Evaluating the Impact: From Promise to Evidence
Improved Maternal Health for Haor Dwellers Dhaka, Bangladesh
April 27-29, 2014
Priyanka Chowdhury (Team Leader) Masud Khan Abu Hanif Sabuj Kanti Mistry Saiful Islam Sruthi Chandrasekaran (Moderator)
1. Intervention Summary
Brief description of program activities and outputs:
• The Haor basin Bangladesh is one of the most vulnerable regions and are viewed as poverty pocket. People of these area are facing multi-dimensional problems—deprivation from mainstream service provisions and development opportunities and because of inaccessibility exclusions, they are becoming increasingly marginalized and isolated
• BRAC is implementing Integrated development program since 2011 based on its strategic plan and priorities (2011-2015) to boom development of these socio-economically depressed regions which are falling behind on MDG achievement.
1. Intervention Summary (continued)
• IDP is ensuring basic services (education, health, nutrition & population, and WASH) promoting sustainable livelihoods (Agriculture, fisheries, poultry, livestock, TUP, Migration & MF)), Social Mobilization (CEP, GJD and HRLS)
• For this particular exercise, we are focusing specifically on improving maternal health by providing awareness, ANC/PNC, effective referral systems and skill training to health workers
Where is it conducted?
• Derai in Sunamganj and Baniachong Sub-district in Habiganj
• IDP-Haor is being implemented for 0.6 million people through it’s 10 offices in Baniachong Upazila and 5 offices in Derai Upazila
Who is targeted?
• Pregnant women
• Targeting 50,000 pregnant women over course of 3 years
• When is it conducted? January 2013 to December 2015
Name of implementing organization
• BRAC
2. Results Chain PROGRAM
INTERMEDIATE OUTCOME IMPACT
Inputs • Training to CSBA, NHW SK SS • Subsidy for complicated
pregnancy cases • Kitboxes, communication
materials Activities • Antenatal and postnatal
care checkups • Establish an effective
referral system • Delivery through trained
and skilled work attendants
Outputs • Receiving regular checkups • Access an effective referral
system • Receiving deliveries through
trained and skilled attendants
• Reduced complicated pregnancy cases (PPH)
• Increase of safe deliveries
• Reduction of maternal mortality rate and hence improve maternal health
3. Research Questions
Will an improvement in maternal healthcare facilities lead to a decrease in maternal mortality rate?
Will offering a package of services – antenatal and postnatal care, effective referral systems and access to skilled attendants – lead to a decrease in maternal mortality?
4. Impact Evaluation Design
A. Describe the intervention in the (add treatment arms, if applicable):
Treatment: provide maternal health services
ANC & PNC check ups
Effective referral system
Number of skill development training to birth attendants
Control: No service
B. Describe the sample size
Treatment: 341 villages
Control: 341 villages (will be served on the next phase)
C. Describe the program assignment rule:
Random selection of Villages
64 Districts
Habiganj (Districts) Sunamganj (Districts)
Baniachong (Sub-districts) Derai (Sub-districts)
15 Union 10 Union
441 Villages 241 Villages
220 Villages (T) 221 Villages (C) 121 Villages (T) 120 Villages (C)
341 Villages (C) 341 Villages (T)
Describing the sample size
5. Data Collection A. List program indicators to be collected:
• Maternal Mortality Rate
• Access to (maternal) healthcare services
– Level of awareness of facilities, care options
– Level of health care (maternal) knowledge
– Level of expertise, comfort level with participants
– Received ANC, SBA services
– Status of care for complications
– Referral
• Access to skilled workers, healthcare workers
• Frequency of referring to health centre
• Resolution of cases (place, provider)
• Health status
– Frequency of pregnancies
– Frequency of complications
B. Method of data collection:
• HH survey
• Process monitoring data
C. Frequency of data collection:
• HH Survey: Baseline, Midline (1.5 years), Endline (3 years)
• Process monitoring: Monthly
D. Who will collect the data: Research Assistants
Thank You!
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