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PR, IFPRI3; ISI; DCA; CRP4; Alive and Thrive; 2 Promoting Healthy Diets and Nutrition for all; IFPRIOA, Nutrition, Diets, and Health (NDH); Food and Nutrition Policy; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Background: Bangladesh is urbanizing rapidly, facing challenges of malnutrition, low coverage and poor quality of urban nutrition services. Objectives: We assessed the impact of integrating maternal, infant, and young child nutrition interventions, delivered at urban Maternal Neonatal and Child Health facilities, on maternal dietary diversity, iron-folic acid (IFA) and calcium consumption, and child feeding practices. Methods: We used a quasi-experimental design with a non-random assignment of 20 health facilities in Dhaka to intensive and standard service arms. We conducted facility-based observations and community-based surveys at baseline (2020) and endline (2022) (n=2,455 observations and surveys with 1,678 pregnant [PW] or recently delivered women [RDW] at endline). We derived difference-in-difference (DID) estimates, adjusted for characteristics that differed at baseline or endline, and accounted for clustering. Results: Exposure to antenatal care (ANC) was similar in both arms: two-thirds of RDW received ANC during the first trimester and three-fourths received ≥4 ANC check-ups. Compared to the standard arm, a higher proportion of PW in the intensive arm received counselling on dietary diversity (DID: 45 percentage points [pp]), and a higher proportion of RDW received IFA (25pp) and calcium supplementation (19pp), adequate weight gain (44pp), and appropriate child feeding (27pp). Improvements were greater in the intensive than standard arm for number of food groups consumed (DID: 1.1 food groups) and minimum dietary diversity (23pp); no impact was observed for IFA and calcium consumption during pregnancy. Impacts were observed for early initiation (20pp), exclusive breastfeeding (45pp), introduction of solid or semi-solid foods (28pp), and egg and/or flesh food consumption (33pp) among children. Minimum dietary diversity and acceptable diet remained low in both arms. Conclusions: Intensifying nutrition in government-aligned health services delivered by experi

Non-PR, IFPRI5; 2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive, PHND, The COVID-19 pandemic disrupted health services worldwide. Alive and Thrive (A&T) is testing MIYCN integration into non-governmental organizations’ (NGOs) health services in eight facilities in Dhaka. We aimed to develop a data-driven urban MIYCN intervention pathway adapted to continue delivering nutrition services during COVID-19.

Introduction Despite high prevalence of malnutrition little is known about the quality of nutrition services provided through urban health systems. This study aimed to fill in knowledge gaps on quality of nutrition service provision at public primary health care facilities in urban Dhaka. Method This cross-sectional study was conducted from April-July 2019 in Dhaka City. Fifty-three health facilities were sampled following NetCode protocol. Quality of nutrition services was assessed in terms of structural readiness, process, and client satisfaction. Structural readiness included equipment, guidelines, and registers, and knowledge of health professionals (n = 130). For process, client provider interaction was observed (ANC: n = 159, Pediatric: n = 150). For outcome assessment, client’s satisfaction with nutrition service provision was measured through interviews with pregnant women (n = 165) and caregivers of 0–24 month-old children (n = 162). Bivariate and multivariate analyses were conducted using SPSS. Results There were gaps in availability of equipment and guidelines in health facilities. Only 30% of healthcare providers received basic nutrition training. The mean knowledge score was 5.8 (range 0–10) among ANC providers and 7.8 for pediatric service providers. Process: Only 17.6% health facilities had dedicated space for counselling, 48.4% of pregnant women received four key nutrition services; 22.6% of children had adequate growth monitoring; and 38.7% of caregivers received counselling on exclusive breastfeeding. Outcome: The mean satisfaction with services was 4.3 for ANC and 4.0 for paediatric visits (range 1–5). Participants attending public facilities had significantly lower satisfaction compared to those attending private and NGO health facilities. Conclusion There were gaps in facility readiness, and implementation of nutrition services. The clients were more satisfied with services at private facilities compared to public. The gaps in nutrition service