Vol. 20 No. 1 © Oxford University Press, 2005; all rights reserved
An evaluation of the impact of a US$60 million nutrition programme in Bangladesh
1 UNICEF, Islamabad, Pakistan and 2 Save the Children UK, London, UK
* Correspondence: Anna Taylor, Nutrition Adviser, Save the Children UK, 1 St John's Lane, London, EC1M4AR, UK. Tel: 020 7012 6804; Fax: 020 7012 6951; Email:Email: a.taylor{at}savethechildren.org.uk
Objective: To compare levels of childhood malnutrition in areas where the Bangladesh Integrated Nutrition Project had been operational for over 5 years with matched non-project areas, with the purpose of evaluating whether the project had achieved its objective of reducing the prevalence of underweight among children <24 months.
Methods: The study involved an ex-post cross-sectional survey in six thanas (a locality with a population of approximately 200 000–450 000 people) in Bangladesh. Participants were 6820 households (4554 in the project areas and 2266 in the non-project areas) including 7183 children aged 6–59 months selected using a two-stage stratified cluster sampling frame. Main outcome measures were moderate and severe underweight, wasting and stunting reported using z scores, and indicators of mothers' reported nutritional knowledge and practice.
Results: 2388 children aged 6–23 months and 6815 children aged 6–59 months had clean anthropometric data. No significant difference was found between the socio-economic variables of households in the project and non-project areas. No significant difference was found in the prevalence of either severe or moderate underweight (weight-for-age) in children aged 6–23 months in the project and non-project areas: 183 (11.4%, 95% confidence interval 9.9–13.2%) children in project areas and 96 (12.2%, 95% confidence interval 9.9–14.8%) children in non-project areas. Mothers in project areas reported significantly better caring practices than in non-project areas.
Conclusion: There is no evidence that the Bangladesh Integrated Nutrition Project has achieved its objectives to reduce severe underweight by 40% if project areas are compared ex-post with non-project areas. There is urgent need to review the evidence behind investments based on growth monitoring and promotion.
Key Words: nutrition, growth monitoring and promotion, programme impact, child health
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