Client: Light House Bangladesh

RTM International conducted a study named “Gender Based Violence Against Female Sex Workers and Transgenders (Hijra) During COVID-19 Pandemic: In Dhaka and selected brothels (Case Study)” under the supervision of Light House. The general objective of the study was to measure the magnitude of gender-based violence among the female sex workers and transgender during the COVID-19 pandemic. Study has been conducted among the Street Based Female Sex Workers (SBFSW) and Transgender/hijra in Dhaka. The study also included the Brothel Based Female Sex Workers (BBFSW) from Doulatdia brothel, Rajbari. A mixed method approach of data collection was used for this study. For quantitative survey, a total of 989 KPs (Sex workers and Hijra) had been interviewed for the study. For qualitative survey, 5 to 7 Case Studies/In-depthinterviews per KP group (e.g. SBFSW, Hijra and BBFSW) had also been conducted with the selected KPs.

Marie Stopes Bangladesh has assigned RTM International to conduct Client Exit Interview Survey – 2019. Client exit interview survey is a standard Marie Stopes International’s global monitoring tool to assess the profile of clients, their satisfaction with services and the quality of care. By using this tool, Marie Stopes Bangladesh would like to know the answers of the following questions: who are clients, are MSB services meeting the unmet need of the poor and underserved, are clients satisfied with their MSI experience, do Marketing / Behavioural Change Communication (BCC) activities work, are clients being offered appropriate choice of Family Planning (FP) and Menstrual Regulation (MR) methods, how can we communicate with our clients in a more effective and appropriate way. The exit clients accessing only family planning and menstrual regulation services have been selected from clinics, outreach sites of Marie Stopes and also from public sector facility. A total of 787 exit clients from the selected 30 static clinics and 30 outreach sites of Marie Stopes and also from 30 public sector facilities have been selected for interview.

RTM International in currently conducting a survey named “Utilization of Essential Service Delivery (UESD) Survey-2019” under the supervision of NIPORT. The general objective of the study is to obtain information on utilization of essential HPN services and equity in service utilization, and also to measure awareness of mothers on healthy behavior. The data has been collected from a nationally representative sample of 16,320 households drawn from 340 PSUs. At first 340 PSUs (both urban and rural PSUs) were selected centrally from the list of all PSUs by divisions used in BDHS 2017. A PSU is a part of a mouzas/mohallas with approximately 120 households. Household listing in each selected PSU has already been conducted in accordance with EA map of BDHS 2017 and a systematic sample of 48 households have been selected from each PSU. All ever married women aged 15-49 have been selected as eligible respondent for the survey.

 
• Facilitating Adolescent Health Education and Human Rights Abuse Reporting through mobile devices in the Rohingya camps of Bangladesh mPower (January 2019 to November 2019)
  Client: mPower Social Enterprises Ltd.

mPower Social enterprises contracted RTM International to conduct the project titled “Facilitating Adolescent Health Education and Human Rights Abuse Reporting through mobile devices in the Rohingya camps of Bangladesh mPower”. The purpose of this 10 months long project was to assess the situation currently prevailing regarding health of the Rohingya population, especially among the adolescents, and identify the barriers to use of healthcare by the adolescents during baseline survey and to measure the impact of the intervention during end line survey. The project was conducted with adolescent girls in 2 intervention camps and 2 control camps of displaced Rohingya population living in coxs’ bazar. For this purpose quantitative data was collected from 720 rohingya households (equally divided among control and intervention camps). Further, data was also collected through 18 in-depth interviews (IDIs) of FHWs and 15 key informant interviews (KIIs) with key stakeholders including NGO staff, project manager, majhi (rohingya leader), CIC, Women Friendly Centre committees’ member) were also taken under this study. While adolescent girls were interviewed about their awareness on sexual and reproductive health and rights, KIIs were conducted to know in-depth how NGOs and other stakeholders were resolving SRHR related issues; during an in-depth interview with FHWs were asked how they usually approach with SRHR services to rohingya households and other related issues.


• Assessing Utilization of Satellite Clinic (June 2018 to May 2019)
  Client: National Institute of Population Research and Training (NIPORT)

The Government of Bangladesh introduced a semi-static service center called "satellite clinics" in 1988 to provide health care services, particularly to those people living far away from family welfare centers. Each satellite clinic is providing family planning, maternal and child health services to 3000-4000 people in a ward particularly women, children, adolescents and others who are left out from the services of static centres due to different reasons. Directorate General of Family Planning (DGFP) mostly provides the satellite clinic in rural areas and NGOs provide services in urban areas. After a long journey in the field of family planning program, the effectiveness in terms of program goals and quality of services needs to be evaluated. As part of this assessment effort, the National Institute of Population Research and Training (NIPORT) wanted to assess the utilization of satellite clinic, including any operational or other barriers that may restrain such use in the society. NIPORT contracted RTM International for completing this study. Applying a two-stage probability sampling, questionnaire survey data was collected from 1152 service recipients (768 from rural and 384 from urban areas), 1152 service non-recipients (768 from rural and 384 from urban areas) from 192 satellite clinics of 48 unions of Bangladesh. Besides, face to face interviews of 64 service providers, 12 FGDs with organizing committee members and 48 Key informant interviews (KIIs) with UHFPO, UFPO, and satellite clinic management committee member were conducted in the selected ward.

