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The Chittagong Hill Tracts (CHT) is among the most disadvantaged and isolated areas in Bangladesh. The CHT is divided into three districts – Rangamati, Bandarban and Khagrachari - comprising 25 Upazilas and covering 1.4 million people. Most of the people live in small villages known as paras. There are a total of 4,599 paras in the CHT and each of these consists of 20-100 families.
Between 1997 and 2010, ICDP constructed a total of 2520 para centres and planned that by end of 2011 there will be a total of 3500 in the three CHT districts to provide a range of services including organization of early childhood development sessions for pre-school children, health and hygiene education activities to promote immunization, anaemia prevention, use of safe drinking water and sanitation, hand washing and other community development activities.
The purpose of the project had been to improve the socio-economic conditions of the children and mothers of the disadvantaged families of CHT through providing basic services of health, nutrition, education, water and sanitation and micro-credit.
The purpose of the evaluation was to:
• Review the experience of the ICD
• Assess the project relevance, effectiveness, efficiency, sustainability
• Assess the progress of implementation of the currently ongoing ICDP project.
• The findings, lessons and recommendations from this evaluation would be used to adjust the project design, approach and strategies to ensure its sustainability and progress of implementation of the currently ongoing ICDP project.
• Highlight the main achievements in the last five years and UNICEF’s contribution in terms of outputs and progress made in achieving outcomes in the areas of intervention.
The study was conducted through primary data collection and secondary review of the last evaluation report “Evaluation of the UNICEF Integrated Community Development Project in the Chittagong Hill Tracts, Bangladesh” conducted by Nordic Consulting Group in
In order to collect primary data quantitative and qualitative approaches were followed. The quantitative approach used face to face (F2F) interview method with community household members using a semi-structured questionnaire. The qualitative methods used included:
• Literature Review
• Focus Group Discussions (FGD)
• In-depth interviews
• Case studies
Primary data collection was done through a household survey (2210 respondents); a survey of 340 Para workers; 9 focus group discussions (FGD) and 15 case studies.
Findings and Conclusions:
The majority of respondents, both males and females, were aware of the functions of the para centers, especially ‘preschool classes’, ‘health and nutrition information’ and ‘water and sanitation’. About 95 per cent per cent of respondents or any other family members had visited a para center for some specific purpose in the last six months. Those visiting a para center found it helpful, and all of them were comfortable approaching and liaising with the centers. By far the most mentioned benefit was ‘child education’ mentioned by more than 90 per cent per cent of respondents. Other benefits expressed by respondents were gaining knowledge about healthcare, knowledge about nutrition and creating awareness for pregnant women.
The evaluation found that courtyard meetings are held regularly, and almost all females attended such meetings where they discuss about iodized salt and other nutritional issues. As a consequence of the project around 90 per cent per cent of respondents were found to visit the health center or hospital for healthcare services. Usage of mosquito net was almost universal and consumption of iodized salt was more than 90 per cent per cent.
Access to safe water and sanitary latrines was much better in intervention areas than in non intervention areas. Use of sanitary latrines was 92 per cent in intervention areas compared to 69 per cent in non-intervention areas. Out of the observed latrines, 80 per cent and 77 per cent respectively were found clean in intervention and non-intervention areas. Soap was available in around 73 per cent and 57 per cent of households respectively. Neither soap nor ash was available in 17 per cent of intervention households and 30 per cent of non-intervention households. Water container was available in 71 per cent of intervention households and 37 per cent non-intervention households.
Solid waste in a designated place was significantly higher in intervention areas (76 per cent) than in non-intervention areas (55 per cent).
Para Center Survey:
Most commonly rendered services were preschool classes and health and nutrition information. Other major services included W&S demonstrations (e.g. latrine installation), immunization information, demonstrations on safe water and hygiene, Para information centre, provision of micronutrient supplements, meeting venue, nutrition demonstrations and skills development with varying degrees across districts.
Community information charts were displayed in about 80 per cent of centers, and most of the displayed information/charts were found legible, clear and up to date. Around 90 per cent of children’s attendance to para enters is registered; para centers were reviewed by supervisors in their last visit and the para center stock registers were available and up to date.
Educational and play materials were available and in good condition in most of the centers. Information on date of birth and gender of children was also available in over 95 per cent of centers.
