Key Publications

The main objective of this paper is to document the changing paradigm of malnutrition in Bangladesh and estimating how this is creating an intergenerational risk. This paper also examines national policy responses to tackle the silent epidemic of double burden of malnutrition.

Publicly available datasets of five Bangladesh Demographic and Health Surveys were used to see the changing paradigm of malnutrition among Bangladesh women. In addition to that, four national policies concerning, maternal and child health; and nutrition were reviewed using CDC’s 2013 Policy Analytical Framework.

• To measure the effect of strengthened and systematic PPFP counseling during ANC visits at health facilities and/or offering FP methods during facility- based delivery on the acceptance of FP methods during the PP period.
• To understand women’s perspectives on receiving counseling on PPFP during ANC visits at facilities and/or during facility delivery, and their decision-making process regarding the use of FP methods during the PP period.
• To examine healthcare providers’ view of PPFP service delivery, including the overall service delivery system.

• Generate strong evidence needed for program and policy decision-making through the appropriate use of available data sources and the generation of new data using innovative, rigorous, and efficient methods, approaches, and tools
• Strengthen individual and organizational capacity to generate evidence and use data
• Facilitate and enhance the use of data for global health programs and policies through compelling, user-friendly data organization, visualization, and communication

• Comprendre comment les méthodologies et les outils de SS to EMU et RDQA peuvent être utilisés conjointement pour produire des mesures complètes et exactes de la performance de la qualité des données de PF.
• Utiliser les données collectées par la mise en oeuvre de l’approche intégrée SS to EMU et RDQA pour comparer les données de PF recueillies systématiquement avec les données des enquêtes.
• Développer des recommandations ciblées pour améliorer la qualité des données de PF et encourager la confiance et de la responsabilisation dans le système de santé.

• Comprendre comment les méthodologies et les outils de SS to EMU et RDQA peuvent être utilisés conjointement pour produire des mesures complètes et exactes de la performance de la qualité des données de PF.
• Utiliser les données collectées par la mise en oeuvre de l’approche intégrée SS to EMU et RDQA pour comparer les données de PF recueillies systématiquement avec les données des enquêtes.
• Développer des recommandations ciblées pour améliorer la qualité des données de PF et encourager la confiance et de la responsabilisation dans le système de santé.

• Comprendre comment les méthodologies et les outils de SS to EMU et RDQA peuvent être utilisés conjointement pour produire des mesures complètes et exactes de la performance de la qualité des données de PF.
• Utiliser les données collectées par la mise en oeuvre de l’approche intégrée SS to EMU et RDQA pour comparer les données de PF recueillies systématiquement avec les données des enquêtes.
• Développer des recommandations ciblées pour améliorer la qualité des données de PF et encourager la confiance et de la responsabilisation dans le système de santé.

• Guidance Document
• Module B: Promoting Individual Agency
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module D: Engaging Men and Boys as Partners
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making
• Module F: Addressing Gender-Based Violence

• Guidance Document
• Module A: Gender Sensitive Communication
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module D: Engaging Men and Boys as Partners
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making
• Module F: Addressing Gender-Based Violence

• Guidance Document
• Module A: Gender Sensitive Communication
• Module B: Promoting Individual Agency
• Module D: Engaging Men and Boys as Partners
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making
• Module F: Addressing Gender-Based Violence

• Guidance Document
• Module A: Gender Sensitive Communication
• Module B: Promoting Individual Agency
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making
• Module F: Addressing Gender-Based Violence

• Guidance Document
• Module A: Gender Sensitive Communication
• Module B: Promoting Individual Agency
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module D: Engaging Men and Boys as Partners
• Module F: Addressing Gender-Based Violence

• Guidance Document
• Module A: Gender Sensitive Communication
• Module B: Promoting Individual Agency
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module D: Engaging Men and Boys as Partners
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making

• Module A: Gender Sensitive Communication
• Module B: Promoting Individual Agency
• Module C: Supporting Legal Rights and Status Related to Family Planning
• Module D: Engaging Men and Boys as Partners
• Module E: Facilitating Positive Couples’ Communication and Cooperative Decision Making
• Module F: Addressing Gender-Based Violence

Background: Intimate partner violence (IPV), and especially intimate partner physical violence (IPPV), perpetrated by husbands, and within adolescence marriage are pervasive in Bangladesh. Younger women are more vulnerable to IPPV.

Objectives: We examined factors associated with IPPV experienced by married adolescents ages 15–19 and tested four hypotheses: (1) adolescent girls married to relatively older husbands, (2) adolescents living in extended families with parents or parents-in-law, (3) adolescents who are minimally controlled by husbands, and (4) adolescents who have a child after marriage are protective of IPPV.