 
• Safe Motherhood Promotion: Operation Research on Safe Motherhood and Newborn Survival (July 2017-June 2019)
  Client: International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b)

icddr,b is implementing an operations research (OR) on "Safe Motherhood Promotion: Operations Research on Safe Motherhood and Newborn Survival’ under sponsorship of Ministry of Health and Family Welfare, Government of People’s Republic of Bangladesh (GoB). The OR project is being implemented in 30 unions (15 intervention unions and 15 control/ comparison unions) from the 3 Upazilas (Chandpur Sadar, Kachua and Faridganj) of Chandpur district. icddr,b has signed contract with the NGO (RTM International and SHIMANTIK joint consortium) to implement the comprehensive package of interventions in the intervention areas. The intervention package consists of three components: facility, community and linkages between the community and health facilities. The facility-based interventions were implemented in both the comparison and intervention areas. The scope of services related to facility based intervention was- health facilities assessment and planning, minor renovations and setting up of facilities for improvement of maternal and pediatric corner, capacity building support for improving technical and management capacity of service providers, ANC PNC campaign, strengthen and monitoring supportive supervision. Community interventions includes orientation of Community Group (CG) members, orientation of Community Support Groups (CSG) members and promoting Birth Planning, ANC, PNC and ENC counseling sessions. Linkages between the community and health facilities includes establish and strengthen referral linkages between community and community clinics, establish and strengthen referral linkages between health facilities, observations of Safe Motherhood day, Midwifery day and World Pre-Maturity day to celebrate works for MNH, community clinics and union development coordination committee meetings, and orientation of GOB officials and HM on leadership and good governance.

 
• Mid-term Evaluation of “Nirapod-2: Empowering Women on Sexual and Reproductive Health and Rights and Choice of Safe Menstrual Regulation (MR) and Family Planning (FP)” Project (December 2017-March 2018)
 Client: Shushilan

Shushilan assigned RTM International to conduct a mid-term evaluation of “Nirapod-2: Empowering Women on Sexual and Reproductive Health and Rights and Choice of Safe Menstrual Regulation (MR) and Family Planning (FP)” project. The objective of this Mid Term Evaluation was to compare the current situation of Nirapod-2 with the baseline situation. The study area included the project location of Nirapod-2 including 40 selected upzailas of Barguna, Patuakhali, Khulna, Noakhali and Laxmipur where 21 upazilas were old and 19 upazilas were new; and in 48 Garment Factories in Dhaka, Gazipur and Narayanganj among which 28 are old and 20 are new. A mixed method approach was used in this study. Both qualitative and quantitative methods of data collection were used for the study. Quantitative data was collected from 800 married women of reproductive age, 400 married men, 400 adolescent boys and girls, 150 garment workers and 150 peer educators in Nirapod-2 areas. The qualitative survey which included key informant interviews (KIIs) with GoB officials (e.g. Civil Surgeon, DDFP, ADC, UNO, UFPO); In-depth interviews (IDIs) with media personnel, school/madrasha teachers, garment factory manager and supervisor; and Focus Group Discussion (FGD) with women and men beneficiaries were conducted in Nirapod and Niarpod-2 areas. A total of 36 FGDs, 12 KIIs and 6 IDIs were conducted.

 
• Monitoring and Evaluation of the Second Pilot Project “Health Insurance/card for the Ready Made Garments (RMG) workers with Selected Service Provider at Narayangonj” project (July’17-June’21)
  Client: Auchan International/WoF

RTM International is recently conducting a study on “Monitoring and Evaluation of the Second Pilot Project “Health Insurance/card for the Ready Made Garments (RMG) workers with Selected Service Provider at Narayangonj” with financial support of Auchan  International/WOF. The objectives of the project are to oversee the proper execution of the planned activities and work with implementing agency (IP) to provide technical assistance required for sound management and effective decision-making, provide facilitative supervision, feedback and mentoring support for the  smooth operation of the implementation of the project activities and provide guidance for finalizing contract between implementing partner (IP) & Factory, provide inputs in development of MIS to be developed by IP. The project duration is 4 years with an estimated target beneficiaries of 5000+ employees of Garment factories located around the Narayangonj district of Dhaka Division. The key project activities are to collect and provide routine monitoring data on the key project indicators /activities and conduct annual satisfaction survey with selected workers. RTM International will collect routine monitoring data and provide feedback on the key project indicators/activities. Four survey throughout the project period will also be conducted. During the survey, in each year a total of 225 one-to-one interviews with the garment workers (beneficiaries) and key informant’s interviews with all service providers and the managers of factories will be conducted.

