Annual Evaluation - PDF document

1 Report Annual Evaluation (second
Report Annual Evaluation (second year) for Joint Action for Nutrition Outcome (JANO) Project Submitted to: CARE - Bangladesh RAOWA Complex, Level: 7 - 8, VIP Road, Mohakhali, Dhaka - 1206, Bangladesh Submitted by: Innovative Research & Consultancy (IRC) Limited ABC Spring Flower, House # 52 (1st & 2nd Floor), Road # 02, Block # L, Banani, Dhaka - 1213 info@ircltd.com.bd; November 30, 2020 Table of Contents Acknowledgement ................................ ................................ ................................ ................................ ....................... i List of Tables ................................ ................................ ................................ ................................ ................................ ii List of Graphs ................................ ................................ ................................ ................................ ............................. iii Acronyms ................................ ................................ ................................ ................................ ................................ ..... iv Executive Summary ................................ ................................ ................................ ................................ .................... 1 1. Introduction ................................ ................................ ................................ ................................ ........................ 7 1.1 Overview of JANO project ................................ ................................ ................................ .......................... 7 2 Study Methodology ................................ ................................ ................................ ................................ ........... 8 2.1 Study Area and Target Group ................................ ................................ ................................ ...................... 8 2.2 Geographical Coverage and Sample size ................................ ................................ ................................ ... 9 2.3 Quantitative (Household and School) Sample Distribution ................................ ................................ 10 2.4 Qualitative Sample Distribution ................................ ................................ ................................ ................. 11 2.5 Survey Implementation ................................ ................................ ................................ ................................ 11 2.6 Quality Control Mechan

2 ism ................................ .
ism ................................ ................................ ................................ ....................... 12 2.7 Ethical considerations of the study ................................ ................................ ................................ ........... 13 3 Findings - JANO Annual Evaluation ................................ ................................ ................................ ............. 14 3.1 Household and Demographic Information ................................ ................................ .............................. 14 3.1.1 Household Information ................................ ................................ ................................ ........................ 14 3.1.2 Educational Status ................................ ................................ ................................ ................................ .. 14 3.1.3 Occupation of Household Head ................................ ................................ ................................ ........ 15 3.2. Women and Adolescent Girls Empowerment ................................ ................................ ...................... 15 3.2.1 Women’s decision making and access to markets to buy or sell products ............................ 16 3.2.2 Participation of Women in Formal and Informal Decision - Making Spaces ............................. 19 3.2.3 Functionality of Community Support Groups and School Management Committees ......... 20 3.3 Maternal Adolescent Child Health and Nutrition ................................ ................................ ................. 24 3.3.1 Assistance regarding maternal health and n utrition ................................ ................................ ...... 24 3.3.2 Antenatal and Postnatal Care ................................ ................................ ................................ ............. 24 3.3.3 Indicators of The National Plan of Action for Nutrition ................................ ............................. 25 3.3.4 Nutritional Status of Women of Reproductive Age ................................ ................................ ..... 26 3.3.5 Women and Adolescent Girls in Communities are Empowered to Demand and Utilize Both Nutrition - Sensitive and Nutrition - Specifi c Services ................................ ................................ ................ 29 3.3.6 Students Apply Key Learning Points Regarding Nutrition, Health and Hygiene at Home .. 31 3.3.7 Nutritional Status in Children Under 5 - years of Age ................................ ................................ ... 33 3.4 Nutrition Governance

3 ................................ ......
................................ ................................ ................................ ................................ .. 34 3.4.1 Nutrition Specific Budgeting ................................ ................................ ................................ ............... 34 3.4.2 Nutrition Specific Safety Net Support ................................ ................................ .............................. 36 3.4.3 Meaningfully Participated of Women and Adolescent Girls in The Nutrition Action Plan . 38 3.4.4 Feedback Mechanisms ................................ ................................ ................................ .......................... 39 3.4.5 Tripartite Agreement ................................ ................................ ................................ ........................... 40 3.5 Food Security and Livelihood ................................ ................................ ................................ ..................... 40 3.5.1 Households Practicing Climate Smart Agricultural Techniques ................................ ................. 40 3.5.2 Households Involved in The Production of Higher Value Nutrition Products ...................... 42 3.6 Access to Information, Information and Communication Technology (ICT) Platform ................ 43 3.6.1 Access to information ................................ ................................ ................................ .......................... 43 3.6.2 Accessed or Received ICT Based Nutritional Information ................................ ......................... 46 3.6.3 Mobile Based Learning App are Us ed by Frontline Workers ................................ .................... 47 3.7 WATSAN & Hygiene Practice ................................ ................................ ................................ ................... 48 3.7.1 Safe Drinking water ................................ ................................ ................................ .............................. 48 3.7.2 Types of Latrine ................................ ................................ ................................ ................................ ..... 49 3.7.3 Hand Washing Practices ................................ ................................ ................................ ...................... 50 3.8. Outcome of Covid - 19 Response and Impact of Covid - 19 On JANO ................................ ............. 52 3.8.1 Knowledge about Covid - 19 ................................ ................................ ................................ ................ 52 3.8.2 Outcome of Covid - 19 re

4 sponse ...............................
sponse ................................ ................................ ................................ ........ 53 3.8.3 Hygiene Practices ................................ ................................ ................................ ................................ .. 56 3.8.4 Nutritional Practices ................................ ................................ ................................ ............................. 57 3.8.5 Students Faced problems in going to school during COVID - 19 ................................ ................ 59 3.8.6 Help Needed to Continue Study for Students ................................ ................................ ............... 59 3.8.7 Satisfaction of Doing Classes Through Facebook from JANO ................................ .................. 60 3.8.8 Impact of Covid - 19 on JANO Project ................................ ................................ .............................. 60 4. Logframe Review ................................ ................................ ................................ ................................ ............. 37 4.1. Process of Reviewing the Logframe ................................ ................................ ................................ ......... 37 1.1.1. Indicator 1 ................................ ................................ ................................ ................................ ....... 38 1.1.2. Indicator 2 ................................ ................................ ................................ ................................ ....... 39 1.1.3. Indicator 3 ................................ ................................ ................................ ................................ ....... 40 1.1.4. Indicator 4 ................................ ................................ ................................ ................................ ....... 41 1.1.5. Indicator 5 ................................ ................................ ................................ ................................ ....... 42 1.1.6. Indicator 6 ................................ ................................ ................................ ................................ ....... 43 1.1.7. Indicator 7 ................................ ................................ ................................ ................................ ....... 44 1.1.8. Indicator 8 ................................ ................................ ................................ ................................ ....... 45 1.1.9. Indicator 9 ................................ ................................

5 ................................ ......
................................ ................................ ....... 45 1.1.10. Indicator 10 ................................ ................................ ................................ ................................ ..... 46 1.1.11. Indicator 11 ................................ ................................ ................................ ................................ ..... 47 1.1.12. Indicator 12 ................................ ................................ ................................ ................................ ..... 48 1.1.13. Indicator 13 ................................ ................................ ................................ ................................ ..... 49 1.1.14. Indicator 14 ................................ ................................ ................................ ................................ ..... 50 1.1.15. Indicator 15 ................................ ................................ ................................ ................................ ..... 50 1.1.16. Indicator 16 ................................ ................................ ................................ ................................ ..... 51 1.1.17. Indicator 17 ................................ ................................ ................................ ................................ ..... 52 1.1.18. Indicator 18 ................................ ................................ ................................ ................................ ..... 52 4.2. Measures to Be Taken to Achieve Logframe Results in the Third year of Evaluation ................ 53 5. Conclusion and Recommendations ................................ ................................ ................................ ................. 54 Annex 1: Log frame ................................ ................................ ................................ ................................ .................. 58 Annex 2: Survey Area ................................ ................................ ................................ ................................ .............. 67 Annex 3: Other Tables ................................ ................................ ................................ ................................ ............ 68 Page | i Acknowledgement Innovative Research & Consultancy (IRC) Limited acknowledges and thanks all participants who participated in this study. Without their time and input, this study would have been incomplete. The study would not be possible without the dedication, commitment and hard work of the data collectors , field supe

6 rvisors and qualitative moderators.
rvisors and qualitative moderators. We acknowledge the guideline and support of Mr. Aamanur Rahman, Director, Extreme Rural Poverty Program, CARE Bangladesh . We also acknowledge the valuable input s of Ms. Tania Sharmin, Senior Team Leader , JANO for her support throughput the study. Special thanks and appreciat ion to Md. Mahadi Hasa n, M&E Coordinator, JANO for his contribution toward tools development, active presence in training sessions at Rangpur and in the data collection and analysis phases of the study . We also acknowledge the contribution of all local staffs and volunteers of this project. W ithout their support , it w ould not have been possible to complete data collection within the targeted time frame. Via th is study , we hope that the JANO project will strengthen its contribution to the development and improvement of maternal and child nutrition in Nilphamari and Rangpur districts of Bangladesh. Page | ii List of Tables Table 1: Household and Demography Status ................................ ................................ ................................ ..... 14 Table 2: Education Level of Household members ................................ ................................ ............................ 14 Table 3: Occupation Status of Head of the Household members ................................ ................................ 15 Table 4: Key Learning points applied at School ................................ ................................ ................................ . 32 Table 5: Key Learning points applied at Home ................................ ................................ ................................ .. 32 Table 6: Practice of CSA Technologies (% HH) ................................ ................................ ................................ 41 Table 7: HH Crops and vegetables cultivation during last 12 months ................................ ......................... 42 Table 8: Ways of vegetables cultivation ................................ ................................ ................................ .............. 43 Table 9: Awareness About Getting Information Related to Agriculture, Health & Nutrition ............... 44 Table 10: Women or HH Received Information ................................ ................................ .............................. 44 Ta ble 11: Types of agricultural extension service HH received during the last 12 months ................... 45 Table 12: Sources Service Providers: Agricul tural Extension Service ................................ .......................... 45 Table

7 13: Whether Access Agricultural Extensio
13: Whether Access Agricultural Extension Services when needed over the last six months .. 45 Table 14: Sources of Drinking Water ................................ ................................ ................................ .................. 48 Table 15: Person/ORG provided awareness services related to hygiene - safe water practices ............ 49 Table 16 : Types of services Received ................................ ................................ ................................ .................. 49 Table 17: Types of Latrine used by HH ................................ ................................ ................................ .............. 50 Table 18 : Person provided awareness services related to hygiene - sanitation practices ........................ 51 Table 19 : Hand Washing Practices ................................ ................................ ................................ ...................... 51 Table 20: Source of hearing about COVID - 19 ................................ ................................ ................................ .. 52 Table 21: Perception about the ways of attack by COVID - 19 ................................ ................................ ...... 52 Table 22: Steps should be taken to stay away from COVID - 19 ................................ ................................ ... 52 Table 23: Steps to take if anyone affected by COVID - 19 ................................ ................................ ............... 53 Table 24: Received any service/relief during COVID - 19 ................................ ................................ ................ 53 Table 25: Source of this support and information ................................ ................................ ............................ 53 Table 26: Support from JANO/JANO Volunteer (information about COVID - 19/Hygiene Kit) ........... 54 Table 27: Persons who received support and information from JANO ................................ ..................... 54 Table 28: Benefits by taking support and information ................................ ................................ ..................... 54 Table 29: Usage of the information or knowle dge or information related to nutrition about COVID - 19 ................................ ................................ ................................ ................................ ................................ .................. 55 Table 30: Causes of not getting support ................................ ................................ ................................ ............. 56 Table 31: Types of hygiene practice .....................

8 ........... ............................
........... ................................ ................................ ..................... 56 Table 32: Whether use mask or not ................................ ................................ ................................ .................... 57 Table 33: Time of washing hands ................................ ................................ ................................ .......................... 57 Table 34: Any change of daily food habits of family during COVID - 19 ................................ ....................... 57 Table 35: Source of giving suggestion about eating nutritious food ................................ ............................. 58 Table 36: Persons who take nutritious food ................................ ................................ ................................ ...... 58 Table 37: Benefits by eating nutritious food during COVID - 19 ................................ ................................ .... 58 Table 38: Any problem for earning of family members during this COVID - 19 ................................ ........ 58 Table 39: Steps taking for overcoming COVID - 19 situation ................................ ................................ ......... 59 Table 40: Problems Faced During COVID - 19 ................................ ................................ ................................ ... 59 Table 41: Types of Support Received During COVID - 19 ................................ ................................ .............. 59 Annex: Table 1: Household Sample Distribution by Village ................................ ................................ ......................... 68 Table 2: List of Selected School ................................ ................................ ................................ ............................ 70 Table 3: List of Qualitative Sample ................................ ................................ ................................ ....................... 71 Page | iii List of Graphs Figure 1: Access to Basic Health Services ................................ ................................ ................................ ........... 18 Figure 2: Services received from different health service centers during last 12 months ...................... 18 Figure 3: Percentage of increased participation of community people, particularly women, in formal and/ or informal decision - makin g spaces ................................ ................................ ................................ ............ 20 Figure 4: Incidence of receiving antenatal check - ups during pregnancy ..............................

9 .. ...................... 25 Figure
.. ...................... 25 Figure 5: Incidence of receiving postnatal check - ups after pregnancy ................................ ......................... 25 Figure 6: Percentage of women of reproductive age in t he targeted districts who are consuming a minimum dietary diversity (MDD) ................................ ................................ ................................ ........................ 27 Figure 7: The percentages of women consumed the number o f food items in the previous 24 hours ................................ ................................ ................................ ................................ ................................ ....................... 28 Figure 8: Percentage of MDD food items consumed in the last 24 hours in women of reproductive age ................................ ................................ ................................ ................................ ................................ ....................... 29 Figures 9: Percentage of women and adolescents have claimed nutrition specific and sensitive services from relev ant service providers ................................ ................................ ................................ ............................ 30 Figure 10: Percentage of students disaggregated by sex who apply key learning points regarding nutrition, he alth and hygiene at home ................................ ................................ ................................ ................. 31 Figure 11: Proportion of children 6 – 23 months of age who receive foods from 4 or more food groups (based on the MDD - C methodology) ................................ ................................ ................................ ................. 34 Figure 12: Percentage of households practicing climate smart agricultural techniques (Baseline and Annual evaluation) ................................ ................................ ................................ ................................ .................... 41 Figure 13: Satisfaction level after receiving support from JANO Volunteer (Information or knowledge or Instruments/Hygiene kit) ................................ ................................ ................................ ................................ ... 55 Figure 14: Satisfaction level after receiving information or messages about nutrition ............................ 56 Figure 15: Satisfaction level of doing classes through Facebook ................................ ................................ ... 60 Page | iv Acronyms ANC Antenatal Care CARE Cooperative for Assistance and Relief Everywhere CG

10 Community Group CSG Community
Community Group CSG Community Support Group CSA Climate Smart Agriculture DNCC District Nutrition Coordination Committee EPI Expanded Program on Immunization ESDO Eco - Social Development Organization EU European Union FGD Focus Group Discussion HIES Household Income and Expenditure Survey ICT Information and Communications Technologies IDI In - depth Interviews JANO Joint Action for Nutrition Outcome KII Key Informants Interview NGO Non - Government Organization NPAN National Plan of Action for Nutrition PLW Pregnant and Lactating Women PNC Postnatal Care SMART Specific, Measurable, Achievable, Relevant and Time - bound SMC School Management Committee UH&FWC Union Health & Family Welfare Centre UDCC Union Development Coordination Committee UNCC Upazilla Nutrition Coordination Committee UNICEF The United Nations Children 's Fund VSLA Village Savings and Loan Association WATSAN Water and Sanitation WHO World Health Organization Page | 1 Executive Summary Joint Action for Nutrition Outcome (JANO) project aims at reducing malnutrition and addressing nutritional needs of p regnant and lactating women including adolescents. JANO also focuses on capacity building of multiple levels of government bodies, especially enhancing capacities of Nutrition Committees (NC) at the upazila and district lev els in terms of developing nutritional plans, budget and effective supervision. F unded by the European Union (EU) and implemented by CARE, Plan International , including Eco Social Development Organization (ESDO). JANO collaborated with the Government of Ba ngladesh (GoB) in implementing the National Plan of Action for Nutrition (NPAN) - 2 ) at the local, regional, and national levels selected a ll 65 unions of the seven most vulnerable upazilas of Rangpur and Nilphamari (with a stunting rate of 42.1% ) were selec ted for this project. These include Gangachara , Kaunia, Taraganj, Domar, Jaldhaka, Kishorgonj and Nilphamari Sadar. Approximately , 4.7 million people in Rangpur and Nilphamari were provided with knowledge and training on health and nutrition al practices in line with government priorities. The project’s beneficiaries include 275,415 pregnant and lactating women and married adolescent girls aged between 15 to 49 years of age , 190,322 under five - year - old children, 421,425 unmarried adolescent girls and boys aged 10 to 19 years of age . The purpose of the annual evaluation was twofold : 1. To measure second year progress against given logframe indicators. 1.1. To

11 measure the outcome (on health and nutr
measure the outcome (on health and nutrition) of COVID re sponse project of JANO 2. To m easure the impact of COVID - 19 on the JANO project and recommend way forward. In order to assess the annual year impact of the project, CARE Bangladesh collaborated with Innovative Research and Consultancy (IRC) Limited to measure all 18 indicators that JANO project fixed as outcome and expected results in the log frame. Data for the annual evaluation w as collected from 16 - 23 October 2020 through a mixed method, or combination of quantitative and qualitative methods and techniques. A two - stage systematic random sampling method was used to collec t a representative quantitative sample from the household level. The quantitative sample for the study covered a total of 430 respondents consisting of pregnant women (n=103) and lactating women (n=327) from 35 villages across the 7 targeted project areas. Following the same sampling approach, a total of 430 adolescents comprising of girls (n=262) and boys (n=168) were also selected from 22 schools and m adrashas. Moreover, 35 members of school management committee, 71 community support groups , 100 female me mbers of Community Group (CG) , Community Support Group (CSG), and District Nutrition Coordination Committee ( DNCC ) were also interviewed. Qualitative data w as collected through Focus Group Discussion ( FGDs ) , Key Informant Interviews ( KIIs ) , and In - Depth Interviews ( IDIs ) with CG s , CSG s , Pregnant and Lactating Women (PLW), adolescent girls and boys, men, and other key stakeholders including local Nutrition Committees (NC), service providers, local government bodies, and officials. In total, 10 FGDs, 3 5 KIIs and 10 IDIs were conducted. In the data collection process, (21) female enumerators and three ( 3 ) supervisors were engaged. In addition , relevant documents and literature were reviewed to evaluate the overall scenario of the JANO project. The secon d annual evaluation found that the average household size is 5 . This is higher than the first evaluation survey (4.30) and also higher than the national household size of 4.06. The m ajority (51.4%) of households were female - headed as compared to the first annual evaluation (0.9%). The study identified that the primary occupation of the household head s was agricultural daily wage laboring Page | 2 ( c rop/livestock) (22.1%) followed by non - agricultural daily wage labor ing (20.5%) . During the first annual evaluation the primary occupation of the household heads was non - agricultural wage labo u r ing 24%. M ajor findings of the second annual evaluation are ar

12 ranged into several subcategories, such
ranged into several subcategories, such as 1) Women and adolescent girls’ empowerment; 2) Maternal, adolescent, child health and nutrition; 3) Nutrition governance; 4) Food Security and Livelihood; 5) Access to information, Informat ion and communication technology (ICT), 6) WASH practice, and 7) Covid - 19 response and impact of Covid - 19 on JANO. 1) Women and adolescent girls’ empowerment During the second annual evaluation it was found that the overall participation of community people, particularly of women in formal/informal (government - led and/or information , civil society - led, private sector - led) decision making spaces is increasing since the first evaluation survey. • Participation of the community people (particular ly women) in formal (Govt. led forums: CG, CSG, UP special committee, UP standing committee, adolescent group, student council) bodies has in creased from 0.93% during year evaluation to 2.79% during second annual evaluation. • Participation in informal group s (VSLA, FFS, Mothers group, youth group, women support group) has increased from 3.49% during the first annual evaluation to 4.88% during the second annual evaluation. • In total, 41% (29 out of 71) of the CSG s were functional and active during second evalu ation survey. It is to be noted that during the first annual evaluation it was found that 612 CSG s were newly formed by the JANO project which were non - existent/inactive during the baseline. • The second evaluation survey found that overall, 245 SMCs in the JANO project area raise gender, nutrition, health, hygiene related issues in meeting s , and action plan were accordingly formulated. However, during the first evaluation survey 302 SMCs did the same. The apparent decrease in number reflect s the impact of C O VID - 19. It is still a significant and sustained improvement compared with the baseline when only seven SMCs (7) did the same. These findings suggest that the project needs to concentrate on women’s participation in the formal decision - making spaces to sus tain the project’s achievements. Moreover, SMCs will need reenergization after the COVID - 19 setback . 2) Maternal, adolescent, child health and nutrition Safety - net programs such as maternity allowance, supplementary feeding, m aternal h ealth v oucher, etc. indicate availability of assistance for pregnant and lactating women and potential significant positive impact on the ir nutrition and health conditions. T h e second annual evaluation study found that positive changes exist regarding information about safety - net programs, and availability and access to health c are services during and after pregnancy,

13 and nutrition level among PLW since the
and nutrition level among PLW since the first evaluation stu dy started . The annual evaluation also indicates progress in nutrition, health and hygiene related practices among students . Yet there are areas to be prioritized for further increasing access to healthcare and enhanced nutritional level among these groups . • The study findings show that percentage of pregnant and lactating women (PLW) receiving nutrition specific safety net support (Maternal allowance, 1000 days, Supplementary feeding, m aternal h ealth v oucher, a rea based c ommunity n utrition s cheme, VGF, VGD , i ron folic acid supplementation) is higher in second annual evaluation survey (10.64%) than first annual evaluation study (10.2%) or the baseline (8.4%) . Page | 3 • PLW mainly received safety net support like maternal allowance 3.3% (first evaluation 1.8%), matern al health voucher 2.2% (first evaluation 2.9%), 1000 days 2.2% (first evaluation 1.4%), VGD 2.2% (first evaluation 1.4%), etc. An improving trend is found except in the case of maternal health voucher scheme. • I n the baseline study , it was found that pregnant women received ANC services mostly from the Family Welfare Centre (FWC) (around 33%), whereas Community Clinic (CC) was found to be the major providers of ANC (47%) during the first year annual evaluation. The trend continued and CC was the major service provider in ANC (58.5%) during the second annual evaluation survey. • During the second annual evaluation survey 42.7% of the currently pregnant women took more food than usual. This is a decrease from the first annual evaluation when 55.2% of pregn ant women took more food than usual during their pregnancy. Still this is improvement considering the baseline information when 37.4% of pregnant women took more food than usual. • 68.9% of the pregnant women at the second annual evaluation reported that th ey were taking additional rest whereas 65.7% and 41.7% of the pregnant women reported the same during the first evaluation and baseline surveys, respectively. • During the second annual evaluation 22.9 % ( n= 301 ) of the post - partum women reported that they had received Postnatal Care (PNC). This is a significant increase as during the baseline, “very few” mothers and children had received postnatal care and during the first evaluation survey 19.6% ( n= 342) reported the same. • 38.4% of women of reproductive ag e in the targeted districts consumed a minimum dietary diversity (MDD) during the previous 24 hours of the second annual survey; an increase of 1.4% percentage points compared to the first evaluation survey. Consumption of MDD thus

14 continued to increase fr om 34.9% sinc
continued to increase fr om 34.9% since the baseline. Noticeably, consumption of MDD is higher in Rangpur (44.3%) than Nilphamari (33.5%). • In case of applying at least 5 key learning points (i) Food ingredients, food prepare and food serving, ii) Health sciences and healthcare, i ii) Adolescent health & Hygiene, iv) Hand wash and v) Use of sanitary latrines.) at home, it was found that students from Rangpur (4.38%) applied more than that of Nilphamari (2.22%) during the second evaluation survey. It is identified that while progress is made in Rangpur, the numbers decreased in Nilphamari if compared with first evaluation survey results, when, students in Nilphamari (2.54%) applied their knowledge more than that of Rangpur (1.3%). Remarkably, girls were found to be applying more learn ing points during the second annual evaluation survey (3.1%) than boys (2.0%). This is an overall progress as during the baseline no female student s had reported about such practices. • Minimum dietary diversity consumption by children (6 - 23 month) (who rece ived foods from 4 or more food groups) is higher during the second evaluation survey (22.6%) compared to the first annual evaluation (20.4%) and the baseline (17.8 % ). 3) Nutrition Governance Even though different platforms such as DNCC, UNCC UDCC have started to operate in JANO project areas, more emphasis is required to establish multi - sectoral plans and the installation of the effective feedback mechanism. However, reach of safety - net programs is showing an increasing trend. • The second annual evaluation found that DNCC, UNCC, UDCC platforms or forums are initiated in both Rangpur and Nilphamari. In a KII session with JANO proj ect staff it was mentioned that 2 DNCC, 7 UNCC and 64 UDCC had spent budget on several purposes i.e., distributing foods, sanitary napkin, etc. this is a significant increase as during the first year evaluation or baseline no such activities was recorded. Page | 4 • In total 73 plans were found ( Two multi - sectoral plans (2019 - 2020) at district level , seven at UNCC /upazila and 64 at UDCC/union level) and thus budget was allocated to support nutrition interventions in both districts. It is progress as during the first evaluation survey no multi - sectoral plans at district, upazila, and union level were initiated and thus no budget was allocated to support nutrition interventions. • During the second evaluation survey , a significant progress was recorded in terms of m eaningful participation of women and adolescent girls in government forums (UDCC, CG, CSG), i.e., raised issues during formulating the nutrition action plan and successfully

15 implemented those plans (overall 54.0%
implemented those plans (overall 54.0% [Nilphamari 64.0% and Rangpur 45.5%]). Duri ng the first evaluation “ very few ” did the same (overall 0.5% [Nilphamari 0.9% and Rangpur 0.0%]). • During the second annual evaluation (as like the first year evaluation or the baseline), no platforms /options such as availability of a complain box/ hotline number/or any other mechanisms was found which would allow service receivers to engage into an effective feedback mechanism. 4) Food Security and Livelihood Application of Climate Smart Agriculture (CSA) techniques is increasing in the project area since the baseline and first year evaluation survey. • The prevalence of CSA techniques shows an increasing trend. • Application of CSA techniques (minimum 3 out of 20) is showing a positive trend. During the annua l evaluation survey use of minimum 3 techniques was reported by 9.4% of the households ( Nilphamari 7.3% and Rangpur 12.9% ). The same was reported by 8.3% of the household during the first annual evaluation ( Nilphamari 4.7% and Rangpur 10.6%). While during baseline 5% of the households during did the same (Nilphamari 3% and Rangpur 8%). • During the second annual evaluation survey, the prevalence of various CSA techniques was measured. The farmers were found to be using various CSA techniques, such as use of short duration varieties 10.7% (first evaluation: 6.5%), submergence - resistant varieties 7.7% (first evaluation: 6.0%), disease - resistant varieties 8.2% (first evaluation: 5.1%), drought - resistant varieties 9.2% (first evaluation: 7.4%), Alternative Wettin g and Drying (AWD) methods 1.5% (first evaluation: 1.6%), ribbon retting method 9.7% (first evaluation: 4.9%), growing creeping vegetables on nets over ponds 0.5% (first evaluation: 1.4%). 5) Access to information, Information and Communication Technology ( ICT ) This second annual evaluation reveals gender disparity in access to information and extension services, including access to Information Communication Technology ( ICT ) to receive information about nutrition. Gender disparity is eminent by the fact tha t during the second annual evaluation survey, 55.4% of women (first evaluation: 56.3%) owned mobile phone compared to 89.5 % of men (first evaluation: 81.7%) . • During the second annual evaluation, it was found that 61.2% of the total respondents possessed knowledge about services that could be availed through smart technology (first evaluation: 46.5%) . • In the project area, 66.3% of the households were visited by NGO health workers during the last 12 months (first evaluation: 40.5%) . • During the second annual evaluation sur

