RTM International is involved in the School Nutrition for Adolescents Project (SNAP) designed and funded by Nutrition International (NI) – a Ottawa based multinational organization specializing in nutrition research and intervention. SNAP took place in 2 districts of northern Bangladesh from May 2019 to August 2020, with an aim to evaluate whether secondary schools are an effective platform to deliver weekly iron-folic acid supplementation co-delivered with WASH, menstrual hygiene management, nutrition education, and behavior change interventions for adolescent health and nutrition. A number of partner organizations including RTMI, Centers for Disease Control and Prevention (CDC), NI and BRAC jointly implemented the SNAP project, while RTMI’s involvement is limited to conduct of baseline and end line surveys on a cross-section of 3600 adolescent boys and girls studying in class 8 and 9 of 75 schools at Jaypurhat district, Bangladesh. RTM international has already conducted Baseline survey in 75 schools at Joypurhat district. The ultimate purpose is to share the result with the Government of Bangladesh for effective policy making and intervention for nutrition.

A three years project named ‘Max Value for stunting free village’ was implemented consisting of implementation, research and promotion in Sylhet division in the North-East of Bangladesh. The aim of this project was to provide nearly 50,000 people with access to clean drinking water, clean toilets/latrines and information on hygiene and nutrition in order to create the necessary behavioural change leading to reduction of infection with faecal bacteria. A baseline survey was conducted in two intervention unions and one control union of Sylhet district. KIT Royal Tropical Institute contracted RTM International to conduct the endline survey named “Conduct an endline survey in the intervention and control population of the Max Foundation ‘GrowingUpUpUp’ project”. The overall objective of the evaluation was to identify the prevalence of stunting at the start and the end of the project and to map the related risks factors in the project area (two selected unions) compared to a control area (one selected union) to measure the impact of the project on the prevalence of stunting and related risk factors and understand why the project was successful or not. The primary data collection was mainly based on the mixed-method approach consisting of quantitative and qualitative research methods. Quantitative method of data collection was conducted  with caretakers of under 2 and under 5 year old children through face to face interview and qualitative method of data collection was conducted with male caretakers, female caretakers, and younger females of reproductive age through FGDs and with related stakeholders through IDIs in intervention unions. A total of 1111 quantitative data was collected from three selected unions and a total of 12 FGDs and 18 IDIs were conducted from two intervention unions.

 

According to a recent statistics, 56% of all stunned children worldwide live in Asia. Stunned children remain short in comparison with their standard height-age ratio. For instance, according to the Bangladesh Demographic and Health Survey 2014, 36% of children under 5 are considered to be short for their age or stunted. Among all, rural children are more likely to be stunted than urban children (38% compared with 31%). Further, stunting is most prevalent in Sylhet division (50%) and lowest in Khulna division (28%). A baseline was required to capture this variation in project area. In this regard, KIT Royal Tropical Institute contracted RTM International to conduct the baseline survey named “Conduct a Baseline survey in the control population of the Max Foundation ‘Max Nutri-WASH’ project aiming to reduce stunting in children under the age of 2”. The overall objective of this study was to collect primary data on WASH, child nutrition, child health and access and services related to SRHR. Quantitative method of data collection was used in this study. Using a multi-stage cluster random sampling 23 households under 32 enumeration areas were selected randomly from the 4 selected unions of Patuakhali, Barguna and Satkhira districts for this purpose. Data of one child was collected from each household. Data on other relevant factors causing stunting including the prevalence of diarrhea, available WASH, child health, and child nutrition from mother/caretaker of children was also collected.

 

According to the Bangladesh Demographic and Health Survey 2014, 36% of children under 5 are considered to be short for their age or stunted. Among all, rural children are more likely to be stunted than urban children (38% compared with 31%). Further, stunting is most prevalent in Sylhet division (50%) and lowest in Khulna division (28%). A three years project named ‘Max Value for stunting free village’ was implemented consisting of implementation, research and promotion. The focus of the project was on the poorest population in hard to reach areas. The project took place in the Sylhet division in the North-East of Bangladesh. A baseline survey in control area and midline survey in intervention area was required to see the status of the project. In this regard, KIT Royal Tropical Institute has contracted RTM International to conduct the baseline survey and midline survey named “Conduct a baseline survey in the control and midline survey in the intervention populations of the Max Foundation ’Max Value for Stunting Free Village’ project aiming to reduce stunting in children under the age of 2”. Overall objective of the study was to collect primary data on WASH, child nutrition, child health and access and services related to SRHR. Study was conducted in one control union, namely Charmohalla union and two intervention unions, namely Islampur and Noarai union of Chhatak Upazila in Sylhet division. Target group for this study was caretakers of under 2 year old children. Using a multi-stage cluster random sampling control data was collected from 301 households of Charmohalla union and mid-line data was collected from 152 and 151 unions of Islampur and Noarai unions respectively. Data on anthropometric measurements was collected from one child each household. Data on other relevant factors causing stunting including the prevalence of diarrhea and other diseases, practice of WASH, child health, and child nutrition from caretaker of children was also collected.

