Bangladesh


                            BANGLADESH -- From Pilot to Scale
      Engaging local governments and established local service providers in the Jawtno
                            conditional cash transfer program

Jawtno will bring to national scale early years services through community clinics, post offices, and
mothers’ groups, while coordinating with NGOs to ensure service supply meets demand. Jawtno builds on
key learning from a pilot program that was shown to rapidly reduce malnutrition.

The Situation in Bangladesh:
Children’s nutritional status has been improving in Bangladesh, and yet challenges remain. The prevalence
of stunting is among the world’s highest, at 36 percent. The incidence of low birth weight is also among
the highest, at almost 18 percent. And for mothers, undernutrition is a serious issue that affects one in
every five who are pregnant or lactating. The result of this combination– stunting, low birthweight, poor
maternal nutrition—is a transfer of malnutrition across generations in Bangladesh.

The Program:
Jawtno means “nurture� in Bangla, and is a conditional cash transfer program (CCT) that builds on the
experience of a prior pilot program, Shombhob (“possible�) which showed rapid results in reducing
stunting. It will target the bottom 40 percent of the income distribution and cover 10 percent of the
extreme poor population and 2 percent of total households directly. The program is expected to start in
July 2017.

Jawtno will target pregnant women and mothers of children up to 5 years. The women will receive
nutrition services such as antenatal care and regular growth monitoring and promotion for their children,
as well as counseling sessions that address healthy physical and cognitive development of children in the
early years: pregnancy care, nutrition, hygiene/sanitation, parenting skills, child stimulation and more.

The counseling sessions will be linked to children’s check-ups in clinics and in small group sessions. Local
governments will manage program implementation and deliver services through Community Clinics.
NGOs will play a role in ensuring reliable services and support Clinics in managing the demand, as well as
delivering the counseling sessions. Cash transfers to beneficiaries will be managed through biometrically
secure electronic cash cards that can also provide access to savings accounts at local Post Offices.

Implementation Lessons:
These lessons are from Shombhob, whose experience has been transferred into Jawtno’s design.

(1) Prioritize rural areas with concentration of poverty and malnutrition: Jawtno will concentrate in rural
areas with poverty rates of 40% or higher. The implementation of Shombhob indicated that a wider, and
more comprehensive system of interventions would be required to address nutrition outcomes in poor
urban settings (i.e. housing, sanitation, daycare facilities).

(2) Promote child cognitive development concepts among caregivers: Jawtno will include social and
behavioral change communications on early childhood cognitive development.

(3) Partner with Local Governments and NGOs for coordination and service supply: LGs in Bangladesh
are mandated to facilitate a variety of public services, as well as to coordinate safety net implementation
Bangladesh


across Ministries. Alongside NGOs, they are important partners in ensuring seamless delivery of services
and payments linked to the CCT.

 (4) Provide different points of payment: the program will give beneficiaries the option of getting their
allowance either at the village level (through a “mobile payments team�) or at the Union level through a
local Post Office branch. The program will also facilitate access to interest bearing Post Office savings
accounts. New technology will also be utilized through biometric identification systems to verify
attendance and payments under Jawtno.

(5) A CCT can have a significant impact on poverty reduction and nutrition: the pilot showed that the
intervention contributed to a 4 percentage-point reduction in poverty headcount in target areas.
Beneficiary households also increased their consumption by 70 percent of the average size of transfers
received and improved food consumption patterns (food expenses on proteins increased significantly,
and even more so for households receiving the nutrition awareness sessions). There were also significant
improvements in the outcomes of children aged 10-22 months: wasting was reduced by 12.5 percentage
points (which is a reduction of about 40 percent of wasted children in this age group).

References & Resources:
    •    Ferre, Celine and Sharif, Iffath (2014), Can Conditional Cash Transfers Improve Education and
         Nutrition Outcomes for Poor Children in Bangladesh? Evidence from a Pilot Project.
    •    Hamadani et al. 2014. “Cognitive Deficit and Poverty in the First 5 Years of Childhood in
         Bangladesh� in Pediatrics, 2014;134;e1001
    •    Video Investing in Healthy Mothers and Children in Bangladesh