© Tdh

Terre des hommesin BangladeshTerre des hommes – Lausanne (Tdh) has been working for children in Bangladesh since 1974.A Mother and Child Health (MCH) programme implemented through a comprehensive approach intervenes on Health issues, including Nutrition, Water, Sanitation and Hygiene (WASH), Homestead Gardening, Aquaculture, Rehabilitation of Community Clinics and Disaster Risk Reduction.In 2014, 366’600 people in Kurigram and Barguna District benefi ted from Tdh activities.

2014

The daily activities implemented by Tdh are focused on prevention, treatment and management of malnutrition, and the development of knowledge, skills and practices. Mothers and children benefi t from facilitated access to primary health care and increase capacities to prevent disease for themselves and their dependents.

Through the integration of MCH services in health facilities, primary health care is made more comprehensive in targeted health facilities. These services contri-bute to improve management of child-hood illness and maternal health, which consequently improves the health status of children, pregnant women and mothers.

Integrated Management of Childhood IllnessGeneral health services and prevention of malnutrition are combined to ensure proper child development. Tdh addresses child diseases like diarrhea, respiratory infections, measles, within an integrated Health and Nutrition

project. Mothers receive also education on immunization awareness and fever management.A team of fi eld workers is daily engaged in the community to identify new pregnant mothers, to promote antenatal care and to conduct individual follow-up.

Caring for pregnant and lactating womenAwareness is raised and information on hygiene practices is shared with pregnant and lactating women. Tdh helps preventing the risks linked to pregnancy, ensures ante-and post-natal care, and encourages exclusive breastfeeding during the fi rst six months of life. Specifi c education is

also provided to prevent pregnancies of adolescents, and to promote maternal health and family planning.

Key activities include:►Adequate education and counselling for instilling positive behavioural changes ►Training, guidance and monitoring of health and fi eld workers►Capacity development of government community health staff►Provision of primary health care to children under fi ve years►Ante and Post Natal Care►Referral of high risk pregnancies►Linking with government health programs

The activities are implemented in cooperation with the Revitalization of Community Health Care Initiatives in Bangladesh, the National Nutrition Services/Institute of Public Health Nutrition, under Ministry of Health and Family Welfare.Field operations involve community members and leaders. Coordination with service providers and authorities is strengthened.

Mother and Child Health

The prevention of acute malnutrition is carried out in nutrition centers in the community and in the government’s community clinics. The mothers are trained and sensitized on topics like exclusive breastfeeding and appropriate cooking to ensure a healthy and appropriate diet for children.

Provision of care for malnourished

children and mothersMost cases of moderate and severe acute malnutrition can be treated in the community. Tdh weekly/fortnightly treats affected children as well as pregnant and lactating women, while counselling the mothers. Children with complications are referred to Tdh’s Specialized Nutrition Unit. Tdh also supports and promotes sanitation, and offers capacities to implement proper homestead gardening.

Key activities include:►Capacity development of government‘s community health staff for implementing Community Management of Acute Malnu-trition. ►Screening in the community►Growth monitoring sessions►Home visits►Cooking demonstrations

Mother and Child Nutrition

In 20143’972 cases of malnourished children were ma-naged

44’280 children benefi ted from Integrated Mana-gement of Childhood Illness

244’490 care givers received health care, health/nutrition education, and awareness messages

419 government, Tdh, other NGO staff as well as community members were trained

project. Mothers receive also education

In August 2014, the low-lying, vulnerable and densely populated areas of Kurigram District were affected by severe fl ooding following the monsoon.

Tdh immediately res-ponded during and after the fl oods and coordinated its interventions with govern-ment and other NGOs. Affected people have been supported by Tdh with cash, and hygiene items to satisfy their imme-diate needs. Cash transfer was organized for households that lost crops to allow them to restore their livelihoods.

Moreover, households received income to create assets, repair existing commu-nity infrastructure like roads or raised

the plinths of low lying houses. In addition to satisfy their acute needs, this will increase their coping capacities in future fl oods. With the raised plinths, the houses

become fl ood resistant. Vulnerable households in the worst fl ood affected areas received seed support that allowed them to start own maintain vege-table production, increase food security and prevent malnutrition.

Rehabilitation of Community ClinicsThe Ministry of Health and Family Welfare’s (MoHFW) Community Clinics (CC) provide primary health care services, although with limited human resources, capacities and medical supplies.

Tdh is working in collaboration with health authorities to increase the impact of the services provided by supporting the rehabilitation of clinic buildings including access to safe drinking water, sanitation facilities, extension of space to conduct awareness sessions and to deliver appropriate care.

In 2014, 14 CCs started to be rehabilitate with the involvement of CC Community Groups.Ultimately, 120 CCs are targeted and will be rehabilitated and functional (Kurigram and Barguna Districts).

Disaster Risk Reduction

Water, Sanitation and HygieneAfter providing access to drinking water and sanitation systems in selected working areas during the last years, Tdh WASH team delivered trainings and awareness meetings on hygiene issues.

Through WASH committee meetings (and management committees of community clinics and schools) monitoring and maintenance of WASH facilities is ensured. Child group, mother group discussions, campaign sessions and individual counselling are continuously conducted at community level to deliver messages on hygiene issues such as personal hygiene,

critical times and rules of hand washing, use of sanitary latrines, safe water, and prevention of diarrhea. To complete its work and promote behavior change, Tdh has installed hand washing stations (Tippy-Taps) in communities and schools. Through the realization of the children’s right to suffi cient, safe, acceptable, accessible and affordable water and sanitation, Tdh reduces health threats related to low water quality.A baseline assessment was conducted on WASH related knowledge, facilities and practices at household level. The fi ndings generated from the assessment is used to develop the strategic plan for 2015-17.

43’038 peoplereceived support

during emergencies

(WASH)

Our main partners

Terre des hommes - Bangladesh#141 (5A) Road 4, Banani A, Dhaka Phone: +88 02 88 35 114, www.tdh.ch

Homestead gardening and AquacultureKeyhole Gardens

To increase resilience of families in food-prone poverty pockets, Tdh promotes “Keyhole Gardens”. These disaster resistant homestead gardens are highly productive due to an integrated compost unit, produce different vegetables in all seasons, and require only low inputs. Women build, maintain and monitor the gardens while sharing seeds and tools among each other. Increased vegetable consumption directly increases people’s intake of micronutrients and vitamins.

Children as agents of nutritional change

In cooperation with AIDA and TDH Italy, Tdh initiated an innovative project where children have taken a leading role in improving the population’s food situation.

At school, children are involved in setting up and maintaining raised gardens. They participate in all stages of gardening: preparing the ground for cultivation, planting, harvesting and daily maintenance.

Besides the gardens, children participated in constructing small ponds. Apart from producing vegetables and fi sh, children received nutrition and hygiene courses.In order to increase interest among other members of the community, children organize events such as a theater play. They invite their parents to school and proudly present their work. In addition,

short training sessions are provided to parents to encourage them to replicate these production methods in their own homes.

In 20149’690 people consumed vegetables from gardens built in Kurigram and

Barguna

411 children benefi ted from Aquaculture and Garden activities at

school level

AquacultureAquaculture

Guest house & Training facilities

LocationContactChilmari Guest house,

Thanahat, Ward: DawaitariKurigram Guest house,

Hospital Road, Kurigram-5600+88 01715748848 / +88 58161412kurigramguesthouse@bd.tdh.net