FSUP Baseline Report Final 23 June

Food Security for the Ultra Poor Haor Baseline Study Report
FUNDED BY THE EUROPEAN UNION IMPLEMENTED BY BASELINE STUDY BY
Principal Authors Richard Caldwell Executive Director TANGO International, Inc. Bruce Ravesloot Asia Representative TANGO International, Inc. Md. Abdul Quddus Team Leader, FSUP-H Baseline Study Data Management Aid Maqbul H. Bhuiyan Executive Director Data Management Aid
FSUP-H Baseline Report, June 2010
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Table of Contents
List of Tables, Figures and Pictures ................................................................................................... v Acknowledgements ........................................................................................................................... viii List of Abbreviations ........................................................................................................................... ix Glossary of Bengali Terms................................................................................................................... x Glossary of English Terms................................................................................................................... x Executive Summary ............................................................................................................................. xi 1.0 1.1 1.2 1.3 1.4 2.0 2.1 2.2 2.3 3.0 3.1 3.2 3.2 4.0 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 6.0 6.1 6.2 6.3 6.4 7.0 7.1 7.2 7.3 8.0 8.1 INTRODUCTION .................................................................................................................... 1 Food security and poverty context in Bangladesh ................................................................ 1 Background of the FSUP-H project ....................................................................................... 2 Implementation framework of the FSUP-H project ............................................................... 3 FSUP-H site and impact group selection .............................................................................. 3 FSUP-H BASELINE STUDY .................................................................................................. 4 Rationale of the study ........................................................................................................... 4 Objectives of the study .......................................................................................................... 5 Scope of the study ................................................................................................................ 5 STUDY METHODS ................................................................................................................. 5 Study design.......................................................................................................................... 5 Quantitative study design ...................................................................................................... 5 Qualitative study design ...................................................................................................... 10 DEMOGRAPHIC CHARACTERISTICS ............................................................................... 12 LIVELIHOODS AND ECONOMIC SECURITY .................................................................... 15 Occupational patterns ......................................................................................................... 15 Household employment and income/expenditure ............................................................... 20 Income in peak and lean seasons....................................................................................... 24 Coping strategies for lean seasons ..................................................................................... 25 Migration.............................................................................................................................. 27 Loans ................................................................................................................................... 27 Assets.................................................................................................................................. 31 Housing characteristics ....................................................................................................... 36 FOOD SECURITY ................................................................................................................ 38 Food consumption score ..................................................................................................... 38 Food intake.......................................................................................................................... 40 Coping strategies ................................................................................................................ 43 Trend analysis ..................................................................................................................... 44 WATER AND SANITATION ................................................................................................. 49 Drinking, cooking and washing water sources .................................................................... 49 Arsenic testing ..................................................................................................................... 53 Sanitation ............................................................................................................................ 53 HEALTH PRACTICES AND ILLNESS ................................................................................ 57 Hand washing...................................................................................................................... 57
