food plate. CNPs also are using it as an assistive tool for follow-up counselling with the

pregnant women and their family members. Details of food plate distribution is given in annex 19

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6.2.2. Nutrition Calendar for Pregnant Women distribution among the registered

pregnant

women:

The project

has printed

55,000

pieces of

nutrition

calendar for

pregnant women in this quarter and started distribution among the registered pregnant women. The

project staff including CNPs has oriented on nutrition calendar for pregnant women through their

monthly meetings following the user guideline of this calendar. A total 5,662 of nutrition calendar for

pregnant women were distributed among the pregnant women by the CNPs during their regular

1000 days HH visit and counselling. During the distribution of this calendar, CNPs also engaging

others family members of the respective pregnant women and discussed and demonstrate the use of

the calendar.

6.2.3. Child bowl distribution among the CNPs, Entrepreneur and field based project

staff: In Y2Q2, the project has printed 1,000 pieces of

food bowl for children and distributed 976 bowl

among the CNPs, Entrepreneurs and project staff with

an on job orientation by user guideline of food bowl

through the monthly cluster meetings. After receiving

this food bowl, the CNPs and the Entrepreneurs has

started demonstration on complementary feeding

using it during their regular 1000 days HH visits and

counselling with the mothers and care givers of 7-23

month children.

6.2.4. Distribution of the Nutrition Ludo for Adolescent Girl among the CNPs,

Entrepreneur and field based project staff:

During this quarter, the project has printed 550

pieces nutrition ludo for adolescent girls and

distributed 485 lodo among the CNPs, Entrepreneurs

and the project staff with an on job orientation by

user guideline of this ludo through the monthly

cluster meetings. The CNPs and the Entrepreneur has

started the use of this ludo for conducting courtyard

session with the adolescent girls group as well as

different event of this project with the adolescent at

their locality.

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6.2.5: Distribution of Nutrition Calendar for Pregnant Women and Child Bowl among

the targeted health facilities (CC and UHFWC): The project also has distributed a total 373

pieces of

Nutrition

Calendar

for

Pregnant

Women

and a total

373 pieces

of Child

Bowl

among the targeted health facilities i.e. Community Clinic (305) and Union Health and Family

Welfare Centre (68) in this quarter for using in counselling and demonstration at facility level with

the visiting pregnant women and mothers and care givers of 7-23 month children. During the

distribution of this calendar and child bowl, the respective Field Supervisor and Cluster Manager of

INCA has provided an on job orientation to the respective CHCP and FWV by following user

guidelines. The CHCPs and the FWVs also has started using these materials to providing counselling

and demonstrating with their visiting clients specially the pregnant women and mother and fathers of

7-23 moth children.

6.2.6: Sharing of Nutrition Calendar for Pregnant Women, Nutrition Ludo for

Adolescent Girls and Child Bowl among the national and local level stakeholders: The

project has shared a set of nutrition calendar for pregnant women, nutrition ludu for adolescent girls

and child bowl

among the

partners, related

lined directorate

of MoHFW and

national and local

level stakeholders

for their

information, use

and possible

scale-up. The INCA central and field team has shared these materials physically by a brief

presentation with some stakeholders and some them were reached by the courier. Please see annex

20 for details list of stakeholders and partners received SBCC materials.

7. Supportive supervision Following supporting supervision guideline of INCA, all of the project staff including field supervisor

has been providing supportive supervision to the CNPs as their regular activities. During the

reporting period 1,364 supportive supervision visit by FS to CNP and 298 supportive supervision

visits were taken place. During the supporting supervision, the project staff and Field Supervisor are

providing on job training, coaching and hand to hand support for their capacity building as well as

rolling out the targeted activities at the community level. Supportive supervision visits conducted by FS to

CNPs and CMs to FSs is outlined given in Annex 20

Page 18 of 27

8. Government High officials visit USAID’ INCA in Bhola Dr. A. B. M.

Muzharul Islam,

Director IPHN

and Line

Director NNS

along with Dr.

Pabitra Kumar

Kundu, Deputy

Director, IPHN

and Program Manager, NNS; Dr. Taherul Islam Khan, Program Manager, NNS/IPHN, Dr.

Rathindranath Mazumdar, Civil Surgeon Bhola, and other three Deputy Program Managers of

NNS/IPHN visited activities of USAID’s INCA project in Bhola sadar Upazila and Monpura Upazila

under Bhola district on 28-29 January 2018. During their visits they observed numerous courtyard

sessions including mother’s group, mother’s in law group and adolescent girls group. They also

observed orientation on Nutrition and CNSG operation for Community Nutrition Support Groups.

