Bangladesh

Project—School Nutrition for Adolescents Program (SNAP)

Objective

To improve adolescent nutrition and health through an integrated health package delivered in schools.

Background

In Bangladesh, anemia affects women and children more than other groups. A person with anemia has a low number of red blood cells or a low hemoglobin concentration. Anemia is associated with reduced learning capacity and productivity, which negatively affect economies. Anemia also increases the risk of pregnancy-related complications for the mother and child.

The prevalence of anemia among girls aged 10 through 19 years in Bangladesh is about 30%, according to the Bureau of Statistics and United Nations Children’s Fund (UNICEF).

SNAP delivers an integrated health package in schools by providing:

• Weekly iron and folic acid supplements for girls.
• Support for menstrual hygiene management for girls.
• Support for improved water, sanitation, and hygiene practices for girls and boys.
• Behavior change interventions to bring about dietary change and support the effective delivery of these evidence-based interventions for girls and boys.

SNAP is an initiative of Nutrition Internationalexternal icon in collaboration with the Bangladesh Government and BRAC, an international development organization in Bangladesh. CDC’s International Micronutrient Malnutrition Prevention and Control (IMMPaCt) team provides technical assistance for an impact and process evaluation.

Activities

CDC helped draft and develop a baseline survey that was conducted in the Joypurhat district covering 75 schools. These schools were randomized to receive the SNAP intervention or not, facilitating an impact evaluation to assess program effectiveness and scalability. Schools that received the intervention selected adolescent leaders and teachers to attend a 3-day residential training on the SNAP initiative.

CDC helped design a mixed-methods process evaluation to complement the impact evaluation. In-depth interviews and focus group discussions will gather information on the program fidelity, and participant perceptions, motivations, and experiences with the SNAP intervention. Quantitative data will be extracted from school registers at multiple time points to estimate school attendance, and data will be collected on supply chain management of the nutritional supplement.

Potential Impact

The impact evaluation will inform the Government of Bangladesh about the potential effectiveness of an integrated approach to improve adolescent health, nutrition, and education in Bangladesh. The process evaluation data will contextualize the physical and social environment that may improve the implementation of the SNAP intervention, specifically if the government is interested in delivering a similar program at scale.

Next Steps

CDC will continue to provide technical assistance focused on the impact and process evaluation that includes:

• Preparing and modifying data collection tools.
• Analyzing data and disseminating findings.