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8.2 9.0 9.1 9.2 9.3 9.4 10 10.1 10.2 10.3 11 11.1 11.2 11.3 12 12.1 12.2 13 14
Illness among adults and health-seeking behavior ............................................................. 58 PARTICIPATION AND ACCESS ......................................................................................... 60 Participation in development ............................................................................................... 60 Access to GoB services ...................................................................................................... 62 Access to other services ..................................................................................................... 66 Access to common property................................................................................................ 68 DISASTERS AND CRISES .................................................................................................. 70 Natural disasters: effects and coping strategies ................................................................. 70 Household crises: effects and coping strategies................................................................. 72 Climate change ................................................................................................................... 74 FAMILY AUTHORITY AND DECISION MAKING ............................................................... 76 Household decision making ................................................................................................ 76 Family life attitudes ............................................................................................................. 80 Daily time patterns of men and women ............................................................................... 81 CHILD NUTRITION, ANTENATAL CARE AND FAMILY PLANNING ................................ 83 MCHN characteristics ......................................................................................................... 83 Anthropometric measurements ........................................................................................... 89 STATUS OF FEMALE-HEADED HOUSEHOLDS ............................................................... 91 CONCLUSION AND RECOMMENDATIONS ...................................................................... 92
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List of Tables, Figures and Pictures

TABLES Table 1: Table 2: Table 3: Table 4: Table 5: Table 6: Table 7a: Table 7b: Table 8: Table 9: Table 10a: Table 10b: Table 11: Table 12: Table 13: Table 14a: Table 14b: Table 14c: Table 15: Table 16: Table 17: Table 18: Table 19: Table 20: Table 21: Table 22: Table 23: Table 24: Table 25: Table 26: Table 27: Table 28: Table 29: Table 30: Table 31: Table 32: Table 33: Table 34: Table 35: Table 36: Table 37: Table 38
Four main pillars of food security Illustrative sample sizes for stratified random sampling using variants of deff and standard error Sampling statistics of 1,892 households, by District and Haor type Qualitative techniques applied for the baseline survey Key demographic characteristics of the population, by District and Haor type Demography and dependency ratios, by District and Haor type Primary and secondary occupations for individuals aged 8 years and older, by Haor type Primary and secondary occupations for individuals aged 8 years and older, by District Income sources for previous 30 days, by Haor type Income sources for previous 30 days, by District Key income and expenditure data for households, by District and Haor type Detailed expenditure data, by District and Haor type Top ten ways of coping with lean periods (multiple response), by District Top ten ways of coping with lean periods (multiple response), by Haor type Type of work performed by those migrating out of the household within the last 12 months, by District and Haor type Key loan data for households, by District and Haor type Detailed interest rate data for loans, by District and Haor type Loan source for women, by District and Haor type Reasons for taking out a loan, by Haor type Reasons for taking out a loan, by District Average number of domestic assets owned, by District and Haor type Average number of productive assets owned, by District and Haor type Average number of land assets owned, by District and Haor type Average number of animal assets owned, by District and Haor type Average number of resource assets owned, by District and Haor type Average financial assets owned, in Taka, by District and Haor type Housing characteristics, by District and Haor type Food consumption score Proportion of sampled households by FCS threshold values Seasonal calendar Drinking water sources, by District and Haor type Cooking water sources, by District and Haor type Washing water sources, by District and Haor type Tube wells/tara pumps tested for arsenic, by District and Haor type Types of latrines used by adult men and women, by District and Haor type Types of latrines used by boys and girls 5-15 years of age, by District and Haor type Hand-washing behaviors among the FSUP baseline study households, by District and Haor type (1) Hand-washing behaviors among the FSUP baseline study households, by District and Haor type (2) Top ten illnesses experienced by adults in households during the previous 12 months, by District and Haor type Usual treatment source for household members, by District and Haor type Household members involved in development processes Type of development institution/person that HH members were involved with
1 8 8 10 12 14 16 17 20 21 22 23 26 26 27 29 29 30 30 31 32 33 33 34 34 35 36 38 39 44 49 50 51 53 54 55 57 57 58 58 60 61
