Bangladesh

How Reach Up came to BANGLADESH

In 2004, Dr. Jena Hamadani was pursuing a Doctor of Philosophy degree at the University College London. Under the supervision of Professor Sally McGregor, Hamadani’s thesis studied the effects of psychosocial stimulation on malnourished children’s development and behaviour, and their mothers’ knowledge of parenting, when added to nutritional treatment. The tactics were based on the original Jamaica Home Visit curriculum designed by McGregor.

Four randomised-controlled trials were designed to target moderately underweight or malnourished children attending government-run nutrition centers and community health clinics in Bangladesh. In 2014, after the positive outcomes of the trials and thanks to the support of icddr,b, Dr. Hamadani and her team scaled the intervention. Today, the Reach Up intervention in Bangladesh serves the communities of Mymensingh, Monohardi, Ullapara, and Kishoreganj.

Dr Jena Derakhshani Hamadani

Emeritus Scientist, Maternal, Newborn and Child Health Division, iccdr,b

Dr Syeda Fardina Mehrin

Assistant Scientist, Maternal, Newborn and Child Health Division, iccdr,b

Sheikh Jamal Hossain

Associate Scientist, Maternal, Newborn and Child Health Division, iccdr,b

Our implementation partners

icddr,b

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) is a world-renowned health research institute committed to solving a wide range of public health problems through innovative scientific 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. Reach Up Bangladesh operates from icddr,b’s Maternal and Child Health Division and benefits greatly from the organisation's extensive clinical research infrastructure

Ministry of Health and Family Welfare, Bangladesh

Reach Up Bangladesh is [supported financially by / endorsed by / collaborates with / supervised by …] the People's Republic of Bangladesh through the Ministry of Health and Family Welfare, Bangladesh.

COMMUNITIES WE SERVE

Mymensingh

Monohardi

ullapara

kishoreganji

Our approach

Reach Up Bangladesh complements a range of existing government-run primary health services in rural communities, including food supplementation and an unconditional cash transfer program for pregnant women. We deliver the intervention through group sessions, home visits, or a combination of both. Group sessions usually accommodate two to four mother/child dyads and are held at community health centers.

A community clinic in Bangladesh. Photo credit: Mehrin et al, 2022

Key stats

Age Group

0 – 36 months
Frequency

1x/week
Duration
40 – 50 minutes/session
Total period

6 – 15 months

Our organisational structure

We train and empower government health workers to deliver the Reach Up curriculum. These frontline implementers include community health care providers, health assistants, and family welfare assistants in community clinics. We also recruit local residents to serve as play leaders and village health workers. 


Our research team members and government inspectors are responsible for supporting and supervising the workforce.

 

Cultural adaptations

Although the methods and underlying concepts of the Reach Up intervention remained unchanged, we adapted the content of the curricula and training materials from their original form to be more relevant to the community we serve.

We translated the training manual, toy manual, supervisor manual, and train-the-trainer video voiceovers into Bengali. In our materials, the depictions of mothers wear sarees, the traditional Bangladeshi clothing for women, and houses are made of mud, as seen in our villages. 

We replaced original songs and games with local, traditional versions. 

Home made toys

Outcomes

Thanks to the work of Reach Up Bangladesh, researchers have observed tangible improvements on participating children’s health and well-being, measured in:

Cognition
Behaviour
Expressive and receptive language
Nutritional status
Fine and gross motor skills
Anthropometric measurements

Secondary outcomes include an increase in the mother’s parenting knowledge, more stimulation in the home, reduced maternal depressive symptoms, and reduced staff burnout.

Research & publications

The majority of the studies report significant benefits across all child developmental domains and child behaviour, as well as better parenting knowledge and fewer depressive symptoms.