Mainstreaming Nutrition in BRAC Maternal and Neonatal Child Health Programme

Background: For MNI, an engagement with BRAC developed a strategy of mainstreaming nutrition which is being tested and expected to be scaled up rapidly through BRAC’s existing programs, which cover around half of Bangladesh. Since inception of MNI, Bangladesh activity is based on an appraisal of following actions- a) review of existing IYCF practice, barriers and constraints to optimum ANC and IYCF practices, and b) appraisal of BRAC’s health systems. The assessment and the MNI technical core member’s advice is the basis of the design, and implementation strategy of the Bangladesh activity, which was formulated in a workshop, held in ICDDRB. The goal of the intervention is to test integration of key nutrition actions and messages into BRAC’s health programs. MNI provides technical assistance, e.g. facilitating in problem definition, developing modules and facilitating in work planning. MNI has also provided financial support to run the project. The model of IYCF developed by MNI –BRAC will be used to inform national policy and strategy actors for adoption in national and NGO driven actions.
 
Achievement: Baseline assessment was conducted capturing information on mother’s knowledge and practice in relation to nutrition and child feeding.
 
Training: A training module on nutrition issues, and an IYCF trouble shooting guide was developed. Nutrition messages are included into the existing BCC flipcharts. All Health Managers and Shayastho Shebikas (SSs) and Shayastho Kormis (SKs) of Nilphamari district received training on nutrition issues, interventions and the BCC.
 
Orientation of GOB staff: Government health staffs were oriented on IYCF and project interventions. The orientation highlights the MNI MCH project activities, how it complements the government activities to achieve the MDGs 1 and 4 and also discusses about community perception and practices regarding maternal nutrition, exclusive breastfeeding and complementary feeding, and the updated information regarding these issues.
 
Scaling up of intervention: Implementation of MNI-MCH (comprehensive package of nutrition interventions integrated in BRAC health program) is continuing. The activity initially implemented in 6 unions has been scaled up in 61 unions of Nilphamari district since October 2008. The experience of the MNI approach is the basis of the forthcoming Bill and Melinda Gates Foundation sponsored project of “Alive and Thrive”, which intends to further strengthen the nutrition activities in Bangladesh.
 
Advocacy at National level: Lancet nutrition series was launched in Dhaka in 2008. GOB, Development partners, academicians, NGOs, and media were appraised on maternal & child nutrition issues, actions, and MNI strategy to address these. Relationship with the key stakeholders was strengthened.
 
A very rewarding working relationship has been fostered with the MOH. This was due to the assistance provided by MNI to the Ministry. The MNI was asked by the Ministry to disseminate the findings of the anemia program review done by MNI. This dissemination has already resulted in actions from the Directorate General Family Planning. The MNI was also asked by the Ministry to conduct a rapid survey on the effects of price hike on food and nutrition security. The MNI efforts were key to developing and disseminating (December, 2008) the national guidelines for management of severe acute malnutrition for the GOB. Nutrition Technical Group (NTG) is the highest advisory and technical team to MOH for nutrition related activities (policy formulation, strategy development, and implementation). A member of MNI core group, also member of the NTG informs the MOH and the national policy on technical inputs on nutrition as and when required.