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General

Study Overview

Title:

Impact Evaluation of BRAC's Nutrition and Early Childhood Development Programs

Study is 3ie funded:

No

Study ID:

RIDIE-STUDY-ID-563a7d17974f3

Initial Registration Date:

11/04/2015

Last Update Date:

11/04/2015

Study Status:

Ongoing

Location(s):

Bangladesh

Abstract:

BRAC Bangladesh has designed a large-scale nutrition program and a pilot early childhood development (ECD) program to combat malnutrition. BRAC’s nutrition program focuses on building the capacity of community health workers, establishing an effective community based integration nutrition service delivery, and raising awareness and empowering communities to improve feeding practices. The ECD intervention focuses on improving the knowledge of caregivers on how to stimulate the development of children, for example by emphasizing the importance of exclusive breast feeding and complementary feeding practices. The ECD program also stimulates nutrition directly by antenatal and postnatal care and home visits for infants and toddlers. American Institutes for Research and BRAC will use a combination of experimental and nonexperimental evaluation methods to determine the impact of BRAC’s nutrition and ECD programs. We will conduct a cluster-randomized controlled trial to determine the impact of BRAC’s ECD program and a nonexperimental propensity score matching design to determine the impact of BRAC’s nutrition program. A process evaluation will assess the fidelity of the intervention.

Registration Citation:

de Hoop, T., 2015. Impact Evaluation of BRAC's Nutrition and Early Childhood Development Programs. Registry for International Development for Impact Evaluations (RIDIE). Available at: 10.23846/ridie073

Categories:

Agriculture and Rural Development
Economic Policy
Health, Nutrition, and Population
Multisector
Other

Additional Keywords:

Early Childhood Development, Community Health Workers, Food Security, South Asia

Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:

Thomas de Hoop

Affiliation:

American Institutes for Research

Name of Second PI:

Affiliation:

Study Sponsor

Name:

Nutrition Embedding Evaluation Program

Study Sponsor Location:

United States

Research Partner

Name of Partner Institution:

BRAC Impact Assessment Unit

Type of Organization:

NGO-international

Location:

Bangladesh

Intervention

Intervention Overview

Intervention:

BRAC’s nutrition program is designed to reduce malnutrition among pregnant-lactating women, and young children. The nutrition program aims to fulfill its objectives by building the capacity of community health workers, establishing an effective community based integration nutrition service delivery, and raising awareness and empowering communities to improve feeding practices . Specifically, community health workers will provide age-appropriate home visits, and will be on call to handle feeding problems and give recommendations on antenatal care and dietary allowances during pregnancy. BRAC’s Nutrition Program is a four year program that started in 2012 and will be continued up to 2016. In some trial areas, the nutrition intervention is complemented with a comprehensive early childhood development (ECD) intervention to improve knowledge of caregivers on how to stimulate the cognitive and physical development of children, for example by emphasizing the importance of exclusive breast feeding and complementary feeding practices. The ECD program also stimulates nutrition directly by antenatal and postnatal care as well as nutrition for infants and toddlers through home visits.

Theory of Change:

Multiple Treatment Arms Evaluated?

Yes

Implementing Agency

Name of Organization:

BRAC Bangladesh

Type of Organization:

NGO (International)

Program Funder

Name of Organization:

Department for International Development

Type of Organization:

Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?

Yes

Start Date:

01/01/2012

End Date:

12/31/2016

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Randomized control trial

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Matching

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

AIR and BRAC will implement a two-stage evaluation design that starts with an impact evaluation with baseline and endline data collection and then follows with process evaluation. We will randomly assign 26 unions in Mymensingh to the early childhood development intervention and 26 unions to the control group to determine the impact of BRAC’s ECD intervention. We will assess the impact of BRAC’s ECD program by comparing 78 beneficiary Moujas in 26 unions with 20 households per Mouja to 78 beneficiary Moujas in 26 unions with 20 households per Mouja that do not benefit from the ECD program. Each of these unions will also benefit from BRAC's nutritition program so we estimate the additive effect of the ECD intervention in the 26 unions. The impact of BRAC’s nutrition program will be determined by comparing 78 Moujas with 20 households per Moujas in the 26 unions in the control group for the ECD intervention to a matched comparison group of 40 Moujas with 20 households per Mouja that does not benefit from BRAC's nutrition program and ECD program. The comparison Moujas will come from districts in Bangladesh that are neighboring Mymensingh and will be matched based on Census data.