Table 39: Table 40: Table 41: Table 42: Table 43: Table 44: Table 45: Table 46: Table 47: Table 48 Table 49: Table 50: Table 51: Table 52: Table 53: Table 54: Table 55: Table 56: Table 57: Table 58 Table 59: Table 60: FIGURES Figure 1: Figure 2a: Figure 2b: Figure 3: Figure 4: Figure 5a: Figure 5b: Figure 6 Figure 7: Figure 8: Figure 9: Figure 10: Figure 11: Figure 12: Figure 13: Figure 14: Figure 15: Figure 16: Figure 17:
Type of collective action that households have participated in, by District and Haor type Proportion of households using various types of Government service providers, by District and Haor type Types of services received by GoB service providers, by District and Haor type Proportion of households that have various property types available in their household area, by District and Haor type Proportion of available property that is accessible by households, by District and Haor type Disasters experienced by households in the last 12 months, by District and Haor type Proportion of households experiencing various consequences of a natural disaster in the last 12 months, by District and Haor type Household decision making, by Haor type (1) Household decision making, by Haor type (2) Household decision making, by District (1) Household decision making, by District (2) Attitudes about family life, by Haor type Attitudes about family life, by Haor type MCHN characteristics, by District and Haor type Weaning foods used, by District and Haor type Who attended last delivery, by District and Haor type Child health and immunization, by District and Haor type Health issues of mothers with children under 2, by District and Haor type Health issues of children under 2, by District and Haor type Anthropometric measurements Key variables for female-headed households, by district and Haor type Baseline values and recommendations for FSUP-H logframe indicators
61 63 65 68 69 70 71 76 77 78 79 80 81 85 86 86 87 88 89 90 91 92
Age distribution of study population, by sex Mean values of annual per capita income, by District Median values of monthly household cash income and expenditures per capita, by District and Haor type Average monthly incomes during peak and lean seasons, by District and Haor type Mean FCS values, by District and Haor type Proportion of households reporting enough food, by month and Haor type (1) Proportion of households reporting enough food, by month and Haor type (2) Mean number of lean months, by District and Haor type Frequency of three 'square meals' taken a day in 12 months, by District Frequency of three 'square meals' taken a day in 12 months, by Haor type Coping Index for households, by District and Haor type Distances to sources of drinking water, by District and Haor type Distances to sources of cooking water, by District and Haor type Distances to sources of washing water, by District and Haor type Types of service providers accessed, by District Types of service providers accessed, by Haor type Level of satisfaction with selected GOB services Mean asset loss from households experiencing asset loss in a natural disaster in the last 12 months, by District and Haor type Mean number of working days lost from households experiencing a natural disaster in the last 12 months, by District and Haor type
13 22 24 25 39 40 41 41 42 42 43 51 52 52 63 64 65 71 72
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Figure 18: Figure 19: Figure 20: Figure 21: Figure 22: PICTURES Picture 1: Picture 2: Picture 3: Picture 4: Picture 5: Picture 6: Picture 7: Picture 8: Picture 9: Picture 10: Picture 11: Picture 12: Picture 13: Picture 14: Picture 15: Picture 16: Picture 17: Picture 18: Picture 19: Picture 20: Picture 21: Picture 22: Picture 23:
Loss of assets among households experiencing household crises in the last 12 months, by District and Haor type Loss of work days among households experiencing household crises in the last 12 months, by District and Haor type Average number of days lost due to illness for those households with an ill member designated as a household crises in the last 12 months, by District and Haor type Daily time use of men and women Comparison between SHOUHARDO and FSUP-H malnutrition levels
73 73 74 82 90
Baseline enumerator using the PDA for a household interview Agricultural day labor - males Agricultural day labor - females Cow rearing by ultra-poor households Grameen Bank office Jack fruit trees Housing made of jute and straw Housing made of corrugated iron Women supporting household income through produce sales Men fishing in the peak season Non-agricultural day labor Non-agricultural day labor - mat making Woman uses hand tube well as the water source for washing Ring slab latrine Open defecation facilities Village medicine shop Union Health Center Community collective action to improve road infrastructure Women engaged in alternative livelihood activities Government-owned Khas land Damage to buildings as a result of natural disasters Social mobilization around community issues Balanced meal taken by a pregnant woman
11 15 18 19 28 35 37 37 45 46 47 48 50 54 56 59 59 62 66 69 70 75 84
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Acknowledgements
The baseline study was organized by TANGO International in partnership with Data Management Aid (DMA). Special thanks go out to Mr. Md. Abdul Quddus, DMA Team Leader, Mr. Maqbul H. Bhuiyan, Executive Director of DMA, and the DMA study team for their fantastic work in organizing the field data collection, and their contributions to the study design and report. The members of the baseline study team wish to thank the staff of CARE Bangladesh and their local NGO partners for their time and effort during this study, in particular CAREs Social Development Unit for their guidance to and facilitation of the qualitative data collection. We thank Mr. Zakir Khan, the Team Leader of FSUP-H, and Mr. M. Zakaria, M&E Coordinator for FSUP-H, for all the support and guidance they provided to this study. We would also like to acknowledge Ms. Khaleda Khanom, Deputy Team Leader, and Ms. Salma Akter, F&A Manager, the FSUP-H Technical Coordinators and the many CARE, ASD, POPI and SUS field staff that did a great job in facilitating the baseline survey needs. This study would not have been possible without their efforts. Finally, we want to acknowledge the Government of Bangladesh professional staff, FSUP-H program participants, the FSUP Program Coordinating Unit and EC Delegation officials who gave freely of their time throughout the baseline process. TANGO International 8 June 2010