16 vey, it was found that 9.3% of the house
vey, it was found that 9.3% of the households accessed or received nutritional information through text messages (first evaluation: 7.2%) . This indicates an increasing trend since the base line when 4.2% of the households received nutritional information though text messages. Page | 5 • No ICT based e - learning platforms was used by the frontline workers. Besides, no portal is established for planning and decision making at district and upazila level. JANO’s next plan may focus on develop ing and mainstreaming ICT based e - learning platforms at local level to connect relevant government departments and increase awareness of the community people about nutrition specific interventions. 6) WASH Practic es The second annual evaluation study explored the situation of access to safe drinking water, safe sanitation, and prevalence of hand washing practices at critical times. • Use of tubewell for drinking water is rising (second evaluation: 97.9%, first eva luation: 96.7%). • Open defecation has decreased since the baseline (second evaluation: 1.9%, first evaluation: 6.3%, baseline: 7.8%). • Second annual evaluation reveals a decreasing trend in percentage of households having water facility and soap/detergent a vailable near the latrines. The second evaluation survey identified water facility near the latrines for washing hands in 43% of the cases (first evaluation 59%). Further, soap/detergent near the water for washing hands was identified in 53% of the cases in second evaluation as compared to 60 % during first annual evaluation. 7) Covid - 19 Response and Impact The JANO project has proven to be pivotal in disseminating C OVID - 19 related. information. Approximately, 90 % of respondents in Nilphamari heard about th e pandemic through JANO Volunteer s whe reas the percentage in Rangpur was 69.1%. Other than th is , the percentage of alternative sources such as miking, media and g athering information from community people is above 50% . This indicates need for reaching out to these groups with correct information at the local level. • 98.8% of the respondents reported to be washing hand s frequently while 55.3% of the respondents mentioned keeping social distance as a way to avoid COVID - 19. Moreover, 9.5% and 7.4% of the respondents mentioned “police would take the patients” and “keep it secret”, respectively. • Major services provided by JANO included : idea and knowledge about COVID - 19 (84. 8%), washing hands in a perfect way (59.3%), and wearing mask in a perfect way (57.0%). • The average number of visits or contact with JANO v olunteers from March to

17 September is 7. • More than 50%
September is 7. • More than 50% of the respondents specified that their family members received support and information from JANO. • Around 34% of the lactating mother and 28.9% of the pregnant women received support from JANO. • Respondents mentioned that they received knowledge about nutrition. More th an 25% of the respondents shared the learning/ information with their family. • Nearly 59% of the participants reported to be satisfied with the support regarding COVID - 19 received from JANO volunteer. The percentage of respondents who were very satisfied var ies across districts (Nilphamari 31% and Rangpur 12.8%). However, overall, 16.5% of the respondents were dissatisfied. • More than 50% of the respondents stated that they changed their food habits in their family during COVID - 19. Around 70% of them eaten decreased the amount of food. • Around 60% respondents pointed that all their family members took nutritious food during COVID - 19. The percentag e of lactating mother taking nutritious food was 23.9%. • More than 55% respondents claimed that their income declined due to COVID - 19. Page | 6 • Around 60% respondents took loan for overcoming this pandemic situation. More than 20% of the respondents were taking low amount of food or food with good quality at the present time during the second evaluation . Besides, 6.7% of the respondents have already sold their land/ gold/ asset due this pandemic. Recommendations and way forward The following recommendations and guidance on the way forward for JANO to create sustainable impact in the lives of target communities is presented below. • Advocacy with stakeholders : In order to sustain gains from the Bangladesh National Plan of Action for Nutrition (NPAN), JANO may consider advocacy with the Government and other stakeholders going forward to improve the process of analyzing budget and expenditure of nutrition Toward this end, JANO may focus on integrating the NPAN in various public off ices to strengthen effective interventions through adequate support from these stakeholders. • Communication, Coordination and Cooperation : JANO can create the position of Nutrition Officer to identify barriers to effective communication and coordination am ong different committees and commence advocacy at the governmental level. Through JANO, CSG committee members could be encouraged to donate or contribute to the local nutrition plan to more effectively integrate healthcare services at the community level. Each concerned project committee member could align, collaborate and establish a platform to share and expand cooperation betwee

18 n stakeholders at different levels.
n stakeholders at different levels. • Monitoring and Evaluation : JANO could set up a robust system to plan and monitor women’s participation in different forums. Adolescents’ and volunteers could be engaged in this process. • Awareness - raising Tools : Toll - free hotlines and community radio can be utilized as two major awareness tools that links community people to essential nutriti on information. • Accountability : An active complaints and feedback mechanism should be established and monitored under DNCC, UNCC, UDCC, CC level to strengthen the rights of beneficiaries to have their voices heard. • Education for All : JANO should continue its online classes with local school students and also arrange online training for SMC members and school teachers. • Upholding Income Generation : In order to cope with the effects of the Covid - 19 pandemic, JANO can identify income - generating opportunities for beneficiaries In Bangladesh’s evolving development landscape, the growing needs of vulnerable groups remains paramount. Addressing malnutr ition and boosting nutrition levels in children under 5 years, pregnant women and lactating mothers remains a priority for the JANO project in future. Significant commitment and buy - in from concerned stakeholders will contribute to ensuring value added, accountable and sustainable service delivery to these groups in order to uphold their overall wellbeing. Page | 7 1. Introduction 1.1 Overview of JANO project “ The Joint Action for Nutrition Outcome ” (JANO) project implemented through a consortium of CARE, Plan International and ESDO will work with the GoB ) at the national, regional and local levels, to support the effective implementation of the National Plan of Action for Nutrition (NPAN) - 2. JANO will work with multiple levels of the government, specifically with Nutrition Committees at the district, upazila and union levels , building their capacity to better develop nutritional plans, implement and allocate budget s for these plans, and provide effective oversight in project implement ation. JANO has intentionally selected Rangpur and Nilphamari as its coverage. districts. Under Rangpur division , t hese regions are among the two most vulnerable areas in terms of poor nutrition levels, with a stunting rate of 42.1 % , according to the Multiple Indicator Cluster Survey of Bangladesh (2012 - 2013). Government structures at the local and regional levels will act as key partners, where JANO will work with the Nutrition Coordination Committees s o that they implement effective nutritional programs within their regions, which

19 are inclusive of all citizens, and accou
are inclusive of all citizens, and accountable to all . The private sector is also seen as a major systemic partner, where JANO will motivate and encourage businesses to inves t in local markets, where they consider local populations to be a part of their core business. Throughout all of JANO’s activities, women and girls will remain central. These activities will follow a gender - transformational approach to develop capacity of women and girls to be informed decision makers , better producers and income earners. JANO intends to shift four domains of change : Domain 1: Communities particularly adolescent s and women are informed, engaged and empowered to improve their nutritional status Domain 2: Committed, capacitated and invested local government structures and systems Domain 3: Responsive, engaged private sector and civil societies in co - creating innov ative and affordable solutions for improved nutrition Domain 4: Well - coordinated multi - sectoral efforts to transform nutrition governance process Overall Objective of JANO The Overall Objective of JANO is to “contribute in ending malnutrition of childr en under five - years of age, together . Specific Objective of JA NO Specific Objective of JANO: Strategic objective is to “Improve maternal and child nutrition in Nilphamari and Rangpur districts of Northwest Bangladesh.” 1.2 Purpose and Objective s of the JANO Annual Evaluation JANO has recently completed its second year. Due to the COVID - 19 pandemic JANO launched a response program besides implementation of regular activities. Hence , in 2020, besides measuring the results for the given log frame i ndicators , JANO has also intended to measure the impact of COVID - 19 on the project in a holistic way and also a ssess the progress and impact of COVID response program s . Page | 8 The purpose of the annual eva l uation was to: 1. To measure annual (second year) progress against given logframe indicators. 1.1 To measure the outcome (on health and nutrition) of COVID response project of JANO 2. To measure the impact of COVID - 19 on project and recommend way forward. The study c overed all indicators that the JANO project set for outcome s and expected results for the log frame. Please see Annex 1 Indicators List for full list of indicators and their baseline and annual evaluation (first and second year) values. 2 Study Methodolo gy 2.1 Study Area and Target Group The study was carried out by adopting a combination of quantitative and qualitative assessment methods . Q uantitative sample survey was adopted with pregnant and lactating wo

20 men and adolescent boys and girls at ta
men and adolescent boys and girls at targeted schools. A face - to - face interview method was followed among the randomly selected respondents including SMC members and C ommunity S upport G roups. A mostly structured questionnaire was used . Also, tele phone interview s w ere conducted to collect data from DNCC, CSG CG members . The quantitative assessment enable d us to quantify the incidences of different activities that were collect ed from either knowledge or habitual practices . In - depth interviews, Focus Group Discussion and Key Informants Interviews under qualitative assessment were carried out to encourage discussion , expression of differing opinions and points of view regarding the study topic . In addition, desk research was c arried out mainly to get a comprehensive idea about relevant project documents and published results of the context at hand . The qualitative assessment help ed us to uncover prevalent trends in thought and opinion on nutritio n - - specific or nutrition - sensiti ve actions and plan. The study reviewed the following documents provided by the JANO project: • JANO Inception Report • JANO Baseline Report • JANO first year evaluation Report • Baseline data collection tools • Logical Framework of the JANO project The survey was conducted in CAPI (Tab based), as preferred by the client. The S urveyCTO Platform was used for data capturing. The following types of respondents were covered for the quantitative study: • Pregnant and Lactating women • Adolescent g irl s & b oys at s chool • School Management Committees and • Community Support Groups Page | 9 The following types of respondents were covered for qualitative study: 1. Community S upport G roup s 2. Community G roup s CG s 3. Unmarried adolescents’ boys and girls ( 1 with boys and 1 with girls’ group) 4. M ale h ead of the h ousehold 5. Sub Assistant Agriculture Officer (SAAO) – DAE 6. Community Health Care Provider 7. Family Welfare Assistant 8. Health Assistant 9. Representatives of UDCC 10. Representatives of UNCC 11. Representatives of DNCC 12. Livestock Officer 13. JANO Project staff 14. Public Health and Engineering Officers 2.2 Geographical Coverage and Sample size The study covered the seven most vulnerable upazilas of Rangpur and Nilphamari districts: Gangachara, Kaunia, Taraganj, Domar, Jaldhaka, Kishorgonj and Nilphamari Sadar. The survey comprised results from 35 villages, selected as Primary Sampling Units across the above upazilas . The

21 survey select ed a statistically rep
survey select ed a statistically representative sample to receive annual res ults of indicators across all unions. The sampled households were selected from the sampled area equally applying a simple random sampling method. Since information on the number of pregnant, lactating women and adolescent boys and girls were unknown at the time of the survey; the quantitative sample size for the study was calculated using the following formula: Where, n= R equired sample size p= Estimated value of the parameter = 50% e= Permissible Margin of error=5% z= 1.96 which corresponds to the 95% confidence level Deff . (Design Effect) = 1 Considering 50% as P value (which yield the maximum sample) with e set at 5%, z at 1.96, and design effect 1 the sample size for the study becomes 384. Adding 1 2 % non - response , the minimum sample size of the study was calculated 4 30 . T he study covered 430 pregnant/lactating women. Using the same formula and assumptions , the sampling size of adolescent girl s and boy s w as 430 as well. The a chieved sample distribution and respondents of the quantitative samples for household and school survey are : Page | 10 Respondent Types Total Sample Distribution Lactating and Pregnant women 4 30 Adolescent Girl s & Boys at School 4 30 Members of (MC s 35 CSG s 71 Female members of CSG, CG, DNCC 100 2.3 Quantitative (Household and School) Sample Distribution Household Selection • All 35 villages were selected by the following systematic random sampling method . − Step 1: Assigned a number to all of the 640 villages − Step 2: Determined the sample size (in this case, it is 35) − Step 3: Divided 640 (the total number of villages) by 35. This came to 18.28567 or 18 (when rounded off). Then, a number in between 1 and 18 was drawn randomly. It came out as ‘2’. That is, 2nd, [2 + (18.28567 X1)] or 20th, [2 + (18.28567 X2)] or 39th, and other villages were chosen following the same rule until 35 villages were selected. • A t arget beneficiary list was provided by CARE Bangladesh covering the stated 7 target upazilas , which served as a sampling frame. • Adolescent boys and girls were selected from the same household of adult respondents or from nearby households as per their availability. School Selectio n In total 22 schools were selected from surrounding areas of the surveyed village . Picture 1: Household Interviews being conducted Picture 2: Interview with adolescent g irl s Picture 4: Interview with adolescen t g irl s Picture

22 3: Interview with adolescen t bo ys
3: Interview with adolescen t bo ys Page | 11 2.4 Qualitative Sample Distribution Multiple techniques were employed for collecting qualitative data from target respondents and and meet study ’s objectives. These techniques are outlined below. Respondents were selected following purposive sampling technique. Please see Annex 3 to see the list of participants an d sample size of the qualitative segment of the study. • Focus Group Discussions w ere conducted with JANO beneficiaries and project stakeholders , including Community Support Group, Community Group , u nmarried adolescents’ boys and girls, (1 with boys and 1 w ith girls’ group), Men (Head of the Household) and School Management Committee. Two FGDs were taken with each of the categories in both Rangpur and Nilphamari districts. • Key Informant Interviews were taken from PNGOs, LGI s and other related government officials , i.e., SAAO – DAE, Community Health Care Provider (CHCP), Family Welfare Assistants, Health Assistants, Representatives of UDCC, Representatives of UNCC, Representatives of DNCC, Livestock Officers , JANO Project staf f, Public Health and Engineering Officers of the project area. • In - Depth Interview s w ere taken with Pregnant, Lactating women and m arried adolescent girls in coverage districts. 2.5 Survey Implementation The survey was implemented in several phases shown below. i. Phase - I: Preparatory Phase Field management and recruitment of interviewers: E xperienced interviewers were recruited for this project. Since the target respondent s w ere female, only female interv iewers were employed for this study. Finalize data collection instruments: A Pre - test of draft questionnaire was conducted and outcome s w ere shared with CARE before finalization. Training for data collection staff: A 4 - day central training session was arranged in Rangpur ( for enumerators, supervisors, quality control officers and field management personnel. The o bjective s of the project, introduction to respondents and code of conduct were discussed in addition to a question /answer session. A m ock test was also taken to ensure enumerators were well - prepared for conducting interviews. ii. Phase - II: Data Collection A total of 21 female enumerators and 3 field supervisors collected data during this survey. 4 Qualitative Research Associates were appointed to cover the qualitative segment . The data collection process took place between October 16 - 23 , 2020 . Page | 12 iii. Phase - III: Data Manage

23 ment and Analysis The collected dat
ment and Analysis The collected data was processed by IRC’s in - house Electronic Data Processing (EDP) w ing, which ensure d the strictest possible data checks and confidentiality, as per the global analysis practice. The company’s senior programmers and researchers supervised data checking, coding, punching and editing. After all the data was entered, it was cross - checked thoroughly with the corresponding questionnaires. Required editing was completed as per need. Also, respondents were contacted whe n required. For analysis purposes, IRC’s programmers and researchers jointly develop ed output formats, wr ote necessary programs and use d advanced software. All outputs (tables, charts, and maps) were thoroughly checked by a team of researchers before repor ting An SPSS database was used to analyze and present data. iv. Phase - IV & V: Drafting Final Report and Presentation The final report was prepared after receiving feedback and comments from CARE . This evaluation report is a collaborative effort between IRC and CARE . 2.6 Quality Control Mechanism The q uality control measures taken at various stages of r esearch projects are indicated below: Field/Data Collection Leve l: • Interviewer recruitment: I nterviewers with experience who have work ed with IRC w ere recruited for the study. • Survey control: D ifferent levels of supervision (Managers, Quality Controllers and Team Leaders) are all on our permanent payroll, are graduates and have relevant experience of more than 5 years. • Support with Interviews: Our Field Supervisor (FS) and Field Controller (FC) supported more than 30% of the interviews. This helped us to closely monitor and maintain the quality of data collection. • Quality control and bac k - checking: The c hecking procedure was very stringent. All completed questionnaires were scrutinized 100%. Then, 40% of all completed interviews were randomly back - checked for respondent and response validity by team leaders, quality controllers, field managers, research coordinators and senior researchers. Each high - level authority check ed the work of all others at lower levels . Picture 5 : Training Session at Rangpur Page | 13 At Data Entry/Analysis: • 100% punched data were re - checked and analyzed . O utputs we re - checked by senior EDP personnel and researchers. 2.7 Ethical considerations of the study Maintaining research ethics is pivotal in conducting a study of this nature in a standard and bias - free manner. While data collection from the field continued , the research team also m

24 aintained the ethical standards that
aintained the ethical standards that would provide the study with a more in - depth insight without compromising with the freedom and confidentiality of respondents. Before conducting any of the FGDs and in - depth interviews, written consent w as collect ed from the respondents. For the respondents of FGDs verbal consent was collected and for respondents of the in - depth interviews both verbal and written consent were collected. The FGDs and interviews were recorded only after receiving permission from resp ondents. Photographs were taken for research evidence; that too after receiving permission from respondents. The hierarchical relationship between researcher and respondent were avoided and a friendlier approach was undertaken while conducting the FGDs and In - depth I nterviews. The research team informed the respondents prior to the FGDs and interviews that they were free to leave or skip any questions if they found it offensive or too sensitive Maintaining the confidentiality of the respondents was the utmo st priority of the research team. If any respondents were un willing to publish his/her name, pseudo names were used instead of their real names. The note keeper of the FGDs and interviews read out the key findings to the respondents after the completion of every FGD and interview. The respondents also incorporated their signature on the se notes after listening to the findings of the FGD s and interviews. In this way, the research team tried to maintain ethical standards while collecting data from the field of study. Page | 14 3 Findings - JANO Annual Evaluation 3.1 Household and Demograph ic Information The JANO project’s second annual evaluation collected basic household and demographic data on 430 (Rangpur: 194, Nilphamari: 236) sampled households. The sample was split into a 3:1 ratio between pregnant and lactating women. The key findings from this data are presented below. 3.1.1 Household Information The average household size in Bangladesh consists of 4.06 members per household according to the recently released Household Income and Expenditure Survey (HIES). F r om this study, i t was found that the average household size was 4 for Nilphamari and 5 for Rangpur. The average household size of the second - year evaluation study was found to be greater (5) than the first annual eva luation (4). Table 1 below highlights the household and demographic status of the study’s participants. Table 1: Household and Demography Status Response 2019 2020 Average Household Size 4.30 5 Sex of Household head Male 99.1% 48.6% Female 0.9% 51.4% Education al Status of Ho

25 usehold head Education al Status of
usehold head Education al Status of Household head ( who had e ver a ttended s chool) 73.3% 77.3% N 430 430 3.1.2 Education al Status The education al status of the household members shows that 28.9% completed primary education during the first evaluation survey . H owever, th is rate has decreased to 16.1% during the second evaluation . Similarly, the rate of M asters/higher education degree holders has dec lined from 3.8% to 2.1% during the second evaluation . In addition, the proportion of discontinued completing SSC/equivalent s was 21% while it in creased to 34.4% in the current study . In contrast, the percentage of completing HSC/equivalent and graduat es increased from 3.5% to 5.4% and 3.2% to 4.1% , respectively. Table 2 shows the education level of household members. Table 2: Education Level of Household members Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All 0 Class 3.4% 0.7% 2.2% 2.3% 2.7% 2.5% Primary incomplete (less than class 5) 26.6% 17.4% 22.5% 26.2% 21.7% 24.3% Primary complete (class 5 passed) 31.6% 25.4% 28.9% 17.2% 14.6% 16.1% SSC/equivalent incomplete 17.5% 25.4% 21.0% 32.7% 36.7% 34.4% SSC/equivalent complete 2.8% 12.3% 7.0% 7.6% 10.0% 8.7% HSC/equivalent incomplete 6.8% 2.2% 4.8% 2.0% 2.4% 2.2% HSC/equivalent complete 4.0% 2.9% 3.5% 6.3% 4.2% 5.4% Graduate/equivalent 2.8% 3.6% 3.2% 3.8% 4.6% 4.1% Masters/equivalent/higher 1.7% 6.5% 3.8% 1.6% 2.7% 2.1% Informal/pre - school 0.0% 0.0% 0.0% 0.3% 0.4% 0.3% Don’t know 2.8% 3.6% 3.2% 0.0% 0.0% 0.0% N 177 138 315 236 194 430 Page | 15 Among target respondents, more than 85% are married and only 10% were never married. The study found that the proportion of widow s increased from 2.6% in 2019 to 3.1% in 2020. However, the rate of divorces and those separat ed are negligible. 3.1. 3 Occupation of Household Head The second annual evaluation identified that the primary occupation of household head s was agricultural daily wage laboring (Crop/livestock) (22.1%), followed by non - agricultural daily wage labo u r ing (20.5%). The p revalence of f arm/cro p production and sales as primary occupation increased to 10% from 1.6% . H owever, s alaried work (non - agricultural) decreased from 16.7% to 12.6% whereas salaried work ( a gricultural) declined from 8.1% to 2.8%. Table 3 displays the occupational status of ho usehold heads. Table 3: Occupation Status of Head o

26 f the Household members Response Ann
f the Household members Response Annual Assessment 2019 Annual Assessment 2020 Nil phamari Rangpur All Nil phamari Rangpur All Farm/crop production and sales 0.4% 3.1% 1.6% 12.7% 6.7% 10.0% Agricultural daily wage labor (crop/livestock) 17.1% 23.5% 20.0% 22.9% 21.1% 22.1% Non - agricultural daily wage labor 27.4% 19.9% 24.0% 17.8% 23.7% 20.5% Salaried work (agricultural) 10.3% 5.6% 8.1% 2.5% 3.1% 2.8% Salaried work (non - agricultural) 15.4% 18.4% 16.7% 11% 14.4% 12.6% Handicrafts 0.4% 0.0% 0.2% 0.0% 1% 0.5% Household/domestic/housewife (unpaid) 0.4% 0.0% 0.2% 3.4% 2.1% 2.8% Other self - employment/own business (non - agricultural) 26.9% 27.6% 27.2% 25.8% 25.3% 25.6% Retired/elderly 1.7% 2.0% 1.9% 2.1% 0.5% 1.4% Other 0.0% 0.0% 0.0% 1.7% 2.1% 1.9% N 234 196 430 236 194 430 3.1.3.1. Disability Status Almost all respondents from Nilpah a mari and Rangpur mentioned that they have no disabled members in their famil ies . The Annual Assessment r ate s on disability status among these groups remained the same at 99.1% in both 2019 and 2020 . 3. 2. Women and Adolescent Girls Empowerment This section discusses women and adolescent girls’ empowerment . H ere , the annual progress of the JANO project will be presented mainly focusing on women’s decision - making power that can impact on nutrition and health care services. This section also follows som e sub - theme s that emerged from the project , such as access to buying and selling products to market, participation in formal and informal decision spaces, having said this, this segment looks at the level of empowerment w omen and adolescent girls in commun ities hold in order to demand and utilize both nutrition - sensitive and nutrition - specific services. A UNICEF (2010) study finds that malnutrition is transferred from women to children and th at children grow up with the risk of being affected by different diseases and poses less immunity. Thereby, women’s increased participation in decision making, agriculture and income generating capacities have an impact on the ir household nutrition level (Sraboni et al., 2014) . However, burdened by an age - old patriarchal system , women and adolescent girls are still far from attaining a level of empowerment that would contribute significantly to improving th eir nutritional status . Men are mostly decision makers Page | 16 about agricultural activities and social participation limiting women’s equal participation o n differen

27 t levels. Therefore, this project needs
t levels. Therefore, this project needs to concentrate on developing women’s decision - making power and increas ing their public participation as well as employment to have a direct impact on health and nutrition. 3. 2 .1 Women’s decision making and access to market s to buy or sell products In order to understand the major roles of both men and women in production and marketing of household produces, it is important to note that there exists a huge gender difference in terms of taking decisions about various types of products such as seeds, p esticides, fertilizers, livestock, agricultural instruments , commodity production and market sales . The decision to maintain a homestead garden with several crop varieties would be used as a production measure , the percentage of adult male s engaged in this activity is 54.5% and 63.7%, respectively. This trend has increased from the first year ’s evaluation whe re decisions were taken by men in 37.9% and presently in 44.0% cases, respectively. Combining both Rangpur and Nilphamari districts, only 14.2% (first year evaluation 5.6% ) women can decide to maintain the homestead garden, and 2.8% (first year evaluation 1.9% ) can participate in choosing crops to grow for selling later on. This degree of participation by women reveals the ir initial challenge toward accessing nutrition as they can rarely plant what they deem as nutritious. Seeds, pesticides, fertilizer: The study revealed that men play an important role in the production of crops, seeds, pesticides and fertilizer . They also lead the decision - making process in purchasing these items . In Rangpur, 64.7% (first year evaluation 59.7% ) men took decisions on w hether they would buy improved seeds such as certified, Hybrid, HYV which is higher compared to women . 3.1% ( first year evaluation 2%) and I n Nilphamari, this feature was also higher in men 68.2% ( first year evaluation 30.8%) as compared to women 3.4% ( first year evaluation 1.7% . In terms of pesticides, 66.3% men (Rangpur: 62.4% and Nilphamari: 69.5 %) ( first year evaluation 43.7%, Rangpur: 60.2% and Nilphamari: 29.9%) take decision s combining both districts, whereas women’s participation rate is 2.8% (Rangpur: 2 .6 % and Nilphamari: 3 .0 %) (first year evaluation 1.6% ; Rangpur: 2% and Nilphamari: 1.3%) . The situation manifests that women are excluded and marginalized from public spheres due to social norms such as Purdah 1 and hampers their economic participation (Ahmed, 1992; Kashem & Islam, 1999) . In fact, women are not considered as ‘farmers’, therefore, their decisions regar

28 ding seed, pesticides and fertilizer pr
ding seed, pesticides and fertilizer production are challenged unless they belong to Female Headed Households (Rosy & Haque, 2017) . Both adolescent girls’ and boys’ participation in the above decision - making processes are less than 1% in both districts. this means that men bein g the head of the household are themselves decision makers, this reality not only excludes women but also young girls and boys. Nonetheless, a m any positive changes is noticeable, women have participated in diction - making on a yearly basis. Livestock: L i vestock include s oxen, cattle, goats, sheep, chicken, ducks and turkeys . It is interesting to note that the percentage of men’s role s in purchasing or selling oxen and cattle is relatively higher than the rest of the se animals . This trend has continued since the first year evaluation and men’s control over this process increased from 40.7% of 66.7% during the second year of evaluation . In contrast, women enjoy a higher level of participation in managing poultry, ( 10% combining both districts ) d uring the first year of the evaluation. This percentage increased to 18.6% in the second year of evaluation . In the first year , women’s participation in decisions regarding purchase and s ale of livestock types was higher in Rangpur district compared to Nil phamari , this trend continued in the second year of evaluation . Hence, these findings show that there are scopes to improve women’s 1 Wearing veil to cover body and face. Page | 17 participation in the purchase and s ale of livestock, especially in Nilphamari to increase of their empowerment levels . Farm tools: The use, purchase or rent of mechanized farm equipment such as hand tools, animal - drawn ploughs , tractor s , power tiller s , and treadle pump s , are also determine d by stereotypical gender roles. It was revealed that 2.8 % (first year evaluation 0.9 %) women only participate in mechanized farming related decision making compared to 61.2% (first year evaluation 4 1 . 6 %) men. Women have relatively more participation (3.0%) in dealing with non - mechanized farm equipment (first year evaluation 1.4%) . These r esults show that due to perceived social norms, women have limited scope to use mechanized equipment (Chipande, 1987; Saito & Spurling, 1992) . In addition, a study conducted in Manikganj reveals that women find motorized techniques difficult to operate as they are not user - friendly (Rosy & Haque, 2017) . Similarly, to purchase or rent transformation equipment such as milling machine, and food processing equipment, men take the lead, a

29 nd the difference is 6 2 . 3 % versus 2
nd the difference is 6 2 . 3 % versus 2.6% women (first year evaluation 43.0% men and 1.9% women) . This difference remains visible in deciding to invest in n on - farm ing business es , where men control how the money would be used. Therefore, the project has great potential to increase women’s participation in decision making related to production. Control over income money 2 T he money earned from selling different produces and other sources are mostly managed by men, which is 64.2% (first year evaluation 42.3% ) compared to 3.0% (first year evaluation 2.6% ) women. The division in decision making power indicates that women also lack proper control over the ir income, although women are extensively involved in livestock production (Anderson & Eswaran, 2009) . Moreover, women’s lack of access to information, market value chain and men’s control over the market also play s a role in limiting women’s control over livestock or related income (Paudel, ter Meulen, Wollny, Dahal, & Gauly, 2009) . About children: in terms of children ’s education, marriage or medical treatment, men play a major role in taking decisions. Only, in terms of children ’s immunization do women play twice as much a role as men (62. 6% versus 28.4%). This is a significant increase in terms of women’s role play as during the first year of evaluation where men and women played almost equal r ole s regarding children’s immunization being primary caregiver s. This feature is clearly absent i n decisions regarding children’s education public participation or marriage. Access to basic health service: As shown in the below graph, 87.4% women have access to basic health services across both coverage districts representing an increase from 73.5% during the first annual evaluation. They mostly receive services from community clinic s 57.8% (first year evaluation 49.1%) followed by UH&FWC 37.5% (first year evaluation 16.8%) and Upazila Health Complexes 8. 7 % (first year evaluation 13.6%). Figure 1 shows access to basic health service s across project areas for target groups . 2 Access to and control over: Opportunity to receive and utilize information and ability to make approach to gain ownership. Page | 18 Figure 1: Access to Basic Health Services In this segment of the study, 92.6% of participants mentioned that they did not visit a healthcare centre because it was ’’ not required . A total of 5.6 people said that these services were of a “high expense”. The health facilities that are available in the catchment area s are Union He alth & Family Welfare Centre

30 ( UH&FWC ) (54.0%) and Community Clini
( UH&FWC ) (54.0%) and Community Clinic s (90.2%) , representing an increase from 22.3% and 72.6%, respectively during the second year evaluation from the first year evaluation . Figure 2: Service s received from different health service center s during last 12 months According to the preg nant women groups from IDIs , every pregnant woman should be careful during her pregnancy by eating nutritious food, avoiding heavy work and while availing health services. A r espondent from Gangachara, Rangpur specified that she received health services from BRAC. On the other hand, a respondent from Nilphamari mentioned that she receives services from one service provider each from both BRAC and the JANO project . Both responde nts mentioned that they received health 56.3% 65.7% 59.4% 71.4% 76.0% 73.5% 88.6% 86.1% 87.4% 43.8% 34.3% 40.6% 28.6% 24.0% 26.5% 11.4% 13.9% 12.6% Nilphamari Rangpur All Nilphamari Rangpur All Nilphamari Rangpur All Baseline Annual Assessment 2019 Annual Assessment 2020 Yes No 35.5% 15.7% 9.2% 3.2% 7.4% 49.1% 16.8% 13.6% 3.2% 5.4% 57.8% 37.5% 8.7% 6.9% 4.0% Community Clinic UH&FWC Upazila Health Complex Other NGO Health Service centre Govt. Satellite Clinic Baseline Annual Assessment 2019 Annual Assessment 2020 - “Not only I get the service of measuring BP, iron tablets or calcium, they also give vaccines for the new born baby” - One pregnant woman, Gangachara, Rangpur Page | 19 services such as measuring b lood p ressure measurement , an ultrasound , prescribed medication including advice for keeping fit . According to participants, adolescent girls face different physical problems during menstruation such as heavy bleeding body and chest pain. As they all attended the meetings of JANO program, they know that they need to maintain personal hygiene, eat healthy and nutritious food and take rest during these times on a monthly basis. Respondents also mentioned the services they received from Community Clinic s such as TT vaccines, Iron and Folic acid tablets. These groups also specified that they visit ed th e doctor from a local market if they face d any problem s during menstruation as Community Clinics would not always open. According to the respondents, every pregnant woman or lactating mother should receive knowledg e about avoiding heavy works eating nutritious food, receiving health services from doctors, taking steps for taking care of her new born child and most importantly treatment for her children. All of the project’s respondent’s received essential knowledge and information on these issues through courtyard meeting s co

31 nducted by the JANO program . All the
nducted by the JANO program . All the respondents received health services during their pregnancy such as measuring blood pressure , position of the baby, provide iron, vitamin and calcium tablets ultrasound and medication. They added that service provider s from Community Clinic s also provide health care services to children. 3.2.2 Participation of Women in Formal and Informal D ecision - Making Spaces The following section will explore the extent to which women participants engage in formal and informal decision - making spaces. Specific objective: Outcome Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts Indicators: % of increased participation of community people, particularly women, in formal (government - led) and/ or informal (civil society - led, private sector - led) decision - makin g spaces Definition Indicators: •Govt. led forums: CG, CSG, UP special committee, Up standing committee, adolescent group, student council, •Informal group: VSLA, FFS, Mothers group, youth group, women support group •Participation in the meeting and in the discussion Data disaggregation by sex (Definition aligned with CARE global indicators.) Formal Informal Nilphamari Rangpur Overall Nilphamari Rangpur Overall Baseline 1.79% 1.81% 1.79% 1.79% 1.81% 1.79% Annual Evaluation 2019 0.47% 0.47% 0.93% 2.33% 1.16% 3.49% “We want to go to c ommunity clinic s as there are female doctors there but the y are not always open. That’s why we have to visi t the village doctor found in the local market.” - One adolescent girl, Nilphamari. “Not only I get the service of measuring BP, iron tablets or calcium, they also give vaccines for the new born baby.” - One pregnant woman, Gangachara, Rangpur Page | 20 Annual Evaluation 2020 1.16% 1.63% 2.79% 2.56% 2.33% 4.88% Figure 3 show that participation of formal (Govt. led forums: CG, CSG, UP special committee, UP standing committee, adolescent group, student council) and informal group (VSLA, FFS, Mothers group, youth group, women support group) differs from baseline to the annu al evaluation survey. Participation of community people in formal group s has increased as compared to the baseline and first a nnual evaluation survey (2019) . This element has steadily increased in Nilphamari district in the second annual evaluation survey . Figure 3 : Percentage of increased participation of community people, particularly women, in formal and/ or informal decision - making spaces Figures in % 3. 2 . 3 Functionality of C ommunity S uppo

32 rt G roup s and S chool M anagement
rt G roup s and S chool M anagement Committee s T he CSG groups have been established since 2018 . The main profession of CS G members are ho memakers , teacher s , farmer s and fisherm e n . approximately, 17 members were selected for th e CSG. In this group, 9 members are female including one adolescent girl and the re maining are male including one adolescent boy In both Rangpur a nd Nilphamari, the CSG members worked with CG s by checking family planning vaccines, provid ed list s of pregnant women and old age allowances. In addition, the se groups also arranged courtyard meetings on health, nutrition and hygiene issues and recommended participants go to CC s to avail treatment , regular checkup s of pregnant women and also for adolescent health issues. 1.79 1.79 0.93 3.49 2.79 4.88 Formal Informal Baseline Annual Survey 2019 Annual Survey 2020 “If we see a girl sick for her menstruation and she does not want to go to school, we suggest her for taking treatment from Community Clinics. We also refer t he community people for the CC who are sick or cannot go to hospital.” -- CSG member “Community Clinics provide medicine. Generally, they provide 30 different medicines but seldom one or two remain stocked out. Besides, primary care for general health problems is provided. We also provide PLW with iron, calcium supplements, follow ups and encourage mothers to exclusively breastfeed children up to 6 months. Similar support regarding supplements is given to adolescents” – KII with a HA Page | 21 Meeting s and decision - making process According to the members of CSG s , meeting s are arranged on a bi - monthly basis. D iscuss about planning and improvements for community people as well as the program are held at these sessions . Community support group s organize coordination meeting s (Shomonnoy S hova) every 6 month s . From 2018, members attended approximately 34 CSG meetings. They mentioned that their decisions are normally recorded by the meeting’s P resident and that they always try to provide relevant recommendations for all community member at these sessions . Women and adolescent girl mem bers of this CSG always make decisions about health and nutrition related issues for adolescent, pregnant women, lactating mothers including disabled children visit CC s for various kinds of treatment. Problems and suggestions for improvement of CC servic es Though the CSG members did not specify any problems, they suggested keeping C Cs neat and clean, improving their medical resources and provid ing more knowledge ab

33 out their health services to the commun
out their health services to the community people. According to the CSG members, the se meetings are very effective for both CSGs and the community. In addition, they mentioned the importance of providing nutrition - specific services fo r women and adolescent girls. Resource mobilization The CSG respondents specified that they provide knowledge about the use of modern latrine s , improving nutrition by growing vegetables in front of community people’s ho mes and ask them to go to CC s with out hesitation. The C S G members from the FGD s mentioned that they normally organize meetings and plan for their upcoming work accordingly inform ing the community about their agendas . In addition, they arrange court yard - meeting s providing information about the benefits of CC s. They also flagged areas where they could support community people to improve their health and nutrition status. A f ew of the m ale household heads from both Nilphamari and Rangpur are also member s of CSG s . They mentioned that they were selected for the CSG s through discussion s on potential participants who possess leadership skill s . They added that if anyone is regularly absent for the se meeting s , t he y would be denied membership . T hese participants also stressed that the CSG members knew their responsibilities toward the community. Along with the m embers, the Chairman and the Secretary of the Union Parishad, CG and CSG jointly organize a nnual planning forum s and make decisions by providing financial and technical support . The One of the HA during a KII mentioned, “Community Clinics has a group including UP members, schoolteachers, imams, etc any others then list, do not use etc. In this group, 5 - 7 out of 17 members are women. [what is this bracket for…]?? only 1 or 2 women forward acceptable recommendations, if their recommendations are valuable, they are taken into consideration. It was also mentioned, community groups hold meetings every month and so far, almost 25 - 30 meetings have been held.” Page | 22 respondents went on to mention that they receive the support of some NGOs who provide information about adolescent health during courtyard meeting. They normally use the method of route mapping to engage the demand of community people with second year a nnual plan program. Th rough this process, the challenge s and problems of the community people are share d meetings. According to the members of the CG s , they face challenges in providing nutritious food, making sanitary latrine s and build ing tube - wells in the communit

34 y as they do not have financial support.
y as they do not have financial support. Th ough they collect very minimal amount s of money from the patients of CC s , they use th is fund to repair tube wells and/ or sanitary latrines. In total , 71 members of the CSG s were interviewed to evaluate their functionality during the second year annual evaluation. As per survey data, out of 71 CSGs, 29 have been functionalized based on their performance on seven indicators prescribed by the Institute of Public Health and Nutri tion mentioned below (from program personnel) . i) Mobilize and motivate the community people for taking health and nutrition services from community clinic, ii) Motivate and ensure the household members to taking additional food for women and adolescent and taking rest of pregnant women, iii) Motivate and ensure the household members to exclusive breast feeding, iv) Motivate and ensure the household members to taking additional food to the child after 6 months age, v) Assist to identify the malnourished child and women and arrange to send in community clinic, vi) Taking a ction to protect child marriage and vii) Motivate the adolescent women to taking Iron tablet and deworming tablet Expected Result I: Output I Results chain: Women and adolescent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; Indicators : % of CSGs in targeted communities are functional Definition Indicators: Qualify five out of seven performance indicator prescribed by government Nilphamari Rangpur Overall Baseline 0% 0% 0% Annual Evaluation 2019 CSG (functional/Active) 414 198 612* Annual Evaluation 2020 * CSG (functional/Active) 37% 45% 41% (out of 71) *Here values are calculated in percentage in the second year annual evaluation survey It was found that, during the baseline survey, in total 7 SMCs had raised issues related to nutrition specific and sensitive services for women and adolescents. In the first annual evaluation, 199 SMCs from Nilphamari and 103 SMCs from Rangpur raised these issues during these meeting s , set them in the action plan and recorded them in the meeting minutes. In the second - year annual evaluation, face - to - face interviews were conducted with SMCs, it was identified that monthly meeting s were conducted in 61.1% cases (Nilphamari 73.9% and Rangpur 38.5%), and 50% of them received training (Nilphamari 60.9% and Rangpur 30.8%). In those meeting s , priority issues included discussion related to nutrition “We take 5 TK from the CC patients. We use them on repairing other problems. The amount for i

35 mproving nutrition of commun ity people
mproving nutrition of commun ity people is very negligible. For this reason, we need financial support. If Govt. can implement the budget for this project effectively, the project will see the success.” - FGD with Community Group Page | 23 awareness (100%), health issues (100%) and hygiene (97.1%), involvement of students in nutritional activities (44.4%) including vegetable gardening at school ( 83.3%). However, the knowledge of SMC members in gender sensitive hygiene issues was comparatively low at 42.9%. Expected Result I: Output I Results chain: Women and adolescent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; Indicators : # of School Management Committees set agenda for nutrition specific and sensitive services for adolescents in the SMC meeting Definition Indicators: SMCs will raise issues in the meeting, set them in the action plan and that will be mentioned in the meetin g minutes Nilphamari Rangpur Overall Baseline 6 1 7 Annual Evaluation 2019 199 103 302* Annual Evaluation 2020 * 157 88 245 * Th is indicator value was calculated based on the interview data ( quantitative survey with 35 members of SMC ) The above findings from the survey indicates that 157 SMCs from Nilphamari and 88 SMCs from Rangpur have raised issues on gender, n utrition, health and hygiene in corresponding meetings and incorporated them in to action plan s . Role of SMC s According to the SMC respondents from both Rangpur Kaunia and Nilpha mari, the P resident normally makes decisions along with SMC members for leading school development planning, increasing the attendance of students, their academic performance and most importantly their knowledge about gender, health, nutrition and hygiene. They specified that the SMC team s also select representative s from guardians whose children attend these school s . Selection for SMC s The SMC respondents from both areas specified that they usually select the members of this group through a voting process. They have separate position s for female candidate by which they follow gender equality guidelines . They arrange meeting s based on upcoming planning schedule s and issues related to health, student attendance and hygiene. Planning for student dev elopment According to the SMC participants of Kaunia Rangpur, they could not f inalise any plan s for the students with the new committee as the se schools are closed due to COVID - 19. Recommmendations : The respondents from Kaunia Rangpur suggested trainin gsbe provided on women and adolescent hea

36 lth. They specified that th e JANO prog
lth. They specified that th e JANO program would help SMCs provide accurate knowledge about nutrition, hygiene and academic development to students as well as to the community . “We call the famous personality of our area in this election. We have 4 candidates from parent s’ section and one separate position for female candidate s .” - One SMC respondent from Nilphamari. Page | 24 According to a JANO project staff, CSG will be functioned in the third year as these projects take some time to be implemented properly. However, CSG members have actively participate in events and meetings , made response plans for Covid - 19 and delivered messages to the community. Required training had been provided to the concerned team, meetings were held and planning was completed . However , due to COVID - 19, SMCs’ operations were paused. At this point, is a nticipated that at least 5 - 6 months is needed to overcome this phase. Moreover, the team expects that the project will reach its peak during the 5th year. In order to bridge the gaps between the initial goal and actual result s from CSG s , the plan is to incorporate the findings of the first year going forward . Having said this, if major flaws are found, then training will be provided and based on the situation, new module s will be created. 3.3 Maternal Adolescent Child H ealth and Nutrition Th e following section discusses maternal, adolescent and child health, nutrition and the status of health care facilities. Nutrition is a part of health and women’s empowerment, it’s crucial for advancing the health and productivity of whole families and communities. Therefore, understa nding the types of assistance regarding ANC, PNC including nutritional level s is important to get an overall idea about reproductive health and nutrition. 3.3.1 Assistance regarding maternal health and nutrition In terms of assistance regarding maternal he ath total of 3.2 % women in Nilphamari and 3.4 % in Rangpur informed about having maternity allowance among the total number of 312 and 2 37 of these women respectively. Similarly, 1 .5% (decreased compared to first annual evaluation survey) women r eceived supplementary feeding and 2. 2 % received maternal h ealth v oucher s. This demonstrates a poor service delivery from both the government and NGOs. In case of area - based the Community Nutrition Scheme, (CNS) no service delivery was imparted in the second annual evaluatio n compared to the first annual evaluation study. In the baseline study, similar findings were identified varying from 1 - 2

37 % for each category such as 1000 - day a
% for each category such as 1000 - day assistance, support (maternity allowance, Vulnerable Group Development (VGD), Valuable Group Feeding (VGF), maternal health vouchers) and C B NS . There is a slight improvement in th is percentage in terms of 1000 - day assistance , m aternity allowance and VGD s , yet it is an area where more focu s must be given . 3.3.2 Antenatal and Postnatal C are Antenatal care also known as prenatal care refers to the regular medical and nursing care recommended for women during pregnancy. It begins from the early stages of pregnancy and aims to provide care during pregnancy, at the time of delivery, and soon after delivery which is extremely important for the survival and well - being of both the mother and her newborn baby. Page | 25 From Figure 4, t he survey results show tha t approximately 79.6 % of pregnant women (at least received 2 check - ups during their pregnancy) received antenatal checkups during pregnancy in the second evaluation. District wise, the highest percentage of pregnant women who sought at least 2 ANC support services was in Nilphamari , The he lowest was found in Rangpur (76. t ) in the second evaluation. The percentage of pregnant women who made 2 antenatal visits has increased, from 78.1% in 2019 to 79.6% in 2020 though this result was unsatisfactory compared to the baseline (84.3%). Those who had received ANC support , Of t hose who received , more than half of them (58.5%) received it fr om CC s in the second annual evaluation, which is higher than the first annual evaluation ( 47.6%). Th is result also show s that 20.7 % of pregnant women received ANC from FWCs and around 13.4% from UHCs during the second annual evaluation. Th ere is also a significant increase in the percentage of pregnant women taking more rest than usual from 65.7% in 2019 to 68.9% in 2020 . Pregnant women had also consumed more food during pregnancy in the second annual evaluation (60%) than in the first annual evaluati on (36.2%). However, the ratio of husbands not accompanying wiv es outdoors during pregnancy has decreased compared to the baseline study and first annual evaluation study . However, i n both annual evaluations approximately 28 % of pregnant women admitted tha t their husband s sometime s accompanied them to health center s . In Figure 5, the incidence of receiving po stnatal care ( immediately after the birth ) and checkups after pregnancy is recognized as an essential component of maternal and newborn care. Interviewers asked each mother if she had received a health checkup af

38 ter delivery and a PNC checkup wit
ter delivery and a PNC checkup within 42 days of her last delivery. The graph shows that approximately 23% ( among 301 women) of mothers reported t hat they have received PNC in the second annual evaluation compared to the first annual evaluation (19.6%, women said yes among 342 women) study . The survey results show that the number of mothers receiv ing PNC within the 42 days of their last child’s delivery ha s increased during the second annual evaluation (36.2%) survey as compare d to the first annual evaluation (32.8%) . The m ajority (more than 30%) of mothers received PNC services from h ospital/ m edical colle ge s in both annual evaluation survey s . They had also visited UHCs and CC s after the birth of their children. Furthermore, 47.2% of mothers delivered their child ren at home as compared to the first annual evaluation (55.6%). To facilitate the ir delivery, relatives, skilled birth attendant (SBA), community based skilled birth attendant s (CSBA) , d octor s and nurse s played better role s in both annual evaluation s than in the baseline study . 3.3. 3 Indicators of The National Plan of Action for Nutrition The g overnment, NGOs and some p rivate s ector organizations are focusing on poverty, education, health and nutrition, water, and sanitation, as current development issues in Bangladesh. The National P lan of Action for Nutrition has been adopted with different stakeholders to improve the nutritional status in Bangladesh. National Nutrition Policy 2015 emphasizes ensuring proper nutrition of people by identifying the causes of malnutrition. This policy f ocuses on the underlying causes of malnutrition Figure 4 : Incidence of receiving antenatal check - ups during pregnancy 84.3% 78.1% 79.6% Baseline Annual Assessment 2019 Annual Assessment 2020 Figure 5 : Incidence of receiving post natal check - ups after pregnancy 19.6% 22.9% Annual Assessment 2019 Annual Assessment 2020 Page | 26 and strengthening improvement areas to ensure the facilities and improve nutritional status in Bangladesh. Mostly children and women suffer malnutrition in Bangladesh. National Nutrition Policy 2015 emphasize s several health points for children. Those are: breastfeeding be started within one hour after birth; the baby be exclusively breastfed up to age 6 months (180 days); and after completion of the 6 months the baby be given homecooked, nutritious complement ary food up to 2 years of age along with breastfeeding. The following paragraph discusses the status of child nutrition in Rangpur and Nilphamari areas. The second evaluation findings show that mothers with 0 - 23 - month -

39 old children were asked about the ini t
old children were asked about the ini tiation of breastfeeding within one hour of birth. The results revealed that 60.8% of mothers began breastfeeding within 1 hour of their child’s birth. Nearly two - thirds (63%) of the se mothers (those have a child below 6 months) exclusively breastfed their children. Also, more than 80% of mothers (those who have a child between 20 and 23 months) provided breast milk and they are still breastfeeding their child ren . Nearly 98% o f mothers g ave V itamin A capsules to their 6 - 59 - month - old child and 63.0% of the HH reported using iodized salt/packaged salt for cooking. The series of FGDs held with the male head of the household found that these groups attend courtyard meeting s once a month. Dur ing these sessions, participants learned how to provide care for women during their pr egnancy such as regu lar checkups at CCs, ensuring that they avoid heavy work , t ake rest and eat healthy food. The FGD respondents from Nilphamari specified that they take their household’s female members to the CCs for various types of treatment including availing medicine . “Not only we go to the Community C linic for the checkups for our pregnant women, w e also receive medicines for different types of illnesses like fever, cough, headache s, itching and diarrhea. They are very supportive. They also give iron and vitamin tablets for pregnant and adolescent girls.” - One respondent from Nilphamari. From the courtyard meeting s , they also receive knowledge on saving money for the delivery of newborns , various treatments, investing in nutritious food cultivation and emergency need s . In addition, respondents from Rangpur talked about ‘Green Umbrella’ an d UHC where they can access health services for women. According to CSG members (from the FGD s ), female community people are not fully un aware of their healt h, nutrition and hygiene , especially about their pregnancies and lactation . Hence, these members p rovide knowledge to local women on CC based health services, particularly for malnutritional children , pregnant women, and lactating mothers, doctor’s consultations , inform them including adolescent girls about the importance of medical checkups, takin g iron and calcium tablets. The members also provide counselling services about the legal marriage age , adolescent and reproductive health in addition to the negative effects of the dowry system. 3. 3 . 4 Nutritional Status of Women of Reproductive Age Specific objective: Outcome Results chain: Improved maternal and child nutrition in Nilphamari and R

40 angpur districts Indicators : % of wom
angpur districts Indicators : % of women of reproductive age in the targeted districts who are consuming a minimum dietary diversity (MDD) Definition Indicators: Women 15 - 49 years of age have consumed at least five out of ten defined food groups the previous day or night. (FANTA - III) Nilphamari Rangpur Overall Baseline 30.9% 41.8% 34.9% Page | 27 Annual Evaluation 2019 32.5% 42.3% 37.0% Annual Evaluation 2020 33.5% 44.3% 38.4% Th is was asked to women aged between15 - 49 years who have consumed at leas t five out of 10 defined food groups the previous day or night. During the second year annual evaluation, a t otal of 430 women (23 6 in Nilphamari, 19 4 in Rangpur) at reproductive age responded to this question on Minimum Dietary Diversity ( MDD ) . The b elow graph in Figure 6 shows that the stated food consumption is slightly higher ( 38.4%, in the second year annual evaluation survey compared to 37% in the first year evaluation and 34.9% in the b aseline survey) . “MDD - W is a dichotomous indicator of whether or not women between 15 – 49 years of age have c onsumed at least five out of 10 defined food groups the previous day or night. The proportion of women 15 – 49 years of age who reach this minimum in a population can be used as a proxy indicator for higher micronutrient adequacy, one important dimension of diet quality. The ten food groups are: 1. Grains, white roots and tubers, and plantains 2. Pulses (beans, peas and lentils) 3. Nuts and seeds 4. Dairy 5. Meat, poultry and fish 6. Eggs 7. Dark green leafy vegetables 8. Other vitamin A - rich fruits and veget ables 9. Other vegetables 10. Other fruits” http://www.fao.org/3/a - i5486e.pdf . Figure 6 displays the percentage of women of reproductive age in coverage districts consuming a Minimum Dietary Diversity. In th e second - year evaluation, this percentage is 38.4%, a slight increase from both the baseline (34.9) and first year’s evaluation (37.0%). Figure 6 : Percentage of women of reproductive age in the targeted districts who are consuming a minimum dietary diversity (MDD) Figures in % From the second year evaluation, it was revealed that m ost women (9 9 % in Nilphamari and Rangpur) consumed ‘Grains, white roots, tubers, plantains (rice, potatoe s)’ over the previous 24 hours, o ther V itamin A rich fr uits and vegetables (including ripe mangoes and papaya, carrot s , pumpkin s , sweet potato es )", o ther vegetables and fruits (including green mango es and papaya)" . It was found that consumption of the above foods is higher in the women of Nilphamari, while pulses (beans, peas, len

41 tils and dairy (yogurt, cheese, milk),
tils and dairy (yogurt, cheese, milk), nuts and seeds, m eat, pou ltry, fish (including dry fish), e g gs and dark green leafy vegetables were consumed more in Rangpur . In addition, 56.5 % women in th e second year annual evaluation ( 48.5% in first year evaluation) took Vitamin - A after the delivery of the ir child, and 31.2 % ( 28.9% in the first year evaluation) took iron 30.9 41.8 34.9 32.5 42.3 37.0 33.5 44.3 38.4 Nilphamari Rangpur All Baseline Annual Evaluation 2019 Annual Evaluation 2020 Page | 28 tablets while 26.2% (18.1% in the first year evaluation) took folic acid as well. It must be noted that receiving of Vit - A , iron tablets and folic acid has increased in the second - year annual survey, when comparing first year evaluation. Figure 7 shows the percentage of women who consume d a selective number of food items in the past 24 hours of the survey period. In the second - year evaluation, dairy was the most popular food items consumed as they were in the first - year evaluation 24%. This was not the case in the baseline with only 4% pr eferring to consume dairy products. Similar consumption patterns can be observed in the Nuts and seeds category ranked as the second most popular followed by eggs. Participants did not prefer to eat other fruits or vegetative outside those highlighted in t he below table. Figure 7 : The percentages of women consumed the number of food items in the previous 24 hours Given that the main staple food item is rice in Bangladesh, 61% of women in the ‘ better MDD ’ group consumed Grains but 38%% of women in the ‘ no MDD ’ group consumed this food. Other food items that were commonly consumed were dark green vegetables, which we re consumed by 32% of women reporting improved MDD (i.e. having consumed 5 or more food items) and 32% of women in the no MDD (i.e. having consumed 4 or fewer food items); Pulses (beans, peas and lentils), which were consumed by 32% of women reporting bett er MDD (i.e. having consumed 5 or more food items) and 27% of women in the no MDD (i.e. having consumed 4 or fewer food items); meat, poultry and fish – consumed by 30% of women reporting better MDD and 27% in the no MDD group; and other vegetables – consu med by 26% of women reporting better MDD and 17% in no MDD group. 6% 11% 21% 25% 18% 9% 6% 4% 0% 0% 1% 9% 18% 34% 11% 11% 9% 6% 1% 0% 1 2 3 4 5 6 7 8 9 10 Annual Assessment 2019 Annual Assessment 2020 Page | 29 Figure 8 : Percentage of MDD food items consumed in the last 24 hours in women of reproductive age 3. 3 . 5 Women and Adolescent Girls in Communities are Empowered to Demand and Utilize Both Nutrition - Sensitive

42 and Nutrition - Specific Services W
and Nutrition - Specific Services W omen and adolescent s from the annual evaluation survey have claimed that they received more nutrition - specific and sen sitive - services from relevant servi ce providers such as C Cs for health services and Extension services for agriculture and livelihoo d as compared to the baseline and first year annual survey. Expected Result I: Output I Results chain: Women and adolesc ent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; Indicators: % of women and adolescent have claimed nutrition specific and sensitive services from relevant service providers Definition Indicators: • Community Clinic (CC) for health services • Extension services for agriculture and livelihood Community Clinic Extension services Nilphamari Rangpur Overall Baseline 37.8% 30.7% 35.5% 3.98% Annual Evaluation 2019 39.7% 31.6% 36.1% 7.44% Annual Evaluation 2020 40.68% 32.99% 37.21% 8.84% As per survey findings , women and adolescents claimed that they availed nutrition - specific and sensitive services mainly from CCs and extension services for agriculture and livelihood from DAE, NGOs, and the private sector . Women and adolescents get health services from community clinic but in adequate manner . Figure 9 reflects the percentage of women and adolescents who claimed nutritious specific and/ or sensitive services f rom relevant service providers during the second annual evaluation survey. 38% 32% 7% 23% 30% 26% 32% 20% 26% 9% 61% 27% 2% 13% 27% 15% 32% 11% 18% 2% Grains, white roots and tubers, and plantains Pulses (beans, peas and lentils) Nuts and seeds Dairy Meat, poultry and fish Eggs Dark green leafy vegetables Other vitamin A-rich fruits and vegetables Other vegetables Other fruits Better MDD No MDD Page | 30 Figures 9 : Percentage of women and adolescent s have claimed nutrition specific and sensitive services from relevant service providers The above result s in Figure 9 show that few adolescent girls and women have received basic nutrition al services ( such as growth monitor ing) from CCs , UH s and FWCs in the last 12 months. However, they did receive ANC, PNC, SBCC, E PI, LIM. Curative care curative care services from these service providers . The evaluation also found that the overall level of accessibility to basic health care service packages from the above service providers was satisfactory . The FGD s conducted with married adolescent girls revealed that they face physical problems such as heavy bleeding, headache s , body p

43 ain , acidity and chest pain durin
ain , acidity and chest pain during menstruation . One of these respondents said that she stayed at home during her menstruation as she felt that it was a normal problem . On the other hand, another respondent said that she went to the CC for t reatment after learning about their services from the JANO project through mi king. “I did not know that we could share about this heavy bleeding and headache problems during menstruation to anyone. When I heard the miking of JANO program for going to Community Clinic for taking treatments. I went there and got to know that if we e at healthy vegetables, these types of pro blems won’t happen. They also ga ve suggestions on how we can keep our body healthy”. -- a married adolescent girl. The respondents also mentioned that they do not like to visit the doctor except when experiencing major health problems. According to one of the participants , around 80% people in her community visit the local hospital in cluding her in - law’s family . The rest of them go to CCs . In contrast, a respondent from Rangpur stated that she avails g ood quality services and treatment from CCs These groups went on to state that they are very interested in availing knowledge about nutrition, health and hygiene as it helps pe ople to keep their bodies fit. One respondent specified that healthy food and/ o r hygiene maintenance is merely not enough, physical exercise is also important to uphold good health. P articipants from Rangpur specified that they could not avail knowledge regarding nutrition, health and hygiene from the CCs and courtyard meeting s . According to a participant from Nilphamari, newly married adolescents do not have knowledge abou t family planning. She recommended that this information be provided in courtyard meeting s . On the other hand, participants from Rangpur recommended providing health related information through female members of CCs . 37.80 30.70 35.50 3.98 39.70 31.60 36.10 7.44 40.68 32.99 37.21 8.84 Nilphamari Rangpur All Extension services Baseline Annual Survey Annual Evaluation 2020 Page | 31 3. 3 . 6 Students Apply Key Learning Points Regarding Nutrition, Health and Hygiene at Home Expected Result I: Output I Results chain: Women and adolescent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; Indicators: % of students disaggregated by sex who apply key learning points regarding nutrition, health and hygiene at home Definition Indicators: At least 5 learning of the below: • Food ingredients, preparatoin and food serving •

44 Intake of diversified food • Ho
Intake of diversified food • Home gardening • Safe drinking water • Adolescent health & Hygiene • Han d - wash ing in key times • Use of sanitary latrines • Information about health service providers Boys Girls Nilphamari Rangpur Overall Baseline 0.44% 0.0% 0.22%, 0% 0.15% Annual Evaluation 2019 1.67% 2.26% 2.54%, 1.30% 2.09% Annual Evaluation 2020 2.98% 3.05% 2.22% 4.38% 3.02% School children/adolescents applied 5 key learning points on ( i) Food ingredients, preparation and serving, ii) Health sciences a nd healthcare, iii) Adolescent health & h ygiene, iv) Hand - wash ing and v) Use of sanitary latrines. The graph in Figure 10 shows that s tudents of Rangpur (4.4 %) applied most of the highlighted learning points than did students from Nilphamari ( 2.2 %). Also, girls followed slightly more learning points in this annual evaluation survey ( 3.1 %) than b oys ( 3.0 %). Overall, 3.0% of students applied key learning points on nutrition, health and hygiene at home which is higher than both in the first - year annual e valuation and baseline survey s. The r esults in this section were also consistently higher for girls than for boys. Figure 10 showcases the percentage of students who applied key learning points regarding nutrition, health and hygiene at home during the sur vey period . Figure 10 : Percentage of students disaggregated by sex who apply key learning points regarding nutrition, health and hygiene at home Figures in % 0.2 0.4 0.2 2.5 1.3 1.7 2.3 2.1 2.2 4.4 3.0 3.1 3.0 Nilphamari Rangpur Boys girls All Baseline Annual Evaluation 2019 Annual Evaluation 2020 Page | 32 Table 4 shows d ata from the second annual evaluation survey where 95.3 % of 430 students considered applying key learning points regarding nutrition, health and hygiene at home, and 95.6 % were already applying at least some of those key learning points at school. Table 4 shows the levels of application Table 4: Key Learning points a pplied at School Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Apply learning on gender, health, hygiene & nutritional knowledge at school Yes 81.9% 95.5% 86.7% 96.7% 93.8% 95.6% No 18.1% 4.5% 13.3% 3.3% 6.3% 4.4% N 276 154 430 270 160 430 Learnings that apply at school Concept of Gender equality & Equity 24.8% 17.7% 22.0% 12.3% 5.3% 9.7% Nutrition 37.6% 45.6% 40.8% 55.2% 50.7% 53.5% Food ingredients, food prepare and food serving 8.8% 6.1% 7.8% 15.

45 3% 4.0% 11.2% Health sciences and
3% 4.0% 11.2% Health sciences and healthcare 16.4% 11.6% 14.5% 14.2% 18.7% 15.8% Hygiene 66.8% 91.8% 76.7% 83.5% 83.3% 83.5% Puberty and reproductive health 32.3% 15.6% 25.7% 7.3% 11.3% 8.8% Food & food nutrition management 10.6% 4.1% 8.0% 11.5% 11.3% 11.4% Child Development, Family Relations and personal safety 11.9% 2.7% 8.3% 5.7% 4.7% 5.4% Adolescent health & Hygiene 28.8% 14.3% 23.1% 19.5% 15.3% 18.0% Hand wash 69.0% 82.3% 74.3% 75.1% 52.7% 66.9% Use of sanitary latrines 44.7% 38.8% 42.4% 43.7% 39.3% 42.1% Child Marriage 16.8% 14.3% 15.8% 8.0% 4.7% 6.8% N 226 147 373 261 150 411 The levels of application of learning points at home and at school has increased during the second annual evaluation as compared with the first annual evaluation. Table 5: Key Learning points applied at Home Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Apply learning s on gender, health, hygiene & nutritional knowledge at home Yes 79.3% 87.7% 82.3% 97.0% 92.5% 95.3% No 20.7% 12.3% 17.7% 3.0% 7.5% 4.7% N 276 154 430 270 160 430 Learnings applied at home Concept of Gender equality & Equity 8.7% 14.8% 11.0% 9.5% 4.1% 7.5% Nutrition 32.0% 37.0% 33.9% 60.5% 54.7% 58.4% Food ingredients, food prepare and food serving 4.6% 8.1% 5.9% 16.7% 4.7% 12.4% Health sciences and healthcare 6.8% 6.7% 6.8% 14.4% 16.2% 15.1% Hygiene 37.4% 40.7% 38.7% 84.0% 85.1% 84.4% Puberty and reproductive health 10.0% 9.6% 9.9% 11.8% 10.8% 11.4% Food & food nutrition management 6.8% 4.4% 5.9% 11.8% 10.1% 11.2% Child Development, Family Relations and personal safety 5.5% 3.7% 4.8% 6.8% 3.4% 5.6% Adolescent health & Hygiene 16.9% 10.4% 14.4% 18.6% 14.2% 17.0% Hand wash 37.9% 43.7% 40.1% 76.8% 52.7% 68.1% Page | 33 Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Use of sanitary latrines 29.2% 31.9% 30.2% 47.1% 41.9% 45.3% Child Marriage 11.0% 10.4% 10.7% 7.2% 3.4% 5.8% About Corona 3.8% .7% 2.7% N 219 135 354 263 148 411 3. 3 . 7 Nutritional Status in Children U nder 5 - y ears of Age The following section explores the nutritional status in children under 5 - years of age who constitute the target population. Specific objective: Outcome Results chain: Improved maternal and child nutrition in Nilph

46 amari and Rangpur districts Indicators
amari and Rangpur districts Indicators: Proportion of children 6 – 23 months of age who receie food from 4 or more food groups (based on the MDD - C methodology) by sex (Percentage) Definition Indicators: Proportion of children 6 – 23 months of age who receive food from 4 or more food groups (based on the MDD - C methodology) by sex (Percentage) Boys Girls Nilphamari Rangpur Overall Baseline 18.1% 17.4% 18.1% 17.2%. 17.8% Annual Evaluation 2019 19.4% 21.2% 20.7% 20.2% 20.4% Annual Evaluation 2020 21.8% 23.5% 22.7% 22.4%. 22.6% The mother s of 2 39 children aged 6 - 23 months were asked about the proportion of food from 4 or more food groups consumed by t he i r children over the previous 24 hours. The d ata shows a minim um dietary diversity consumption in these children which is slightly higher in the second year annual evaluation as compared to the baseline and fi rst year annual evaluation studies . Noticeably, the food consumption rate is higher among girls than boys. ( according to WHO standard s ). Most of the children (responded by 64% mothers of Nilphamari and 62% by Rangpur) consumed “ Grains, white roots, tubers, plantains (rice, potatoes) ” ( 47 % in improved MDD and 16 % in no MDD groups) over the previous 24 hours. “ Egg ” (26% in improved MDD and 15% in no MDD groups) and “ Dairy (yogurt, cheese and milk) ” ( 42 % in improved MDD and 15 % in no MDD groups) . “ Other V itamin A rich fruits and veg etables (including ripe mango e s and papaya, carrot s , pumpkin s , sweet potatoes ) ” consump tion is higher in children aged 6 - 23 months) of Nilphamari while in Rangpur, consumption of “ Dairy “in children of this age range is more widespread . Figure 11 highlights the proportion of children aged between 6 - 23 months who received food from 4 or more food groups based on the MDD - CC methodology. Minimum dietary diversity: Proportion of children 6 – 23 months of age who receive food from 4 or more food groups was assessed using WHO guidelines for evaluating Infant and Young Child Feeding (IYCF) practices among children 6 - 23 months old (WHO, 2010). The 7 food groups used for tabulation of th is indicator are: — grains, roots and tubers — legumes and nuts — dairy products (milk, yogurt, cheese) — flesh foods (meat, fish, poultry and liver/organ meats) — eggs — Vitamin - A rich fruits and vegetables — other fruits and vegetables. https://apps.who.int/iris/bitstream/handle/10665/43895/9789241596664_eng.pdf;jsessionid=B2230551 772DCABDFE2AEDF1B9311059?sequenc e=1 Page |

47 34 Figure 1 1 : Proportion of chil
34 Figure 1 1 : Proportion of children 6 – 23 months of age who receive foods from 4 or more food groups (based on the MDD - C methodology) 3. 4 Nutrition Governance The elements of nutrition governance include: an inter - sectoral mechanism for nutrition ; having a national nutrition plan/strategy; adoption of the nutrition plan/ strategy; nutrition in the national nutrition plan and so on. Nutrition Governance is one of the core components of the JANO project. This section will discuss nutrition governance, nutrition - based budgeting , safety net support, nutrition action plan s , feedback and a tripartite agreement between government officials . These efforts will harness the drive to boost nutrition in target groups and structurally create more food secure communities 3. 4 .1 Nutrition Specific Budget ing Specific objective: Outcome Results chain: Improved maternal and child nutrition in Nilphamari and Rangpur districts Indicators : # of DNCC, UNCC and UDCC spent budget effectively on nutrition - specific or nutrition - sensitive actions Definition Indicators: 50% of the fiscal year budget spent Nilphamari Rangpur Overall Baseline 0 DNCC, UNCC, UDCC 0 DNCC, UNCC, UDCC 0 DNCC, UNCC, UDCC Annual Evaluation 2019 0 DNCC, UNCC, UDCC 0 DNCC, UNCC, UDCC 0 DNCC, UNCC, UDCC Annual Evaluation 2020 2 DNCC, 7 UNCC, 64 UDCC In the first annual evaluation it was found that D istrict N utrition Coordination C ommittees (DNCCs) , U pazila Nutrition Coordination Committees (UDMCs) and U nion D evelopment C oordination C ommittees (UDCCs) are platforms or forums initiated in two target districts namely Rangpur and Nilphamari. Until the first annual evaluation , two meetings were held by JAN O. During the second 16% 17% 15% 14% 15% 13% 11% 47% 22% 42% 22% 26% 11% 13% Grains, roots and tubers (bread, rice, noodles, porridge, white potetoes) Lesumes and nuts (lentils, peas, nuts) Dairy products (milk, yoghut, cheese) Meat and fish (including dry fish) Eggs Other vitamin A rich fruits and vegetables (including ripen mango, ripen papaya, carrot, pumpkin, sweet… Other fruits and vegetables (Including green mango, green papya and vegetables ) Better MDD No MDD Page | 35 annual evaluation, i n a KII session with JANO project staff, it was mentioned that 2 DNCC s , 7 UNCC s and 64 U DCCs had spent their allotted budgeted funds in several areas for instance, on distributing food and sanitary nap kins. Thoug h at the local level , these institutional budget funds were allocated for different nutrition related activ ities, budge

48 t limitations remain a great challenge
t limitations remain a great challenge. This issue can be innovatively addressed, as one C ommunity H ealth C are P rov ider (CHCP ) mentioned that though CG s and CSG members do not receive funds from the government, they collect and maintain fund ing from those patients who can afford to pay ( BDT 2 - 5). These members donate and collect fund ing during agricultural seasons, they collect w hat is produced by locals whatever possible . This fund is then used for local nutrition plan ning activities for instance , planting fruit trees. However, this approach did not work everywhere, one FWA mentioned, even though they tried to initiate a fund, pe ople did not contribute much, and it did not run well. This feature also indicates scope of further work to be done by JANO. According to a JANO project staff, as an indicator of the performance of the project, Nilphamari had completed it’s planning and budgeting. And, Rangpur has completed all of the process from C S G to DNCC, which can be considered as a big achievement for second year. The project was expected to formally be launched on December of first year, but due to some administrative change and as well as for the impact of corona virus, the launching has been delayed to second year. For the third year, the goal is to build operational capacity. Expected Result 2: Output 2 Results chain: Coordinated and resourced sub - national and local government structures recognize, respond and are accountable to demands of poor and marginalized communities Indicators : # of Multi - sectoral plans at district, upazila and union level have allocated budget to support nutrition interventions in the two target districts Definition Indicators: At least allocated budget to address one action in the multi - sectoral nutrition action plan in each year Nilphamari Rangpur Overall Baseline 0 0 0 Annual Evaluation 2019 0 0 0 Annual Evaluation 2020 1 1 2 DNCC, 7 UNCC, 64 UDCC, (7 3 plans) Two multi - sectoral plans (2019 - 2020) at district level , seven plans at union level and 64 plans at upazila level were found and thus budget have allocated to support nutrition interventions in this area by annual evaluation study. There is also an upcoming project of JANO, which will be implemented in 2020 – 2021 year. Here also, a progress is identified as during the first annual evaluation there was no multi - sectoral plans at district, upazila and u nion level found and thus no budget was allocated to support nutrition interventions in the two target district s. However, the project is challenged by the fact that government officers are transferred to o

49 ther areas, thus, the project face chal
ther areas, thus, the project face challenge of orienting the incoming officers. One of the project managers mentioned, “A lot of time and energy goes into esta blishing a working relationship but sometimes office transfers go to vain”. Page | 36 3. 4 .2 Nutrition Specific Safety Net Support Expected Result 2: Output 2 Results chain: Coordinated and resourced sub - national and local government structures recognize, respond and are accountable to demands of poor and marginalized communities Indicators: % of increase of PLW people from the target population received nutrition specific safety net support Definition Indicators: • Maternal allowance , 1000 days , Supplementary feeding , Maternal Health Voucher , Area based Community Nutrition Scheme , VGF , VGD , Iron folic acid supplementation Nilphamari Rangpur Overall Baseline 8.0% 9.2% 8.4% Annual Evaluation 2019 9.7% 10.7% 10.2% Annual Evaluation 2020 10.26% 11.11% 10.64% The study findings show that percentage of receiving nutrition specific safety net support (Maternal allowance, 1000 days, Supplementary feeding, Maternal Health Voucher, Area based Community Nutrition Scheme, VGF, VGD, Iron folic acid supplementation) is higher in second a nnual evaluation survey (10. 64 %) than first year annual evaluation study ( 10.2 %) among pregnant and lactating women (PLW) in both program districts. According to Health Assistant of Belagram, “The basic health services for pregnant women are immunization, distribution of folic acid, regular health check - up, weight check - up etc. For lactating mother, they have a separate breast - feeding corner in CC. Services includes here is counselling about th e importance of feeding breast milk, not to feed any other substance right after birth like honey or sugar etc. Adolescent services in CC includes counselling about menstruation, personal hygiene and knowledge about changing factors of their body. Also, th ey are provided IRON Tablets as it is very common to have iron deficiency at this age. Medicines (during menstruation) and immunization is also available for adolescents. PLW mainly received safety net support like maternal allo wance 3.3% (first evaluation 1.8%) , maternal health voucher 2.2% (first evaluation 2.9%) , 1000 days 2.2% (first evaluation 1.4%) , VGD 2.2% (first evaluation 1.4%) , etc. An improving trend identified except in the case of maternal health voucher scheme. A ccording to them allowances are allocated from UP, some of them get these supports but some of are not. Only relatives of chairman, member and other UP personnel get this opportunity. Some PLW co

50 mplained that those who can pay get the
mplained that those who can pay get the allowances. Every com munity clinic has their common drug like folic acid, iron tablet, calcium tablet but in limited quantity. PLW people mainly visit community clinic for regular health treatment, some of them visit the family planning center, private doctor, upazila health c omplex for better treatment. A SAAO mentioned, “we know and do many things on paper, but we have to make change practically”. Similarly, a UDCC member suggested the same, “poorer segment needs material support so that nutritional status is improved”. The refore, extending coverage of allowances would benefit the people to a larger extent. This does not really happen due to limitation of fund as different committee members have indicated. Page | 38 According to the FGD participants (head of the household s ) , the concept of pregnancy has been changed after involving with this JANO program as they have the scope to get any type of services from Community Clinic. In addition, they also mentioned allowance and medicines f or mothers received from CC. Few respondents even stated that they spent the allowance money for buying nutritious food. The respondents from Rangpur stated that they also get disabled allowance. The respondents from Nilphamari spent the allowance of preg nant women on their generating income. One of them bought cow by taking few amounts of money from the allowance. The other respondents shared that they discuss about their upcoming cultivation with known people at their local market. In addition, they obse rve the demand of the crops and vegetables. They also received support from agricultural and fisheries offices. “We talk to our elders and known vegetable sellers about the demand of vegetables such potato, cataract, corn etc. They also cultivate cauliflo wer, tomato, brinjal, chili, spinach etc. We also take support from our agriculture office as we are known to them.” - One participants from FGD with men from Rangpur. The participants from FGD ( Nilphamari ) also shared that they get the knowledge about usi ng technology, timeperiod and better ways for cultivation. 3. 4 .3 Meaningfully Participated of Women and Adolescent Girls in The Nutrition Action Plan Overall, 54% (Nilphamari 644%, Rangpur 45.5%) of women and adolescent girls of target population in government forums (UDCC, CG, CSG) meaningfully participated (Raise issue in the forum and incorporated raised issues in planning) in the nutrition action pl an development and implementation process. Expected Result 2: Output 2 Results chain: Coordinated and resourced sub - national and local government structures recognize, respond and are accounta

51 ble to demands of poor and marginalized
ble to demands of poor and marginalized communities Indicators: % of women and adolescent girls of target population in government forums (UDCC, CG, CSG) meaningfully participated in the nutrition action plan development and implementation process Definition Indicators: Meaningful Participation: • Raise issue in the forum • Incorporated raised issues in planning Nilphamari Rangpur Overall Baseline 0 0.6% 0.2% Annual Evaluation 2019 0.9% 0.0% 0.5% Annual Evaluation 2020 64.4% 45.5% 54.0% (Source: Overphone Survey with (UDCC, CG, CSG) members) FGD’s with adolescent revealed that they knew about the CG, CSG, Club for adolescent girls by which they get the knowledge about taking care of their health, nutritious foods, maintaining hygiene and many more like hand washing, taking services from Community clinic, stay clean during menstr uation. All of the respondents are involved with the adolescent girls’ club. They appreciated the services they received from this program not only from Community clinic but also from their school. They visit to the CC as they found it clean, its fresh env ironment and behavior of doctors and members. The “We get money for the pregnant women. We buy milk, banana, egg, fish with that money. We all know that we cannot expense too much for only food items. Through these services, we are really benefitted in case of taking nutritious food.” - One respondent from Nilphamari. Page | 39 respondents from Rangpur added that they also got the information from the adolescent girls’ club about the bad impact of child marriage. They also found that this program arranges meetings for the mothers for providing knowledge about good health, eating nutritious food, maintain hygiene. The participants also mentioned about the different types of govt. offices like health, agriculture and fisheries by where the community get services in their specific sector. In addition, they pointed about School Committee where the elders take action plan for their educational and nutritional development. According to CSG (from FGD), the women and adolescent members play in decision making process of the CSG in their health issues, hygiene practice during their menstrual time and important information about nutritious food for their health specially in menstruation and pregnancy. They added that they provide their level best and for this reason, they have not fou nd any complain on their quality of services. 3. 4 .4 Feedback Mechanisms According to the DNCC, they do not have any platform by which they can get feedbacks on the provided services to the service recipients. Also, UDCC from Kaunia me

52 ntioned that they don’t have any sepa
ntioned that they don’t have any separate platform for the service recipients yet. If they wis h, they can convey their message to Union Parishad Chairman. Expected Result 2: Output 2 Results chain: Coordinated and resourced sub - national and local government structures recognize, respond and are accountable to demands of poor and marginalized co mmunities Indicators: # of platforms in the target districts which allow effective feedback mechanisms for service receivers Definition Indicators: • Availability of a complain box/hot line number/or any other mechanism • Open complain box regularly for addressing in the monthly meeting. • Register all submitted complain • Public hearing meeting • Discussed in the regular meeting about the submitted complains. Nilphamari Rangpur Overall Baseline Nilphamari 0 Rangpur 0 0 Annual Evaluation 2019 Nilphamari 0 Rangpur 0 0 Annual Evaluation 2020 Nilphamari 1 Rangpur 1 64 Upazila and 208 CCs Overall, during the second annual evaluation 62.3% (Nilphamari: 56.4% and Rangpur 69.6%) HH reported that they did not know that they can complain against issue related to services of Social Safety Net, Health & Nutrition, Agriculture, Livestock/poultry and quality education. This increased from 51.4% duri ng the first annual evaluation. Further only 0.9% did complain to any office or committee during the past 12 months of second annual evaluation. The percentage of complain decreased from 1.9% (found during the first annual evaluation). I t is still a priori ty area that community people raise their issues in different platforms. One reason of not raising complaints is lack of responses, it was found that only 25% complaint received a response (a decrease from 33.3% found during the first annual study). In re sponse to the question, how do they receive and act upon service receivers’ feedback, response from a service was “There was no opportunity before but now there is. However, the reality is do not know much about nutrition so I am unable to say much”. Besid es, a UDCC member mentioned Page | 40 about existence of complain box. It appears though some mechanism is established both the service providers and service receivers need sensitization about effective feedback mechanism that would eventually enhance quality of the service. 3. 4 .5 Tripartite Agreement Expected Result 3: Output 3 Results chain: Production and access to high value nutritious commodities and services are increased Indicators: # of initiative jointly taken as a result of tripartite agreement. Definition Indicators: Tripartite initiative (Govt.+JANO+Private sector) will be taken

53 on agriculture, livestock, WASH, micron
on agriculture, livestock, WASH, micronutrient supplementation and financial inclusion as an outcome of tripartite MoU signing. Nilphamari Rangpur Overall Baseline 0 0 0 Annual Evaluation 2019 0 0 0 Annual Evaluation 2020 0 0 0 No tripartite agreement was signed or found in active in second annual ev a lu a tion study as during the first evaluation study . 3. 5 Food Security and Livelihood 3. 5 . 1 Households Practicing Climate Smart Agricultural Techniques According to the baseline study, a Climate Smart Agriculture (CSA) is considered as an agricultural method that sustainably increases productivity, enhances resilience (adaptation), reduces/removes GHGs (mitigation) where possible, and enhances achievement of national food security and development goals . Expected Result 3: Output 3 Results chain: Production and access to high value nutritious commodities and services are increased Indicators: % of households practicing climate smart agricultural techniques Definition Indicators: Minimum 3 techniques have to be used out of 20 criteria Nilphamari Rangpur Overall Baseline 3% 8% 5% Annual Evaluation 2019 4.7% 10.6% 8.3% Annual Evaluation 2020 7.3% 12.9% 9.4% Practicing and applying climate smart agricultural techniques has slightly increased in the second year annual evaluation study (Nilphamari 7.3%, Rangpur 12.9%, Overall 9.4%) A m inimum of 3 techniques were used out of 11 criteria than the first year annual survey in Nilphamari 4.7%, Rangpur 10.6%, Overall 8.3%). In the second year annual evaluation , it was found that 50% of the households do not apply any climate smart technologies which was lower than the first annual evaluation survey an d the baseline study. Notably , 50% of households used at least one climate smart technology in the second annual evaluation as compared to the first annual evaluation (33%) and the baseline study (25%). Page | 41 Figure 12: Percentage of households practicing climate smart agricultural techniques (Baseline and Annual evaluation) The f ollowing table shows the types of climate - resilient techniques used by households during the second annual evaluation. Out of twenty categories, 25.6% of respondents followed h igh efficiency fertilizer a pplication s , a total of 16.7% of respondents used disease - resistant varieties (blast) and 16.3% engaged in crop diversifi cation techniques. Table 6 : Practice of CSA Technologies (% HH) Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nil phamari Rangpur All Use of submer

54 gence - resistant varieties (BRRI 51,
gence - resistant varieties (BRRI 51, BRRI 52) 4.3% 7.7% 5.8% 15.3% 5.7% 10.9% Use of drought - resistant varieties 5.6% 9.2% 7.2% 14.4% 12.4% 13.5% Use of short duration varieties (BINA 7, BRRI 33, 43) 2.6% 10.7% 6.3% 9.7% 10.3% 10.0% Zinc Enriched variety of rice (BRRI Dhan 62, 72) 7.7% 7.1% 7.4% 3.8% 8.2% 5.8% Ribbon retting method .9% 9.7% 4.9% 1.3% 0.5% 0.9% High Yielding Variety (HYV) 2.1% 8.2% 4.9% 11.9% 10.3% 11.2% Growing creeping vegetables on nets over ponds 1.7% .5% 1.2% 5.1% 1.5% 3.5% Use of disease - resistant varieties (blast) 2.6% 8.2% 5.1% 15.3% 18.6% 16.7% Conservation agriculture (Zero/ Minimum tillage) 3.4% 1.9% 12.7% 10.3% 11.6% Alternative Wetting and drying (AWD) methods 1.7% 1.5% 1.6% 14.4% 4.6% 10.0% High efficiency fertilizer Application .9% 5.1% 2.8% 28.0% 22.7% 25.6% Crop diversification 4.3% 2.6% 3.5% 21.6% 9.8% 16.3% 74.1% 12.9% 8.0% 2.4% 1.4% 1.0% 0.2% 65.6% 17.7% 6.5% 4.4% 2.3% 2.1% 1.2% 0.2% 49.8% 9.8% 11.6% 8.4% 8.1% 8.8% 2.3% 1.2% None 1 Tech 2 Tech 3 Tech 4 Tech 5 Tech 6 Tech 7 Tech Baseline Annual Assessment 2019 Annual Assessment 2020 Page | 42 Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nil phamari Rangpur All N 234 196 430 236 194 430 3. 5 .2 Households Involved in The Production of Higher Value Nutrition Products Expected Result 3: Output 3 Results chain: Production and access to high value nutritious commodities and services are increased Indicators: % of households involved in the production of higher value nutrition products Definition Indicators: Higher value nutrition products: 1. Is bio - fortified 2. Is a legume, nut, or some seeds 3. Is an animal source food, including dairy products 4. Is a dark yellow or orange - fleshed root or tuber 5. Is a fruit or vegetable Nilphamari Rangpur Overall Baseline 34.5% 41.0% 36.7% Annual Evaluation 2019 32.9% 45.4% 38.6% Annual Evaluation 2020 35.6% 46.9% 40.7% The survey data depicts that among the respondents who were involved in the production of higher value nutrition products, household involvement was slightly higher in the second - year annual evaluation than baseline and first year evaluation studies . The findings in Table 7 shows that very few of f the target population cultivated crops and vegetables during the last 12 months. However, they cultivated b ottle gourd and b e an (26%), Indian S pinach and l alshak (14%), e ggplant and p umpkin (12%), potatoes ( 11%) mostly.

55 The f inding also show that only us
The f inding also show that only used homestead land mainly used for v egetable cultivation (40%), l ivestock (58%), p oultry (59%), p ond (13%), f ruit Trees (60%), t imber t rees (36%). Table 7: HH C rops and vegetables cultivation during last 12 months Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Sweet Potato 2.3% 0.0% 1.3% 11.1% 9.7% 10.5% Cauliflower 2.7% 0.0% 1.6% 8.1% 6.7% 7.4% Cabbage 2.3% 0.0% 1.3% 6.6% 4.8% 5.8% Okra 2.0% 1.8% 1.9% Raddish .9% .6% .8% 5.1% 1.8% 3.6% Tomato 2.7% .6% 1.8% 6.6% 12.1% 9.1% Bitter gourd 0.0% .6% .3% 7.1% 7.9% 7.4% Cucumber .9% .6% .8% 1.5% 1.2% 1.4% Eggplant 0.0% .6% .3% 10.6% 13.3% 11.8% Pointed gourd 0.5% 0.0% 0.3% Pumpkin 2.3% .6% 1.6% 15.2% 10.3% 12.9% Chili 1.8% 1.2% 1.6% 3.5% 3.6% 3.6% Nafa vegetables 2.0% 0.6% 1.4% Bottle gourd 4.6% 4.2% 4.4% 30.8% 20.0% 25.9% Tobacco .5% 6.6% 3.1% 3.5% 6.7% 5.0% Mustard 0.0% .6% .3% Potato 1.8% 9.6% 5.2% 12.1% 9.7% 11.0% Onion 1.4% 1.8% 1.6% 3.5% 0.6% 2.2% Page | 43 Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Garlic .5% 1.8% 1.0% 2.5% 0.6% 1.7% Pulses .5% 0.0% .3% Ginger .5% .6% .5% 0.5% 0.6% 0.6% Bean 2.7% 7.8% 4.9% 30.3% 20.6% 25.9% Carrot 0.5% 0.0% 0.3% Palong shak 2.7% 2.4% 2.6% 10.1% 6.1% 8.3% Napa vegetables 1.8% 3.0% 2.3% 12.6% 3.6% 8.5% Lalshak 1.8% 4.8% 3.1% 18.2% 8.5% 13.8% String Bean 0.0% 1.8% .8% 1.5% 1.8% 1.7% Snake gourd .5% 2.4% 1.3% 1.0% 0.6% 0.8% White gourd 0.0% .6% .3% 1.0% 0.0% 0.6% Wax gourd .5% 4.2% 2.1% 3.0% 3.6% 3.3% Indian Spinach .9% 4.8% 2.6% 19.2% 8.5% 14.3% Kang Kong 0.0% 2.4% 1.0% 4.0% 1.8% 3.0% Papaya 0.0% 2.4% 1.0% 1.5% 1.2% 1.4% Not Cultivated 79.0% 71.3% 75.6% 42.9% 53.9% 47.9% N 219 167 386 198 165 363 Fo r cultivating vegetables, participants used the pit/hip method and plain method s . Most of them use d following practices (compost and biogas production, livestock fattening, fodder production, artificial insemination, vaccination, de - worming, disease management, recommended feeding practices, improved housing) for the ir livestock/poultry during the past 12 months. Table 8: Ways of vegetables cultivation Response Annual Assessm

56 ent 2019 Annual Assessment 2020 Nilp
ent 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Pit /Hip method 38.6% 67.4% 52.9% 77.3% 82.0% 78.9% Bed method 13.6% 2.3% 8.0% 10.9% 9.8% 10.5% Plain method 47.7% 30.2% 39.1% 38.2% 31.1% 35.7% N 44 43 87 110 61 171 3. 6 Access to Information, Information and Communication Technology (ICT) Platform 3.6.1 Access to information This second annual evaluation study intends to reveal the gender differences in many areas emphasizing on nutrition, where access to information is also an indicator that is connected to health, hygiene, nutrition and other services. A toal of 5 5 % women own mobile phone s com pared to 8 9 % of men. However, there is no separate data on how many women or men know about the services they can avail through smart technology, although the combined percentage is 61 % who have some idea of the se services. Married adolescents girls (from FGD) mentioned that most of the male members of households use mobile phone rather the female ones. In addition, health app would be effective for them. The other respondent from Rangpur added that they would get the information through text m essages on the mobile phone. Page | 44 “Through mobile phone, we get the information about nutritious food for health, what should be done when we become sick and where would we get the treatment for this illness.” - One married adolescent from Rangpur Also lactating mother s are very interested to receive the information through text messages. They did not receive this information over mobile phone during this COVID - 19 as they could not be outside with their children. Table 9 : Awareness About Getting Information Related to Agriculture, Health & Nutrition Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Self - Knowledge Yes 49.6% 42.9% 46.5% 56.8% 66.5% 61.2% No 50.4% 57.1% 53.5% 43.2% 33.5% 38.8% N 234 196 430 236 194 430 HH members knowledge Yes 47.9% 39.3% 44.0% 44.5% 60.3% 51.6% No 22.6% 13.8% 18.6% 25.0% 12.4% 19.3% Don’t know 29.5% 46.9% 37.4% 30.5% 27.3% 29.1% N 234 196 430 236 194 430 Types of Information household received during last 12 months Agriculture 38.6% 14.8% 28.8% 30.9% 27.1% 29.1% Livestock 2.4% 1.1% 1.9% 5.1% 3.9% 4.5% Health 66.1% 61.4% 64.2% 79.4% 67.4% 73.6% Nutrition 11.8% 18.2% 14.4% 14.0% 16.3% 15.1% Information on feeding infants 29.9% 9.1% 2

57 1.4% 10.3% 4.7% 7.5% Don't know
1.4% 10.3% 4.7% 7.5% Don't know 21.3% 34.1% 26.5% 14.7% 20.9% 17.7% N 127 88 215 136 129 265 Information related to health: A total of 72% women of Nilphamari and 62% women of Rangpur have received knowledge ab out feeding infants during the last 12 months. Meanwhile, 69.3% women (total 430 women) have received information on feeding children under 5 during the last 12 months. In both cases, Nilphamari is in a better position to provide information; ho wever, the overall rate is still poor to ensure children’s improvied health. To improve the ir health, hygiene and nutrition, so far NGO health workers have contributed the most as 40.5% households are visited by NGO health workers in both districts. Tabl e 1 0 : Women or HH Received Information Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Whether women of HH received information on feeding infants during last 12 months Yes 32.1% 16.8% 25.1% 72.9% 61.9% 67.9% No 67.9% 83.2% 74.9% 27.1% 38.1% 32.1% N 234 196 430 236 194 430 Whether any women of HH received information on feeding of children under 5 years during last 12 months Yes 41.9% 20.9% 32.3% 73.7% 63.9% 69.3% No 58.1% 79.1% 67.7% 26.3% 36.1% 30.7% N 234 196 430 236 194 430 Whether you or any household member access any service from UP information Centre during last 12 months Yes 29.5% 14.8% 22.8% 33.5% 21.1% 27.9% No 47.4% 54.1% 50.5% 56.4% 64.9% 60.2% Don't know 23.1% 31.1% 26.7% 10.2% 13.9% 11.9% Page | 45 N 234 196 430 236 194 430 Extension services: This project has greater scope to focus on extension services as the extent of providing extension services is very low in both districts. Livestock/Poultry extension services mostly given by DLS, NGOs , Private sector/business organization and LSP . They a dvise on Input use, disease management, vaccinations, feed, artificial insemination etc. I n addition, people hardly visit Upazila Veterinary hospital to ask for services. Only 2.6% people (N 430) went to veterinary hospital during last 12 months. Many of them think it is not necessary to avail the service – 85% in Nilphamari and 86% in Rangpur. However, almost 82% visit to hospital was for treatment. It is to be noted that 9% visit was to get vaccination and extension service. Table 1 1 : Types of agricul tural extension service HH received during the last 12 months Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Adv

58 ice on input use 3.4% .5% 2.1% 5
ice on input use 3.4% .5% 2.1% 5.1% 2.1% 3.7% Training 3.8% .5% 2.3% 2.5% 3.1% 2.8% Practical Demonstration .9% .5% .7% Application of Input (Fertilizer, Pesticide, Fungicide, Herbicide) 0.0% 1.0% .5% 4.2% 1.0% 2.8% Disease and pest control 0.0% 1.5% .7% 4.7% 1.5% 3.3% Irrigation management 3.0% 2.6% 2.8% Introduce new variety .9% .5% .7% 2.5% 1.5% 2.1% Crop harvest technique 0.4% 1.5% 0.9% Soil Test 1.7% 1.0% 1.4% Post - harvest management 1.7% .5% 1.2% 1.7% 1.0% 1.4% No service received 89.7% 95.9% 92.6% 91.1% 91.2% 91.2% N 234 196 430 236 194 430 Agricultural extension service is mostly given by DAEs, NGOs and Private sector/business organization. They advise on ‘ Advice on input use ’, ‘Application of Input (Fertilizer, Pesticide, Fungicide, Herbicide)’, ‘Disease and pest control’, ‘Irrigation management’ and ‘ Introduce new variety’. Table 1 2 : Sources Service Providers : Agricultural Extension Service Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All DAE 16.7% 62.5% 28.1% 47.6% 47.1% 47.4% NGOs 75.0% 37.5% 65.6% 19.0% 29.4% 23.7% Private sector/business organization 8.3% 0.0% 6.3% 33.3% 23.5% 28.9% N 24 8 32 21 17 38 The reasons behind no using various agricultural extension services were: shortage of extension worker, extension workers did not visit regularly, extension center was far away, poor communication, financial problem, quality of extension services is very poor and Family member does not allow women to contract with Extension service. Table 1 3 : Whether A ccess A gricultural E xtension S ervices when n eeded over the last six months Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Yes 2.1% 1.2% 2.5% 2.6% 2.6% No 67.9% 59.2% 64.0% 82.6% 78.4% 80.7% Page | 46 Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Don’t know 29.9% 40.8% 34.9% 14.8% 19.1% 16.7% N 234 196 430 236 194 430 3. 6 . 2 Accessed or Received ICT Based Nutritional Information Expected Result 4: Output 4 Results chain: Information and communication technology (ICT) platform is established at local level to connect relevant govt. departments and increase awareness of community people on nutrition interventions’ Indicators: % of community members who have accessed or receiv

59 ed ICT based nutritional information
ed ICT based nutritional information Definition Indicators: community members will have access nutritional information from the mobile based learning apps and receive text messages Male Female Nilphamari Rangpur Overall Baseline 4.1% 8.3% 2.4% 7.8% 4.2% Annual Evaluation 2019 5.3% 4.7% 6.4% 8.2% 7.2% (% of community member received text messages on nutrition. No learning apps found) Annual Evaluation 2020 9.7% 10.5% 8.1% 10.8% 9.3% 7.2 % households in first annual evaluation study, 6 .4% in Nilphamari and 8.2 % in Rangpur accessed or received nutritional information from mobile based learning apps. While, overall, 9.3 % households in second annual evaluation study received text messages on nutrition, no portal has made yet. From a FGD discussion with adolescent found that they watch videos on YouTube about nutrition and hygiene. They suggested for providing health, nutrition and hygiene related information through text messages along with courtyard meeting with projectors as community people learn any kind of issues through any kind of meetings. They felt that it is an easy way for community people to get the knowledge about health, nutrition and hygiene. On the other hand, respondents from Nilphamari specified that mothers of adolescent girls should get the information from these kinds of projects. A pregnant mother from Rangpur pointed that receiving knowledge about health, nutrition and hygiene through mobile phone would be easier for community people. Additionally, she suggested for providing knowledge to the husbands so that they could motivate th eir spouses. However, pregnant mother from Nilphamari pointed that as everybody do not have mobile access, they would never get information through text messages. In addition, pregnant mother from Domar stated that mass people could not read the texts. They can also get the information through courtyard meeting. “We do not have mobile phone for every person in our house. Only my husband has one phone. If anyone gives information about healt h, nutrition and hygiene, I would never get that as my husband stays outside for his work. It would be better if we get these types of information from courtyard meeting.” - One Pregnant mother, Nilphamari “It would be easier if we get phone calls for fr ee from Govt. to get the information about health, nutrition and hygiene.” - One pregnant woman from Rangpur Page | 47 3. 6 . 3 Mobile Based Learning App are Used by Frontline Workers Expected Result 4: Output 4 Results chain: Information and communication technology (ICT) platform is established at local level to connect re

60 levant govt. departments and increase aw
levant govt. departments and increase awareness of community people on nutrition interventions’ Indicators: % of frontline workers using the ICT based e - learning platform to support the community based on needs Definition Indicators: Mobile based learning app are used by frontline workers Nilphamari Rangpur Overall Baseline 0% Frontline workers Annual Evaluation 2019 Monitoring reports Annual Evaluation 2020 0 The study found no ICT based e - learning platforms to support community - based needs were being used by frontline workers and no portal s have been established for planning and decision - making at district and upazila level s eiher . Expected Result 4: Output 4 Results chain: Information and communication technology (ICT) platform is established at local level to connect relevant govt. departments and increase awareness of community people on nutrition interventions’ Indicators: # of government forums (UNCC, DNCC,) utilizing Nutrition Information Portal for planning and decision making at district and upazila level Definition Indicators: One web - based platform established Nilphamari Rangpur Overall Baseline There is no Nutrition Information Portal for planning and decision making at district and upazila level (February - 19) Annual Evaluation 2019 0 Annual Evaluation 2020 0 A n FGD was conducted among male household heads . They recommended providing information about health, nutrition and hygiene through TV or courtyard meeting s as the female members of their household would not get enough time to check mobile phone texts. Additionally, the re spondents from Rangpur recommended providing more information about women and adolescent health along with nutritious food and taking necessary steps during menstruation through text messages. The pregnant women (from FGDs pointed out that receiving knowledge about health, nutrition and hygiene through mobile phone s would be easier for community people. However, respondent s from Nilphamari stated that as nobody hsa mobile phone access, they would never receive information through text messages. However, they can also receive this information through cour tyard meeting s . “We do not have mobile phone for every person in our house. Only my husband has one phone. If anyone gives information about health, nutrition and hygiene, I would never get that as my husband stays outside for his work. It would be better if we get these types of information from courtyard meeting.” - One Pregnant mother, Nilphamari Page | 48 3.7 WATSAN & Hygiene Practice Accesss to s afe drinking water is a human ri

61 ght and a basic requirement for good hea
ght and a basic requirement for good health (Multiple Indicator Cluster Survey 2012 - 2013). This following section describes the situation of Safe water including drinking water sources , safely managed drinking water, safely managed sanitation, water treatment, type of sanitation facility, hand - washing practices and waste management. 3.7.1 Safe Drinking water According to the JANO baseline report safe drinking water means: water sources considered as being safely managed in cluding tube - wells, dw ellings with piped water, yard/ lot piped water, public taps, protected wells and pond sand filters. In the annual evaluation, it was found that the main drinking w ater source of the household were tube wells and few of them used piped connections into a dwelling. Usually , water is collected by adult women (20 years and above) and the household build s it on its own . They had received awareness related ser vices concerning hygiene - safe water practices from NGO s and Community Clinic s and health - related services such as arsenic testing including know ledge on the recommended depth of tube well s . Table 1 4 : Sources of Drinking Water Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Source of Drinking Water Tube - well 98.7% 94.4% 96.7% 99.2% 96.4% 97.9% Piped into dwelling 1.3% 5.6% 3.3% 0.8% 3.6% 2.1% Place of drinking water source Own Homestead Area 98.7% 87.2% 93.5% 99.6% 99.0% 99.3% Neighbors .4% 1.0% .7% 0.4% 1.0% 0.7% Common place .9% 11.7% 5.8% 0.0% 0.0% 0.0% N 234 196 430 236 194 430 The FGD s conducted with these groups explored that adolescents in both Rangpur and Nilphamari who shared that they always drink safe water from tube - well s . Specifically, the adolescent girls in Nilphamari stated that the so urce of their drinking water are tube - well s though they use water from direct line s for cooking. On the other hand, participants from Rangpur stated that drinking safe water keeps the body healthy. They also pointed out that brining water from far away is very difficult as it takes a lot of time an d requires great effort from women and girls. “We s hould drink safe water. We learned it from our school. If our drinking water is pure, we can prevent the waterborne diseases.” - One adolescent girl, FGD, Rangpur Also, pregnant women mentioned from the IDIs that they Both respondents have tube - well in their own house. The respondents men tioned that government . officer s checked their tu be - wells and marked them arsenic - free.

62 One of them from Rangpur mentioned that
One of them from Rangpur mentioned that t hey also drink water from motorized machine s . In contrast, respondent s from Nilphamari mentioned that they had extreme iron but now they receive safe water supplies . One of them also mentioned that they too drink water from motorized machine s . . Page | 49 Table 1 5 : Person/ORG provided awareness services related to hygiene - safe water practices Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All DPHE 28.2% 6.1% 18.1% 10.2% 8.8% 9.5% UP 9.4% 5.1% 7.4% 13.1% 6.2% 10.0% NGO 15.8% 16.8% 16.3% 50.0% 46.9% 48.6% Community Clinic 18.8% 20.4% 19.5% 43.6% 26.3% 35.8% Did not received 17.5% 45.9% 30.5% 16.1% 26.8% 20.9% JANO 0.0% 0.0% 0.0% 15.3% 6.2% 11.2% Don’t know 17.1% 19.4% 18.1% 3.4% 5.2% 4.2% N 234 196 430 236 194 430 According to all lactating mother s , most of the people in their communities have tube - well s in their house as they are conscious about drinking safe water. One mother from Rangpur mentioned that they drink water from motor ised machine s . They also use water from tube - well s for daily household activities. They too a mentioned that government officer s had checked their tube - well s and marked them arsenic - free. In contrast, respondent s from Nilphamari mentioned that they had extreme iron but now they receive safe water supplies . Table 1 6 : Types of services Received Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Recommended depth of tube well 24.9% 2.8% 17.1% 20.7% 17.6% 19.4% Arsenic testing 26.9% 7.5% 20.1% 18.2% 30.3% 23.2% Coliform testing 0.0% 0.0% 0.0% 2.5% 4.9% 3.5% Distance maintaining with latrine 6.2% 3.8% 5.4% 31.8% 28.2% 30.3% Health related service 30.1% 49.1% 36.8% 74.7% 65.5% 70.9% Didn't receive any service 11.9% 36.8% 20.7% 2.0% 6.3% 3.8% N 193 106 299 198 142 340 3.7.2 Types of Latrine Flush to septic tank s (40. 2%) was commonly used by both households of Nilphamari and Rangpur districts in the second annual evaluation. They also use “Pit latrine s with slab/ (water sealed intact)” (26%), “Flush to piped sewer syste m” (14.4%) and Flush to pit latrine (13.3%) Regardi ng hygiene practices , 99.3% family members notably use sandals w hile using latrine. A slightly lower percentage of households in the annual evaluation ( 1.9 %) reported that they followed open defecation sys te

63 m s as compared to the first annual e
m s as compared to the first annual evaluation ( 6.3%) and the baseline surveys (8%). The FGD participants with men found that they have knowledge about sanitary latrine s , hygiene, and nutritious food through several courtyard meetings. This group also shared that they did not have sanitary latrine s but they all have it in the present - day including soap, wat er and bleaching powder in their current latrines . The participants stated that they share this information with their family member s as they l earnt those ideas from their communtieis . In addition, they received the service from the pr oject organized by JANO by attending courtyard meetings. Participants from Nilphamari pointed out that people are now more conscious about hygiene because of COVID - 19. On the other hand, the participants from Rangpur stated that they received BDT 1 50 from BRAC for the purpose of making modern sanitary latrine s . A dolescent girls from the FGDs specifie d that they have knowledge about sanitary latrine. They added that they have soap and water in front of their toilet s . The respondent from Rangpur pointed out that Page | 50 “We need to keep our toilet clean. We should wear sandals during entering the toilet. We h ave Harpic for cleaning our toilet. Through this, we always try to maintain our hygiene in sanitation.” - One adolescent girl, FGD, Nilphamari According t o a pregnant woman from Rangpur, their modern latrines are hygienic as they always keep those clean. She marked that they always have tissue, bleaching powder and a commode - brush for their latrine. In contrast, respondent s from Nilphamari mentioned that they do not have hygienic latrine s as it is surrounded by tin - shed s . B oth groups have knowledge about washing hands with soap and water. They even pointed that mothers should wash their hands properly as they need to feed their child ren . During interviews with mother s , they specified that they always keep their latrine s clean. They added that they use sandals for using latrine s. Due to this COVID - 19 pandemic, they are now more conscious about cleanliness such as washing hands with soap for 20 seconds. they do not forget to wash their hands before touching t heir children or feeding them. Table 1 7 : Types of Latrine used by HH Response Baseline Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All Flush to piped sewer system 0.4% 16.2% 3.1% 10.2% 11.4% 18.0% 14.4% Flush to septic tank 8.8% 20.9% 38.8% 29.1% 38.6% 42.3% 40.2% Flush to pit latrine 16.5% 50.0% 33.7% 42.6% 15.

64 7% 10.3% 13.3% Flush to somewhere
7% 10.3% 13.3% Flush to somewhere else 0.4% 0.9% 0.5% 0.7% 0.8% 1.0% 0.9% Flush, don’t know where 0 0.4% 0.5% 0.5% 0.0% 0.0% 0.0% Ventilated improved pit latrine 0.4% 2.1% 1.5% 1.9% 0.8% 0.5% 0.7% Pit latrine with slab/ (water sealed intact) 32.7% 0.9% 15.3% 7.4% 28.4% 23.2% 26.0% Pit latrine without slab/open pit (water sealed broken) 26.7% 0.4% 1.0% 0.7% 1.7% 2.6% 2.1% Open defecation/ No toilet facility/bush/field 7.8% 7.7% 4.6% 6.3% 2.5% 1.0% 1.9% Advanced offset pit closet 1.6% .4% 0.0% .2% 0.0% 0.5% 0.2% offset pit closet 3.4% 0.0% .5% .2% 0.0% 0.0% 0.0% Refused to observed toilet 0 0.0% .5% .2% 0.0% 0.5% 0.2% N 234 196 430 236 194 430 3.7.3 Hand Washing Practices During the second annual evaluation, nearly 43% ( 59% , in first evaluation ) of the household members mentio ned that they have water facilities and 53% (60%, in the first evaluation) of the household members have soap/detergent available near the ir latrines for washing hands. Hand - washing practice s with water and soap before eating is well maintained by adult males ( 98 %) , adult females (96%) , boys (23%) and girls (34%) . “There is a link between washing hands and eating nutritious food. If we eat nutritious food but do not wash hands, germs would affect our stomach. We need to maintain the hygiene also, otherwise nutrition would never keep our body healthy.” - One pregnant woman from Gangachara, Rangpur. Page | 51 Table 18 : Person p rovided awareness services related to hygiene - sanitation practices Response Annual Assessment 2019 Annual Assessment 2020 Nilphamari Rangpur All Nilphamari Rangpur All DPHE 2.6% 2.6% 2.6% 0.0% 0.5% 0.2% UP 12.0% 5.6% 9.1% 13.1% 9.3% 11.4% NGO 27.4% 24.5% 26.0% 55.1% 53.1% 54.2% Community Clinic 26.9% 25.0% 26.0% 46.6% 26.8% 37.7% None 38.0% 53.1% 44.9% 17.8% 27.3% 22.1% JANO 0.0% 0.0% 0.0% 12.7% 6.7% 10.0% N 234 196 430 236 194 430 Survey results show that NGO s and CC provided awareness services related to hygiene - sanitation practices (e.g. hand washing, use of hygienic latrines etc.). However, 22% of the HH reported that they didn’t get any on the same. In baseline HH members reported that water facility is not near to the latrines for washing hands (87.5%), soap/detergent not available near to the water for washing hands (83.3%). Table 19 : Hand Washing Practices Response Annual Assessment 2019 Annual Assessment 2020 Nilphamar

65 i Rangpur All Nilphamari Rangpur
i Rangpur All Nilphamari Rangpur All Before food preparation ((Use of materials) 97.0% 81.6% 90.0% 95.8% 92.8% 94.4% Before eating 97.4% 94.9% 96.3% 98.7% 100.0% 99.3% Before feeding of Children 89.3% 91.8% 90.5% 89.4% 91.8% 90.5% After defecation 95.7% 98.5% 97.0% 98.7% 96.9% 97.9% After cleaning baby’s defecation 88.9% 90.8% 89.8% 88.6% 89.7% 89.1% N 234 196 430 236 194 430 They wash their hands before food preparation (94%), before eating (99%), bef ore feeding their children (91%), after defecation (98%) and af ter cleaning their baby’s defecation (89%). They usually use soap and water for cleaning hands. The frequency of hand - washing practice among adult males and f emales (20 years and above) was found to be higher than respective ho useho lds. The incidence of hand - washing was found to be higher in this annual evaluation survey than the baseline survey. FGD with newly married adolescent mentioned that they live in their in - law’s house and the source of drinking water is safe as the tube - w ell is arsenic free. One of them specified that she saw when the water of tube - well has checked. “We get safe water but not all the tube - well in this area is safe for drinking. Out of 10 tube - wells, 3 or 4 tube - wells would be found unhygienic.” One participant specified that women face problems of back and hand pain for using tube - wells. The respondent claimed that it is difficult for the adolescent girl to take water from far away as they have to maintain a line and need some time for that. The adolescent married girls specified that they use modern toilet which is surrounded by tin and have soap and water in front of the toilet. Page | 52 3. 8 . Outcome of Covid - 19 Response and Impact of Covid - 19 On JANO 3. 8 .1 Knowledge about Covid - 19 All the respondents from both Rangpu r and Nilphamari have heard about COVID - 19. Approximate 90% of respondents in Nilphamari heard about this pandemic through JANO Volunteer s and while69.1% respondents in Rangpur heard about the same from volunteers . Alternatively, over 50% received this source of information through miking, media and by receiving information from the community. other Table 2 0 : Source of hearing about COVID - 19 Response Nilphamari Rangpur All JANO Volunteer 90.7% 69.1% 80.9% Miking 70.3% 58.8% 65.1% Media (Facebook/Radio/TV) 65.3% 58.8% 62.3% from community people 58.5% 63.9% 60.9% Mosque 28.0% 36.1% 31.6% Courtyard meeting 34.7% 17.5% 27.0% Newspaper/Magazine 19.5% 26.3% 22.6%

66 Leaflet 23.3% 11.9% 18.1% Commu
Leaflet 23.3% 11.9% 18.1% Community Clinic/FWC (Through the service provider) 14.8% 9.8% 12.6% Poster 11.9% 12.9% 12.3% CSG Members 9.7% 3.6% 7.0% N 236 194 430 More than half of the respondents mentioned that people would get infected by COVID - 19 if they came from abroad. Approximately, r 30 - 45% of respondents in both Nilphamari and Rangpur stated that everyone can get infected ( 41.2% participants) by going outdoors ( 39.3% participants ) and not wash ing their hands with soap (38.4% participants ). Table 2 1 : Perception about the ways of attack by COVID - 19 Response Nilphamari Rangpur All Those who come from abroad 56.4% 55.2% 55.8% Those who were close to the effected patients 46.6% 51.0% 48.6% Everyone can get attacked 39.0% 43.8% 41.2% Those who are going outside 36.0% 43.3% 39.3% Those who do not wash hands with soap 41.1% 35.1% 38.4% Child & oldest 10.6% 5.7% 8.4% N 236 194 430 More than 90% respondents shared that people should wash their hands with soap frequently and wear masks. Half of the respondents mentioned maintaining social distance an d eating nutritious food, drinking water and other liquids. Table 2 2 : Steps should be taken to stay away from COVID - 19 Response Nilphamari Rangpur All Wash hands with soap frequently 99.2% 98.5% 98.8% Wear Masks 93.2% 93.3% 93.3% Maintain social distance 53.0% 58.2% 55.3% Eat nutritious food, drink lots of water and take liquids 50.8% 45.4% 48.4% Make the hands disinfected by washing hands with sanitizer 45.3% 42.8% 44.2% Keep distance from the effected people 44.5% 40.7% 42.8% N 236 194 430 Page | 53 Nearly 90% respondents recommended taking treatment if anyone w ere to get affect by COVID - 19. In addition, they marked that people should stay alone at their home for this disease. Below 10% mentioned that police would take the patients and keep the news secret. Table 2 3 : Steps to take if anyone affected by COVID - 19 Response Nilphamari Rangpur All Take treatment 88.1% 88.7% 88.4% Stay home alone 65.7% 64.4% 65.1% To call the govt. number 22.9% 20.1% 21.6% Police would take the patients 12.7% 5.7% 9.5% Keep it secret 6.8% 8.2% 7.4% N 236 194 430 3. 8 .2 Outcome of C ovid - 19 response According to approximately 67% of respondents, they received services/relief during COVID - 19 like knowledge about this virus, hygiene kit and financial support as well. Most of them (86.8%) got the information about idea and knowledge about COVID - 19. Around 50% rec

67 eived advices and learnt how to wash ha
eived advices and learnt how to wash hands and use masks in a perfect way. Table 2 4 : Received any service/relief during COVID - 19 Response Nilphamari Rangpur All Yes 75.0% 57.2% 67.0% No 25.0% 42.8% 33.0% N 236 194 430 Type of services received for COVID - 19 Idea and knowledge about COVID - 19 89.3% 82.9% 86.8% Advices 64.4% 42.3% 55.9% learnt how to wash hands in a perfect way 65.5% 35.1% 53.8% learnt how to wear mask in a perfect way 61.0% 34.2% 50.7% Information about nutrition 25.4% 22.5% 24.3% Any kit for safety from COVID - 19 (Mask, Gloves, Hand Sanitizer, soap) 21.5% 21.6% 21.5% Food 2.3% 11.7% 5.9% Trainings 6.2% 1.8% 4.5% Financial Support 3.4% 5.4% 4.2% Medicine 1.7% 3.6% 2.4% N 177 111 288 Above 90% respondent received the information about COVID - 19 from JANO Volunteer. Very few of them mentioned that the source of getting knowledge about COVID - 19 is community people (34.7%), Community clinic (22.6%), CSG members (10.4%) and Government (7.3% ). The percentage of getting the news from NGOs is negligible. Table 2 5 : Source of this support and information Response Nilphamari Rangpur All JANO Volunteer 96.0% 83.8% 91.3% From the community people 37.9% 29.7% 34.7% Community Clinic/FWC (Through the service provider) 26.6% 16.2% 22.6% CSG Members 13.6% 5.4% 10.4% Govt. support 7.9% 6.3% 7.3% NGO 0.0% 2.7% 1.0% N 177 111 288 Page | 54 According to the respondents, they received support from JANO Volunteers for COVID - 19. Above 50% of them got support about the learning of washing j \ hands and wearing masks perfectly. More than 20% of them stated that they also received hygiene kit like mask, gloves, hand sanitizer and soap from JANO. Table 2 6 : Support from JANO/JANO Volunteer (infor mation about COVID - 19/Hygiene Kit) Response Nilphamari Rangpur All Idea and knowledge about COVID - 19 85.3% 83.9% 84.8% learnt how to wash hands in a perfect way 68.8% 41.9% 59.3% learnt how to wear mask in a perfect way 62.9% 46.2% 57.0% Advices 62.4% 37.6% 53.6% Any kit for safety from COVID - 19 (Mask, Gloves, Hand Sanitizer, soap) 24.1% 23.7% 24.0% Information about nutrition 22.9% 19.4% 21.7% Give information by miking 18.8% 6.5% 14.4% Leaflet/promotion form 5.9% 1.1% 4.2% Medicine 2.4% 6.5% 3.8% Trainings 3.5% 3.2% 3.4% N 170 93 263 The average number of visits or contact with JANO Volunteers from March to September is 7. More than 50% specified that their family members received support

68 and information from JANO. Around 34%
and information from JANO. Around 34% lactating mother and 28.9% pregnant women also received the support from JANO. Table 27 : Persons who received support and information from JANO Response Nilphamari Rangpur All Average number of visits or contacts of JANO Volunteers (March to September) 8 6 7 N 170 93 263 All family members 51.2% 57.0% 53.2% Lactating mother 39.4% 25.8% 34.6% pregnant women 32.4% 22.6% 28.9% Adult men 18.2% 14.0% 16.7% Mother of child aged under 5 (Who do not take breast milk) 17.6% 7.5% 14.1% Adolescents 14.7% 6.5% 11.8% Children aged under 5 11.8% 4.3% 9.1% N 170 93 263 The respondents mentioned they appreciated the way they received support from JANO for COVID - 19. Around 27% stated that their family members are healthy and they become more aware about this virus. Table 28 : Benefits by taking support and information Response Nilphamari Rangpur All Everyone is healthy still now 26.0% 30.6% 27.8% Became more aware 27.7% 26.1% 27.1% Learned a lot 10.7% 8.1% 9.7% Was able to stay clean 7.9% 8.1% 8.0% Increased knowledge about health 5.6% 6.3% 5.9% Enhance carefulness 6.2% 2.7% 4.9% Learned about Corona 5.1% 2.7% 4.2% learned about the correct rules 3.4% 5.4% 4.2% Was able to live a normal life 1.7% 3.6% 2.4% Food shortages have been reduced .6% 3.6% 1.7% Page | 55 Response Nilphamari Rangpur All Got advice 2.8% 0.0% 1.7% Financial crisis has subsided 1.1% 1.8% 1.4% Protected from the virus .6% .9% .7% No problem .6% 0.0% .3% N 177 111 288 Not only about COVID - 19 information, the respondents mentioned that they also received knowledge about nutrition related to COVID - 19. They are using the information everywhere. More than 25% share the information with their family. In Rangpur, people share the information in outside rather in Nilphamari. Table 29 : Usage of the information or knowledge or information relate d to nutrition about COVID - 19 Response Nilphamari Rangpur All Everywhere 34.5% 23.4% 30.2% With family 30.5% 21.6% 27.1% At home 27.1% 26.1% 26.7% At outside .6% 11.7% 4.9% To stay healthy 3.4% 1.8% 2.8% With neighbors 1.1% 5.4% 2.8% Nearby .6% 3.6% 1.7% At work 0.0% 2.7% 1.0% From JANO 0.0% 2.7% 1.0% In cooking 1.1% .9% 1.0% In eating 1.1% 0.0% .7% N 177 111 288 Figure 13 reflects that m ore than half of the participants were satisfied after receiving support from JANO volunteer s about COVID - 19. The percen

69 tage of respondents who are very satisfi
tage of respondents who are very satisfied are from Nilphamari (31%) as opposed to Rangpur (12.8%). The percentage of dissatisf ied participants is 16.5%. Figure 13 : Satisfaction level after receiving support from JANO Volunteer (Information or knowledge or Instruments/Hygiene kit) Nearly 45% participants satisfied as they received information messages about nutrition related to this pandemic. More than 25% respondents are very satisfied whether the percentage of di ssatisfaction is 26.3%. 13.5% 55.5% 31.0% 20.9% 2.3% 64.0% 12.8% 16.2% .8% 58.5% 24.5% Very dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied Nilphamari Rangpur All Page | 56 Figure 14 : Satisfaction level after receiving information or messages about nutrition Out of 142 r espondents, half of them claimed that no one helped them during this COVID - 19. Nearly 30% participants mentioned that no one visited to their house for providing any kind of support. Only 6.3% respondents stated that they felt no need of this support. Table 3 0 : Cause s of not getting support Response Nilphamari Rangpur All No one helped 59.3% 50.6% 54.2% No one came 27.1% 31.3% 29.6% Don't know 10.2% 9.6% 9.9% There was no need 3.4% 8.4% 6.3% N 59 83 142 3. 8 .3 Hygiene Practices Around 90% respondents stated that they wash their hands for 20 seconds with soap frequently because of hygiene practice. Half of them marked that they use hand sanitizer outside and coming back to home. Almost all the participants have soap or hand saniti zer in their home. Table 3 1 : Types of hygiene practice Response Nilphamari Rangpur All Wash hands with soap frequently for 20 seconds 94.1% 87.1% 90.9% Use hand sanitizer outside 57.6% 57.7% 57.7% Use other things for hand wash 55.1% 59.3% 57.0% Use hand sanitizer after coming from outside 52.5% 53.6% 53.0% Keep house and latrine clean by using Bleaching powder/detergent 27.1% 25.8% 26.5% Maintain the hygiene during cold or cough 17.4% 8.2% 13.3% Used a mask 8.9% 5.2% 7.2% do not wash hands 2.1% 3.1% 2.6% Do not have soap or hand sanitizer .4% 1.5% .9% N 236 194 430 More than 95% respondents agreed that they use mask when they go outside. Only 0.9% use mask all the time. However, the percentage of not using mask is very tiny (1.4%). 30.8% 0.0% 43.6% 25.6% 16.7% 5.6% 44.4% 33.3% 26.3% 1.8% 43.9% 28.1% Very dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied Nilphamari Rangpur All Page | 57 Table 3 2 : Whether use mask or not Response Nilphamari Rangpur All Yes, only in

70 outside 98.3% 96.9% 97.7% No, d
outside 98.3% 96.9% 97.7% No, do not use mask 1.3% 1.5% 1.4% Yes, all the time .4% 1.5% .9% N 236 194 430 Almost all the participants wash their hands after using bathroom, before and after cooking and eating. Only 26.5% respondents mentioned that they wash their hands after touching anything. They are also conscious about preparing food for children as they (71.2%) wash their hands before and after the work. Table 3 3 : Time of washing hands Response Nilphamari Rangpur All After using bathroom 96.2% 97.9% 97.0% Before and after cooking 96.6% 93.3% 95.1% Before and after eating 95.3% 94.8% 95.1% Before preparing food for children 68.6% 74.2% 71.2% Before and after meeting with effected person 53.8% 55.7% 54.7% After giving bath to the children 46.2% 45.4% 45.8% After touching anything 31.4% 20.6% 26.5% N 236 194 430 3. 8 .4 Nutritional Practices More than 50% respondents stated that they changed their food habits in their family during COVID - 19. Around 70% of them decreased the amount of food. Only 35.1% increased their amount of nutritious food for this pandemic. They also specified the cause of changing food habits. Table 3 4 : Any change of daily food habits of family during COVID - 19 Response Nilphamari Rangpur All Yes 57.2% 61.9% 59.3% No 42.8% 38.1% 40.7% N 236 194 430 Type of changes Decrease the amount of taking food 71.7% 71.2% 71.4% Increase the amount of nutritious food 37.8% 32.2% 35.1% Keep the food in store 0.0% 2.5% 1.2% N 127 118 245 Cause of changes Financial problem 43.7% 54.2% 48.6% Try to stay healthy 20.0% 17.5% 18.8% Because of Corona 16.3% 8.3% 12.5% There was no job 12.6% 10.0% 11.4% Poverty 4.4% 5.0% 4.7% Business was closed .7% 3.3% 2.0% Nutrition 1.5% 1.7% 1.6% For baby .7% 0.0% .4% N 135 120 255 Nearly 90% respondents marked that they received the knowledge about nutritious food from JANO Volunteers. In addition, other family members (42%), neighbors (39.6%) and members of Community Clinic (26.7%) has also informed the respondents about eating nutritious food. Page | 58 Table 3 5 : Source of giving suggestion about eating nutritious food Response Nilphamari Rangpur All JANO Volunteer 95.6% 81.7% 89.0% Family 39.3% 45.0% 42.0% Neighbor 37.8% 41.7% 39.6% Member of Community Clinic 32.6% 20.0% 26.7% FWC 7.4% 0.0% 3.9% N 135 120 255 Around 60% respondents pointed that all their family members take nutritious food during COVID - 19. The percentage of

71 lactating mother for taking nutritious f
lactating mother for taking nutritious food is 23.9%. However, the percentage of adult men and adolescents are very low. Table 3 6 : Pers ons who take nutritious food Response Nilphamari Rangpur All All family members 59.3% 60.0% 59.6% Lactating mother 22.2% 25.8% 23.9% Children 20.7% 15.0% 18.0% pregnant women 13.3% 15.0% 14.1% Adult men 7.4% 5.8% 6.7% Adolescents 5.9% 5.8% 5.9% N 135 120 255 More than 80% respondents felt that they are benefitted by taking nutritious food during COVID - 19. As their family members are still healthy and strong (65.7%). They also mentioned about increasing immunity, less illness and their children of any family are healthy. Table 37 : Benefits by eating nutritious food during COVID - 19 Response Nilphamari Rangpur All Whether get benefits by eating nutritious food during COVID - 19 Yes 85.9% 80.8% 83.5% No 14.1% 19.2% 16.5% N 135 120 255 Benefits by eating nutritious food during COVID - 19 Everyone in the family is still healthy 63.8% 68.0% 65.7% Increased immunity 13.8% 3.1% 8.9% Got less ill 6.9% 9.3% 8.0% Didn’t got infected in Corona 4.3% 10.3% 7.0% Baby was healthy 7.8% 2.1% 5.2% Consumed nutritious food for betterment 3.4% 4.1% 3.8% Don’t know 0.0% 3.1% 1.4% N 116 97 213 More than 55% respondents claimed that their income declined due to COVID - 19. However, 18.4% respondents mentioned that they have no incoming problems during this COVID - 19. Table 38 : Any problem for earning of family members during this COVID - 19 Response Nilphamari Rangpur All Decrease the income 53.4% 61.3% 57.0% Income is off 25.4% 23.7% 24.7% No problem 21.2% 14.9% 18.4% N 236 194 430 Page | 59 Around 60% respondents took loan for overcoming this pandemic situation. More than 20% are now taking low amount of food or food with good quality at the present time. Very few (6.7%) respondents have already sold their land/ gold/ asset for this pandemic. Table 39 : Steps taking for overcoming COVID - 19 situation Response Nilphamari Rangpur All Take loan 59.7% 58.8% 59.3% Take low amount of food or the quality of food 19.1% 25.8% 22.1% Nothing 18.2% 12.4% 15.6% take help for mental support 14.8% 10.3% 12.8% Sell the land/gold/asset 5.9% 7.7% 6.7% N 236 194 430 3.8. 5 Students Faced problems in going to school during COVID - 19 More than 80% students faced problems during COVID - 19 in both Nilphamari and Rangpur. Around 92% respondents specified that they are now facing problems in understan

72 ding their study. Few of them (13.3) me
ding their study. Few of them (13.3) mentioned that they could not get food from school in this pandemic. Half of the respondents are unhappy as they have to stay at home and could not see their friends from school. Table 4 0 : Problems Faced During COVID - 19 Response Annual Assessment 2020 Nilphamari Rangpur All Faced problems 87.8% 82.5% 85.8% N 270 160 430 Type of Problems Friends are not seen due to school being closed 51.9% 54.5% 52.8% Having to study at home 51.1% 62.1% 55.0% There has been / is a problem in understanding education 95.4% 87.1% 92.4% The food I got from school stopped 13.1% 13.6% 13.3% Can't play sports 27.0% 18.2% 23.8% N 237 132 369 3.8.6 H elp Needed to Continu e Study for Students Out of 430 students, only 19.5% respondents got online classes on Facebook through the help of JANO volunteer. The majority (40.9%) took help from their friends for study. More than 20% respondents went to teachers’ house for taking help on study. Table 4 1 : Types of Support Received During COVID - 19 Response Annual Assessment 2020 Nilphamari Rangpur All I took a class on Facebook (with the help of JANO volunteer) 23.3% 13.1% 19.5% Heard from friends 37.0% 47.5% 40.9% Went to the teacher's house 30.4% 23.1% 27.7% No help was received 22.2% 32.5% 26.0% From family members 13.0% 8.8% 11.4% From Television 8.5% .6% 5.6% N 270 160 430 According to a JANO project staff, as the schools are closed, the team arranged a total of 64 facebook live classes with the teachers of the schools. The volunteers ensured the participation and motivation of both teachers and students through monitoring. And, since the government has also arranged TV Page | 60 sessions of class, the team also ensured that the students were reached. And for the online classes, the link was also provided. 3.8.7 Satisfaction of Doing Classes Through Facebook from JANO Half of the respondents are happy for doing classes on Facebook by taking the help of JANO program . More than 30% are very satisfied for that. In contrast, the proportion of being dissatisfied for this classes are below 10% (Very dissatisfied - 9.5% and diss atisfied - 2.4%). Figure 15: Satisfaction level of doing classes through Facebook Causes of Dissatisfaction : The students shared the causes of their dissatisfaction for doing classes on Facebook through JANO project. Half of them marked that they did not find anyone during the class. They also mentioned that lack of communication, not having smartphone and Facebook account, facing problems on study and so on.

73 3. 8 . 8 Impact of Covid - 19 on J
3. 8 . 8 Impact of Covid - 19 on JANO Project Because of this pandemic, the staffs of this project could not work properly except the volunteers. The volunteers visited to the community people and provided awareness about this COVID - 19 which is the main challenge as they need to be very careful and ma intained the social distance. Their regular meetings have also stopped as they had to provide awareness about COVID - 19. As the schools has also stopped, they could not work in the school premises. In addition, the vegetable gardens have destroyed during th is COVID - 19 period. The project staffs work from home while the volunteers needed to visit their project areas. They started using PPE and visit door to door. On the other hand, the project started providing information about awareness to the school going children like the online classes. According to the community people, they had to stay at home because of this lockdown. They could not take medicines if they felt sick. They could not even get treatments by going to the community clinic. They received th e medicines from the JANO program staffs at home. They also received masks, hand sanitizer and awareness about COVID - 19. 33.30% 51.20% 3.60% 2.40% 9.50% Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Page | 37 4. L ogframe Review 4.1. Process of Reviewing the Logframe In order to adopt the JANO project Logframe, the IRC team carefully reviewed the context of the COVID - 19 pandemic situation and the project ’s performance . In addition, it examined relevant government approach es , different service delivery options and the way forward to adopt the Logframe in future . The IRC team tested required indicator definitions , actions and approach es and conducted context analysis as per the current Bangladesh and geographical aspects in north Bengal as well . The team fur ther reviewed all project process es documentation , monitoring and progress reports, events report s including other key stakeholder mapping report s to identify the future direction of the project. The o utcome indicators or expected results of the JANO project are segregated into 4 sections below. They intend to improve maternal and child nutrition in Nilphamari and Rangpur districts. 1. Women and adolescent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; 2. Coordinated and resourced sub - national and local government structures recognize, respond and are accountable to demands of poor and marginalized communities ; 3. Production and

74 access to high value nutritious commodi
access to high value nutritious commodities and services are increased ; and 4. Information and communication t echnology (ICT) platform is established at local level to connect relevant govt. departments and increase awareness of community people on nutrition interventions’ The logframe has been reviewed on the basis of the JANO project goal and targets. The follo wing segments have been reviewed by using SMART criteria 3 . SMART Indicators • Specific : The indicator should accurately describe what is intended to be measured, and should not include multiple measurements in one indicator. • Measurable : Regardless of who uses the indicator, consistent results should be obtained and tracked under the same conditions. • Attainable : Collecting data for the indicator should be simple, straightforward, and cost - effective. • Relevant : The indicator should be closel y connected with each respective input, output or outcome. • Time - bound : The indicator should include a specific time frame. 3 George T. Doran, developed the concept of S.M.A.R.T. goals in the discipline of project and program management Specific Measurable Achievable Relevant Time - bound Page | 38 The Logframe has been reviewed by considering each of the above SMART points and address es several assumptions that may support an d encourage the project to determine whether a project is on track. F ollowing color code s are used to assess the performance of the indicators based on their achievements and targets. 1 On track 2 Marginally behind target 3 Lagging behind 1.1.1. Indicator 1 % of women of reproductive age in the targeted districts who are consuming a minimum dietary diversity (MDD) Def. Women 15 - 49 years of age have consumed at least five out of ten defined food groups the previous day or night. (FANTA - III) Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 30.9% Rangpur 41.8% Overall 34.9% (February - 19) Nilphamari 32.5% Rangpur 42.3% Overall 37.0% (October - 19) +1% over baseline Nilphamari 33.5% Rangpur 44.3% Overall 38.4% (October - 20) +3% over baseline (37.9%) +6% over baseline (40.9%) 46.9% (2023) “MDD - W is a dichotomous indicator of whether or not women 15 – 49 years of age have consumed at least five out of ten defined food groups the previous day or night.” ( http://www.fao.org/3/a - i5486e.pdf ). The t en food groups ar

75 e: 1. Grains, white roots and tubers, an
e: 1. Grains, white roots and tubers, and plantains 2. Pulses (beans, peas and lentils) 3. Nuts and seeds 4. Dairy 5. Meat, poultry and fish 6. Eggs 7. Dark green leafy vegetables 8. Other vitamin A - rich fruits and vegetables 9. Other vegetables 10. Other fruits” T his indicator was able to explain how women’s’ diet or food consumption has influenced their micronutrient intake levels . This indicator was measured through the % of women reporting consu mption of at least five (5) out of 10 defined food groups the previous day or night during the 2 nd year annual assessment, which is 38.4% (slightly lagged behind from the second - year target) . How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Can be a major challenge to deliver adequate nutrient in women’s diet if COVID - 19 continue to rise until the next annual assessment. Hence, COVID - 19 could lead to further changes in food security. • Current trend shows that this indicator is achievable but JA NO needs to continue its training and awareness program on nutrition . • Women (of reproductive age) consumed more dairy, eggs, dark green leafy vegetables, vitamin A - rich fruits & vegetables, and fruits during the Page | 39 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe second evaluation as compared to the first annual evaluation. Therefore, Program can encourage the community to fo cus more on homestead production and consumption of agricultural products and rearing of livestock to cope up with the pandemic situation. • Alternative employment creation through various local government committees to mitigate income losses due to pandemi c. Comments: Also, JANO program can review the similar nature of the program to establish guidelines for monitoring dietary diversity levels and assess targets for the next year. 1.1.2. Indicator 2 Proportion of children 6 – 23 months of age who receive foods from 4 or more food groups (based the MDD - C methodology) by sex (Percentage) Def. Children 6 - 23 months age who received four food groups out of seven (WHO standard) Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Boys 18.1% Girls 17.4% Nilphamari 18.1% Rangpur 17.2%.

76 Overall 17.8% (February - 19) Boys
Overall 17.8% (February - 19) Boys 19.4% Girls 21.2% Nilphamari 20.7% Rangpur 20.2%. Overall 20.4% (October - 19) 2% over baseline Boys 21.8% Girls 23.5% Nilphamari 22.7% Rangpur 22.4%. Overall 22.6% (October - 20) 4% over baseline (21.8%) 10 over baseline (27.8%) (Assuming 10 means +10%) 37.8% (2023) This indicator calculated the percentage of Children 6 - 23 months of age who received four food groups out of seven following WHO guidelines for assessing infant and young child - feeding (IYCF) practices among children 6 - 23 months old (WHO, 2010). A total of 7food groups have been used for tabulation of this indicator including grains , roots and tubers, legumes and nuts , dairy products (milk, yogurt, cheese ), flesh foods (meat, fish, poultry and liver/organ meats ), eggs , Vitamin - A - rich fruits and vegetables , including other fruits and vegetables. This indictor measured the percentage of children 6 – 23 months of age who se mothers reported that they have consumed food from 4 or more food groups, which is 22.6%. Page | 40 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Like MDD - W, there will be a major challenge to deliver adequate nutrients in children’s diet/consumption if COVID - 19 continue s to rise until the next annual assessment Hence, COVID - 19 could lead to further changes in food security. • Project can review and adjust the 3rd year and overall target. • JANO needs t o provide separate training and continue courtyard meeting, and awareness program focusing MDD to the mothers of the children. • Program can encourage the community to focus more on homestead production and consumption of agri cultural products and rearing of livestock to cope up with the pandemic situation. • Need a linguistic change for the third year target ( 10 over baseline ). We are assuming this as ‘ + 10 % over baseline value ’ . Comments: Also, JANO program can review the similar nature of the program to establish guidelines for monitoring dietary diversity levels and assess targets for the next year. 1.1.3. Indicator 3 # of DNCC, UNCC and UDCC spent budget effectively on nutrition - specific or nutrition - sensitive actions Def. 50% of the fiscal year budget spent Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Targe

77 t (Y2) Nilphamari 0 Rangpur 0 Ove
t (Y2) Nilphamari 0 Rangpur 0 Overall 0 (February - 19) Nilphamari 0 Rangpur 0 Overall 0 (October - 19) 2 DNCC, 7 UNCC, 64 UDCC (73 plans) (October - 20) 1 DNCC 4 UNCC 10 UDCC 2 DNCC 7 UNCC 30 UDCC 2 DNCC, 7 UNCC 65 UDCC (will be monitored from 2nd year to 5th yea r) (2023) As reported by stakeholders of the JANO project, 2 DNCC s , 7 UNCC s and 64 DNCC s have spent the ir respective budgets i n various areas , but were not limited to nutrition - specific or nutrition - sensitive actions. They spent money to distribute relief during the Covid - 19 lockdown , they distribute d sanitary napkins among community people and to repair CCs . They also spent funds on Nutrition and Breastf eeding week activities during Covid - 19. Page | 41 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Regular activities have been impacted by COVID - 19. • According to the definition of the indicator, it was difficult to measure by third party. It doesn’t measure whether these budgets are actually spent on nutrition - specific or nutrition - sensitive actions. • Require monitoring system to ensure that what portion of the budgets are spent on nutrition - specific and nutrition - sensitive actions by the project . • Need to define the unit of measure as Percentage . • New definitions can be added as a measurement of nutrition - specific or nutrition - sensitive actions separately. • JANO can revise or update the overall target for 2023 (numbers of UDCC). (since the target has been changed according to the program officials). Comments : This indicator can be measurable if it is clearly defined as a separate ‘budget expenditure head’ for nutrition - specific or nutrition - sensitive actions. In addition, it is recommended that the meaning of ‘effectively’ needs to be properly defined. 1.1.4. Indicator 4 % of increased participation of community people, particularly women, in formal (government - led) and/ or informal (civil society - led, private sector - led) decision - making spaces Def. • Govt. led forums: CG, CSG, UP special committee, Up standing committee, adolescent group, student council, • Informal group: VSLA, FFS, Mothers group, youth group, women support group • Participation in the meeting and in the discussion Data disaggregation by sex (Definition aligned with CARE global indicat ors.) Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y

78 1) Annual Assessment 2020 (Y2) Tar
1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 30.9% Rangpur 41.8% Overall 34.9% (February - 19) Nilphamari 32.5% Rangpur 42.3% Overall 37.0% (October - 19) +1% over baseline Nilphamari 33.5% Rangpur 44.3% Overall 38.4% (October - 20) +3% over baseline (37.9%) +6% over baseline (40.9%) 46.9% (2023) Here, in order to calculate the above indicator, the project will consider the following aspects to measure the participation of community people, particularly women, in formal (government - led) and/ or informal (civil society - led, private sector - led) decision - making spaces. Page | 42 • Government - led forums: CG, CSG and UP special committee, Up standing committee, adolescent group, student council, • Informal group: VSLA, FFS, m others ’ group s , youth group s , and women support group s How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Project's regular activities have been impacted by COVID - 19. • This indicator needs to be separated by the participation of ‘only women’ or ‘only community people’. Also, Disaggregate by type of groups, i.e., formal and informal. • It will be challenging to achieve the 3rd year target of 'Formal' session. JANO can review the target of 'formal' sessions. • 'Informal' session needs effective monitoring system. Comments: This indicator needs to be measured through monitoring process es and needs to be empowered women for their active participation. 1.1.5. Indicator 5 % of students disaggregated by sex who apply key learning points regarding nutrition, health and hygiene at home Def. At least 5 learning of the below: • Food ingredients, food prepare and food serving • Intake of diversified food • Home gardening • Safe drinking water • Adolescent health & Hygiene • Hand wash in key times • Use of sanitary latrines • Information a bout health service providers Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 0.22%, Rangpur 0% , Boys 0.44% , Girls 0.0% , Overall: 0.15% (February - 19) Nilphamari 2.54%, Rangpur 1.30% Boys 1.67% , Girls 2.26% , Overall: 2.09% (October - 19) Nilphamari 2.22%, Ra

79 ngpur 4.38% , Boys 2.98% , Girls
ngpur 4.38% , Boys 2.98% , Girls 3.05% , Overall: 3.02% (October - 20) 3% over baseline (3.15%) 5% over baseline (5.15%) 20.15% (2023) Page | 43 This indicator was calculated by the percentage of School children/adolescents who applied 5 key learning points (i) Food ingredients, food prepar ation and food , ii) Health sciences and H ealthcare, iii) Adolescent H ealth & Hygiene, iv) Handwash ing and v) Use of sanitary latrines. How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe The COVID - 19 pandemic has had a severe impact on students. • Since schools are shut down over the pandemic situation, this indicator can be challenging to achieve. Needs to adopt new methods for teaching and learning aligned with the education board and Jano project. 1. Online class 2. Awareness campaigns 3. Regular Assessment /assignment 4. Video/Audio learning tools Comments: The COVID - 19 pandemic has had a severe impact on education system . Hence, s ince schools are shut down over the COVID - 19 pandemic, this indicator will be challenging to estimate. If th is situation continues, the overall target and/or definition needs to be revised. 1.1.6. Indicator 6 % of women and adolescent have claimed nutrition specific and sensitive services from relevant service providers Def. • Community Clinic (CC) for health services • Extension services for agriculture and livelihood Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) CC: Nilphamari :37.8% Rangpur :30.7% Overall :35.5% Extension services: 3.98% (February 2019 CC: Nilphamari :39.74% Rangpur :31.63% Overall :36.05% Extension services: 7.44% (October 2019) CC: Nilphamari :40.68% Rangpur :32.99% Overall :37.21% Extension services: 8.84% (October 2020) CC=5% over baseline (42.8 %) Extension services=5% Over baseline (8.98%) CC=8% over baseline (45.8%) Extension services=8% over baseline (11.98%) CC=53.5% Extension services=23.9% (2023) Page | 44 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Women and adolescents in the project area have faced difficulties getting the services they need (during pande

80 mic) • These target indicator ne
mic) • These target indicator needs to be segregated for the different groups since the project is targeting multiple groups. • Especially the targe t for extension service needs to be revised Comments: There should be separate indicators for women and adolescent groups. The method operationalize and measure these nutrition specific and sensitive services also needs to be determined . 1.1.7. Indicator 7 % of CSGs in targeted communities are functional Def. Qualify five out of seven performance indicator prescribed by government Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) 0% (February - 19) Rangpur - 198 Nilphamari - 414 Total – 612* (Source – Project Manager KII) (October - 19) Nilphamari 37 % Rangpur: 45 % Overall: 41% (October - 20) 20% 60% 60% (2023) During the second annual evaluation, it was revealed that a total of 624 CSGs are currently working in project areas. This indicator provid es information about whether CSGs are qualified based on five performance indicators prescribed by the Government. How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve th e results / Suggestions on logframe Difficult to arrange face - to - face meetings; organize events and regular activities of CSG • This indicator provides subjective data rather than quantifiable or measurable data. • Also, needs to define the unit of measures: Percentage or Numbers • To avoid bias in evaluation, this indicator needs clear instructions on how to be measure in terms of fu nctionality. • Need to focus on documentation, meeting minutes, etc. Comments: I t is recommended that the meaning of functionality be further defined and revised to be aligned with project goals. It will otherwise be time consuming to measure th is indicator according Page | 45 to the definition set in in the log frame. They are functional but la ck of documentation may decreases the percentage . 1.1.8. Indicator 8 # of School Management Committees set agenda for nutrition specific and sensitive services for adolescents in the SMC meeting Def. SMCs will raise issues in the meeting, set them in the action plan and that will be mentioned in the meeting minutes Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target

81 (Y3) Mid term review Target Tot
(Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari - 6 Rangpur - 1 Overall - 7 (February - 19) Nilphamari : 199 Rangpur: 103 Overall - 302* (Source SMC members) Monitoring reports Nilphamari 157 Rangpur: 88 Overall: 245 (Source: Survey with SMC members) (October - 20) 50 SMCs 150 SMCs 330 SMCs (2023) This indicator is calculated from data gathered during the quantitative survey, in which the number of SMC members are recorded who set agenda for nutrition specific and sensitive services for adolescents during SMC meeting s . P roject staff will then conver t these numbers into percentages by considering the total number of SMC s (330) and segregat ing them by districts. How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve th e results / Suggestions on logframe The COVID - 19 has restricted school activities to a larger extent. • Recommend to define the unit of measures as Percentage . • It was challenging for t hird party to measure this indicator. Comments: It will be time - consuming to measure the indicator according to the definition set in the log frame. This indicator can use a percentage indicator to track results in a percentage format. Besides this , indicator s can be measured on a monitoring basis. Event r eport s , m eeting records, m onitoring reports and a nnual r eports can be the means of verification in this context . 1.1.9. Indicator 9 # of Multi - sectoral plans at district, upazila and union level have allocated budget to support nutrition interventions in the two target districts Def. At least allocated budget to address one action in the multi - sectoral nutrition action plan in each year Page | 46 Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 0 Rangpur 0 Overall 0 (February - 19) Nilphamari 0 Rangpur 0 Overall 0 (October - 19) 2 DNCC, 7 UNCC, 64 UDCC (73 plans) (October - 20) 74 74 74 plan with allocated budget (65unions, 7 upazilas, 2 districts in each years) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe • Along with interviews with key officials, Budget records, Monitoring reports and Annual rep

82 orts need to checked regularly to captu
orts need to checked regularly to capture this information. • Need to update yearly and overall target for this indicator (since the target has been changed according to th e program officials) in the logframe (74 or73?) . Comments: In 2021’s annual assessment, along with interviews with key officials, budget records, regular monitoring reports and annual reports can be the means of verifications to capture this informatio n. 1.1.10. Indicator 10 % of increase of PLW people from the target population received nutrition specific safety net support Def. • Maternal allowance • 1000 days • Supplementary feeding • Maternal Health Voucher • Area based Community Nutrition Scheme • VGF • VGD • Iron folic acid Page | 47 Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 8.0% Rangpur 9.2% Overall 8.4% (February - 19) Nilphamari 9.7% Rangpur 10.7% Overall 10.2% (October - 19) Nilphamari 10.26% Rangpur 11.11% Overall 10.64% (October - 20) 2% over baseline (10.4%) 5% over baseline (13.4%) 18.4% (2023) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe PLW in the project area may have faced difficulties getting the safety net services they need. • Need to establish a system to track this indicator. Comments/Assumptions: This indicator is well specified and measurable . 1.1.11. Indicator 11 % of women and adolescent girls of target population in government forums (UDCC, CG, CSG) meaningfully participated in the nutrition action plan development and implementation process Def. Meaningful Participation: • Raise issue in the forum • Incorporated raised issues in planning Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 0 Rangpur 0.6% Overall 0.2% (February - 19) Nilphamari 0.9% Rangpur 0.0% Overall 0.5% (October - 19) (conducted interview with community people) Nilphamari: 64.4% Rangpur: 45.5% Overall: 54.0% (October - 20) (Source: Overphone Survey with (UDCC, CG, CSG) members) (October - 20) Representation: 100% of CSGs Participation: 30 % of CSGs Representation: 1

83 00% of CSGs Participation: 40 % of CS
00% of CSGs Participation: 40 % of CSGs 60% (2023) Page | 48 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Difficult to arrange face - to - face meetings; organize events and regular activities related to project. • Need to establish a system to monitor what specific issues are incorporated in the planning process. • Need to revisit the definition and target and fix the calculation of this indicator. Comments: This indicator calculated the percentage of women and adolescent girls of target population in government forums (UDCC, CG, CSG) meaningfully participated in the nutrition action plan development and implementation process in the second - year evaluation . There should be a separate indicator for women and adolescent groups , there also needs to be a clear definition of the term ‘ meaningful participation ’ . Th ese ef forts will require identifying key practices that are consistent with project goal that can be easily observed in th is survey. This process could be effectively assessed through document review. A system also needs to be established to monitor the specific issues that are incorporated in the planning process. 1.1.12. Indicator 12 # of platforms in the target districts which allow effective feedback mechanisms for service receivers Def. • Availability of a complain box/hot line number/or any other mechanism • Open complain box regularly for addressing in the monthly meeting. • Register all submitted complain • Public hearing meeting • Discussed in the regular meeting about the submitted complains. Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 0 DNCC - UNCC - UDCC - CC - Rangpur 0 DNCC - UNCC - UDCC - CC - Overall 0 (February - 19) Nilphamari 0 DNCC - UNCC - UDCC - CC - Rangpur 0 DNCC - UNCC - UDCC - CC - Overall 0 (Ocotober - 19) 64 Unions and 208 CCs (Ocotober - 20) 74 (unions 65, Upazila 7 and District 2) and 211 CCs 74 (unions 65, Upazila 7 and District 2) and 211 CCs 73 (unions 64, Upazila 7 and District 2) and 208 CCs Page | 49 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Difficul

84 t to arrange face - to - face meetings;
t to arrange face - to - face meetings; organize events and regular activities related to project. • There should have a specific definition of indicator to reflect what will be considered as an effective feedback mechanism. • Need to monitor the indi cator (according to the def.). It was difficult to measure for third party. • Need to update yearly target for this indicator (since the target has been changed according to the program officials) in the logframe . Comments/Assumptions: This indicator will be required to check availability and functionality of complaints box es. and, whether complaints register s have all been submitted during public hearing meeting s and discussed in regular meeting s at U nion , Upazila, District and CC levels to capture co mplaints and community feedback comprehensively . A specific definition of this indicator should also be provided to reflect effective feedback mechanisms . 1.1.13. Indicator 13 % of households involved in the production of higher value nutrition products Def. Higher value nutrition products: 1. Is bio - fortified 2. Is a legume, nut, or some seeds 3. Is an animal source food, including dairy products 4. Is a dark yellow or orange - fleshed root or tuber 5. Is a fruit or vegetable Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 34.5% Rangpur 41.0% Overall 36.7% (February - 19) Nilphamari 32.9% Rangpur 45.4% Overall 38.6% (October - 19) Nilphamari 35.6% Rangpur 46.9% Overall 40.7% (October - 20) 10% over baseline (46.7%) 15% over baseline (51.7%) 56.7% (2023) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe The pandemic has been affecting the entire agricultural production and food security . • New/Alternative techniques relevant to the indicators could be developed • Need to review yearly target for this indicator , it w ould be challenging to implement in this pandemic situation. Page | 50 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe • JANO can revise or update the target /definition of indicator considering the pandemic situation. Comments: This indicator is well speci

85 fied and measurable. 1.1.14. Indic
fied and measurable. 1.1.14. Indicator 14 % of households practicing climate smart agricultural techniques Def. Minimum 3 techniques have to be used out of 20 criteria Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 3% Rangpur 8% Overall 5% (February - 19) Nilphamari 4.7% Rangpur 10.6% Overall 8.3% (October - 19) Nilphamari 7.3% Rangpur 12.9% Overall 9.4% (October - 20) 10% over baseline (15%) 15% over baseline (20%) 25% (2023) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe The pandemic has been affecting the entire agricultural production and food security. • New/Alternative techniques relevant to the indicators could be developed . • JANO can revise or update the target/definition of indicator considering the pandemic situation. Comments: In this case, we calculated the percentage of households who used a minimum of 3 techniques out of 20 criteria. 1.1.15. Indicator 15 # of initiative jointly taken as a result of tripartite agreement. Def. Tripartite initiative (Govt.+JANO+Private sector) will be taken on agriculture, livestock, WASH, micronutrient supplementation and financial inclusion as an outcome of tripartite MoU signing. Baseline (incl. referenc e year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievemen t Targe t (Y1) Achievemen t Target (Y2) Nilphamar i 0 Rangpur 0 Nilphamari 0 Rangpur 0 Overall 0 Nilphamari 0 Rangpur 0 Agriculture - 1 (crop) Education Agriculture - 1 (livestock) Wash and At least 2 initiatives will be taken on Page | 51 Baseline (incl. referenc e year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievemen t Targe t (Y1) Achievemen t Target (Y2) Overall 0 (February - 19) (Ocotober - 19) Overall 0 (Ocotober - 20 department - 1 hygiene - 1 Micro nutrient supplementation - 1 Financial instituti on 1 each of the following thematic areas; agriculture, livestock, WASH, micronutrient supplementatio n and financial inclusion as an outcome of tripartite MoU signing. Reference year: 2023 How and at what extent COVID - 19 impacted on JANO in the second y

86 ear (project year) Measures that JANO
ear (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe • Need joint efforts with JANO consortium . • JAN O may consider bipartite instead of triparty or other types of efforts to achieve this indicator. Comments: This indicator is well specified and measurable but It needs to be measured through monitoring process es . 1.1.16. Indicator 16 # of government forums (UNCC, DNCC,) utilizing Nutrition Information Portal for planning and decision making at district and upazila level Def. One web based platform established Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) There is no Nutrition Information Portal for planning and decision making at district and upazila level (February - 19) 0 (October - 19) 0 (October - 20) 2 DNCC 7 UNCC 2 DNCC 7 UNCC 9 govt. forums (2 DNCC, 7 UNCC) (2023) Page | 52 How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe • Need program efforts Comments/Assumptions: This indicator is well specified and measurable. It too needs to be measured through monitoring processes. 1.1.17. Indicator 17 % of frontline workers using the ICT based e - learning platform to support the community based on needs Def. Mobile based learning app are used by frontline workers Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) 0% Frontline workers (February - 19) 0 (October - 19) 0 (October - 20) 10% over baseline 25% over baseline 50% relevant govt. front line workers (2023) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe Difficult to arrange face - to - face meetings; organize events and regular activities related to project. • JANO can revise indicator, results and target by reviewing reports, consultation with partners. • Can add “Government frontline workers ’ in the defini tion of the indicator. Comments: This indicator needs to have a clear definition of the term ‘community based needs’

87 . 1.1.18. Indicator 18 %
. 1.1.18. Indicator 18 % of community members who have accessed or received ICT based nutritional information Def. community members will have access nutritional information from the mobile based learning apps and receive text message Page | 53 Baseline (incl. reference year) February 2019 Annual Assessment 2019 (Y1) Annual Assessment 2020 (Y2) Target (Y3) Mid term review Target Total 2023 Achievement Target (Y1) Achievement Target (Y2) Nilphamari 2.4% Rangpur 7.8% Male: 4.1% Female: 8.3% Overall 4.2% (February - 19) Nilphamari 6.4% Rangpur 8.2% Male: 5.3% Female: 4.7% Overall 7.2% (October - 19) Nilphamari 8.1% Rangpur 10.8% Male: 9.7% Female: 10.5% Overall 9.3% (October - 20) 10% of community members 20% of community members 60% of community members (2023) How and at what extent COVID - 19 impacted on JANO in the second year (project year) Measures that JANO immediately need to take to achieve the results / Suggestions on logframe During pandemic, Community people may have received health/nutrition - related messages • This indicator needs to have a clear definition. Whose message/texts will be included? Comments: As the g overnment sends text messages in order to spread health/nutrition - related messages to people through mobile operators , this process makes it difficult to monitor/track the results of this activity by JANO under this category . 4.2. Measures to Be Taken to Achieve L ogframe Result s in the Third year of Evaluation The IRC team is strongly recommended to under take more awareness related activities keeping in mind the COVID - 19 pandemic situation and the lograme for quick recovery from subsequent shocks potentially created by the pandemic . It will need to engage community people through using more people sensitiv e and social distancing measures as per WHO guideline. Stronger referral system s are also need ed to achieve the project’s goal and objectives. In order t o monitor th is entire process, the JANO project can under take the following approaches : • A short check list could be developed to review meeting minutes and relevant registers • Some additional observation s along with general meeting observation s could be effective • Year wise specific targets (for the remaining years ) can be set after every annual review. Thi s will show which indicators are on track for 2023. • Year wise target s and activities/indicators related to Covid - 19 can be incorporated in to the logframe. • Definit

88 ion of the indicator can be revised or
ion of the indicator can be revised or update considering the results of the first year and second year annual evaluation. Page | 54 5. Conclusion and Recommendations Women’s increased participation in education, income generating activities, credit programs, and public life can be considered as the development of women’s position that directly links with empowerment. Moreover, the intervention of JANO have brought changes in terms of women and adolescent girls’ knowledge about nutrition and reproductive healthcare services. However , there are many structural and ideological barriers against sustainable transformation in a society. Thus, it is also important to explore the socio - cultural norms, poverty, religious barriers, lack of education, violence against women, health risk, and i nequality in economic and political spheres to identify the causes of limited changes in different sectors. Considering the overall project activities, the following s are possible way forwards: i. Advocacy for integrating NP A N as a major component of public and private intervention During the second annual evaluation, it was identified that many service providers are aware of NPAN and they have different ideas about how to improve nutritional status of the people. One of the H As perceived NAP as follows: “Our responsibility as part of the NAPN is to identify and aware mothers and children about nutrition. We also refer them to the health complex if needed.” He also, mentioned, nutrition action plan is part of their overall action plan in terms of providing healthcare services. However, one of the drawbacks is that they could only aware the people but cannot support materially to establish changes. Similarly, a SAAO mentioned, “we know and do many things on paper, but we hav e to make change practically”. Similarly, a UDCC member suggested, “poorer segment needs material support so that nutritional status is improved”. Therefore, extending coverage of allowances would benefit the people to a larger extent. This does not really happen due to limitation of fund as different committee members have indicated. Therefore, JANO should strive to make nutrition action plan s a major component of overall action plans of different public offices. Initiatives can be taken for increasing n utrition specific and nutrition sensitive budget s and need to classify the expenditure into two categories as well. JANO can record the spending on nutrition activities by monitoring both planned and executed proportion of the budget in regular interval. ii. Functionality of committees to develop and implement nutrition based action plan s In Total 73 mu

89 lti - sectoral plans at dist rict, upazi
lti - sectoral plans at dist rict, upazila or union level were found during the second annual evaluation survey. However, the project is challenged by the fact that government officers are occasionally transferred to other areas, thus, the project face renewed challenge of orienting the incoming officers. One of the project managers mentioned, “a lot of time and energy goes into establishing a working relationshi p but sometimes all go to vain”. Thus, it is highly recommended to active the co - ordination committee for the development of multi - sectoral nutrition action plan for its proper functioning. Possibly an advocacy program could be designed for a dedicated pos t that would coordinate multi - sectoral nutrition action plans. Possibly JANO could start advocacy initiatives at the government level for creating a n active post of Nutrition officer at the district/ upazila level . Page | 55 iii. Poor Coordination, Communication and C ooperation Between Nutrition Based /Development Committees at Different Levels One of the H ealth A ssistant s in the study mentioned, CSGs do not have opportunity to work together with UNCC or D N CC, he mentioned “we just fol low instructions given from the Upazila level”. It is also attested by the fact that National Nutrition Portal is rarely used as mentioned by many service providers. Moreover, many never used the national portal and as a reason, they mentioned that “we are always under various kinds of pressure, so these sorts of things are not done”. In the same vein, in response to a question of what new initiatives were taken at the catchment area a Upazila Women Affairs Officer said, “we follow the guidelines designed f or upazilas. Instructions come from above”. Members of different committees repeatedly mentioned, they do their work following instructions from higher authorities. Additionally, a UDCC member said, “DNCC and UNCC never gave financial or other supports exc ept some suggestions”. Overall, a strict hierarchical system limits possibility of innovation to take form from the grassroots. Therefore, JANO project should aim to develop a bottom - up approach in terms of policy formulation and implementation. JANO can arrange a sharing platform for the active corporation, involving CSG and other committees. Regular m eetings , events, role play activities may be used to gather feedback and suggestions for increasing engagement of CSGs. One of the Project Managers of JANO stated that, “the nature of this project is different. Unlike other projects here, we do not have any input support. Besides, working with UNCCs and DNCCs is a major challenge. In these committees, many g

90 overnment office rs are included because
overnment office rs are included because they are incumbents of particular offices. However, when they are occasionally transferred to other areas, we face challenges of orienting incoming officers. A lot of time and energy goes into establishing a working relationship wit h these stakeholders but, sometimes these efforts go all in vain”. Yet another issue that was raised was challenges faced in coordination between different public offices, for instance: when arranging a meeting of the UNCC or DNCC. The administrative proce ss takes a lot of uncalled for time. Though COVID - 19 has halted much of JANO’s project activities (especially in schools), JANO project officials continued working by following government guidelines. iv. Barriers in women ’s participation at various forums P articipation of the community people (particularly women) in formal (Govt. led forums: CG, CSG, UP special committee, UP standing committee, adolescent group s , student council s ) bodies has increased from 0.93% in first annual evaluation to 2.79% during sec ond annual evaluation. Though the number shows an increase, the project should consider sensitizing relevant stakeholders . If deemed suitable their opinion is taken into consideration.” The statement reveals reservations about women and their competence, w hich needs to be changed for a sustainable and meaningful participation of women in public forums. Increase number of women and adolescents, possibly introduce adolescents’ volunteers and JANO could establish a separate group for women to aware, monitor, and ensure their participations. v. Lack of Awareness on Feedback M echanism During the second annual evaluation 62.3% (Nilphamari: 56.4% and Rangpur 69.6%) HHs reported that they did not know that they can complain against issue related to services of Socia l Safety Net, Health & Nutrition, Agriculture, Livestock/poultry and quality education. This increased from 51.4% during the first annual evaluation. Further, only 0.9% did complain to any office or committee during the past 12 months of second annual eval uation. One reason for not raising complaints was “lack of responses”, Page | 56 it was found that only 25% complaint received a response (a decrease from 33.3% found during the first annual study). These statistics represent needs of improving the feedback mechanis m. On this similar issue, in response to the question, how do they receive and act upon service receivers’ feed back, a service provider stated that “there was no opportunity before but now there is. However, the reality is do not know much about nutrition so I am unable to say much” . Another UDCC member mentioned about the e

91 xistence of complain boxes. It appears t
xistence of complain boxes. It appears that though some mechanism is establis hed both the service providers and service receivers need sensitization about effective feedback mechanism that would eventually enhance quality of the service. JANO can continue to advocate at DNCC, UNCC, UDCC, CC level to focus or maintain proper and fo rmal feedback mechanism. JANO needs to set up the system, raise awareness among communities, local members of the committee for their active participation and also need to receive and register complaints and take action in response to feedback. vi. Funding Limitations In a KII session with a JANO project staff it was mentioned that 2 DNCC, 7 UNCC and 64 UDCC had spent budget on several purposes i.e., d istributing food and sanitary napkin s this is a significant increase as during the first annual ev aluation or baseline no such activities were recorded. Though some local level budget has been allocated for different nutrition related activities, budget limitation s remain a great challenge. This issue can b e innovatively addressed, as a Community Healt h Care Provider ( CHCP ) mentioned that their CG s and CSG s do not receive funds from the government, but they collect and maintain their own fund s (BDT 2 - 5) from those patients who can afford to pay. These members donate and collect fund s during agricultural harvesting seasons; they collect a portion of income from the local produce as regularly as possible . This fund is then used for local nutrition plan ning for instance , planting fruit trees and improved maintena nce of CC s . This approach could be mainstreamed to engage local people more into the project/ ensuring better healthcare of the community. However, the above approach did not work well everywhere, a Family Welfare Assistant ( FWA ) mentioned that even though they tried to initiate a similar scheme in their area , people did not contribute much to the fund resulting in this initiative performing poorly . This indicates the scope of further work to be done by JANO in this area . Encourage CSG members to donate an d collect funds/contributions for implementing the local nutrition action plan. It will create an ownership mentality among them and it will help to promote substantiality practice over time. vii. Women’s Access to Technology During the second annual evaluation survey, it was found that 9.3% of households accessed or received nutritional information through text messages. This indicates the that 7.2% of the households received nutritional information though text messages during the first annual evaluation survey. Further, gender d

92 isparity is imminent by the fact that
isparity is imminent by the fact that during the second annual evaluation survey, 55.4% of the women owned mobile phone (first evaluation: 56.3%) compared to 89.5 of men (first evaluation: 81.7%) . This reflects , women are at great need of digital extension services which could improve both nutrition level and economic empowerment of women. Moreover, ma rried adolescent girls recommended it would be better if they could receive family planning and other he alth related information through mobile phone . However, challenges exist as women do not have the access to phone s. As one woman commented, “ We do not have mobile phone for every person in our house. Only my husband has one phone. If anyone gives informat ion about health, nutrition , and hygiene, I will never get that as my husband stays Page | 57 outside for his work. It would be better if we get these types of information from courtyard meeting s .” The cost of a mobile phone s call is another challenge for poorer communities as reflected by a pregnant woman from Rangpur, “It would be easier if we make phone calls for free to get the information about health, nutrition and hygiene” . In this regard, toll free hotlines could be a solution. In addition , during the second evaluation survey no ICT based e - learning platforms to suppo rt the community were used by frontline workers. The statistics indicate that there is an enormous possibility and need to develop this sector. Hence, d evelopment of a nutrition - focused portal could be very effective as it will store all relevant information and deliver it to target communities in project area s . JANO could introduce toll free hotlines , use community radio platforms to disseminate knowledge . viii. Rolling back school interventions T hrough interviews with SM C members, it was identified that monthly meeting s were conducted in 61.1% cases (Nilphamari 73.9% and Rangpur 38.5%), and 50% received some form of training (Nilphamari 60.9% and Rangpur 30.8%). Moreover, capacity of SMC members in gender sensitive hygiene issues was comparatively low at 42.9%. Thus, initiativ es must be emphasized more in schools and Rangpur needs to catch up with Nilphamari. Besides, the COVID - 19 has restricted school activities to a larger extent. Therefore, initiatives should be taken to restart nutrition focused activities in schools. JAN O can continue the online class and create a schedule to keep track of student's regular learning activities and tasks. Also, the project can arrange online competitions, games, and other activities for their social and mental development in this pandemic. Training of teachers is a

93 lso essential under the National Curric
lso essential under the National Curriculum and Textbook Board (NCTB). ix. Constraints to Income Generation More than 55% respondents claimed that their income declined due to the COVID - 19 pandemic . Approximately 60% of respondents took loan s to overcome this situation. The strain on their economic situation will have a direct detrimental effect on the nutritional status of the se people as the survey indicates that more than 20% of respondents consumed less food or food o f lower quality during the pandemic as compared to earlier times. This trend will in turn severely affect the JANO project’s aim of ending malnutrition and addressing the nutritional need of pregnant, lactating women and adolescent girls. In order to reduce the impact of the pandemic on the wellbeing of beneficiaries’ during this time , JANO provided information about how to maint ain hygiene and social distance , mapped people’s movement and C OVID - 19 infection, distributed relief including sanitizers, soaps, and cleaning products. Moreover, innovative activities were supported by JANO such as mask manufacturing by the local community . Page | 58 Annex 1 : Log frame 4 If not indic ated otherwise, to be achieved by the end of the projec t. Results chain Indicators 4 Definition Indicators Baseline (incl. reference year) Annual Assessment 2019 Annual Assessment 2020 Targets (incl. referen ce year) Sources and means of verification Assumptions Overall objective: Impact To contribute in ending malnutrition of children under five years of age, together with addressing the nutritional needs of Pregnant and Lactating Women (PLW) and adolescent girls; Prevalence of stunting among children under 5 years of age Nilphamari and Rangpur districts height for age – 2 SD of the WHO Child Growth Standards median (WHO guideline) Nilphamari 34.1% Rangpur 36.1% Overall 34.8% (February - 19) 24.8 % (2023) Baseline Midline evaluation Final Evaluation No disaster and long - time pandemic (COVID - 19) situa tion persist (for mid term) Prevalence of wasting among children under 5 years of age Nilphamari and Rangpur districts weight for height – 2 SD of the WHO Child Growth Standards median (WHO guideline) Nilphamari 7.5% Rangpur 12.3% Boys 10.1%, Girls 8.2% Overall 9.2% (February - 19) 4.2% (2023) Baseline Midline evaluation Final Evaluation Prevalence of underweight women age 15 - 49 years in Nilphamari and Rangpur districts BMI is a simple index of weight - to - height (WHO guideline)

94 Nilphamari 10.2% Rangpur
Nilphamari 10.2% Rangpur 7.3% Overall 9.3% (February - 19) 4.3% (2023) Baseline Midline evaluation Final Evaluation Specific objective: Outcome Improved maternal and child nutrition in Nilphamari % of women of reproductive age in the targeted districts who are consuming a Women 15 - 49 years of age have consumed at least five out of ten defined food groups the previous day or night. (FANTA - III) Nilphamari 30.9% Rangpur 41.8% Overall 34.9% Nilphamari 32.5% Rangpur 42.3% Overall 37.0% (October - 19) Nilphamari 33.5% Rangpur 44.3% Overall 38.4% (October - 20) 46.9% (2023) Annual report Baseline, midline & No major catastrophes and natural disasters such as floods , Page | 59 and Rangpur districts minimum dietary diversity (MDD) (February - 19) final evaluation pandemic situation. Political environment remains conducive, especially after elections in 2018, to project implementatio n Nutrition remains high in the development agenda of the Government Ministries and departments are supportive to operationalize multi - sectoral approaches to nutrition programming % reduction of anaemia among pregnant women in Nilphamari and Rangpur districts Pregnant women as a haemoglobin concentration g/l at sea level. (WHO guideline) Nilphamari 55.7% Rangpur 60.0% Overall 57.3% (February - 19) 45.3% (2023) Baseline & f inal evaluation Proportion of children 6 – 23 months of age who receive foods from 4 or more food groups (based the MDD - C methodology) by sex (Percentage) Children 6 - 23 months age who received four food groups out of seven (WHO standard) Boys 18.1% Girls 17.4% Nilphamari 18.1% Rangpur 17.2%. Overall 17.8% (February - 19) Boys 19.4% Girls 21.2% Nilphamari 20.7% Rangpur 20.2%. Overall 20.4% (October - 19) Boys 21.8% Girls 23.5% Nilphamari 22.7% Rangpur 22.4%. Overall 22.6% (October - 20) 37.8% (2023) Annual report Baseline, midline and final evaluation # of DNCC, UNCC and UDCC spent budget effectively on nutrition - specific or nutrition - sensitive actions 50% of the fiscal year budget spent Nilphamari 0 DNCC UNCC UDCC Rangpur 0 DNCC UNCC UDCC Overall 0 (February - 19) Nilphamari 0 DNCC UNCC UDCC Rangpur 0 DNCC UNCC UDCC Overall 0 (October - 19) 2 DNCC, 7 UNCC, 64 UDCC (7 3 plans) (Source: KII) (October - 20) 2 DNCC, 7 UNCC 65 UDCC (will be monitore d from 2 nd year to 5 th year) (2023) Annual reports Action plan documen

95 ts at district and upazila level Ba
ts at district and upazila level Baseline Midterm and final evaluation Page | 60 % of increased participation of community people, particularly women, in formal (government - led) and/ or informal (civil society - led, private sector - led) decision - making spaces • Govt. led forums: CG, CSG, UP special committee, Up standing committee, adolescent group, student council, • Informal group: VSLA, FFS, Mothers group, youth group, women support group • Participation in the meeting and in the discussion Data disaggregation by sex (Definition aligned with CARE global indicators.) Participation in meeting discussion Formal: Nilphamari: 1.79% Rangpur: 1.81% Overall 1.7 9% Informal: Nilphamari: 1.79% Rangpur: 1.81% Overall 1.79% (February - 19) Participation in meeting discussion Formal: Nilphamari: 0.47% Rangpur: 0.47% Overall 0.93% Informal: Nilphamari: 2.33% Rangpur: 1.16% Overall 3.49% (October - 19) Participation in meeting discussion Formal: Nilphamari: 1.16% Rangpur: 1.63% Overall 2.79% Informal: Nilphamari: 2.56% Rangpur: 2.33% Overall 4.88% (October - 20) Formal 11.79% Informal 11.79% (2023) Monitoring reports Annual reports Baseline, midline & final evaluation (Social audit) Page | 61 Expected Result I Output I Women and adolescent girls in communities are empowered to demand and utilize both nutrition - sensitive and nutrition - specific services; % of students disaggregated by sex who apply key learning points regarding nutrition, health and hygiene at home At least 5 learning of the below: • Food ingredients, food prepare and food serving • Intake of diversified food • Home gardening • Safe drinking water • Adolescent health & Hygiene • Hand wash in key times • Use of sanitary latrines • Information about health service providers Nilphamari 0.22%, Rangpur 0% Boys 0.44% Girls 0.0% Overall: 0.15% (February - 19) Nilphamari 2.54%, Rangpur 1.30% Boys 1.67% Girls 2.26% Overall: 2.09% (October - 19) Nilphamari 2.22%, Rangpur 4.38% Boys 2.98% Girls 3.05% Overall: 3.02% (October - 20) 20.15% (2023) Monitoring reports Annual reports Baseline Midterm and final evaluation Pandemic situation will not be continued. Schools will be open and SMCs are functional. % of women and adolescent have claimed nutrition specific and sensitive services from relevant service providers • Community Clinic (CC) for health services • Extensi

96 on services for agriculture and liveli
on services for agriculture and livelihood CC: Nilphamari :37.8% Rangpur :30.7% Overall :3 5.5% Extension services: 3.98% (February 2019) CC: Nilphamari :39.74% Rangpur :31.63% Overall :36.05% Extension services: 7.44% (October 2019) CC: Nilphamari :40.68% Rangpur :32.99% Overall :37.21% Extension services: 8.84% (October 2020) CC=53.5 % Extensio n services= 23.9% (2023) Service record book of the respective service providers Monitoring reports % of CSGs in targeted communities are functional Qualify five out of seven performance indicator prescribed by government 0% (February - 19) Rangpur - 198 Nilphamar i - 414 Total – 612* (Source – Project Manager KII) (October - 19) Nilphamari 37 % Rangpur: 45 % Overall: 41% (October - 20) 60% (2023) Monitoring reports Annual reports Baseline Midterm and Page | 62 final evaluation # of School Management Committees set agenda for nutrition specific and sensitive services for adolescents in the SMC meeting SMCs will raise issues in the meeting, set them in the action plan and that will be mentioned in the meeting minutes Nilphamari - 6 Rangpur - 1 Overall - 7 (February - 19 ) Nilphamari : 199 Rangpur: 103 Overall - 302* (Source SMC members) Monitoring reports Nilphamari 157 Rangpur: 88 Overall: 245 (Source: Survey with SMC members) (October - 20) 330 SMCs (2023) Event Report Meeting records Monitoring reports Annual reports Expected Result II Output II Coordinated and resourced sub - national and local government structures recognize, respond and are accountable to demands of poor and marginalized communities # of Multi - sectoral plans at district, upazila and union level have allocated budget to support nutrition interventions in the two target districts At least allocated budget to address one action in the multi - sectoral nutrition action plan in each year Nilphamari 0 Rangpur 0 Overall 0 (February - 19) Nilph amari 0 Rangpur 0 Overall 0 (October - 19) 2 DNCC, 7 UNCC, 64 UDCC (7 3 plans) (October - 20) (Source: KII) (October - 20) 74 plan with allocated budget (65union s, 7 upazilas, 2 districts in each years) Budget records Monitoring reports Annual reports Government of Bangladesh continues efforts to implement the NPAN stays high No political and/or economic crisis (especially due to elections) % of increase of PLW people from the target population received nutrition specific safety net support • Mat

97 ernal allowance • 1000 days â€
ernal allowance • 1000 days • Supplementary feeding • Maternal Health Voucher • Area based Community Nutrition Scheme • VGF • VGD • Iron folic acid supplementat ion Nilphamari 8.0% Rangpur 9.2% Overall 8.4% (February - 19) Nilphamari 9.7% Rangpur 10.7% Overall 10.2% (October - 19) Nilphamari 10.26% Rangpur 11.11% Overall 10.64% (October - 20) 18.4% (2023) Participant list from UP Project MIS Monitoring reports Annual reports Page | 63 % of women and adolescent girls of target population in government forums (UDCC, CG, CSG) meaningfully participated in the nutrition action plan development and implementation process Meaningful Participation: • Raise issue in the forum • Incorporated raised issues in planning Nilphamari 0 Rangpur 0.6% Overall 0.2% (February - 19) Nilphamari 0.9% Rangpur 0.0% Overall 0.5% (October - 19) Nilphamari: 64.4% Rangpur: 45.5% Overall: 54.0% (October - 20) (Source: Overphone Survey with (UDCC, CG, CSG) members) (October - 20) 60% (2023) Meeting minutes Annual reports # of platforms in the target districts which allow effective feedback mechanisms for service receivers • Availability of a complain box/hot line number/or any other mechanism • Open complain box regularly for addressing in the monthly meeting. • Register all s ubmitted complain • Public hearing meeting • Discussed in the regular meeting about the submitted complains. Nilphamari 0 DNCC - UNCC - UDCC - CC - Rangpur 0 DNCC - UNCC - UDCC - CC - Overall 0 (February - 19) Nilphamari 0 DNCC - UNCC - UDCC - CC - Rangpur 0 DNCC - UNCC - UDCC - CC - Overall 0 (Ocotober - 19) 64 Unions and 208 CCs (Ocotober - 20) 73 (unions 64, Upazila 7 and District 2) and 208 CCs Project MIS Meeting minutes of different platforms Annual reports Page | 64 Expected Result III Output III Production and access to high value nutritious commodities and services are increased % of households involved in the production of higher value nutrition products Higher value nutrition products: 1. Is bio - fortified 2. Is a legume, nut, or some seeds 3 . Is an animal source food, including dairy products 4. Is a dark yellow or orange - fleshed root or tuber 5. Is a fruit or vegetable Nilphamari 34.5% Rangpur 41.0% Overall 36.7% (February - 19) Nilphamari 32.9% Rangpur 45.4% Overall 38.6% (October - 19) Nilphamari 35.6%

98 Rangpur 46.9% Overall 40.7% (Oct
Rangpur 46.9% Overall 40.7% (October - 20) 56.7% (2023) Annual reports Baseline Midterm and final evaluation Opportunities for pro - poor market exist Private companies recognize the potential of last mile marketing % of households practicing climate smart agricultural techniques Minimum 3 techniques have to be used out of 20 criteria Nilphamari 3% Rangpur 8% Overall 5% (February - 19) Nilphamari 4.7% Rangpur 10.6% Overall 8.3% (October - 19) Nilphamari 7.3% Rangpur 12.9% Overall 9.4% (October - 20) 25% (2013) Annual reports Baseline Midterm and final evaluation # of initiative jointly taken as a result of tripartite agreement. Tripartite initiative (Govt.+JANO+Private sector) will be taken on agriculture, livestock, WASH, micronutrient supplementation and financial inclusion as an outcome of tripartite MoU si gning. Nilphamari 0 Rangpur 0 Overall 0 (February - 19) Nilphamari 0 Rangpur 0 Overall 0 (Ocotober - 19) Nilphamari 0 Rangpur 0 Overall 0 (Ocotober - 20) At least 2 initiatives will be taken on each of the following thematic areas; agricultur e, livestock, WASH, micronut rient Project Monitoring report Baseline Midterm and final evaluation Page | 65 suppleme ntation and financial inclusion as an outcome of tripartite MoU signing. Referenc e year: 2023 Expected Result IV Output IV VGF Information and communicatio n technology (ICT) platform is established at local level to connect relevant govt. departments and increase awareness of community people on nutrition interventions’ # of government forums (UNCC, DNCC,) utilizing Nutrition Inf ormation Portal for planning and decision making at district and upazila level One web based platform established There is no Nutrition Information Portal for planning and decision making at district and upazila level (February - 19) 0 (October - 19) 0 (October - 20) 9 govt. forums (2 DNCC, 7 UNCC) (2023) Meeting minutes Final evaluation Sufficient internet facilities in the targeted locations Limited fluctuation of front line workers Government continues efforts in ICT solutions Community members use data from ICT platforms % of frontline workers using the ICT based e - learning platform to support the community based on needs Mobile based learning app are used by frontline workers 0% Frontline workers (February - 19) Monitoring reports 0 (October - 20) 50% relevant govt. fron t line workers (2023)

99 Monitoring reports Annual rep
Monitoring reports Annual reports Final evaluation % of community members who have community members will have access nutritional Nilphamari 2.4% Rangpur 7.8% Nilphamari 6.4% Rangpur 8.2% Nilphamari 8.1% Rangpur 10.8% 60% of communi Monitoring reports Page | 66 accessed or received ICT based nutritional information information from the mobile based learning apps and receive text messages Male: 4.1% Female: 8.3% Overall 4.2% (February - 19) Male: 5.3% Female: 4.7% Overall 7.2% (October - 19) Male: 9.7% Female: 10.5% Overall 9.3% (October - 20) ty members (2023) Annual reports Final evaluation Page | 67 Annex 2: Survey Are a Page | 68 Annex 3: Other Tables Table 1 : Household Sample Distribution by Village District Upazila/Thana Name Union/Ward Name Area/Village Name MZ / MH Village RMO Name RMO Code Both Male Female Nilphamari Domar Upazila Bhogdabari Union 1 *Nij Bhogdabari 762 1 RURAL 1 11784 5865 5919 Nilphamari Domar Upazila Gomnati Union 2 *Purba Ambari 825 1 RURAL 1 2738 1353 1385 Nilphamari Domar Upazila Ketkibari Union 3 *Dakshin Ketakibari 317 1 RURAL 1 4272 2130 2142 Nilphamari Jaldhaka Upazila Balagram Union 4 *Chhit Mirganj 235 1 RURAL 1 1820 888 932 Nilphamari Jaldhaka Upazila Golmunda Union 5 *Paschim Golmunda 693 1 RURAL 1 9957 4989 4968 Nilphamari Jaldhaka Upazila Kaimari' Union 6 *Talukbadi 942 1 RURAL 1 831 418 413 Nilphamari Jaldhaka Upazila Mirganj Union 7 *Mirganj 615 1 RURAL 1 1986 1091 895 Nilphamari Jaldhaka Upazila Saulmari' Union 8 *Taluk Saulmari 955 1 RURAL 1 12558 6217 6341 Nilphamari Kishoreganj Upazila Chandkhana Union 9 *Saranjabari 881 1 RURAL 1 1606 810 796 Nilphamari Kishoreganj Upazila Kishoreganj Union 10 *Pushna 795 1 RURAL 1 4922 2481 2441 Nilphamari Kishoreganj Upazila Putimari' Union 11 *Kalikapur 369 1 RURAL 1 13042 6664 6378 Nilphamari Nilphamari Sadar Upazila Chapra Saramjani Union 12 *Beradanga 169 1 RURAL 1 6831 3363 3468 Nilphamari Nilphamari Sadar Upazila Gorgram Union 13 *Dhobadanga 318 1 RURAL 1 8627 4442 4185 Nilphamari Nilphamari Sadar Upazila Khokshabari Union 14 *Dakshinpara 288 1 RURAL 1 373 188 185 Nilphamari Nilphamari Sadar Upazila Kunda Pukur Union 15 *Patkamuri 786 1 RURAL 1 2813 1383 1430 Nilphamari

100 Nilphamari Sadar Upazila Palashba
Nilphamari Sadar Upazila Palashbari Union 16 *Kismat Kanaikata 606 1 RURAL 1 589 308 281 Nilphamari Nilphamari Sadar Upazila Ramnagar Union 17 *Char Charabari 228 1 RURAL 1 3384 1713 1671 Page | 69 District Upazila/Thana Name Union/Ward Name Area/Village Name MZ / MH Village RMO Name RMO Code Both Male Female Nilphamari Nilphamari Sadar Upazila Sonaroy Union 18 *Chak Dublia 208 1 RURAL 1 3729 1898 1831 Nilphamari Nilphamari Sadar Upazila Tupamari Union 19 *Nilphamari Bazar (Part)B 829 1 RURAL 1 5173 2666 2507 Rangpur Gangachara Upazila Alam Biditar Union 20 *Saragandha Ismail 867 1 RURAL 1 3552 1758 1794 Rangpur Gangachara Upazila Betgari Union 21 Chhayani Aldadpur 27 3 RURAL 1 1185 607 578 Rangpur Gangachara Upazila Gangachara Union 22 *Bhutka 163 1 RURAL 1 2629 1300 1329 Rangpur Gangachara Upazila Gajaghanta Union 23 *Umar 954 1 RURAL 1 3683 1855 1828 Rangpur Gangachara Upazila Lakshmitari Union 24 Paschim Ichli 449 2 RURAL 1 2237 1164 1073 Rangpur Gangachara Upazila Marania Union 25 *Alal 13 1 RURAL 1 868 442 426 Rangpur Gangachara Upazila Marania Union 26 *Kismat Marania 572 1 RURAL 1 1035 551 484 Rangpur Gangachara Upazila Nohali Union 27 *Madhya Kachua RURAL 1 1233 639 594 Rangpur Kaunia Upazila Kaunia ' Bala Para' Union 28 *Arazi Khorda Bhutchara 62 1 RURAL 1 807 397 410 Rangpur Kaunia Upazila Kaunia ' Bala Para' Union 29 *Panjarbhanga 708 1 RURAL 1 1436 732 704 Rangpur Kaunia Upazila Kursha Union 30 *Mahesha 634 1 RURAL 1 2694 1337 1357 Rangpur Kaunia Upazila Sarai Union 31 *Kachu 534 1 RURAL 1 4593 2279 2314 Rangpur Kaunia Upazila Tepa Madhupur Union 32 *Baje Mazkur 111 1 RURAL 1 2178 1022 1156 Rangpur Taraganj Upazila Alampur Union 33 *Fazilpur 373 1 RURAL 1 2779 1417 1362 Rangpur Taraganj Upazila Hariarkuti Union 34 *Khalea Nandaram 547 1 RURAL 1 2120 1080 1040 Rangpur Taraganj Upazila Sayar Union 35 *Baidyanathpur 74 1 RURAL 1 1167 595 572 Page | 70 Table 2 : List of Selected School Sl. No. Name of School Village Union Upazila District 1 Chor Eshorkol Junior school Char Eshokol Lakshmitari Gangachara Rangpur 2 Uday Narayon Mashari High School Udaynarayon Mashari Sarai Kaunia Rangpur 3 Shamolgonj Jun

101 ior High School Shamgonj Sayar Tar
ior High School Shamgonj Sayar Taraganj Rangpur 4 Rajballav High School Rajballav Gajaghanta Gangachara Rangpur 5 Aldadpur BL High School Aldadpur Betgari Gangachara Rangpur 6 Fazilpur BL High School Fazilpur Alampur Taraganj Rangpur 7 Bazamuskur Girls Dakil Madarasha Bazamuskur Tepa Madhupur Kaunia Rangpur 8 Dhormeshwar Mohesha BL high School Mohesha Kursha Kaunia Rangpur 9 Kalikapur High School ( Kalikapur School and College) Kalikapur Putimari Kishoreganj Nilphamari 10 Ambari Bangobondhu High School Purbo Ambari Gomnati Domar Nilphamari 11 Doxminpara Girls High School Doxminpara Khoksabari Nilphamari Nilphamari 12 Dhobadanga High School Dhobadanga Gorgram Nilphamari Nilphamari 13 Chorchorabari High School Chorchorabari Ramnagar Nilphamari Nilphamari 14 Uttorpatkamuri High School Patkamri Kundapukur Nilphamari Nilphamari 15 Talukbodi High School Talukbodi Koimari Jaldhaka Nilphamari 16 Shoulmari ML High School Taluk Shoulmari Shoulmari Jaldhaka Nilphamari 17 Shoulmari Girls School & College Taluk Shoulmari Shoulmari Jaldhaka Nilphamari 18 Golmunda ML High School Paschim Golmunda Golmunda Jaldhaka Nilphamari 19 Chalk dublia Govt. Primary School Chokdublia Sonaroy Nilphamari Nilphamari 20 Doxmin Ketkibari Telipara Govt. Primay School Dakhin Ketkibari Ketkibari Domar Nilphamari 21 Fokirgonj Chalkbera Dakhil Madrasha Chokdublia Sonaroy Nilphamari Nilphamari 22 Khankaye Keramotia Dakhil Madrasha Neej Bhogdaburi Bhogdaburi Domar Nilphamari Page | 71 Table 3: List of Qualitative Sample Respondents Type Rangpur Nilphamari Total Gangachara Kaunia Taraganj Domar Jaldhaka Kishorgonj Nilphamari Sadar Focus Group Discussions (FGDs) Community Support Group 1 1 2 Community Group 1 1 2 Unmarried Adolescents boys and girls (1 with boys and 1 with girls’ group) 1 1 2 Men (Head of the Household) 1 1 2 School Management Committee 1 1 2 Total FGDs 10 Key Informant Interviews (KIIs) SAAO – DAE 1 1 2 Community Health Care Provider (CHCP) 1 1 2 Family Welfare Assistants 1 1 2 Health Assistants 1 1 2 Representatives of UDCC 4 1 1 1 1 8 Representatives of UNCC 4 1 1 1 1 8 Representatives of DNCC 2 1 3 Livestock Officer 1 1 JANO Project staff 5 5 Public Health and Engineering Officers 1 1 2 Total KIIs 3 5 In - depth Interviews (IDIs) Pregnant women 2 2 4 Lactating women 2 2 4 Married adolescent girls 1