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Sustained Opportunities for Nutrition Governance (SONGO

Countries:
Start project:
  • 2018
Donors:
  • Dutch Ministry of Foreign Affairs, European Commission, ICCO
Partners:
  • Rangpur Dinajpur Rural Service Bangladesh

Sustained opportunities for nutrition governance project aims to improve maternal and child nutrition. This is a five-year-long project lead by ICCO Cooperation along with RDRS funded by the European Union. The project will implement in 18 unions in under 6 Upazilas where 3 UPZs in Kurigram District and 3 UPZs in Gaibandha District, Rangpur Division with direct beneficiaries of 128,000 households . The project will work for strengthening local nutrition governance mechanism at Upazila level.

Background: To prepare for this Action, the Consortium conducted participatory research and consultations with all stakeholders concerned, including various community groups. The Consortium has a long-standing presence in the area, and a deep understanding of the local situation, the specific challenges and conditions faced by the beneficiaries. This target area was chosen because of the high occurrence of malnutrition and stunting, high poverty levels, limited GoB service provision, limited markets and disaster-proneness.

Objectives, results, activities and linkages: The four outcomes of the specific objective of this proposed Action SONGO reflect the Consortium’s experiences and conviction that in order to contribute sustainably towards the overall EC objective, a multi-sectoral, multi-stakeholder, and proven and validated inter-linked set of interventions with a focus on effective and cost-efficient reduction in malnutrition and stunting is required. A set of integrated interventions, including FNS (Food & Nutrition Security), Care and WASH, will be based on the NPAN 2016-25 and the SDG agenda, and brought under the governance of a locally embedded steering mechanism. This nutrition governance system, established through the Action’s activities is essential for the target groups and stakeholders to jointly own, align, catalyse, support and facilitate the various needs identification and service delivery processes at local level as well as vertically and horizontally. Without exception, all stakeholders consulted were supportive towards the Action and willing to play their governance role. The main activities are all inter-linked and together contribute to the pillars food, care and WASH for an enhanced maternal and child nutritional status, as shown in the figure. Under Oc 1, the related outputs and activities are key to make the three pillars equally strong and complementary and to ensure a comprehensive and sustained basket of goods and services which will benefit all. Oc 2 ensures that the poor maternal behaviour with regard to pregnancy, delivery, dietary intake, breastfeeding, sanitation, water-use, personal and environmental hygiene is addressed, as is SRH for their empowerment. And by making adolescent girls and boys aware of the same as well as on the consequences of early marriage and -pregnancy, they will start their own families on a better footing. Simultaneously, the male HH members are made aware of their responsibilities and the importance of gender equality. For the HHs to have better access to WASH and livelihood goods & services, GoB and the private sector are stimulated to respond adequately (Oc 3) to the identified needs and constraints regarding access to water and latrines. Without an enhanced availability and access to food and nutrition (Oc 4), the HHs will still not be sufficiently able to provide healthy nutrients to the mothers and infants. Poor and extreme poor HHs will receive training in small-scale, climate-resilient agricultural/livestock Income Generating Activities (IGA) with Heifer principle based asset transfer to improve on their ability to change their behaviour. Through Horizontal Learning Platforms (HLP) and media, experiences are shared between local governments and stakeholders thus providing opportunities for replication/scaling-up of nutrition governance.

Key Stakeholders: of the action are local Government, private sector and civil society organisations (CSOs) who collectively and in close cooperation will be playing a crucial role in nutrition governance. The key local GoB stakeholders are representatives of: the department of Agricultural Extension (DAE), Fisheries (DoF), Livestock (DoL), Public Health Engineering (DPHE), Health and Family Planning (DoHFP), and the Union Parishads (UPs), UZP and District (DP). The private sector stakeholders consist of farmer groups, input sellers and output buyers, (wholesalers and retailers) including their local service providers rendering doorstep goods and services as well as the Nutrition Sales Agents (NSA). Community members in their capacity as producers are also considered part of the private sector. Local CBOs/NGOs, incl. RDRS Federations represent the interests of the targeted community groups (often affected by displacement and limited social cohesion) and crucial for raising the voices of the underprivileged.