 

Save the Children have recently assigned RTM International to conduct a study on “Social Behaviour Change Communication Formative Research for Understanding the Behavioural Determinants of Key Behaviours Targeted by the Programme”. The main objective of this study is to address some of the key information gaps underlying programme design components by increasing understanding of the behavioral determinants of key behaviors targeted by the programme. The objectives will be achieved using a formative research to be conducted in Sylhet and Moulvibazar districts of Bangladesh where Shuchana will implement a nutrition intervention. The formative research will utilize qualitative information for promotion and adoption of priority nutrition practices. Focus of the study is on the analysis of barriers to use of nutrition and on identification of approaches and materials to guide the design of SBCC. The main methods to be used for collecting data are- Focus Group Discussions (FGDs), In-depth Interview (IDI) and Key Informant Interview (KII), Consultative Workshop and doer/non-doer surveys for key target behaviors. For this study information will be gathered from pregnant mother, lactating mother, adolescent girls, mother-in-law, male (husband), mothers/fathers of adolescent girls and key informants.

 
• Conduct Baseline Survey for the "Urban Pilot Project on IFA Supplements among Pregnant Women" in Bangladesh (August’16-February’17)
  Client: Micronutrient Initiative

RTM International is currently conducting a baseline survey for the "Urban Pilot Project on IFA Supplements among Pregnant Women" in Bangladesh with financial support of Micronutrient Initiative. The overall objective of this study is to establish baseline estimates of knowledge, attitudes and practices among pregnant women and health workers regarding IFA supplementation and causes and consequences of anaemia and interpret the findings to inform the program strategies described above for implementation in the project area. The survey will be conducted in the program area (Shahjadpur, Purba & Paschim in ward No. 18) and a comparison area in Dhaka North City Corporation (DNCC). Data will be collected from 360 care-givers of less than six months child and 10 vaccinators Govt. health workers and 20 NGO frontline workers from a program area (Shahjadpur, Purba and Pashchim in Ward no. 18) and a comparison area in Dhaka North City Corporation (DNCC). In addition, 5 Health Officials (1 CHO, 1 Zonal Health Officer and 3 NGO manager/doctors/supervisors) from DNCC will also be interviewed.

 

Micronutrient Initiative Bangladesh contracted RTM International to conduct an end line Survey of the project Strengthening the zinc supplementation and ORS distribution for childhood (6-59 months) diarrhoea in Bangladesh. The main purpose of the end line evaluati on was to inform the Government of Bangladesh, The Micronutrient Initiative (MI) and other key partners involved in the Diarrhoea management program regarding the impact of program activities on the coverage of zinc and ORS in diarrhea cases among children aged 6-59 months who had an episode of diarrhea in the one month preceding the survey in the two project districts (Barisal and Gaibandha) and the two comparison districts (Jhalokati and Lalmonirhat) of Bangladesh. The other respondents for the survey were the HAs, FWAs, CHCPs and Gram doctors of the sampled clusters for the household survey. As a result, the study population comprised two groups of respondents: Care-givers and Health workers. Data would be collected from 600 Care-givers and 308 Health workers. In order to conduct the proposed endline evaluation an experimental pre and post intervention design would be adopted.

 

RTM International conducted a study on perceived quality and satisfaction on nutrition services and their utilization among the community people. The study was based on both the quantitative and qualitative techniques for data collection. In order to make the study findings representative and valid all seven divisions were selected. The main focus of the study was to explore the knowledge on the users’ satisfaction with nutrition care provided to children aged 0-5 years in Bangladesh. Thus the respondents’ group of the study comprised the parents/care givers of children under 5. Detailed knowledge and practice of the parents/caregivers on nutrition indicators specially IYCF indicators were assessed. Further, the study included the current pregnant women, lactating mothers and adolescent girls for data collection on the selected nutrition activities.