The delegation saw how USAID’s INCA has been working with the households, community and

government to improve the delivery of quality nutrition services with the engagement of government

front line health workers and CNSG at the community level. The line director and other delegates

has appreciated INCA efforts and suggested for more engagement government front line health

workers in community-based activities.

9. INCA staff meeting According to

the field

operation plan

of INCA, in

Y2Q2 INCA

has organized

several

meetings among

the INCA staff

and CNPs at different level. Each FS has organized their

cluster meetings with their assigned CNPs at their

cluster at the community level in every month; each

Cluster Manager has organized their cluster meeting

with their assigned FS at Cluster Office level/Upazila

level in every month and each FC has organized their

monthly field office level at the FO with the assigned

cluster managers, WIC Coordinators, PO-M&E and

AAO in every month. The INCA central team also

organized quarterly staff meeting once in a quarter at

central level with the FCs, CMs, PO-M&Es, AAOs and other regional and central level managerial

staff. Field level meetings has organized in two parts: first half is for performance review and follow-

up of work plan, prepare monthly individual work plan and addressing required administrative issues

and in second part, respective facilitator has facilitating identified and selected topics of the training

Page 19 of 27

manual as part of follow-up training. INCA quarterly staff meeting is organizing focusing the FO wise

performance review, sharing field findings, reviewing overall project activity plan, addressing

operational issues and providing direction for accelerating and implementing project activities.

During this reporting period, a total 112 FS monthly cluster meetings, 32 monthly cluster office

meetings, 7 FO monthly meeting and one quarterly staff meetings were organized.

10. Challenges

Nationwide strike of Community Health Care Provider (CHCP)

Frequent Drop out of Community Nutrition Promoter (CNP);

High ratio of 1000days HH VS CNPs;

Scattered catchment area of CNPs;

Difficulty to reach fathers and husbands in 1,000 days household;

Difficult to ensure regular communication and supportive supervision to those CNPs who

are posted in isolated char;

Unavailability of qualified CNPs at local level;

Health service providers of Govt. community based health facilities are reluctant to open

their facilities timely and regularly;

Community-based Govt. health service providers are reluctant to provide nutrition services

due to their other priority health services;

Difficult to ensure GMP among 1000days HH beneficiaries due to unavailability and

nonfunctioning anthropometric devices in the community-based health facilities;

11. Annex Annex 1: Achievement summery of milestone 4

Sl # Milestone-4

targeted

activities

Status of

accomplishment

Brief description Remarks

01

Develop

quarterly report

CNP work plan

Done

Each CNP has been developing their quarterly

work plan considering their targeted activities

following prescribed format. Each Field Supervisor

has been conducting a day long monthly cluster

meeting with their CNPs at their cluster for

performance review, necessary troubleshooting,

capacity building and hand to hand support to

CNPs for reviewing and preparing their work plan.

02

Support CNSGs

to establish their

action plans

Partially done

Following formation of CNSGs, the process has

started for establishing the action plan of CNSGs

from the beginning of this milestone but not

completed due to countrywide CHCP strike. After

withdrawn of the strike of CHCP, the project has

resumed the process of establish CNSGs action

plan and it will complete in the milestone 5.

Hampered

due to

nationwide

strike of

CHCP

03

Train health care

providers,

CNPs, FS and

WIC

Done

Following developed training manual on INCA

apps, the project has provided training to CNPs,

FSs, Entrepreneurs of WIC, Cluster Managers, PO-

M&Es and Field Coordinators. The training on the

Page 20 of 27

Annex 2: Participants attended in ToT on mobile app

S.L Designation Y2Q2 achievement Cumulative

target

Cumulative

achievement

%

Male Female Total

01 Cluster Manager 09 02 11

27

27

100

02 Field Coordinator 01 02 03

03 Program director 01 00 01

04 SBCC specialist 00 01 01

05 Nutrition specialist 01 00 01

06 Sr. Expert M&E 01 00 01

07 Sr. Expert WIC and Gender 00 01 01

08 Project Officer-M&E 02 01 03

09 WIC coordinator 02 01 03

10 Information and

Communication officer

01 01 02

18 09 27

entrepreneurs

on app

mobile app has been organized following two steps:

1. ToT on the mobile app and 2. Basic training on

the app.

