BRAC has mainstreamed nutrition under the MNCH programme since 2010. This component aims to fulfil its objectives through several strategies that focus on building the capacity of community health workers, establishing an effective community based integrated nutrition service delivery, and raising awareness and empowering communities to improve infant and young child feeding (IYCF) and breastfeeding practices. BRAC trains two types of community health workers (Shasthya shebhikas and Shasthya kormis) and BRAC programme staff in delivering messages about appropriate IYCF and breastfeeding practices.
To determine the impact of the mainstreaming of nutrition, we used a propensity score matching design that includes 1600 households with children under two years old in 40 beneficiary mouzas (administrative district that corresponds to a specific land area in Bangladesh) and 40 comparison mouzas. To identify the impact of the ECD programme on children’s cognitive and motor skills and nutrition outcomes, we used a clusterrandomised controlled trial (RCT) that includes 3,120 households with children under two years old in 78 treatment mouzas and 78 control mouzas.
Our findings indicate that the mainstreaming of nutrition under BRAC’s MNCH programme reduces the likelihood of stunting by seven percentage points, but we do not find evidence for positive programme impacts on reductions in stunting. The positive impacts appear to stem from improvements in the primary caregivers’ bargaining power, IYCF practices, antenatal care, and postnatal care that are caused by the programme. However, we find no evidence that the programme improved breastfeeding practices. We find evidence that programme impact appears to depend on whether the primary caregiver has completed primary school; we find no evidence for positive programme impacts on either stunting or wasting for households with primary caregivers who have not finished primary school while the positive programme impacts on stunting appear to be almost exclusively driven by households with primary caregivers who have finished primary education at a minimum.