Methods: We analyzed IPPV data from 1,846 married girls ages 15–19 obtained from a national adolescent survey conducted in 2019–20. IPPV is defined as the respondent having physical violence perpetrated by her husband at least once in the last 12 months. We implemented logistic regression models to test our hypotheses.

Results: Sixteen percent of married adolescent girls experienced IPPV. Girls living with parents-in-law or parents had adjusted odds ratio (AOR) of 0.56 (p < 0.001) of IPPV compared to those girls who lived with husband alone. Girls with husbands ages 21–25 years and 26 years or older had AORs of 0.45 (p < 0.001) and 0.33 (p < 0.001) of IPPV compared to those girls with their husband ages 20 and younger. Married adolescent girls who did not own a mobile phone (an indicator of spousal power dynamics) had an AOR of 1.39 (p < 0.05) compared to those girls who had a phone. IPPV risk increases with an increased duration of marriage for those with no living children (p < 0.001) but not for those with at least one living child; the risk was higher among those who had a child within the 1^st year of marriage than those who had not yet had a child. At a duration of 4 years and longer, IPPV risk was higher among those with no living children than those with children.

Discussion: Findings related to those living with parents-in-law or parents, girls married to relatively older boys/men, having the ability to communicate with outside world, and having a child are protective of IPPV in Bangladesh are new, to our knowledge. Strictly adhering to the law that requires men waiting until the age of 21 to marry can reduce married girls' risk of IPPV. Raising girls' legal marriage age can minimize adolescents' IPPV and other health risks associated with adolescent childbearing.

Background: In Bangladesh, large gender differentials exist in outcomes in almost all spheres of life, stemming from conservative norms and attitudes around gender. Adolescence is a crucial period for social-emotional learning that can shape gender norms and attitudes.

Objective: The aim of the paper is to investigate the extent to which adolescents hold egalitarian attitudes toward gender roles, and to examine the factors that influence egalitarian gender attitudes.

Methods: The paper uses data from a nationally representative sample survey of 7,800 unmarried girls and 5,523 unmarried boys ages 15–19 years. Adolescents were considered to have egalitarian attitudes on gender role if they disagreed with all the following four unequal gender role statements with regards to socio-economic participation, while respondents who agreed with any one of the four statements were considered to have non-egalitarian attitudes: (1) It is important that sons have more education than daughters, (2) Outdoor games are only for boys, not girls, (3) Household chores are for women only, not for men, even if the woman works outside the home, and (4) Women should not be allowed to work outside the home. Multivariable linear probability regression analysis was implemented to identify the factors shaping attitudes on gender roles.

Results: Unmarried girls and boys differ hugely in their views on gender roles regarding socio economic participation-girls were much more egalitarian than boys (58 vs. 19%). The multivariate linear probability model results show girls and boys who completed at least grade 10 were 31% points and 15% points more likely to have egalitarian views on gender roles respectively, compared to girls and boys with primary or less education. Having strong connection with parents is associated with having egalitarian views on gender roles among girls but not boys. Adolescents' individual attitude on gender role is highly associated with the views of their community peers for both girls and boys. Girls and boys who had participated in adolescent programs were 6–7% points more likely to have egalitarian attitude than those who were not exposed to these programs. Egalitarian views were also significantly higher, by 5% points among girls and 6% points among boys, who were members of social organizations compared to those who were not. Watching television had positive influence on egalitarian attitudes among girls but not among boys. To create a more egalitarian society, both men and women need to hold progressive attitudes toward gender roles. The interventions must be multilevel, influencing adolescents at the personal, interpersonal, communal, and societal levels.

1. map the MCWCs (i.e., matching the DGFP listed MCWCs with those included in the 2017 BHFS dataset);
2. produce a readiness inventory of required staff service provision guidelines, equipment and supplies, and medications, as per the range of services provided by an MCWC;
3. categorize the MCWCs based on their readiness statistics; and
4. identify gaps for each of the MCWCs based on specific services.

1. To what extent has Access improved the quality of health services and the continuum of care?
2. To what extent did ACCESS implement a capacity building approach and how effective has it been?
3. To what extent have the ACCESS social and behavior change initiatives been implemented?
4. How effective is the program’s approach to supportive supervision and monitoring, while building Ministry of Public Health (MOPH) leadership and capacity to conduct these efforts on its own?
5. What are recommendations across all questions that will reinforce and strengthen ACCESS activities and initiatives for the duration of the program?

Health organizations around the globe regularly make evidence-based decisions for effective health programming. Qualitative evaluation fulfills an important role in rigorous evaluation of programs. The strength of qualitative evaluation is its ability to provide valuable insight into complex issues, which quantitative methods may not provide. Qualitative data sources can answer the “why” behind program successes or challenges. Additionally, qualitative data illuminate the uniquely human side of health programming and bring to light important contextual factors, such as culture, gender, or societal norms. Qualitative evaluation may be used to complement quantitative data, answer a question not accessible quantitatively, or provide a cost-effective data source when one would not otherwise be available.