 
• Project entitled "Health Insurance/card for the Ready Made Garments (RMG) workers with Gonoshasthaya Kendra (GK) in Savar" (July 2016- July 2019)
 Client: Auchan International

RTM International has recently conducted a Monitoring and Evaluation study on the pilot project entitled "Health Insurance/card for the Ready Made Garments (RMG) workers with Gonoshasthaya Kendra (GK) in Savar" with financial support of Auchan International. The duration of the project is 4 years. Targeted beneficiaries for the first year are 20,000 and it will be increased by 10% in every year from the baseline, so in 4th year the total beneficiaries will be 26,000. GK will select garment factories around Tongi and Konabari of Gazipur, Ashulia, EPZ and Hemayetpur of Savar and Kalampur of Dhamri, Dhaka. Initially, 5 to 8 factories are expected to join. The main objective of the assignment is to provide Monitoring and Evaluation support to the Pilot Project on "Health Insurance/card for the Ready Made Garments (RMG) workers with Gonoshasthaya Kendra (GK) in Savar". RTM International will collect routine monitoring data and provide feedback on the key project indicators/activities. RTM International will conduct four survey throughout the project period. In order to conduct the survey RTM will collect information from 230 garment workers (beneficiaries). Key Informant Interview with all service providers and the managers of factories will also be conducted.

 
• Fertility and contraceptive behavior of women with migrant and non-migrant husbands: Identify the ways to address client needs (October’16-December’16)
 Client: National Institute of Population research and Training (NIPORT)

NIPORT has recently contracted RTM International to conduct the study named “Fertility and contraceptive behavior of women with migrant and non-migrant husbands: Identify the ways to address client needs”. The overall objective of the study is to identify the dynamics of contraceptive behavior of women having migrant and non-migrant husbands. This study has been conducted in the rural and urban areas in the selected districts of Bangladesh. The district has been selected in such a way that all the eight administrative divisions are represented. The study is based on both the primary and secondary data.  The requisite secondary data has been collected through review of relevant documents. In contrast, to collect primary data different types of quantitative and qualitative research methods covering in-depth interview at household and focus group discussion has been conducted with women with migrant or non-migrant husband. The study has been collected information from 600 women with migrant husband and 600 women with non-migrant husband from all of 8 divisions in Bangladesh.

 
• Baseline Survey of “Nirapod-2: Empowering Women on Sexual and Reproductive Health and Rights and Choice of Safe Menstrual Regulation (MR) and Family Planning (FP)” project (September’16-December’16)
 Client: Shushilan

Shushilan has assigned RTM International the task to conduct a baseline survey “Nirapod-2: Empowering Women on Sexual and Reproductive Health and Rights and Choice of Safe Menstrual Regulation (MR) and Family Planning (FP)” project. The objective of this Baseline Survey is to identify the current situation of the area, data analysis and report generation including recommendation for future course of action on the basis of the survey findings. The study has been conducted in Barguna, Patuakhali, Khulna, Noakhali, Laxmipur, Narayanganj and Gazipur. Both quantitative and qualitative method of data collection has been used for the survey. The quantitative data has been collected from Married Women of Reproductive Age, Married Men, Adolescent and Garments worker. For qualitative data collection, NGO group members, relevant stakeholders, GoB Officials and Shushilan’s project management staff has been interviewed. A total of 2200 quantitative data has been collected and 51 qualitative data has been collected.

 
• Utilization of Essential Service Delivery (UESD) Survey-2016 (September’16 - December’16)
 Client: National Institute of Population research and Training (NIPORT)

RTM International has recently conducted a survey named “Utilization of Essential Service Delivery (UESD) Survey-2016” under the supervision of NIPORT. The general objective of the study is to obtain information on utilization of essential HPN services and equity in service utilization, and also to measure awareness of mothers on healthy behavior. The data has been collected from a nationally representative sample of 12,000 households drawn from 300 PSUs. At first 300 PSUs (both urban and rural PSUs) has been selected123 centrally from the list of all PSUs by divisions used in BDHS 2014. A PSU is a part of a mouzas/mohallas with approximately 120 households. All ever married women aged 15-49 has been selected as eligible respondent for the survey.

 
• Conducting a Study on the Use of Sanitary Napkins among the Adolescent and Married Women of Reproductive Age (MWRA) (May’16-August’16)
 Client: Social Marketing Company (SMC)

SMC has assigned RTM International to conduct a study on the use of sanitary napkins among the adolescent and married women of reproductive age (MWRA). The main objective of this study is to measure Knowledge, Attitude, Perception and Practice regarding the usage of sanitary napkin during the menstruation period and try to investigate users’ perception about their current brands, history of past used brands, brand loyalty, preference of attributes and key considerations in brand choice. The study has covered urban and rural areas of all seven divisions e.g. Dhaka, Chittagong, Rajshahi, Rangpur, Khulna, Barisal and Sylhet. The data has been collected from the female aged between 13- 35 years from middle class, lower middle class and lower class including housewife, garments workers, school/ college/university students, working women in urban and rural areas. A total of 1031 data has been collected where 461 female are non-users and 570 female are the users of sanitary napkin.

