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Evaluation arrangements for Improved Implementation: The OTEP case of BRAC Md. Hasib Reza

Evaluation arrangements for Improved Implementation: The OTEP case of BRAC Md. Hasib Reza Research and Evaluation Division (RED) BRAC, Bangladesh Presentation for the workshop on- Evaluation for Policy Making 27-31 October 2014, Suzohu City, Jiangsu Province, China. Outline.

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Evaluation arrangements for Improved Implementation: The OTEP case of BRAC Md. Hasib Reza

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  1. Evaluation arrangements for Improved Implementation: The OTEP case of BRAC Md. Hasib Reza Research and Evaluation Division (RED) BRAC, Bangladesh Presentation for the workshop on- Evaluation for Policy Making 27-31 October 2014, Suzohu City, Jiangsu Province, China

  2. Outline BRAC: At a Glance Overview of OTEP Taking Science Where the Diarrhoea Is Piloting and Continuous Learning: Ingredients for Scale Up Linking Evaluations to Actions for Improved Implementation of OTEP Lessons Learned 2

  3. BRAC: At a Glance Established in 1972 in Bangladesh Goal: Empowering people to lift themselves out of poverty Currently operates in 11 countries Served 135 millions of lives 1,20,000+ Staff Budget in 2014: US$ 900m (70% self) 3

  4. Overview of OTEOP Oral Therapy Extension Programme An ORW teaching a mother; PC- BRAC 4

  5. Overview of OTEOP 10 year-long (1980-90) > 13 million mothers > 75,000 villages > Treat diarrhoea at home > Semi-literateORWs 5

  6. Taking Science Where the Diarrhoea Was • In 1970s, diarrhoea was the major cause of infant mortality in Bangladesh • Ideas took shape: Options for interventions • 1. Treat all diarrhoea patients by trained personnel • 2.Diarrhoea prevention through safe water & sanitation • 3. Marketing of Oral Rehydration Solution (ORS) • 4. Teach mothers how to make ORS at home with easily available ingredients 6

  7. Taking Science Where the Diarrhoea Was • Challenge emerged • Developing a simple formula for home-made ORS • The ‘kitchen experiment’: • Lobon(salt)-Gur(brown sugar) Solution (LGS) • Harinagar & Anandapur: From Kitchen to the field • Contents of educational message • The recipients of education • Method of teaching • The teachers 7

  8. Taking Science Where the Diarrhoea Was • Lessons learned from the first field trial • Rural mothers were capable in preparing ORS • ORWs could provide education on ORT • Quality enhancing monitoring and corresponding logistic systems could be developed • Should BRAC go for a national level programme? • “Small is beautiful but big is necessary” 8

  9. Piloting and Continuous Learning: Ingredients for Scale Up Oral Therapy Programme (OTP): The pilot project Solved crucial implementation and management issues and served as the blue-print for OTEP -Developed team building and training methods for ORWs -Introduced incentive based salary system -Ensured safe and effective solution -Developed monitoring and logistic systems 9

  10. Piloting and Continuous Learning: Ingredients for Scale Up Felt importance of continuous learning through real-time evaluations from BARD case of 1970s Chowdhury and Cash (1998) In-house Research and Evaluation Division (RED) emphasized on real-time process evaluation of OTEP Arranged supports from ICDDR,B, Government agencies and Technical Advisory Committee (TAC) 10

  11. Linking Evaluations to Actions for Improved Implementation of OTEP Altering LGS formula: ORWs showed the way A fistful of brown sugar (gur);PC- BRAC A pinch of salt (lobon); PC- BRAC 11

  12. Linking Evaluations to Actions for Improved Implementation of OTEP Improving quality of teaching and learning An ORW teaching mother using flipchart; PC- BRAC A mother preparing LGS under the watchful eye of an ORW 12

  13. Linking Evaluations to Actions for Improved Implementation of OTEP Increasing male involvement in the programme as well as medical professionals Village men were taught by male staff;PC-BRAC 13

  14. Linking Evaluations to Actions for Improved Implementation of OTEP Ensuring higher usage of LGS Problems identified -Misperception about ORWs -Mothers were not convinced -Fear of becoming ‘sterile’ -Local perception about diarrhoea- 4 types 14

  15. Linking Evaluations to Actions for Improved Implementation of OTEP Ensuring higher usage of LGS Devised solutions -Extended length of stay of ORWs and the team -Tasting LGS by ORWs in front of the mothers -Revised “Ten points” messages 15

  16. Linking Evaluations to Actions for Improved Implementation of OTEP Ensuring higher usage of LGS Results Source: Chowdhury and Cash (1998) 16

  17. Linking Evaluations to Actions for Improved Implementation of OTEP Impact evaluation on mortality Source: Chowdhury and Cash (1998) 17

  18. Lessons Learned NGOs can implement national level programme Up scaling must take into account organization’s capability In-house research and evaluation can play a critical role in programme’s development National and international support can be obtained if the process is opened and information is shared 18

  19. Thank you Website of RED: www.brac.net/research 19

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