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Study Overview

Assessing coverage, utilization, and barriers to coverage in the BRAC home fortification program in Bangladesh
Study is 3ie funded:
Study ID:
Initial Registration Date:
Last Update Date:
Study Status:

In Bangladesh, in order to improve anaemia, nutritional status and optimum child feeding practice, the Bangladesh Home Fortification Programme Phase 2 is initiated. The Children’s Investment Fund Foundation (CIFF), UK is the funding authority and this Programme which is implemented by Global Alliance for Improved Nutrition (GAIN) and Building Resources Across Communities (BRAC). The focus of the program is to promote the usage of the Micronutrients Powder (MNP) by caregivers of under-5 children, nutrition education/counselling and awareness campaigns, and the creation of an enabling policy environment. The target is to increase the effective coverage of the program and to reduce the prevalence of anaemia by at least 10% among targeted infants and young children in 170 sub-districts in Bangladesh. The findings from this survey will ensure that credible, accumulated evidence is available to feed in to programmatic decision-making and for communication with the Government of Bangladesh (GoB) and other key stakeholders. Overall aims of this study are to determine the effective coverage of MNP usage and assess the prevalence of anaemia among children 6–59 months of age.

Registration Citation:

Sarma, H., 2015. Assessing coverage, utilization, and barriers to coverage in the BRAC home fortification program in Bangladesh. Registry for International Development for Impact Evaluations (RIDIE). Available at: 10.23846/ridie049

Health, Nutrition, and Population
Additional Keywords:
Health and Health Sector Benefits, Knowledge Production, Informing Policy
Secondary ID Number(s):
PR-14048, icddr,b; GR-01205, icddr,b

Principal Investigator(s)

Name of First PI:
Haribondhu Sarma
Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
Name of Second PI:

Study Sponsor

Global Alliance for Improved Nutrition (GAIN)
Study Sponsor Location:

Research Partner

Name of Partner Institution:
This is a collaborative study among icddr,b, GAIN and CIFF
Type of Organization:
Foreign or Multilateral Aid Agency

Intervention Overview


The second phase of this program (2013-2018) in Bangladesh funded by CIFF, harness the existing partnerships between GAIN and BRAC mainly, with manufacturing support from Renata and SMC for social marketing, to significantly increase the scale of delivery, demand and use of Pushtikona-5 (5 ingredients). In addition, program aims are to train and empower 49,000 Shasthya Shebikas (SS) to promote sales of pushtikona-5 and deliver quality inter personal communication on home fortification use in the context of optimal infant and young child feeding practices (IYCF); and ensure that, by Year 2018, 1 million Bangladeshi children under 5 have access to adequate home-based complementary food, via the promotion and adoption of appropriate consumption of MNP (120 sachets/child/year). The program will focus on implementing and improving the delivery of home fortification through market-based channels via BRAC, as part of a comprehensive packages of message for optimum IYCF practices (continuous breastfeeding, timely introduction of home-made complementary foods and appropriate use of home fortification), with a particular focus on 170 upazilas.

Theory of Change:
Multiple Treatment Arms Evaluated?

Implementing Agency

Name of Organization:
Type of Organization:
NGO (International)

Program Funder

Name of Organization:
Children's Investment Fund Foundation (CIFF)
Type of Organization:
Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?
Start Date:
End Date:
Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:
Other (specify)
Other (not Listed) Method:
Survey with a modified stepped wedge design
Additional Evaluation Method (If Any):
Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

A total of 6 cross-sectional surveys will be conducted during 2014-2017, utilizing a modified stepped wedge design. This approach entails conducting a series of 3 baseline and 3 corresponding end line surveys, which will be staggered according to BRAC’s program implementation plan. Each set of baseline and end line surveys will be implemented at the same time of year to control for potential seasonal effects. The surveys are designed to be representative at the district level and population consist of children 6-59 months of age and primary caregivers (PC) of the children. For these surveys, interviewer administer the questionnaire to PC who may be the biological mother or the person who cares for and gives the child most meals on most days. A structured questionnaire has developed based on key indicators designed to collect demographic, health and dietary diversity of mother and child, living standards, MNP coverage, barriers to coverage and utilization, IYCF practices, household hunger, water and sanitation practices, and nutrition status. The study also consider collecting information on haemoglobin of child and Mid-Upper Arm Circumference measurement of mother and child.

Outcomes (Endpoints):

1. Percentage of children who are anemic; 2. Coverage of Pushtikona 5 among <5 children

Unit of Analysis:
Children 6-59 months of age and the caregivers of the children.

1. The MIYCN intervention programme will reduce the prevalence of anaemia among the target children (6–59 months of age) by at least 10% in programme areas by the end of the project; 2. The MIYCN intervention programme will increase the coverage of Pushtikona (MNP) in programme areas.

Unit of Intervention or Assignment:
BRAC community is the unit of intervention, each community consisted with about 150-250 households and a SS is responsible for providing health and nutrition services to them.
Number of Clusters in Sample:
Number of Individuals in Sample:
13056 children between the ages of 6-59 months and their mothers/caregivers
Size of Treatment, Control, or Comparison Subsamples:
For the overall program estimates, sample sizes are equivalent to the sum of all households surveyed across program districts. Therefore, sample sizes range from 1920 to 2880 households per survey.

Supplementary Files

Analysis Plan:

Outcomes Data

Household survey
Data Already Collected?
Data Previously Used?
Data Access:
Restricted -- Access requires a formal approval process
Data Obtained by the Study Researchers?
Data Approval Process:
Access requires a formal approval procedures as per icddr,b data centre access policy.
Approval Status:
Yes-obtained approval and have received the data

Treatment Assignment Data

Participation or Assignment Information:
Data Obtained by the Study Researchers?
Data Previously Used?
Data Access:
Data Obtained by the Study Researchers?
Data Approval Process:
Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:
This is a structured questionnaire, was developed in English and translated into Bangla and back translated, is being used the first baseline coverage survey. It will be revised for necessary modifications prior to use in the next five surveys.: Questionnaire_Coverage Survey.pdf

Registration Category

Registration Category:
Non-Prospective, Category 4: Data for measuring impacts have been obtained/collected by the research team and analysis for this evaluation has started

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:


Preliminary Report:
Preliminary Report URL:
Summary of Findings:
Paper Summary:
Paper Citation:

Data Availability

Data Availability (Primary Data):
Date of Data Availability:
Data URL or Contact:
Access procedure:

Other Materials

Survey Instrument Links or Contact:
Program Files:
Program Files Links or Contact:
External Link:
External Link Description:
Description of Changes:

Study Stopped