This population based cross-sectional survey collected data from the randomly selected six upazilas of Nilphamari district (Nilphamari Sadar, Joldhaka, Kishoriganj, Syedpur, Dimla, and Domar) during both baseline (2006) and the follow-up (2008) using quantitative methods. A total of 1,800 respondents, comprising currently pregnant women (n=600), mothers of under-1 children (n=600) and mothers of under-5 children (n=600) were sampled at each phase. All information was collected with reference to the last pregnancy or the last birth. Comparative analysis was done between baseline and one year since intervention to document changes, if any, with respect to variables of interest.
Findings revealed that there was no significant backward or forward shift in the age of the pregnant women and mothers of under-5 children during the study period. A decrease in induced abortion was observed. Use of herbs for induced abortion decreased; however, self-treatment and treatment-seeking from informal providers for complication of abortion remained high. Pills are gaining popularity as a family planning method; also discontinuation and switch to another method was decreasing. Mean number of ANC visit increased as also attendance of deliveries by skilled providers than at baseline. However, majority of deliveries continued to take place at home; the proportion delivered by the TBAs remained substantial. Post-natal follow-up was increasing, as also attending to these visits by the Shasthya Kormis (SKs) and trained TBAs. For treatment of neonatal complications, mothers increasingly preferred UHCs/district hospitals. Management of illnesses of the under-fives is fragmentary and the thrust is on prevention only. In conclusion, The MNCH intervention in Nilphamari made some noteworthy improvement in the coverage of ANC, vaccination of children, safe delivery, etc., but failed to provide primary and secondary level of basic emergency obstetric care (EmOC) adequately. The proportion of actual referral did not reach the desired level which give the programme opportunities to rethink and reorganize their system. The implications of these findings for scaling up phase of the programme is discussed.