 
• A Harm Reduction Approach to Improve Access to MRM through selected pharmacies in urban areas of 2 districts (Sylhet & Chittagong) (Feb 2016-March 2016)
 Client: Marie Stopes Bangladesh

Marie Stopes Bangladesh assigned RTM International to conduct an end line study on ‘A Harm Reduction Approach to Improve Access to MRM through selected pharmacies in urban areas of 2 districts’ The maternal mortality ratio (MMR) of Bangladesh is estimated at 1.9 per thousand live births (BMMS, 2010).  It has remained as a great challenge since Bangladesh has been trying its best to achieve the Millennium Development Goal (MDG) which clearly defines to reduce maternal mortality ratio. Along with many socio-economic causes; lack of awareness, poor quality of services, lack of trained providers, availability and accessibility of services, high proportion of rejection of MR clients contributes in the maternal morbidity and mortality and delays the overall efforts to recede the situation. To reduce maternal mortality and morbidity due to unsafe MR and unsafe abortion in outside of clinic facilities, Marie Stopes provided training to 2000 service providers (mostly drug sellers) and 60 medical representatives so that, the capacity develops to dispense MRM accurately and safely. Marie Stopes also advocated support through pharmaceutical companies and the Drug Owners Association of Sylhet and Chittagong. This end line study is focused on the aftermaths of the project. In order to collect the information, a mixed method of secondary data collection through literature/documents review as well as collection of primary data through adopting both quantitative and qualitative approaches such as, face to face interview, in-depth interview, key informants interview (KII) and focused group discussion (FGD) were used. It aimed to collect information from informal practitioners, particularly drug sellers, and private-NGO service providers; selected pharmaceutical companies and the Drug-Shop Owners’ Association; and women of reproductive age to determine whether the objectives of the project has been achieved.

 
• Conduct Mapping Study and Size Estimation of Key Populations in selected priority districts in Bangladesh" (Oct 2015-Jan 2016)
 Client: Save the Children

RTM International conducted ‘Mapping Study and Size Estimation of Key Populations in selected priority districts in Bangladesh’. Bangladesh is a low prevalence country with HIV prevalence but in certain geographical areas due to socio-economic and cultural settings, the key populations have high HIV prevalence. In order to guide the national response on HIV and AIDS, it is required to have robust and updated estimates of the size of different key populations (KPs). This study aims to estimate the size of Key Populations (KPs) and Young Key Populations (YKPs) (e.g. male and female sex workers, men who have sex with men, people who inject drugs, hijra, clients of sex workers, etc.) at national and district levels. The study conducted a mapping and size estimation of KPs and YKPs in selected 21 districts of Bangladesh. These 21 selected districts were classified into three categories, e.g. high program concentration; moderate program concentration; and low program concentration districts which included age groups of 10-19 and 20-24 years. Stakeholders meeting, broad mapping, identification of hot spots, identification of KPs and YKPs in the hotspots, conduction of PRA and interviews were conduct with the facilitation of 8 teams. The information generated from this study will be used to guide HIV prevention policy, planning and responses as well as to monitor progress and accountability in achieving programme goals and objectives.

 
• Conducting a "Baseline Study with target factories and their workers in RMG Factories" (20 Sep 2015-17 Dec 2015
 Client: SNV Netherlands Development Organization

The Ready-Made Garments largest export industry occupies a unique position in the Bangladesh economy. Nearly four million workers are directly and more than twelve million inhabitants are indirectly associated with the industry, of which female are the main workforce plays a significant role in the socio-economic development on the garment sectors. Because of working environment women workers are very much prone to various risks. SRHR is a common health issue among them. As a result the whole garment sector suffers low productivity issues related to SRHR challenges.

To address the issues SNV, an International not-for-profit development organization, is implementing Working with Women Project, through a grant received from the Dutch Embassy (EKN) for “Promoting SRHR through Inclusive Business Practices within Ready Made Garment Industry in Bangladesh.” The project will create business models that will facilitate linkages for ensuring SRHR services and products for female RMG workers and at the same time demonstrating the profitability and embedded business benefit to RMG factories. SNV has assigned RTM to conduct a baseline survey on current situation on SRHR challenges before project interventions. The objective of the base-line study was to provide benchmark data on SRHR service provision, accessibility, usage among workers, gender sensitive and other key social impact and outcomes indicators before IB model or any project intervention has been carried out.

The study adopted a mix-method approach. Both quantitative and qualitative methods of data collection and analysis were envisioned for the baseline study. The duration of the study was 12-weeks. This baseline conducted in 15 target factories located in the Savar, Ashulia & Gazipur under 5 ‘Inclusive Business (IB) model’ to capture the SRHR service provision, accessibility, usage among workers, gender sensitive and other indicators to be set for tracking the progress and evaluate results at the end of the pilot. The study population comprises: Garment workers: both female and male; Factory management; Existing NGOs and other private sector service providers; and other relevant stakeholders. For survey, each production line was considered as a cluster, thus a total of 30 clusters were selected per IB model for the proposed study from each factory randomly. Total 2444 female workers were interviewd from 15 factories. Male groups and community elite were involved in focus group discussion and in depth interviews.