TANGO International, Inc. 406 S. Fourth Ave. Tucson, Arizona 85701 Tel: (1)-520-617-0977 Fax: (1)-520-617-0980 info@tangointernational.com
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List of Abbreviations
ASD BADC BBS BDHS BMI CBO DAE DMA FoSHoL FSUP-H FGD GoB KI MDG NCHS NIPORT NGO POPI PPS SHOUHARDO SUS TBA UN WB WFP VGD VGF
Assistance for Slum Dwellers Bangladesh Agricultural Development Corporation Bangladesh Bureau of Statistics Bangladesh Demographic and Health Survey Body Mass Index Community Based Organization Department of Agricultural Extension Data Management Aid Food Security for Sustainable Household Livelihoods Food Security for the Ultra-Poor in the Haor Region Focus Group Discussion Government of Bangladesh Key Informant Millennium Development Goals National Center for Health Statistics National Institute of Population Research and Training Non-Government Organization Peoples Oriented Program Implementation Probability Proportional to Size Strengthening Household Ability to Respond to Development Opportunities Sabalamby Unnayan Samity Traditional Birth Attendant United Nations World Bank World Food Programme Vulnerable Group Development Vulnerable Group Feeding
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Glossary of Bengali Terms

Ana Beel Dadon Khas Logni Madrasha Masjeed Mohajan Salish Upazila Union Parishad Local unit of measuring gold/silver Open water body Advance sale of crops/products Government-owned land or water bodies High interest loans Religious education center Mosque Informal moneylender Informal village court/arbitration A geo-administrative unit under a district comprising several Unions Lowest local government unit
Bengali Calendar:
Aprmay Baishak MayJun Jaisti JunJul Ashar JulAug Sravan AugSep Bhadra SepOct Ashin OctNov Kartik Nov-Dec Agrahayan DecJan Payush JanFeb Magh FebMar Falgun MarApr Chaitra
Glossary of English Terms

Decimal Homestead Household Decimal (100 decimals is equal to 1 acre) The yard or compound of a household A family unit, who share common resources for cooking and eating
Executive Summary
Background According to the 2005 Joint UN/GoB MDG report, Bangladesh was home to over 60 million food 1 insecure people (GoB-UN 2005). Income inequality and chronic poverty are the primary causes for wide-spread food-insecurity, which is one of the most pressing crises facing Bangladesh today. To respond to this challenge, CARE Bangladesh operates a longstanding and reputable program on food security. The Food Security for the Ultra Poor - Haor (FSUP-H) Project, funded by the European Union, was initiated in 2009. The design of the FSUP-H Project has taken into account the lessons learnt from SHOUHARDO and other projects like FOSHoL, SETU etc. and is aligned with CARE-Bs long-term programming strategy for the Haor region. The overall objective of FSUP-H Project is to reduce extreme poverty and food insecurity in the Haor region of Northeast Bangladesh. The specific objective is to sustainably improve food access and utilization and reduce vulnerability for women and their dependents in ultra poor households in Sunamganj, Netrokona and Kishoreganj Districts The project has four specific results: a) Increase inclusion and capacity of 55,000 ultra poor HHs with focused attention to women headed ultra poor HHs and their dependents, to actively engage with development processes with greater support from their communities and local level institutions, b) 55,000 ultra poor households (particularly women) have additional economic opportunities and income, improving their access to food and household food security round the year, c) 55,000 ultra poor households have reduced vulnerability to food insecurity and poverty and improved resilience to quick and slow onset disasters, and d) Improve and equitable utilization of food as well as reduced malnutrition among women and their dependents in 55,000 ultra poor households.
Baseline study methodology The objective of the baseline study is to better understand the current food insecurity, poverty and vulnerability situation of the program impact group, and to establish baseline values of indicators for intended outcomes against which future change can be measured in terms of: behavior, systemic capacity and impact on the socio-economic conditions of target households such as number of food insecure months, income and expenditure. In addition to tracking impact-level changes and livelihood trends over time, the information and data generated by the survey will be useful in: designing future similar projects and scaling up the current project. The baseline survey was undertaken in January February 2010, and utilized a combination of quantitative and qualitative methods. The quantitative methods involved a detailed household-level survey using Personal Digital Assistants (PDAs) for data collections instead of paper questionnaires; and collection of anthropometric data from children aged 6-23 months, for which standard weight and height scales were used. The survey utilized a multi-stage sample design stratified by district and haor type. After data cleaning, the final sample size was 1892 respondents.