 

Imagine Bangladesh free of the scourge of malnutrition - what will it take to achieve this? What would be the benefit? How much would it cost to achieve this goal? Over the past year national stakeholders and technical experts gathered to attempt to answer these questions. RTM International was contracted by Academy for Educational Development to generate new PROFILES estimates and develop a national costing model for nutrition programming for Bangladesh under its Food and Nutrition Technical Assistance Project (FANTA-II). A series of stakeholder meetings, field-cum-site visits, expert opinions and costing workshops were organized to achieve this end. The study was led by a Lead Economist of the country. It presents the results of this consultative and consensus-building process and seeks to provide a better understanding of the value of investing in nutrition and the level of investment required to improve nutrition as a means to achieve the MDGs and Bangladesh Vision 2021 goals. This report presents the projections on the benefits of investing in nutrition in terms of gains in development outcomes; and the cost of providing maternal and child nutrition services at scale nationally. PROFILES, a data-based tool that provides estimates of economic and other benefits that would result from improved nutrition, was used to project the benefits of investing in nutrition in terms of improvements in development outcomes, specifically reduced maternal and child mortality and improved economic productivity. The cost of providing maternal and child nutrition services at scale nationally was estimated by developing a national costing model for nutrition programs. The objective of this report was to share estimates that were generated from these two models to guide policy makers on the scope of nutrition interventions and costs of nutrition programming for consideration as the operational plans for the HPN sector program are implemented.

 
• Conducting Baseline Survey of the Project "Strengthening the Iron and Folic Acid Supplementation (IFA) Program to reduce Iron Deficiency Anemia among Pregnant Women" (November 2011 to February 2012)
Client: Micronutrient Initiative, Bangladesh  

The Micronutrient Initiative Bangladesh supports the Government of Bangladesh to demonstrate an effective program model for increasing the coverage and particularly utilization of IFA supplements among pregnant women. This pilot initiative was implemented in Satkhira and Narsingdi districts. RTM International was contracted for conducting the baseline survey in these two districts. Data were collected from intervention districts (Satkhira and Narsingdi) and two control districts. At the household level, 200 pregnant women were interviewed in each of the four districts. A total 800 pregnant women were interviewed at household level. In addition to the collection of data at the household level, a sub study of KAP among Health Workers among four districts was done. The Field Team visited the related health facility of each cluster for interview with Health Workers and for collection of data relating to stock of IFA. The report was submitted on time and has been accepted by sponsor and the programme.



Under a contract signed with Micronutrient Initiative, RTM International conducted a formative research to identify feasible models for delivering new born Vitamin Supplementation (NBVAS) integrated within the existing community-based maternal and newborn services which can be recommended to GoB for scale-up. This formative research conducted a mapping of the existing MNCH facilities and a study to understand needs and interest of the different populations and persons in their community towards designing an integrated program. The study areas covered Sadar and Nesarabad (Swarupkathi) upazilas of Pirojpur district, Madhupur and Shakhipur upazilas of Tangail district, and Jaldhaka and Dimla upazilas of Nilphamari district.
     
    

RTM international conducted a study on perceived quality and satisfaction on nutrition services and their utilization among the community people. The study was based on both the quantitative and qualitative techniques for data collection. In order to make the study findings representative and valid all seven divisions were selected. The main focus of the study was to explore the knowledge on the users’ satisfaction with nutrition care provided to children aged 0-5 years in Bangladesh. Thus the respondents’ group of the study comprised the parents/care givers of children under 5. Detailed knowledge and practice of the parents/caregivers on nutrition indicators especially IYCF indicators were assessed. Further, the study included the currently pregnant women, lactating mothers, adolescent girls and caregivers of under 5 children for data collection on the selected nutrition activities. Data were collected from 2100 pregnant women, lactating mothers, adolescent girls and caregivers of under 5 children.
     
    

RTM International conducted an assessment study on IEC materials used at EPI programs to identify strategies for a cost effective and sustainable IEC campaign. The team visited different sites on the National Vaccination Day and interviewed the staff and clients to assess the effectiveness. The study report is expected to aid MI in designing appropriate and effective IEC materials.