Strengthening Multisectoral Nutrition Programming (MSNP) through Implementation Science

The vision of MSNP is evidence-based multi sectoral nutrition programming that accelerates the annual rate of reduction in stunting among Bangladeshi children under five from 1.5 to 3.3 percent to meet the World Health Assembly(WHA) target. The project is being implemented by FHI360 as prime and SMC is one of the partners in implementation through its Blue Star providers.

Objective of the project is “Nutrition policy making and implementation in Bangladesh is informed by high quality local evidence.”

By implementing a randomized effectiveness hybrid trial and a number of mixed methods implementation science studies, the project will achieve the following two Intermediate Results (IRs):

IR 1:   Increased availability of evidence to guide multisectoral nutrition programming implementation

IR 2:   Improved capacity to use evidence to inform policy and programmatic decision-making

The project will apply a mixed methods research approach to assess the effect of different multisectoral nutrition intervention packages delivered through a coordinated approach by the Government of Bangladesh (GoB), NGOs and the private sector on improving nutrition outcomes known to contribute to overall healthy nutritional status of children under two in Bangladesh. The project will also assess the fidelity of implementation, specifically evaluating the adequacy, acceptability, relevance, coverage and cost-effectiveness of the packages. In addition, the project will create capacity among GoB stakeholders to interpret and utilize the project’s findings (and other high-quality evidence related to nutrition programming) to inform future multisectoral nutrition policymaking and planning. The project will directly support the GoB’s priority nutrition plans, namely the National Plan of Action on Nutrition-2 (NPAN-2), by working through established structures that have been tested and shown to facilitate multisectoral activity convergence at sub-national levels.

SMC will work in three project operational districts. Within the said districts, SMC will deploy staff and Blue Star Providers (BSP) in 45 unions under 10 Upazilas selected at random as intervention area to deliver project services and sell products. SMC will train the existing BSPs to deliver a limited set of nutrition interventions, especially targeting fathers of children under two years of age. BSPs will also be responsible for documenting nutrition service delivery and referrals using guidelines & tools as agreed upon with FHI 360. These activities will be in addition to those currently provided by BSPs, e.g., selling nutrition commodities, and will include:

> Promoting maternal and child care and nutrition practices

> Promoting available nutrition services offered within communities (i.e., outside the BSP scope)

> Providing messages to caretakers on good maternal and IYCF practices

> Growth monitoring and promotion (GMP) and subsequent screening for acute malnutrition

> Referring caretakers to appropriate locations for nutrition-related services; documentation of referrals

> Documentation of target population (PLW, under-2 children) who access these services