 
• Assessment of Stakeholder Perception of Public Health Services (01 August 2015-31 October 2015)
 Client: Crown Agents

RTM International in collaboration with ICDDRB conducted  a study "Assessment of Stakeholder Perception of  Public Health Services" with the aid of JDFTA fund through Crown Agents. Ministry of Health and Family Welfare (MoHFW) of the government of Bangladesh has a wide variety of health service for the population. In the process of achieving an improved health service delivery system, identifying the relevant stakeholders and understanding their perception regarding the public health service delivery is crucial. The aim of this study included mapping the stakeholders; explore perception of different groups of stakeholders and formulating the major recommendations for improving the health care delivery system of Bangladesh. In order to conduct the study, seven high performing and six low performing administrative areas were selected based on general health indicators and convenience to health services. The high performing districts were Dhaka, Munshiganj, Khulna, Rajshahi, Pabna, Rangpur, Dinajpur and the low performing districts were Barishal, Pirojpur, Chittagong, Noakhali, Sylhet and Sunamganj. These areas were studied with different data collection tools, such as guidelines, semi structured questionnaires, and listing questionnaire. In this joint venture, RTM-International assisted icddr,b research team in conducting stakeholder mapping, training the field team, developing the preliminary list of stakeholders, monitoring and supervision of data collection, managing and organizing FGDs/workshops at different levels of district health system.  RTM International also played active role in policy advocacy for incorporation of the recommendation in the next health sector program. As advocacy materials, several policy briefs were developed for dissemination among the relevant stakeholders. The stakeholders’ perceptions were analyzed to identify current gaps, priority areas that need to be addressed, and overall suggestions on the public health care delivery system of Bangladesh.

 
• Assessment of Contribution of MoHFW to the Urban Health Services (01 August 2015-31 October 2015)
 Client: Crown Agents

RTM International in collaboration with ICDDRB conducted  a study titled "Assessment of Contribution of MoHFW to the Urban Health Services" with the aid of JDFTA fund through Crown Agents. Bangladesh faces rapid urbanization and expansion of urban areas; this has placed a significant pressure on health services and facilities. Under these circumstances, Ministry of Health & Family Welfare (MoHFW) is providing a range of healthcare services in urban areas through secondary and tertiary hospitals, including preventive services and urban health provision. The aim of this technical assistance is to comprehensively document the contribution of MoHFW urban healthcare service delivery. In this venture, RTM International and icddr,b jointly worked for policy advocacy. RTM provided support for field implementation and data processing in identifying the residence (urban or rural) of the service users in the sampled health facilities, determining the use of public health services by urban residents living in a reasonable distance from the health facilities and determine the uptake of any MoHFW services provided at the door step/nearby centers. In order to conduct the study, both quantitative and qualitative research methods in Dhaka, Mymensingh, Chittagong, Khulna, Rajshahi, Moulavibazar, Pirojpur and Dinazpur districts were applied. Along with the main report, the output of the study helped in developing several policy briefs for advocacy in the sector program for strengthening the health system for urban population. The project also documented the barriers in delivering health services by maintaining the standards of the health system for effective service delivery for the urban population.

        
• Health Need Assessment in Textile and Hard good Industries in Bangladesh (26 July 2015-12 October 2015)
 Client: Auchan International

RTM International is currently conducting "Health Need Assessment in Textile and Hard Good Industries in Bangladesh" with financial support of Auchan Groupe SA which is a French international retail group and Multinational Corporation headquartered in Croix, France. It is one of the world’s principal distribution groups with a presence in 12 countries and 602 stores. The vocation of WEAVE OUR FUTURE, foundation created by Auchan Group in June 2014, is to support through local NGOs. The projects aiming at participating in the improvement of the living and health condition of workers and their families, in textiles and hard good industries, in the less economically advanced countries. The main purpose of the survey is to assess the first needs and the current health facilities for the workers and their needs regarding health in terms of physical & psychological health, environment linked health issues and workplace accidents. In order to make the sample representative the study will be conducted at 20 factories situated at Dhaka, Gazipur and Narayangonj districts. The study will capture the requisite information from both factory workers and factory health care service providers (Nurses) as well as from supervisor or management authority. The survey findings will help to assess the quality of health status, their needs and to understand the health seeking behavior of garment workers with a mission to increase worker’s health awareness and access to health services through sustainable workplace programs.