04

Roll out and

continuation of

observing

quarterly

themed

“Nutrition Day”

in each health

facility

households with

support from

CNSG

Done

The project has rolled out and observed quarterly

themed “Nutrition Day” in this milestone with

support from CNSG to create mass awareness in

the community people on March 29, 2018 at

Charfalcon Union Parishad Premises, Kamalnagr

upazila under Lakshmipur district. The theme of

the nutrition day was “Measure to know

nutritional status” in Bangla "gvc‡j Z‡eB †evSv hv‡e,

cywó Av‡Q mwVKfv‡e". This event will continue and

observe once in a quarter over the project period

with different themes.

05 Supporting

supervision Done

As continuation of this activity, the project staff has

been providing supportive supervision to the CNPs

as their regular activities following supporting

supervision guideline of INCA,

06

Roll out of

monthly visit of

1000 days HH

Done

The project has been started the roll out of

monthly visit of 1000 days HH in milestone 3 and it

is continuing. The CNPs and Entrepreneur has

been visiting their assigned 1000 days HH monthly

basis according to their work plan.

07

Tracking of 1000

day households

using app by

CNPs

Done

The project has roll out and started tracking of

1000 day households using app by CNPs. The

project has provided training on mobile apps to the

CNPs and Entrepreneur and they have been

starting the tracking of 1000 day households after

receiving this training.

08

Monitoring of all

activities and

reporting

according to

MEL plan

Done

The project has been monitoring of all activities

and reporting according to MEL plan. The project

has been preparing necessary periodic progress

report and submitting accordingly and documenting

as well.

Page 21 of 27

Annex 3: Participants of training on mobile at field level

Field

office

Batc

h

#

Y2Q2 achievement

Cumulative

target

Cumulative

achievement

% Participants attend in app

training

Participants by

sex

CNP FS WIC Ent. Total M F Total

Bhola 07 124 13 18 155 08 147 155

482

497

103

Charfas

sion

09 143 15 20 178 10 168 178

Maijdee 07 113 11 40 164 07 157 164

Total 23 380 39 78 497 25 472 497

Annex 4: women entrepreneurs’ basic training on nutrition and WIC

S.L Field office Y2Q2 achievement Cumulative

target

Cumulative

achievement

% Bath # Male Female Total

1 Bhola 00 00 00 00

200

192

96 2 Charfassion 01 00 14 14

3 Maijdee 01 00 20 20

Total 02 00 34 34

Annex 5: Govt. health staff orientation on nutrition and counselling

Filed office Y2Q2 achievement Cumulative

target

Cumulative

achievement

% # of GoB front line staff oriented

Batch Male Female Total

Bhola 12 129 170 299

1200

1237

103 Charfassion 13 174 125 299

Maijdee 14 155 149 304

Total 39 458 444 902

Annex 6: Participants of CNSG orientation

Filed office Y2Q2 achievement Cumulative

target

Cumulative

achievement

% Batch Male Female Total

Bhola 86 766 608 1374

4944

4684

94 Charfassion 120 1232 645 1877

Maijdee 81 500 792 1292

Total 287 2498 2045 4543

Annex 7: Participants of training on LSP engagement in nutrition services

Sl No Offices Y2Q2 achievement Cumulative

target

Cumulative

achievement

% Field staff Central team Total

01 Bhola 06 0 06

26

26

100

02 Char

Fasson

06 0 06

03 Maijdee 08 0 08

04 Dhaka 0 06 06

Total 20 06 26

Page 22 of 27

Annex 8: Participants status of LSP orientation:

