Narrative Description of Project: In December 2012, USAID/Bangladesh awarded Pathfinder a four-year contract to assist USAID in supporting the delivery of an essential service package (ESP) through a network of local non-governmental organization (NGO) clinics that primarily target the poor and underserved in urban and rural areas.   This program builds on the previous experiences and successes in NGO service delivery under the Bangladesh Smiling Sun Franchise Program (BSSFP) and before that, the National Service Delivery Program (NSDP).  It incorporates new approaches to promote optimal health behaviors and community participation and enhances local ownership of service delivery through institutional strengthening.

The NGO Health Service Delivery Program (NHSDP) aims to increase access to ESP services in reproductive health, child health, limited curative care, TB and HIV/AIDS and has a strong focus on behavior change communication (BCC) activities, in particular community mobilization.  NHSDP aims to create demand for services and increase use of FP and RH services among new user groups and emerging pockets of the poor by increasing awareness on the benefits of using these critical services and changing behavior to improve health outcomes.  It is expected that expanded access to and use of these services will contribute towards decreasing fertility, child morbidity and maternal mortality rates in the country.

The principal objective of the endline survey was the same as the baseline survey – to collect quantitative data on reproductive health, child health, limited curative care, TB and HIV/AIDS in NHSDP urban program areas located in Chittagong City Corporation, Dhaka City Corporation, and remaining City Corporations and areas of District and Thana Municipalities and their respective comparison areas.  These data was used (1) to assess changes in key indicators specified in the NHSDP Project and (2) to evaluate the contribution of the NHSDP project to any of these changes. The endline household survey was conducted among a representative sample

of ever-married women age 12– 49 and children under five years of age living in the urban intervention and non-intervention comparison areas, as was done for the baseline surveys.

The endline survey applied a stratified two-stage sampling designed to obtain a representative sample of households in two domains: project and non-project comparison areas area located in Chittagong City Corporation, Dhaka City Corporation, and remaining City Corporations, and District and Thana Municipalities. The endline survey was conducted in the same 338 clusters in 64 districts that were selected for the baseline survey as well as in 71 additional clusters for a total of 409 clusters.  A new sample of households were selected in each of these clusters.

Samples were drawn from the project and non-project comparison area domains of sufficient size to capture a 10 percent relative change over time in modern contraceptive prevalence among married women age 12-49 (CPR) and a 20 percent relative change over time in the percentage of last births during the two years preceding the survey that were attended by a skilled birth attendant (SBA), with 95 percent confidence and 80 percent power.

Activities and Responsibilities for Mitra and Associates

The specific responsibilities of Mitra include the following:

• To prepare and submit the survey protocol to the local IRB;
• To implement key aspects ofthe sampling strategy, including household listing, cartographic updating of selected clusters in the field, and provision of information for sampling weight calculation for both project and non-project comparison areas;
• To organize field work activities;
• To collect GPS coordinates for both the clusters and health facilities;
• To recruit and train the field work team (with the participation of MEASURE Evaluation staff);
• To provide required ethics/human subject protection training to all staff involved in survey activities;
• To conduct field work with appropriate supervisory and quality check activities;  
• To conduct data entry and management;
• To conduct appropriate quality checks at different stages of field work, data entry and data management processes;
• To produce frequency distributions for the data sets;
• To prepare preliminary and final datasets with appropriate documentation; and
• To draft a report describing all data collection and data management procedures, supervisor observations/comments, and limitations/problems encountered.

The survey was awarded by The University of North Carolina at chaple Hill (UNC-CH) and funded by “Monitoring and Evaluation to Assess and Use Results (MEASURE) Evaluation phase IV project” U.S. Agency for International Development (USAID). 

Duration: April 01, 2017-September 30, 2017.

Contact reference: Dr. James C. Thomas, Project Director, MEASURE Evaluation, UNC- Chapel Hill/Carolina Population Center, 400 Meadowmont Village Circle, 3rd Floor Chapel Hill, NC 27517, Email: measure_subs@unc.edu, web site: www.cpc.unc.edu/measure.