Time Frame: 60 months. During the inception phase (6 Months) field project staff/intermediaries will be selected, trained and aligned towards the project’s objectives, results, outputs and modus operandi. Baseline data will be collected; the specific target group members selected; and nutrition governance stakeholders brought together vis-à-vis the project’s objective. Towards the end of year 4, the project’s interventions will be gradually phased out in order to ensure sustainability. The overall timeframe and planning will encompass sufficient flexibility to accommodate periods of disaster (floods, droughts) and takes into account periods of peak labour, religious festivities and elections. The total cost for this Action is € 9 M.
Relevance of the action (max 3 pages)
1.2.1 Relevance to the objectives/sectors/themes/specific priorities of the call for proposals
The action proposed by the ICCO consortium comes under lot-1 of the Call for Proposals (CfP) as the riverine areas of Kurigram and Gaibandha districts are amongst the poorest, most underserved, least developed, and most disaster-prone (floods, droughts) parts of Bangladesh. To realize “maternal and child nutrition improvement” in a sustainable way, a multi-dimensional, multi-sectoral and inclusive approach is required. While the GoB's NNP 2015 forms a solid framework, the realization, especially in the target areas, remains a challenge addressed by the action. The presented outcome areas are aligned with the CfP's objectives and national pro-poor policies. The approach is based on proven and evolving experiences taking into account the importance of pre-conditions to address e.g. dimensions of availability and access to food as well as the required synergy between interventions and actors at various levels. The figure visualizes the linkages between the different levels as well as the objectives forming part of the Action. Interventions will focus on mobilizing and coaching target groups as well as local public, private and development actors to collectively take the necessary actions towards improved nutrition.
1.2.2 Relevance to the particular needs and constraints
The target area is located in 15 embankment area Unions in 5 UPZs in Kurigram (3) and Gaibandha (2) districts, Rangpur Division. Rangpur has the highest incidence of poverty in the country and the Brahmaputra river embankment population even has the highest extreme poverty figures, and scores very poor on all indicators related to maternal and child health as well as other livelihood aspects. The embank-ment areas are regularly flooded, taking lives and destroying crops and assets. Climate change increases the disaster-proneness, as also witnessed by the August 2017 flooding. Population- and land pressure forces people onto the risks that go with living there, with women and children being the most vulnerable.
Bangladesh has made laudable progress on many aspects of human and economic development. However, regarding child nutritional status the priority indicator “stunting” (low height for age) still remains near the WHO emergency level. According to the Bangladesh Demographic Health Survey 2014, 36% of CU5 are (severely) stunted and for CU2 it’s even 45.6%. Stunting leads to impaired physical and cognitive growth, with detrimental consequences for their health as well as future economic life. Exclusive breastfeeding rate is 55%, and only 23% of children between 6-23 months receive the minimum acceptable diet and 28% obtain the recommended minimum dietary diversity (MDD). Around 33% of CU5 and 26% of women (not pregnant or lactating) are anaemic. 20% of children suffer from vitamin A deficiency and approx. 45% of children and 57% of women from zinc deficiency. Children and women also suffer from high levels of malnutrition and micronutrient deficiencies resulting in low birth weight, iodine-deficiency disorders and anaemia.
Research shows the strong relationship between WASH, nutrition, and the prevalence of stunting. Poor WASH results in frequent infections, contributing to poor nutrition and vice versa. The availability of hygiene products (sanitary napkin, sanitary latrine) in remote HHs is limited. Faecal-oral transmission is the most important pathway to chronic illness leading to malnutrition and stunting. WASH interventions addressing this must be accompanied by nutrition-specific and nutrition-sensitive activities to ensure the intake/ absorption of sufficient amounts and varieties of nutrients necessary for a child’s growth. WHO data show that neonatal mortality can be reduced by 41% if handwashing with soap is practiced. WASH and SRHR are strongly linked because the first 1,000 days of a baby from conception are essential for development. In the target area, early marriage is common, increasing the likelihood of early pregnancy, which has major risks in terms of maternal mortality, pre-term delivery and low birth weight. In addition, child marriage is related to poverty, as girls’ schooling and economic opportunities are often disrupted. Regarding poor maternal and child health, the main causes are lack of appropriate knowledge and skills, and poverty. Inappropriate and inadequate hygiene practice, breast feeding nutrition behaviour, ante- and postnatal care are also important causes. In the target area the GoB services in terms of presence of adequate health facilities (community clinics) and staff capacity are limited. Each community clinic has community nutrition support groups, but these are mostly not well-trained and therefore not fully functional.

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