Sl District Y2Q2 achievement Cumulative

target

Cumulative

achievement

% Batch CNP FS Male Female Total

1 Bhola 6 124 13 08 129 137

418

441

94

2 Char Fasson 7 142 15 10 147 157

3 Maijdee 5 113 11 07 117 124

Total 18 379 39 25 393 418

Annex 9: 1000 days household registration

S.L Field office/Upazila Achievement Y2Q2 Cumulative achievement

01 Bhola field office total 5,851 33,653

01.1 Bhola Sadar 3,224 15.502

01.2 Burhanuddin 1,607 11,067

01.3 Daulatkhan 1,020 7,084

02 Char Fasson field office total 4,771 40,148

02.1 Char Fasson 2,680 19,091

02.2 Lalmohan 1,171 11,908

02.3 Monpura 166 3,242

02.4 Tazumuddin 754 5,907

03 Maijdee field office total 11,254 52,446

03.1 Subarnachar 1,698 10,398

03.2 Hatia 5,967 21,541

03.3 Ramgati 1,973 14,491

03.4 Kamalnagar 1,616 6,016

Total 21,876 126,247

Annex 10: 1000 days beneficiaries’ registration

S.L. Field office

Pregnant women Lactating mother 0-23 months

children Adolescent girls

Y2Q2 Cumulat

ive Y2Q2

Cumulati

ve Y2Q2

Cumula

tive Y2Q2 Cumulative

1 Bhola 2,556 9,517 2,617 9,467 3,573 25,010 1,203 5,367

2 Char

Fasson 3,079 12,277 2,684 10,818 3,994 30,317 369 5,049

3 Maijdee 4,319 16,914 3,817 13,547 7,187 36,438 1,551 10,030

Total 9,954 38,708 9,118 33,832 14,754 91,765 3,123 20,446

Page 23 of 27

Annex 11: Beneficiary group formation

S.L.

Field office

Mothers group (#) Fathers group (#) Mothers in laws

group (#)

Adolescent group

(#)

Y2Q2 Cumula

tive

Y2Q2 Cumulati

ve

Y2Q2 Cumulati

ve

Y2Q2 Cumula

tive

1 Bhola 927 2,014 484 1,339 442 1,206 191 540

2 Char

Fasson 265 1,805 2,90 2,006 373 1,785 000 543

3 Maijdee 2,217 2,437 1,923 2,051 955 1,125 591 741

Total 3,409 6,256 2,899 5,396 1,962 4,308 836 1,878

Annex 12: Beneficiary group orientation

12.1: Mothers group orientation:

Sl Field Office Y2Q2 achievement Cumulative

target

Cumulative

achievement

%

1 Bhola 927 2,014 2,014

100 2 Char Fasson 265 1,805 1,805

3 Maijdee 2,217 2,437 2,437

Total 3,409 6,256 6,256

12.2: Fathers group orientation:

Sl Field Office Y2Q2 achievement Cumulative

target

Cumulative

achievement

%

1 Bhola 484 1,339 2,014

100 2 Char Fasson 2,90 2,006 1,805

3 Maijdee 1,923 2,051 2,437

Total 2,899 5,396 5,396

12.3: Mother-in laws group orientation:

Sl Field Office Y2Q2 achievement Cumulative

target

Cumulative

achievement

%

1 Bhola 442 1,206 1,206

100 2 Char Fasson 373 1,785 1,785

3 Maijdee 955 1,125 1,125

Total 1,962 4,308 4,308

12.4: Adolescent girls group orientation:

Sl Field Office Y2Q2 achievement Cumulative

target

Cumulative

achievement

%

1 Bhola 191 540 540

100 2 Char Fasson 000 543 543

3 Maijdee 591 741 741

Total 836 1,878 1,878

Page 24 of 27

Annex 13: Organized court yard session

S.L. Field office Mothers group Fathers group Mothers in laws

group

Adolescent

group

Y2Q2 Cumulat

ive

Y2Q2 Cumulati

ve

Y2Q2 Cumulativ

e

Y2Q2 Cumulat

ive

1 Bhola 927 1,580 484 602 442 638 191 224

2 Char Fasson 265 1,465 492 1,072 565 1,180 54 225

3 Maijdee 2,217 2,217 1,923 1,923 955 955 591 591

Total 3,409 5,262 2,899 3,597 1,962 2,773 836 1,040

Annex 14: 1000 days Household visit and counseling

S.L. Field

office

1000 days HH visit PW Counseling LM (0-6 month)

counselling

LM (7-23 month)

counselling

Y2Q2 Cumulative Y2Q2 Cumulative Y2Q2 Cumulative Y2Q2 Cumulative

1 Bhola 29,533 57,335 5,428 12,389 7,164 14,014 15,893 35,852

2 Char

Fasson 29,465 64,842 8,772 17,970 8,179 16,313 13,056 31,245

3 Maijdee 47,086 88,278 17,813 30,408 13,165 22,895 17,660 37,181

Total 106,084 210,455 32,013 60,767 28,508 53,222 46,609 104,278

Annex 15: Establish tippy tap

15.1: Establish tippy tap at 1000 day HH level:

S.l Filed office Y2Q2

achievement

Cumulative

target

Cumulative

achievement

%

1 Bhola 1,292

15,000

4,414

29

2 Char Fasson 1,129

3 Maijdee 1,988

Total 4,409

15.2: Establish tippy tap at the targeted health facilities and educational institutions:

S.l Filed office School Targeted Health facilities

Y2Q2 Cumulative Y2Q2 Cumulative

1 Bhola 56 56 27 42

2 Char Fasson 28 29 49 60

3 Maijdee 81 81 42 42

Total 165 166 118 144

Page 25 of 27

Annex 16: Establish Women information center

Annex 17: Spending man-days for assisting targeted health facilities

S.L Field Office CNP man-days FS man-days CM man-days

Y2Q2 Y2Q2 Y2Q2

1 Bhola 1,257 304 52

2 Char Fasson 1,266 366 48

3 Maijdee 404 88 25

Total 2,927 758 125

Annex 18: Women day celebration

Sl

No.

Name of

the Upazila

Organized

events

Batch & # of

participants

Participated in

Govt. events

Remarks

1 Bhola Sadar Courtyard session 18/187 Human Change,

rally and discussion,

Women

development Fair

2 Burhanuddin Courtyard session 1/21 Do

3 Daulatkhan Courtyard session 5/70 Do

4 Charfesson Courtyard session 54/525 Do

5 Tuzumuddinn Courtyard session 78/1170 Do

6 Lalmohan Courtyard session

Adolescent group

15/347

8/257

Do

7 Monpura Courtyard session 8/78 Do

8 Ramgati Courtyard session

CNSG

Orientation

12/216

10/160

- Not participated

Govt. program due

to participate all

staff in Apps training

9 Kamalnagor Discussion

meeting and Rally

3/164

W-138, M-26

Not organized any

event but INCA

involved Govt.

people in rally &

meeting.

10 Subarnachar Courtyard session

Adolescent group

2/30

1/9

Discussion

meeting, Fair and

Rally

-

11 Hatia Courtyard session 34/615 Not invited by the

Govt. Institution.

S.L. Field office Y2Q2 achievement Cumulative target Cumulative

achievement

%

01 Bhola 1

40

40

100 02 Char Fasson 0

03 Maijdee 3

Total 4

Page 26 of 27

Annex 19: Food plate distribution

Sl Field Office Y2Q2 achievement Cumulative target Cumulative

Achievement

%

01 Bhola 5,507

23,822

23,008

96

02 Char Fasson 7,892

03 Maijdee 7,167

Total 20,566

Annex 20: Stakeholders receiving SBCC materials

SL

#

Name of SH/Directorate/partner Nutrition

Calendar for PW

Child Bowl Nutrition Ludu for

Adolescent Girls

01 IEC Technical Committee,

MoHFW

05 02 01

02 Secretariat, MoHFW 01 01 01

03 Line Director, NNS, IPHN 57 08 05

04 Line Director, CBHC 05 05 03

05 Director, MCH Services unit,

DGFP

05 02 01

06 Director General, BNNC 05 02 01

07 Civil Surgeon of 3 districts ( Bhola,

Laxshipur and Noakhali)

03 03 03

08 DDFP of 3 districts (Bhola,

Laxshipur and Noakhali)

03 03 03

09 DC of 3 districts ( Bhola,

Laxshipur and Noakhali)

03 03 03

10 UHFPO of 11 Upazila of Bhola,

Laxshipur and Noakahil

11 11 11

11 UFPO of 11 of Bhola, Laxshipur

and Noakhali

11 11 11

12 Upazila Chairmen of 11 Upazila of

Bhola, Laxshipur and Noakhali

11 11 11

13 Alive & Thrive 02 02 01

14 Measure Evaluation 02 02 01

15 Ujjiban Project 02 02 01

16 Multisectoral Nutrition

Project, FHI 360

02 02 01

17 Bangladesh Breastfeeding

Foundation (BBF)

05 02 01

18 Save the Children 03 01 01

19 United Nations Children’s Fund

(UNICEF)

03 01 01

20 International Food Policy Research

Institute (IFPRI)

03 01 01

21 Concern worldwide 03 01 01

22 World Health Organization

(WHO)

03 01 01

23 Catholic Relief Services (CRS) 01 01 01

Page 27 of 27

Annex 21: Supportive supervision visit from supervisors

S.L. Filed office

# Supportive supervision visit by

FS to CNP

# Supportive supervision visit by

CM to FS

Y2Q2 Y2Q2

1 Bhola 566 116

2 Char Fasson 462 102

3 Maijdee 336 80

Total 1,364 298