Impact of Health Sector Support Project on Essential Nutrition Services : Evidence from Bangladesh

Despite progress over the past two decades, poor nutrition remains a significant public health challenge in Bangladesh. Stunting among children under five years declined from 43 to 31 percent between 2007 and 2018, while 42 percent of women between 15 to 49 years are anemic. The Ministry of Health and Family Welfare is implementing the Health Sector Support Project (HSSP) with financing and technical assistance from the World Bank in the Sylhet and Chattogram divisions of the country. The project considers improving nutrition outcomes as a core priority. Leveraging administrative data from 13,855 community clinics (CCs) from 2018 to 2020 and a difference-in-difference approach, the analysis finds that HSSP led to improvements in the delivery of both maternal and child nutrition services. The proportion of eligible pregnant women who received requisite antenatal services (receipt of at least 30 iron and folic acid tablets, nutrition counseling, and weight measurement) increased by 2.7 percent over the duration. Similarly, the proportion of children between 0 and 23 months, who received age-appropriate nutrition counseling, increased by 8.9 percent over the same period. The paper identifies several factors that led to these improvements and notes the impediments. The HSSP renewed focus on the importance of delivering quality nutrition services, and the technical assistance provided through the HSSP has strengthened capacity, not only around the delivery of services but also in improving the data ecosystem and quality of project monitoring and results verification. There are, however, issues impeding service delivery of nutrition services. The community health care providers (CHCPs) are often faced with competing priorities, as nutrition is one of the many services they provide. Similarly, the CHCPs have been found to lack the required capacity and skills in delivering services and are also burdened with poor information technology (IT) equipment.

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Bibliographic Details
Main Authors: Raza, Wameq, Chaudhery, Deepika
Format: Working Paper biblioteca
Language:English
English
Published: World Bank, Washington, DC 2022-09
Subjects:POOR NUTRITION, STUNTING, ANEMIA, HEALTH SECTOR SUPPORT PROJECT, MATERNAL AND CHILD HEALTH, MATERNAL AND CHILD NUTRITION SERVICES, PUBLIC HEALTH SERVICE DELIVERY,
Online Access:http://documents.worldbank.org/curated/en/099708211162218097/IDU0bafffc6903ee504f0a09b760962387b367f9
http://hdl.handle.net/10986/38328
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Summary:Despite progress over the past two decades, poor nutrition remains a significant public health challenge in Bangladesh. Stunting among children under five years declined from 43 to 31 percent between 2007 and 2018, while 42 percent of women between 15 to 49 years are anemic. The Ministry of Health and Family Welfare is implementing the Health Sector Support Project (HSSP) with financing and technical assistance from the World Bank in the Sylhet and Chattogram divisions of the country. The project considers improving nutrition outcomes as a core priority. Leveraging administrative data from 13,855 community clinics (CCs) from 2018 to 2020 and a difference-in-difference approach, the analysis finds that HSSP led to improvements in the delivery of both maternal and child nutrition services. The proportion of eligible pregnant women who received requisite antenatal services (receipt of at least 30 iron and folic acid tablets, nutrition counseling, and weight measurement) increased by 2.7 percent over the duration. Similarly, the proportion of children between 0 and 23 months, who received age-appropriate nutrition counseling, increased by 8.9 percent over the same period. The paper identifies several factors that led to these improvements and notes the impediments. The HSSP renewed focus on the importance of delivering quality nutrition services, and the technical assistance provided through the HSSP has strengthened capacity, not only around the delivery of services but also in improving the data ecosystem and quality of project monitoring and results verification. There are, however, issues impeding service delivery of nutrition services. The community health care providers (CHCPs) are often faced with competing priorities, as nutrition is one of the many services they provide. Similarly, the CHCPs have been found to lack the required capacity and skills in delivering services and are also burdened with poor information technology (IT) equipment.