Almost all women who gave birth were given vitamin A within six weeks of delivery. However, not all children appear to have been given vitamin A or were fully immunized.
About two-thirds of para workers reported to have received training on preparing action plan for water and sanitation for the community.Courtyard meetings are held twice a month. All para centers have a management committee, which had had on average three meetings in the last 6 months; the same frequency was found for para workers attendance to cluster meetings.
Para workers were found to raise para center related issues with their respective supervisors during supervisory visits.
On an average week a Para worker works for 6 days, spends 18 hours a week and visits 6
households. About one-fourth of the workers perform other work in addition to their activities as Para worker. Such activities include teaching children at home, working with health workers, accompanying sick persons in the community to health facility and taking part in the national vaccination program.
Findings from the group discussions:
• The relevance of the project is evident. There was and still is a high demand for increased community awareness about early childhood development and education, about health and nutrition and about water, environment and sanitation.
• The discussions revealed that Para centers have become the focal place for all social activities. Overall, the project is being managed efficiently and the administration of para centers is considered well managed.
• Community people are satisfied with the management and efficiency of the Para Workers and Centers as a whole.
• Community involvement has increased which demonstrates sustainability of this project.
• The evaluation reveals that the targeted women and children have increased access to services
provided by para centers over the years. The intended beneficiaries of the project have been actually benefitted.
• The group discussions revealed that Para Centers and Para Workers are an integral part of the community
• Community people want to see the Para centers provide more services. They are now aware of their healthcare, children’s education, sanitation and waste disposal.
• A lesson learnt is any integrated community development project with close follow up is bound to produce tangible results and people are clearly benefited. Such programs have the potential for replication in the context of Chittagong Hill Tract districts.
Case stories revealed that people from the CHT district are still very superstitious. They believe in many supernatural things and miracles that can be caused by Ayurvedic doctors, quacks and so-called religious persons. Therefore, when they fall sick they go to these people instead of going to clinics and hospitals. They are mindful about the opinion of other community members if their wife visiting a clinic or hospital is attended by a male doctor. To remove these social practices extensive awareness building programs need to be undertaken. In poor and extreme poor areas, more health services are needed.
1. The Para center project appears to have done a tremendous job especially in terms of pre-school education, paving the path for onward education, promoting health and hygiene and creating awareness about nutrition amongst the target population. On matters of health and hygiene, the findings reveal significant differences between intervention and non-intervention areas, indicating commendable project performance. This level of performance needs to be sustained.
2. The activities undertaken by para workers, such as pre-school activities, record keeping, display of information and charts, regular organization of courtyard meetings, attending cluster meetings, etc. speak for their dedication. More frequent supervisory visits and close supervision would motivate them to deliver better results.
3. Educational and information materials need to be replaced on a regular basis due to damage caused by normal wear and tear.
4. Safe drinking water for preschool children attending the center is a genuine concern. It is therefore imperative that every para centers has a tube well to ensure availability of safe drinking water.
5. The project has been well accepted and appreciated by the people of Hill Tracts. However, it is unlikely that it will sustain without outside assistance. Therefore, the relevant authority would need to find other funding sources to keep the project going.
6. The majority of the centers have suffered from normal wear and hence and require immediate repair, especially of wall/fence. It may be a good idea to do routine maintenance work to make them last longer.
7. Although Para workers were found quite efficient in delivering their services, they need motivation and skills trainings, especially in the areas of health to improve their performance and to ensure improved service delivery, and for preparing community action plans for water and sanitation as a large number of Para workers did not receive this training.
1. Expand the program into non-intervention areas.
2. Include new activities such as tailoring training and other income generating activities and micro-credit financing.
3. Conduct full training of Para workers, especially on preparation of community action plans for water and sanitation and knowledge on first aid, and refresher courses at regular intervals.
4. Make provision for regular repair and maintenance of Para centers.
5. Regular replacement of damaged preschool materials and install tube well in every Para center to ensure access to safe drinking water by children at the centers.
6. Increase the level of remuneration of Para Workers.
7. Increase frequency and type of monitoring activities of Para center and Para Workers.
8. Hold cluster meetings more frequently and include some more health related issues, such as STD and HIV/AIDS, and address superstition and misconception with regard to disease and illness.
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