RTM International conducted an assessment named “Rapid Situation Assessment (RSA) In Teknaf and Ukhiya Upazilas of Cox’s Bazar District Covering Health and GBV Services for Both Local and Refugee Population” which was assigned by UNFPA. The main objective was to provide a situation analysis of all the project components supported by UNFPA in Teknaf and Ukhiya upazilas of Cox’s Bazar district.  A mixed method approach of both secondary and primary data collection was adopted for the RSA. The secondary date were collected through literature/documents review while the primary data were collected through key informant interviews (KIIs) of service providers, community leaders and service delivery point (SDP) managers, focus group discussions (FGDs) with women and adolescents, and in-depth interviews with the service providers. The RSA selected 33 service delivery points (SDPs) for facility assessment. A total of 63 providers were interviewed. Moreover, 18 FGDs with adolescent boys and girls, and women of reproductive age from local host, documented and undocumented refugee population were conducted. In-depth interviews with 18 relevant key informants were also conducted.

The Ministry of Health and Family Welfare (MOHFW) implements the Health, Population and Nutrition Sector Development Program (HPNSDP) with the goal of ensuring quality and equitable health care for all citizens of Bangladesh. Workforce training and competency is essential for delivering this quality and equitable health care. RTM International with the aid of Crown Agents; conducted "Training Needs Assessment for Personnel from the Directorates and Offices under MOHFW" for this purpose. In order to execute the study, various categories of service providers in health service delivery were selected from national to the community level comprising six tiers: national, divisional, district, upazila (sub-district), union, and ward. The selection of respondents was purposive with an objective to cover all categories of professionals. The study consisted both primary and secondary data. Both qualitative and quantitative approaches were used in conduction of organizational analysis, work environment analysis, job analysis, task analysis and getting experts opinion on different aspects of training needs.  Analyzing target group specific training needs, assessment of institutional capabilities to provide training and validation of training needs with MOHFW officials were also covered. The collecting of the feedback through institutional visits, local level interactions, city consultations, questionnaire survey helped in identifying deficiency-in the services and gaps in capabilities to take corrective measures.

Assessing the training needs of personnel from the Directorates and offices under Ministry of Health and Family Welfare (MOHFW) acted as an important step toward providing appropriate training programs for enhancing capabilities to perform job responsibilities and specialized functions.

SNV Netherlands Development Organization assigned RTM International to conduct ’’Capacity Assessment of NGOs/ Private Service Provider Organizations’’. The project focused on the Sexual Reproductive health Right (SRHR) service of female workers in the Ready Made Garment (RMG) industry. Garment industry consist the largest portion of female workers with mostly rural and disadvantaged backgrounds. Health issues such as; malnutrition, communicable diseases, pregnancy complications, incorrect use of family planning materials, reproductive infections are fairly common among the female workers. These diseases also undermine the productivity of the RMG industry. The project aimed to assess existing strengths, needs and gaps of each NGO/ private service provider organizations so that capacity development program for each NGO/private service provider can be designed to facilitate need based quality health care service especially SRHR service to the female workers of the RMG factories. In order to conduct the survey, a total of 20 NGOs/ private service provider organizations were studied for the capacity building intervention. The selected study areas were Dhaka, Gazipur, Mirzapur and Savar, where majority of the RMG is situated. The survey findings will help/ will be used to develop business models of NGOs/private service provider organizations that are based on an understanding of the business needs and concerns of the RMG industry, thus building more effective SRHR service delivery system and Health & Safety issues.
      

•  Assessment for Implementation of Tribal Health Plan under HPNSDP in Providing HNP services among Tribal Population in Bangladesh (November 2014-May 2014)
 Client: Ministry of Health Family Welfare (MOHFW)RTM International is currently conducting an assessment for implementation of Tribal Health Plan under HPNSDP in providing HNP services among Tribal population in Bangladesh for Minisrty of Health Family Welfare (MOHFW) under the sub-contact between Crown Agents. The study will be undertaken to assess the implementation of planned activities of the tribal health plan (MOHFW 2011a) under Health Population Nutrition Sector Development Program (HPNSDP) through the essential service delivery (ESD) Operational Plan (OP) and other relevant OPs. Moreover, the study will determine socio-economic and Health, Nutrition and Population (HNP) service utilization of tribal population and assess the coverage and effectiveness of service delivery in the tribal communities of both hill tracts and flat land in Bangladesh. The study will help to design an effective HNP services focused on ESD services for tribal women and children in Bangladesh. The study is designed for the tribal population living in both hill tracts and flat land areas. Based on the geographical location, the study will cover all three districts of CHT (Bandarban, Khagrachari and Rangamati) and three regions of flat land areas (Mymensingh region, Sylhet region and Rajshahi and Dinajpur region). A total of 4,725 households will be interviewed from CHT and flat land tribal regions. In addition a community survey will be administered in each selected community (village) to assess the existence of development organizations in the community and the availability and accessibility of HNP services and facilities to the tribal population.
      

• Baseline Survey Among the Beneficiaries of UPP-Ujjibito component of "Food Security 2012 Bangladesh-Ujjibito" Project (December 2014-March 2015)
  Client: Polli Karma-Sahayak Foundation (PKSF)

PKSF assigned RTM International to conduct a baseline survey of the “Food Security 2012 Bangladesh-Ujjibito” Project being implemented jointly by Palli Karma-Sahayak Foundation (PKSF) and Local Government Engineering Department (LGED). The study is being conducted to know the prevailing situations of the targeted beneficiaries before introduction of the project. The study will serve as a starting point of reference against which the progress, achievements and success of the project would be subsequently measured.

