Poster Topical Area: Methods and Protocols
Location: Hall D
Poster Board Number: 669
Objective: Evidences based on the evaluation of large-scale nutrition programs are limited. Suchana is a large-scale nutrition program that aims to improve the nutritional status of children belonging to the lowest socio-economic rural segment in Sylhet division of Bangladesh. The program, to be implemented through a stepped-wedge design, shall deliver both nutrition specific and nutrition sensitive interventions, including livelihood components. The objective of this study is to describe the process used to design evaluation of Suchana program in Sylhet division of Bangladesh.
Methods: Suchana is to be implemented in 157 unions, which is the lowest administrative units of Bangladesh. Each year, Suchana will deliver interventions to 40 randomly selected new unions of two districts of Sylhet division. Within four years Suchana shall cover all 157 unions in a stepped-wedge manner. The 40 unions of the last phase will join the program at the beginning of year four. It implies that, unions from the first phase would have received three years of intervention when Suchana will go for the last phase of implementation. Although the intervention program will be implemented in a stepped-wedge manner, the evaluation follows a randomized pre and post design. The 40 unions of the first phase will be considered as intervention unions and 40 unions of the last phase will be considered as active control unions. In order to produce robust evidence about the program outcome and to inform program, the evaluator was involved during the design phase of the program implementation rather than just before the data collection process.
Results: Suchana evaluation approach, ensured that measurable impacts can be attributable to the Suchana intervention. Before starting the intervention in the first phase, a baseline survey will be conducted in both intervention and control unions. Taking the advantage of the stepped-wedge implementation design, two repeated cross sectional surveys in intervention and control unions, three years apart, will be used to measure the program effect.
Conclusions: We conclude that, designing evaluation of large-scale nutrition program in rural segment is feasible; however, active involvement of the evaluator from the designing phase is the key to success.
Dhaka, Dhaka, Bangladesh