This curriculum covers a training that is meant to assist health professionals in using qualitative evaluation skills in sound and rigorous evaluation of their program. The course is meant to assist health professionals in using qualitative evaluation skills in sound and rigorous evaluation of their programs. The sessions go beyond basic concepts to explore important considerations of qualitative methods in the context of rigorous evaluation. Through session content and participatory exercises, participants will gain basic skills in rigorous qualitative data collection, analysis, and use.

• Qualitative Methods in Evaluation of Public Health Programs, a Curriculum on Intermediate Concepts and Practices: Syllabus
• Qualitative Methods in Evaluation of Public Health Programs, a Curriculum on Intermediate Concepts and Practices: Facilitators’ Guide
• Qualitative Methods in Evaluation of Public Health Programs, a Curriculum on Intermediate Concepts and Practices: Participants’ Guide
• PowerPoint presentations for each of the 12 course training workshop sessions

The U.S. Agency for International Development (USAID) and its implementing partners are collaborating with the Bangladesh Ministry of Health and Family Welfare (MOHFW) to help develop a routine health information system (RHIS) in the country. A seminar held January 13, 2015 as part of the next phase of activities for strengthening the RHIS was organized by USAID partners implementing the RHIS in Bangladesh.

Among issues that emerged from the seminar are the following:

• There is a need for bringing collection of data and their use for health service delivery into a regulatory framework so as to ensure the privacy of sensitive personal data and to stop misuse.
• Strengthening RHIS is urgently needed to ensure comprehensive, quality routine data and use of information for decision making at different levels, from local to central.
• There should be a strong coordination mechanism in order to avoid duplication of work among different stakeholders.
• Providing a unique health ID to track all service recipients should be explored.
• Focus should be given to a common web-based platform to ensure interoperability and avoid duplication of efforts.

Agencies are articulating the need to causally attribute health outcomes to investments in an era of shrinking resources and increasingly complex development environments.The opportunity to uncover essential information for program planning and resource allocation is a strong motivation for impact evaluations.Findings from large-scale impact evaluations (IEs) can be instrumental for decision making, yet they are not without challenges and costs.

In this paper, we share field experiences from a number of evaluation studies undertaken during MEASURE Evaluation Phases II and III.A series of case studies highlight design and implementation challenges that required creative solutions to move forward; plus analysis across studies revealed common reoccurring themes and valuable lessons. Examples of these cross-cutting themes presented include: challenges with identification and selection of program beneficiaries, random assignment in complex environments, identification of a robust comparison or control group for estimating the counterfactual, heterogeneity of program impacts, timing of baseline data collection, and absence of baseline data and a counterfactual.

Field experiences from MEASURE Evaluation project demonstrate the need for transparency and collaboration among the key partners, the inevitable balancing of technical requirements with programmatic priorities, and the flexibility required to adapt designs in order to answer the most valuable evaluation questions. Interest in accountability of funding of public health interventions continues to grow, promising continued interest in IEs. Evaluators, implementers, and funders can share in these learnings as we move forward with expanding our understanding of the costs and benefits for rigorous evaluations.

Methods Through an online search and snow-balling, we mapped institutions offering M&E tracks/concentrations in Masters of Public Health (MPH) programs globally. We obtained detailed information about their M&E curriculum from university websites and brochures. The data on curricular contents was extracted and compiled. We analyzed the curricular contents using the framework for core competencies developed by the Association of Schools of Public Health (ASPH); and the Millers triangle. This data was then used to inform a consultative exercise aimed at identifying core competencies for an M&E track/concentration in MPH programs in the South Asian context.

Results Our curricular review of M&E content within MPH programs globally showed that different domains or broad topic areas relating to M&E are covered differently across the programs. The quantitative sciences (Biostatistics and Epidemiology) and Health Policy and Management are covered in much greater depth than the other two domains (Social & Behavioral Sciences and Environmental Health Sciences). The identification of core competencies for an M&E track/concentration in the South Asian context was undertaken through a consultative group exercise involving representation from 11 institutions across Bangladesh, India, Nepal and Sri Lanka. During the consultation, the group engaged in a focused discussion to reach consensus on a set of 15 core competencies for an M&E track in South Asian MPH programs.

Conclusion This work presents an opportunity for institutions to identify and re-examine their M&E competencies as a part of their specialized tracks within MPH programs. Our curricular analysis approach has the potential for adaptation and further use in curriculum analysis across different academic specialties.