RTM International conducted a KAP study on Long Acting/Permanent Method. The purpose of this study was to learn more about health care providers’ knowledge, opinions, and practices regarding long-acting and permanent family planning methods (also referred to as "LA/PM"). This category included: implants, IUDs, injectables, female sterilization, and male sterilization. Data were collected from 385 providers from Dhaka and Chittagong, In addition to these interviews 15 Key Informant Interviews and 12 FGDs with LA/PM users were conducted. The report was submitted on time and has been accepted by sponsor and the programme.

TARSAN-CSO project of Swisscontact is implemented in collaboration with RTM International. The aim of the project is to ensure MCH and safe motherhood services in underserved and unreachable areas through developing health workforce from the same community. It is being implemented in Sunamganj, Patuakhali and Nilphamari districts. RTM International’s personnel conducted a baseline survey to assess the prevailing situation of care in the community both at the facility level and at outreach level. A mapping exercise was undertaken in the project locations and a list of public facilities, private institutions and existing committees was prepared.

Client: JICA Bangladesh

Filariasis is endemic in 34 districts, with highest levels of infection and disease in the northern part of the country. It is estimated that 70 million people are at risk of infection, with a huge number of population suffering from various forms of clinical deformity. Over the past decade, the national programme has concentrated its efforts on interrupting LF transmission through annual mass drug administration (MDA) of two drugs to an entire at-risk population. National Lymphatic Filariasis Elimination Programme requested RTMI to evaluate the MDA coverage in four districts. The study with financial assistance from JICA was conducted to determine the coverage status of mass drug administration, causes of not taking drugs used for MDA and the nature of drug reactions in the study area with a view to inform the findings to the concerned authority to take necessary steps towards elimination of LF. The MDA coverage survey was completed in 5 northern districts (Rangpur, Nilphamari, Lalmonirhat, Panchaghar and Thakurgaon) in January 2012 with a sample of 900 households per district i.e. 4500 households. The report was submitted on time and has been accepted by sponsor and the programme.
      
    

On being assigned by an international development organization named Micronutrient Initiative, RTM International conducted an assessment study on IEC materials used in EPI programs to identify strategies for a cost effective and sustainable IEC campaign.
       
    
• Baseline Survey of the project "Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh" (April – July 2010)
  Client: Population Council Bangladesh

RTM International conducted the the baseline survey of this project. A total 20 female Interviewers and 5 Supervisors were recruited to collect data by visiting 22 upazilas and through conducting 3300 household interviews and 295 provider interviews.
       

•	Study A :	Economic evaluation of the MOHFW’s demand side financing (DSF) pilot maternal health voucher scheme in Bangladesh, including an operational assessment and impact evaluation.
•	Study B :	Costing of maternal health services – including costing maternal and neo-natal health services at public and private providers, as well as estimating cost of achieving MDG 5 by 2015.
•	Study C :	Design of human resource incentives, including financial and non-financial incentives for human resources retention and performance, focusing on doctors and nurses.

• Evaluation of the status of Smoke Free Policy Implementation and Law Compliance (Nov 2009 - December 2010)
 Client: The International Union Against Tuberculosis and Lung Disease (the Union)

RTM International conducted a study to evaluate the status of Smoke Free Policy Implementation and compliance with the anti-tobacco law to find out what has already been done and what remains to be done to ensure a smoke free environment. The study was conducted in six city cooperation areas, six district towns and nine rural upazilas. This exercise was aimed to help planners, administrators and service providers to identify the challenges and present opportunities to put an end to one of the worst health hazards of modern times.
       
    

Under an agreement with Director General of Health Services RTM International conducted this study with the aim to improve the health status of the people of Bangladesh, specially the poor, through improved access to and utilization of efficient, effective and sustainable Essential Service Delivery (ESD) services. The study was based on both primary and secondary information. The requisite secondary data were collected through review of relevant documents, while the primary data were collected through field survey of selected PHC facilities. In order to make the study findings nationally representative all 6 divisions were included in the survey. A representative sample of 71 primary health care facilities comprising 36 UHCs and 35 UHFWCs was selected for the study.

Sanitation, Hygiene Education, and Water Supply in Bangladesh (SHEWA-B) project is jointly implemented by Department of Public Health Engineering (DPHE) and UNICEF since 2007. SHEWA-B is promoting hand wash with soap/ ash before eating, handling food and after defecation. UNICEF developed a flip chart on hand washing devices. RTM International was commissioned by UNICEF to verify whether the text and pictures of the flip chart were understandable and acceptable to both the Community Hygiene Promoters and Para Workers group to communicate with their local community people easily.