49.6% people live in poverty (below US$ 1 per day).
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The qualitative methods utilized mixed tools: male/female focus group discussions (24), key informant interviews (30), in-depth interviews (12) and trend analysis (4 villages). Qualitative data collection was organized by 3 teams made up of CARE and partner staff. Each team organized data collection in 2 villages in the same district: one in the deep Haor, and one in the moderate Haor. Field research was guided by CARE colleagues from the Social Development Unit (SDU) under overall coordination by the FSUP-H M&E Coordinator and with inputs from the CARE Program Quality Unit in CBHQ
Demographic characteristics The FSUP baseline survey included basic demographic information on 1,892 households and 8,957 individuals. The average age of the study population was 22.2 years old. On average, survey households had about 2.3 adults of working age (15 60 years); 0.8 children under age 5; 1.4 children between the ages of 5 and 14 years, and only 0.2 elderly persons above 60 years. For the FSUP-H respondents, the total dependency ratio is 114.5%, which can be considered high. Adult members of working age have more children to support than aged household members. Only about 2 percent of individuals are reported to be disabled. The gender ratio found in the study is 96, which means that there are 96 males for each 100 females. For the overall population, the average age of Head of Household is 42.7 years. Almost 15 percent of sampled households are female-headed, and female heads of households are significantly older (p=.000) than their male counterparts averaging 48.2 and 41.7 years old, respectively. In terms of household size the average for the study population is 4.8 people per household. Female-headed households are significantly smaller than male-headed households (3.1 and 5.0, respectively. Eighty five percent of household heads are married.
Livelihoods and economic security The primary occupation of surveyed household members reflects the principle livelihood strategies of households in the Haor region. Closely linked to occupations and livelihoods are economic indicators of households, such as income, other cash sources, asset ownership, debt and savings. Together these elements of economic security reveal how resilient households are to economic shocks and natural disasters. There are few distinct differences in occupational trends in the Haor region sampled. Agricultural and non-agricultural labor are the two main livelihood opportunities, and together account for half of primary occupations. Other important livelihood activities, in order of predominance, are fishing, petty trade, and housemaid/servant. Few households engage in agriculture on their own fields; less than 1 percent overall. This is a direct result of the extensive degree of landlessness among the ultra poor in Bangladesh. The majority of women are housewives. Non-agricultural laborer and housemaid/servant are the most common primary occupations for women but account for less than 10% across all Districts. The majority of respondents, including most women, reported having no secondary occupation. Agricultural and non-agricultural day labor opportunities are the most common occupational categories for those whose primary activities are in areas such as petty trade, sharecropping, and fishing. Each household had on average only 1.35 income earners. This can be considered quite low but there could be seasonality factors due to the timing of the survey. The data by Haor type and District show that the main household income sources align closely with the primary occupations, as was
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expected based on number of income earners and main occupations. Casual agriculture labor is the main income source across Haor areas and Districts, followed by casual non-agricultural labor. Income from crop and animal sales is low overall. The mean monthly per capita income is 800 Taka and the mean annual per capita income is 9,599 Taka, overall. The per capita income is significantly lower in Sunamganj than in the other districts. Mean monthly expenditure per capita is 1,419 Taka, and the median monthly expenditure per capita is 1,099 Taka. The majority of daily expenditure is on food purchases (72% of daily expenditure). The purchase of tobacco products is the next highest daily expenditure (8%), followed by hiring manual labor from others and purchasing fuel (including gasoline, kerosene, and fire wood). It is interesting to note that the single highest monthly expenditure item is cell phone cards (48% of monthly expenditure). The second highest monthly expenditure item is medical expenses (including fees, medicine and travel) (36%). The single highest item annual expenditure is clothing for household members (51% of annual expenditure), followed by social/religious events (14%) and household goods (11%), on average. Expenditure on fishing or fish raising, agricultural equipment/input, and livestock and poultry rearing accounted for less than 10% of annual expenditure each. Median per capita monthly expenditures (including daily, monthly and annual expenditures) are significantly higher than median per capita income. This is likely due to several factors. First of all, there is the seasonality of the data collection; February falls in a lean period, which is characterized by lower income and high lending. Secondly, respondents have the tendency to overestimate expenditure and underestimate income. There are significant differences between mean monthly income levels during peak and lean seasons. The main coping strategies to deal with the lower income during lean seasons were adjusting meals (60.1%), taking loans from friends/relatives (50.6%), and taking loans from money lenders (35.6%). Selling labor in advance at reduced wage levels is another coping strategy used by households during lean periods. Overall, 7% of households had at least one member who sold labor in advance. Temporary migration was not a common coping strategy to deal with lean periods. However, migration for employment purposes is relatively common in areas with a high degree of seasonal work, such as the FSUP-H project area. In moderate Haor areas, 38.5% of households had somebody migrate in the last 12 months for employment purposes; in deep Haor areas this was 32.3%. About 75% of those who migrated were heads of household, while about 20% were sons/daughters. About 70% migrated to urban areas and 30% to other rural areas. While migration went on throughout the year, there was more migration for employment purposes from August to October. Agricultural contract labor and agricultural day labor are by far the most common types of work performed by migrants. 78% of households overall held at least 1 current loan over the last 12 months. The average number of loans per household overall was 1.4 and 35% of loans were taken by women. The average loan amount was 6,652 Taka and overall interest rates were 51%. Overall, the outstanding loan amount at the time of the interview was 5,393 Taka, which is about 81% of the average loan amount - indicating a very high debt burden on households. The majority of loans (41%) were taken from money lenders, NGOs (24%), and friends/relatives (23%). Only 6% of loans were taken from Grameen Bank and 4% from clubs/CBOs. Informal money lenders give loans without collateral but instead charge higher interest rates; the high level of lending from informal sources such as money lenders largely explains the high interest rates found in this survey. The most common reasons for taking out a loan were consumption purposes (food, clothing etc), followed by medical treatment and non-agricultural purchases. Very few households reported taking out a loan for productive purposes such as the
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purchase of agricultural tools/equipment, purchase of agricultural inputs, land leasing or mortgaging or livestock purchases. Assets are an integral component of livelihoods, and the accumulation and sale of assets reflect important economic characteristics of households. Overall the ownership of productive assets in the survey population was very low. Generally, far less than one out of ten households owned any of the productive assets. Land ownership varied greatly among sampled households. Agricultural land th ownership was the highest and averaged 4.05 decimals per household, or less than 1/20 of one acre. Ownership of homestead land averaged at 2.88 decimals per household. Chickens were the most common animal asset owned, averaging 1.48 per household, followed by ducks and cows. Ownership of resource assets such as timber and fruit trees, bamboo, and medicinal plants, was fairly common in surveyed households. Cash with NGOs was the most common financial asset measured and averaged 495 Taka per household. The majority of all houses have floors made of mud (99.9% and 0.1% made of brick), walls made of straw/jute or corrugated iron sheets/tin/wood, and roofs made of corrugated iron. Less than 1% of all houses have brick walls and only 1 house in Kishoreganj had a concrete roof. Average total square feet of living space is 175ft and the average number of rooms is 2 across all strata. About 10 percent of households share their living space with their cattle, mostly for safety of the animals in absence of more than one housing structure.
Food security The survey used the Food Consumption Score (FCS), which is widely used by the World Food Program and endorsed by FANTA, as a measure of diet diversity and diet quality. The FCS is derived by weighting various food groups based on their protein value and assigning a score for each food group consumed by the household during the recall period. For the FSUP survey population, 52.3% of total households had an acceptable FCS, 31.5% had a borderline FCS and 16.2% had a poor FCS. Overall, the mean number of lean months per year is 4.3 and the mean value for households that take 3 meals per day most of the time is 14%. The combined mean values for most of the time and often is 56.3 %. There are two distinct annual lean periods in terms of insufficient food. The first lean period is from April to June, with the leanest period in April-May (13%), the month of Baishak in the Bengali calendar. The second lean period is from November to February with the leanest period in Dec-Jan (12%), the month of Payush in the Bengali calendar. In both periods, almost 90% of households in the sample reported insufficient food. The recovery from the insufficient food period in April to June is notable longer than for the second lean period - with another smaller decrease in August-September (31%) before reaching a peak at 63 percent in Oct-Nov. The highest number of households report sufficient food in March-April (82%), with a very sharp decrease between the Bengali months of Chaitra and Baishak. The survey utilized a index to measure how households deal with food insecurity. A high score indicates that households in specified areas avail themselves of a broad range of coping strategies to deal with food insecurity; the higher the index value is - the higher the assumed stress on households. Overall, the coping index score of almost 24 indicates a moderately-high level of stress on households due to food insecurity. Bulk purchases of rice, running out of food and reducing personal food intake were the top 3 coping strategies.
