evaluating the impact: from promise to evidencepubdocs.worldbank.org › en ›...
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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)
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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.
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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
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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
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Who is targeted?
• Pregnant women
• Targeting 50,000 pregnant women over course of 3 years
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• When is it conducted? January 2013 to December 2015
Name of implementing organization
• BRAC
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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
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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?
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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
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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
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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
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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
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Thank You!