The Johns Hopkins Bloomberg School of Public Health conducted the study to measure tobacco smoke exposure in Bars and Nightclubs in 22 countries worldwide. RTM International was their country partner to carry out the study in Bangladesh. To assess the employee’s exposure status to second hand smoking, 10 bars and nightclubs were selected and upto 5 employees per bar/nightclub were interviewed. Two nicotine indoor air monitors were placed in different locations within the bar/nightclub. Nicotine concentration on personal hair of employees of non-smoking and smoking bars and nightclub employees was assessed by collecting approximately 50 strands of hair from the back of their head.
    
    
• Study on Improving Hygiene Behavior in Hard-to-reach Areas (Aug - Dec 2008)
 Client: UNICEF

RTM International was assigned by UNICEF the task to conduct a study on improving hygiene behavior in hard-to-reach areas. The recommendation from the study would lead to designing a strategy under the Sanitation, Hygiene Education and Water Supply project (SHEWA-B) for effectively reaching underserved groups in haors, chars and tea gardens. To accomplish the task the project team (i) reviewed the methodology practiced under the SHEWA-B project (ii) assessed its applicability and effectiveness in reaching the underserved groups in hard-to-reach areas and (iii) made recommendation for required changes to the project methodology which might improve its success in reaching these areas. The study was conducted in the districts of Moulvibazar, Sunamgonj, Gaibandha and Sirajgonj.

The Bangladesh Health Action Research Project of ICDDRB was reviewed by RTM International at the request of the European Union.

• Public Expenditure Review (2003-2004)
 Client: HEU / MOHFW

The Health Economics Unit of MOHFW assigned RTM the task of conducting a study on Public Expenditure Review 2003 in the health and population sector. . The main objective of PER was to: assess the progress made towards stated objectives in the health, nutrition and population sectors. The major data sources for the analysis of MoHFW expenditure comprised (a) Central Data Processing Unit (CDPU) of Controller General of Accounts (CGA), Ministry of Finance, (b) Annual Budgets for relevant years, Government of the People’s Republic of Bangladesh, and (c) other requisite secondary information from different published sources including NHA 1999-2001 and previous PERs provided by HEU.
   
    
• Situation of maternal health in Bangladesh(June 2007 - October 2007)
 Client: UNICEF

Under this contract, RTM International compiled the Bangladesh Country paper on the situation of maternal health in the country, a fact sheet on the progress made towards MDG5 and a summary of the maternal health policy. These materials were prepared at the request of UNICEF Headquarters, for dissemination among the senior policy planners from SAARC countries during the SAARC Summit.

RTM international conducted this study to determine the effectiveness of theatre as a communication intervention in rural areas for channelizing selected Avian and Human Influenza (AHI) related messages. The themes of the messages included-(i) general information on avian influenza (ii) migratory birds and bird-flu (iii) bio-security (iv) cleanliness (v) and, cooking. The specific objectives of the assignment were (i) to identify the socio-demographic background of the theatre participants (ii) to assess the level of comprehension of each of the five messages by the theatre participants (iii) to determine the proportion of participants able to recall the core messages received (iv) to assess the attitude and willingness of the theatre participants to change practices based on the messages and (v) to determine the effectiveness of a theatre as a communication media to raise awareness and understanding of the AHI. A total of 513 theatre participants from 14 districts of the 3 administrative divisions of Bangladesh were interviewed.

RTM conducted a review of the country program in Bangladesh of German Red Cross Society implemented in 2006.

• Behavioral Surveillance Survey (July 2006 - December 2007)
 Client: Family Health International, Bangladesh Office

RTM International was commissioned to conduct the sixth round of the BSS. It collected data from 7,167 respondents of ten high-risk population groups such as Injecting drug users Heroin Smokers, Hijras, MSM, MSW, Hotel based sex worker, Street based sex workers, Brothel based sex workers, Rickshaw Pullers and Truckers spread over different geographical areas of Bangladesh. The team listed 5,638 spots/PSUs and identified nearly 48,000 risk group populations from Dhaka, Chittagong, Rajshahi, Chandpur, Chapainawabganj, Khulna and Sylhet. Interviews were conducted with selected members of each group of MARP through a structured questionnaire. Separate data collection instruments were developed for each of the selected risk-practicing populations.
     
    
• Formulation of Bangladesh HNPSP monitoring and Evaluation Plan (May 2005 - August 2005)
 Client: GTZ Bangladesh/ MOHFW

RTM International worked as a resource organization for the Ministry of Health and Family Welfare and development partners in designing a ’Monitoring and Evaluation Plan’ of the Bangladesh health sector (HNPSP). The project team reviewed the existing data sources and identification of gaps with regard to data requirement, and proposed rapid assessment for timely generation of valid data or key measurable HNP outcome indicators, and developed a detailed impact evaluation for operationalizing the evaluation design. The support through this consultancy formed the basis of government M&E Plan for the health sector.

RTM International was a member of the team to review DFID’s Better Health for the Urban Poor (BHUP) project. The evaluation was helpful in using lessons learned and other information to apprise DFID and other development partners about the urban health situation in Bangladesh.