Outcomes (Endpoints):

Nutritional Status of children 0-24 months old: Stunting, Nutritional Status of children 0-24 months old: Under-Nutrition, Nutritional Status of children 0-24 months old: Wasting, Nutritional Status of children 0-24 months old: Stunting prevalence, Nutritional Status of children 0-24 months old: Underweight prevalence, Nutritional Status of children 0-24 months old: Wasting prevalence, Early Cognitive Development of Children 0-24 Months Old, Gross Motor Development of Children 0-24 Months Old, Fine Motor Development of Children 0-24 Months Old, Diarrhoea incidence of children 0-24 months old, Quality of Children's Home Environment: Parenting Practices, Exclusive Breastfeeding, Introduction of solid, semi-solid or soft foods, Minimum dietary diversity, Knowledge about Child Development, Attitudes Towards Child Development, Intake of multiple micronutrient supplements, such as iron-folate, Proportion of mothers who sought antenatal care from a health professional, Proportion of children 12-24 months old who have received BCG (1 dose), OPV (3 doses), DPT (3 doses), and measles vaccinations (1 dose), Mother's Nutritional Status: Body Mass Index,

Unit of Analysis:

Child

Hypotheses:

We hypothesize that BRAC's ECD program has a positive effect on the nutritional status of children. We hypothesize that BRAC's nutrition program has a positive effect on the nutritional status of children. We hypothesize that BRAC's ECD program has a positive effect on the cognitive development and motor skills of children. We hypothesize that BRAC's nutrition program has a positive effect on the cognitive development and motor skills of children. We hypothesize that BRAC's ECD program has a positive effect on the appropriateness of parent's child care, breastfeeding and complementary feeding practices. We hypothesize that BRAC's nutrition program has a positive effect on the appropriateness of breastfeeding and complementary feeding practices. We hypothesize that BRAC's ECD program has a positive effect on parent's knowledge about child care, breastfeeding and complementary feeding practices. We hypothesize that BRAC's nutrition program has a positive effect on parent's knowledge about breastfeeding and complementary feeding practices.

Unit of Intervention or Assignment:

Union

Number of Clusters in Sample:

196 Moujas for full evaluation. 52 Unions for evaluation of ECD intervention. 118 Moujas for evaluation of nutrition intervention

Number of Individuals in Sample:

3910

Size of Treatment, Control, or Comparison Subsamples:

78 Moujas benefit from ECD + Nutrition, 78 Moujas benefit from Nutrition, 40 Moujas in comparison group

Supplementary Files

Analysis Plan:

Other Documents:

: Summary Evaluation Design.docx

Data

Outcomes Data

Description:

Data for the impact evaluation will be collected at two points throughout the study: baseline (for the ECD intervention) and 24 months from the start of the ECD intervention. We collected baseline data starting in July 2015 and plan to collect follow-up data in January, 2017. Data will be collected at the child and household level for the 3910 households selected to be in the study. The household survey took approximately 1 hour. We only have follow-up data for the nutrition intervention.

Data Already Collected?

No

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

No

Description:

We used census data for the treatment assignment. We used a Stata dofile to randomly assign 78 Moujas to the ECD treatment. We also used census data to match the beneficiaries of the nutrition program to 40 Moujas that are comparable in terms of observable characteristics based on the Census of Bangladesh.

Data Obtained by the Study Researchers?

Yes

Data Previously Used?

Yes

Data Access:

Not restricted - access with no requirements or minimal requirements (e.g. web registration)

Data Obtained by the Study Researchers?

Yes

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:

Registration Category

Registration Category:

Prospective, Category 1: Data for measuring impacts have not been collected

Completion

Completion Overview

Intervention Completion Date:

Data Collection Completion Date:

Unit of Analysis:

Clusters in Final Sample:

Total Observations in Final Sample:

Size of Treatment, Control, or Comparison Subsamples:

Findings

Preliminary Report:

Preliminary Report URL:

Summary of Findings:

Paper:

Paper Summary:

Paper Citation:

Data Availability

Data Availability (Primary Data):

Date of Data Availability:

Data URL or Contact:

Access procedure:

Other Materials

Survey:

Survey Instrument Links or Contact:

Program Files:

Program Files Links or Contact:

External Link:

External Link Description:

Description of Changes:

Study Stopped

Date:

Reason: