Who We Are

 

What is Suchana?

Suchana is a large-scale, multi-sector nutrition programme that aims to reduce the incidence of stunting among children under two years-of-age by breaking the intergenerational cycle of malnutrition in Sylhet and Moulvibazar districts, Sylhet division, Bangladesh, and catalyse the provision of support from the government and other stakeholders to achieve a coordinated, multi-sectoral approach to undernutrition nationally.

 

In order to demonstrate a cost-effective, replicable, scalable model, the Suchana consortium has developed and is implementing a nutrition graduation model by sequencing the interventions at various administrative levels with adequate resource allocation over 36 months, along with periodical evaluations of the effectiveness of the model.

Suchana is working with 235,500 poor and very poor households, women and adolescents in 157 unions across twenty upazilas (sub-districts) in Sylhet and Moulvibazar districts. The programme employs a multi-sectoral approach, which includes interventions to improve poor people’s access to essential health and nutrition services, increase their income, and empower women and girls to make better choices about food and nutrition at home.

The programme aims to achieve these goals via three separate, but interconnected, causal pathways. Pathway 1 aims to increase poor people’s incomes through asset transfers and livelihood training, so they can afford more nutritious meals and diversify their diet. Pathway 2 aims to improve the nutrition of pregnant and lactating women and infants by providing information and training

 

on healthy eating habits. Pathway 3 aims to improve the coordination and governance of nutrition services, build demand for these services among the people, and develop a sustained market system. The theory of change assumes that a multi-sectoral approach is necessary, as economic barriers act as binding constraint to a nutritious diet, social norms hinder good nutrition among women and girls, and there is scope to influence government activities.

 

Overall In Bangladesh:

  • More than half the population suffers from malnutrition.
  • Severe acute malnutrition affects 450,000 children, while close to two million children have moderate acute malnutrition.
  • Anaemia affects 52% of children under-five years of age.
  • 41% of children under-five years of age are stunted.
  • 16% of children under-five years of age are wasted.
  • 36% of children under five years of ageare underweight.
  • A quarter of women are underweight and around 15% have short stature, which increases the risk of difficult childbirth and low-birth-weight infants.
  • Half of all women suffer from anaemia, mostly nutritional in origin.
  • Malnutrition is estimated to cost Bangladesh more than USD1bn every year in lost productivity.

 

 

 

The consortium

The Suchana programme is being implemented by a consortium of national and international NGOs, led by Save the Children Bangladesh (SCiBD). The technical partners are Helen Keller International (HKI), International Development Enterprises (iDE), WorldFish (WF). The implementing partners are the Center for Natural Resource Studies (CNRS), Friends in Village Development Bangladesh (FIVDB), Rangpur Dinajpur Rural Services (RDRS) and the icddr,b as the research partner.

 
Save the Children

Save the Children in Bangladesh (SCiBD) is the consortium lead for the Suchana programme. Save the Children works in Bangladesh to promote the rights of children and adolescents to education, to health and to a life without violence. SCiBD’s approach is based on the participation of children and adolescents, their families and communities in their own development.

In Bangladesh, Save the Children is focused on reinforcing their programme learning in a way that brings lessons learned into the programme design and management decision making, leading to continual improvements over time. Save the Children directly reaches more than 12 million children and adults in Bangladesh through implementation of over 90 projects in all 64 districts of Bangladesh.

 
WorldFish

In Bangladesh, aquatic foods play a central role in dietary patterns, livelihoods and culture. Fish is by far the most consumed animal-source food in the country. It is an important diet staple, providing a rich source of micronutrients and accounting for 60 percent of animal protein intake. WorldFish (WF) has been working with the Government of Bangladesh and development partners to create a more

productive fisheries and aquaculture sector that contributes to diversified and resilient rural livelihoods and promotes food and nutrition security. For the Suchana programme, WorldFish is mainly promoting nutrition-sensitive aquaculture and fisheries along with vegetable production systems to the beneficiary households.

Nutrition sensitive fish production focuses mainly on carp-tilapia-mola poly-culture along with locally available other small indigenous fish species using improved management practices. The main aim of these components is to enhance the dietary diversity and nutritional status of reproductive age women and young children (6 to 23 months of age). Up to June 2021, WorldFish has supported a total 64,801 poor and very poor households of Suchana beneficiaries on nutrition sensitive aquaculture and fisheries related alternatives at 4 different phases since 2016.

 

RDRS Bangladesh
(Rangpur Dinajpur Rural Service)

In Bangladesh, aquatic foods play a central role in dietary patterns, livelihoods and culture. Fish is by far the most consumed animal-source food in the country. It is an important diet staple, providing a rich source of micronutrients and accounting for 60 percent of animal protein intake. WorldFish (WF) has

been working with the Government of Bangladesh and development partners to create a more

 

Friends In Village Development Bangladesh

Friends in Village Development Bangladesh (FIVDB) was established in 1979 and works with the mission of giving disadvantaged women, men and children greater voice, reducing their vulnerabilities, increasing their use of citizenship rights and helping them enhance their quality of life. It pursues educational, social and economic capacity building and social-

organisation approaches, and works in collaboration with communities, Government, civil society and private sector. FIVDB emphasises creation of agencies of individuals, families and communities. Livelihood is one of the core programme pillars, which seeks to enhance people’s productive capacity – combining indigenous and new technologies and supports market integration through income generating activities including small and medium enterprises. FIVDB is directly reaching 430 thousand families through its core programmes and 24 projects currently. In Suchana, FIVDB plays the implementation role, carrying out all the field level activities related to livelihood, nutrition, market strengthening, service linkage and advocacy.

 

          

                                

 

Helen Keller International

Hele Keller International Bangladesh has more than 35 years of experience implementing nutrition, food security, and blindness prevention programmes in Bangladesh. The organisation has emerged as a leader in gender-sensitive programming tackling deeply rooted social and cultural barriers to women’s empowerment and development. As a pioneer for homestead

food production (HFP) programmes to improve food security and nutrition outcomes in Bangladesh, HKI work closely with partners to identify effective ways to address HFP in Pillar -3 and gender inequalities across all areas of Suchana’s intervention.

 

IDE

iDE has created business opportunities for the private sector with the goal of improving income, livelihood, and well-being for low-income and marginalized communities. As one of the technical partners of Suchana, iDE has been strengthening market system through engaging lead firms, facilitating parivate sector actors, establshed business groups for briging the last mile gaps and capacity building on market-based

approaches to the Suchana Consortium. iDE’s role has likewise flexed from a purely advisory and training role to include market facilitation aspects as required for both income generating activities and homestead food production in beneficiary households.

 

Center for Natural Resource Studies

The Center for Natural Resource Studies (CNRS) is one of the most recognised pro-environmental national NGOs in Bangladesh. Since formation in 1994, CNRS has been active in this field and has drawn attention of relevant local, national and international actors including government and funding agencies through demonstrating innovations in its approaches and producing tangible learning outcomes. CNRS aims to join

with others in influencing the national development strategy towards directions that support the achievement of Sustainable Development Goals (SDG) in Bangladesh.

CNRS as one of the implementing partners of Suchana has been working with 84,828 households from 1,024 villages under 57 Unions covering all the seven upazilas of Moulvibazar district. The core Suchana interventions of CNRS include capacity strengthening of women and adolescent beneficiaries through knowledge transformation, input support and improving access to services along with advocacy efforts for prioritising nutrition in GoB planning and budgeting.

 

icddr,b

icddr,b is one of the world’s leading global health research institutes committed to solving public health problems facing low- and middle-income countries through innovative scientific research – including laboratory-based, clinical, epidemiological and health systems research. By developing, testing and assessing the implementation of interventions specifically designed for resource-poor settings, icddr,b aims to improve

the health and wellbeing of people living in the world’s poorest nations. icddr,b’s work has had a profound impact on health policy and practice both locally and globally – and this remains their key objective for the future. As the research partner for the Suchana consortium, icddr,b has led evaluation research on the impact of the Suchana interventions.

 

 

Donors

European Union

European Union (EU), international organisation comprising 27 European countries and governing common economic, social, and security policies. Originally confined to western Europe, the EU undertook a robust expansion into central and eastern Europe in the early 21st century. The EU's main objective in Asia is to help engender the political 

and social stability of the region, promoting policies to assist in maintaining as much as possible its high rates of economic growth, also for the benefit of Europe's own economy and citizens. Sustainable political and social stability in the region will continue to require the advocacy of the EU's values and the spread of more resilient forms of democracy - alongside an improved rules-based multilateral order - aimed at serving the people of the region.

 

Foreign, Commonwealth and Development Office

The Foreign, Commonwealth and Development Office (FCDO) was launched in 2020 with the merger of two UK government bodies – Department for International Development and the Foreign and Commonwealth Office. Bangladesh faces several challenges, which include meeting the demands of a large and increasingly urban population while dealing with the

shocks of natural disasters and climate change. FCDO works the Bangladesh government and development partners to fight poverty and help build a prosperous and stable country.

 

 

 

Malnutrition in Bangladesh

Rates of malnutrition in Bangladesh are among the highest in the world. More than 54% of preschool-age children (approximately 9.5 million children) are stunted, 56% are underweight and more than 17% are wasted. The prevalence of underweight ranged from 49.8% in Khulna to 64.0% in Sylhet which also showed the highest prevalence of stunting (61.4%) and wasting (20.9%). Despite the high levels, rates of stunting have declined steadily over the past 10 years.

Bangladeshi children also suffer from high rates of micronutrient deficiencies, particularly vitamin A, iron, iodine and zinc deficiency. However, Bangladesh should be commended for making significant progress in reducing vitamin A deficiency (VAD) among preschool children over the past 15 years; but consumption of vitamin A rich foods is still low, suggesting that the underlying causes of VAD require further attention and support. Anaemia is also highly prevalent among children in Bangladesh and more programmes are needed to improve their iron status.

 

Stunting in children in Bangladesh

Stunting is referred to as linear growth retardation, meaning children are short for their age. The World Health Organization (WHO) defines stunting as: “the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation”.

Two out of five stunted children in the world live in South Asia. A recent global health and monitoring report highlighted how the trends in stunting vary significantly within countries, with the rates even increasing and declining in different regions of the same country. Compared to national data for Bangladesh, the prevalence of stunting among children aged 12-23 months-of-age is higher in Sylhet division; the proportion of children in the lowest quintiles with stunting is also higher in Sylhet division than the national average.

Even though the country has experienced significant economic progress over the last decade, Bangladesh has one of the highest rates of stunting in South Asia, with 31% of under-fives known to be stunted. Moreover, a significant proportion of the country’s population is still food insecure. A report published in 2014 stated that the rate of stunting in Bangladesh was decreasing by 2.7% annually. Despite this apparent improvement, more than a third of Bangladeshi children under-five years of age still suffer impaired linear growth.

Despite the challenges, Bangladesh has made strides in reducing the prevalence of stunting nationally, falling from 41% in 2011 to 36% in 2014. Stunting is highest in the Sylhet division at 50% and lowest in Khulna at 28%. Stunting is most prevalent among children 18–23 months, indicating that poor complementary feeding and hygiene and sanitation practices are likely contributors to stunting in that age group.

 

Malnutrition in women and adolescents

Malnutrition among women is also extremely prevalent in Bangladesh. More than 50 percent of women suffer from chronic energy deficiency and studies suggest that there has been little improvement in women's nutritional status over the past 20 years. As observed for children there were important differences in the prevalence of women malnutrition among administrative divisions. The prevalence of women with a BMI<18.5 kg/m2 ranged from 47.6% in Khulna to 59.6% in Sylhet. Programmes in Bangladesh have to incorporate components for adolescents and school-age children who will also benefit from improvements in nutrition.

Improving nutrition can have a significant impact on survival as well as physical and cognitive development and productivity. Good nutrition, comprising adequate quality and quantity of food intake and reduction of illness is also a basic human right and is an essential input for economic development.

 

Poverty in Bangladesh

Bangladesh has made remarkable progress in reducing the incidence of poverty over the last decade. According to the 2016 Household Income and Expenditure Survey (HIES), the head count ratio of poverty (based on the upper poverty line) reduced by 7.2% from 31.5% in 2010 to 24.3% in 2016. The incidence of poverty based on the lower poverty line was estimated to be 17.6% in 2010 and 12.9% in 2016, representing a reduction of 4.7%.

Based on the lower poverty line, poverty remained almost unchanged in Sylhet division between 2005 and 2010 and started to decline thereafter. Bangladesh also faces regional income inequalities, which are more pronounced in rural Bangladesh; Sylhet region is no exception. Sylhet division has had a 9.2% change in the lower poverty line head count between the 2010 and 2016 HIES. These statistics reveal the rate of reduction of poverty and highlight the need for customised interventions to address the higher geographical incidence of poverty in Sylhet division.

 

Poverty in Bangladesh

Suchana has applied a community-led poverty criteria and participatory selection process to identify beneficiary households from 19 upazillas and 157 unions of Sylhet and Moulvibazar districts. The following are some broad criteria that were used at the initial stage to identify potential programme beneficiaries. These criteria were then validated and adjusted to the local context using a rigorous consultative and participatory selection process. Primary/mandatory criteria: Very poor households with women of reproductive age. In this conxtest, very poor has been defined by the following criteria.

  • Ownership of homestead land - less than 10 decimal
  • Ownership of cultivable land - less than 50 decimal
  • Ownership of other productive assets - value not more than BDT 15,000 in current price
  • Sources of income/livelihood options – Do not have any reliable or sustainable source of income
  • Household food security status –
  • Cannot afford three meals per day for all family members throughout the year (months with adequate food provision),
  • Food security status during lean period
  • Do not have year-round access (either through purchase or production) to nutritious
  • food

In addition to these mandatory criteria, emphasis was given to geographical, social, political and nutritional vulnerability of the households. Once the poor and vulnerable villages/communities are identified, wellbeing analysis/wealth ranking were conducted to identify very poor households within that village/community.