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Water and sanitation Hand tube wells are the most common drinking water source followed by shallow tube wells and deep tube wells. Overall, 97% of households depend on the various types of tube wells for drinking water. Almost no households draw drinking water from open water sources such as ring wells, ponds and rivers/canals. Hand tube wells are also the most common cooking water source followed by rivers/canals and shallow tube wells. Most households reported open water sources for washing. River/canals are the most common washing water source followed by hand tube wells and ponds. The average distance to water sources for drinking, cooking and washing purposes is around 200 meters. Of the households that reported tube wells or tara pumps as a source for drinking, cooking or washing water, 50.5% of households reported that the tube wells / tara pumps were tested for arsenic. Of the tube wells/tara pumps that were tested, 14.1% were found to contain arsenic. The most common type of latrines used by adult men and women are ring slab/offset latrines (with the seal broken) and hanging/open latrines, followed by uncovered pit latrines and then open defecation. Overall, the use of hygienic latrines such as ring slab/offset latrines (with the seal intact), septic latrines, covered pit latrines and locally adapted hygienic latrines is very low in the project area. Similar to adults, the most common types of latrines used by boys and girls 5-15 years of age are ring slab/offset latrines (with the seal broken) and hanging/open latrines. For boys and girls, this is followed by open defecation and then uncovered pit latrines the opposite to adults. Overall, the use of hygienic latrines such as ring slab/offset latrines (with the seal intact), septic latrines, covered pit latrines and locally adapted hygienic latrines is very low.
Health and illness The majority of respondents wash their hands before eating but less than half do so before preparing food and only one-third wash their hands before feeding children. The majority of respondents wash their hands after defecation but only one-third of respondents do so after cleaning a babys bottom. The use of ash or clay for hand washing is most common followed by use of only water. The use of soap is least common. The average number of illnesses cited per household was 2.4. The most common illness experienced by adults during the previous 12 months was a cold attack, followed by gastric illness and diarrhea. Only 3 percent of households reported no illnesses at all. Medicine shops and village doctors are the most common treatment sources for household members.
Participation and access Participation in community development processes is low at 4.5% of all households, which was too low for meaningful analysis. Among the only 186 responses received, household head was mentioned as the most common household member involved in development processes. Females (spouses plus female heads of household) accounted for 15.1% the responses. The Masjeed or religious committee was the most common type of institution that household members were engaged with for development purposes in the last 12 months (24%), followed by engagement with NGOs (19%) as village group members, which is often a prerequisite to receiving microcredit. Half (49.3%) of respondents reported that their engagement with development institutions consisted of receiving services, followed by being a volunteer (27.9%); committee member (19.3%); participant in activities (19.3%); and recipient of training (1.9%). Only 5% of households had experience with collective action
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in last 12 months, primarily consisting of road construction/repair and Mosque construction/repair. Over two-thirds of households (68.7%) had accessed one or more GoB service providers in the previous year. The most common service providers used were Union Parishad and Government Immunization Services, followed by Government Family Planning, Upazilla Health Services and Union Health Services. The most common services received from Union Parishad were categorized as other, which likely refers to government safety net programs. The most common service received from Union and Upazila Health Services is medication followed by suggestions. The most common service received from Government Family Planning are suggestions, medicines and vaccinations. For Government Immunization Services, vaccinations are the main services received, as was to be expected. Overall, training provided by GoB service providers is very low. At present, the main sources of knowledge and skills for economic/livelihood activities are knowledge transfer from previous generations, and from relatives and neighbors. The little external assistance that ultra-poor households do receive comes primarily from NGOs. For all service providers, the majority of respondents indicated they were satisfied or highly satisfied. Only 33% of households reported receiving services from other non-government service providers. The three most common non-government service providers were NGOs (76%), Grameen Bank (16%), and Local Service Providers (18%). Less than 1% of households reported receiving services from Commercial Banks, CBOs, input retailers/dealers and non-Government Vocational Education/Training, respectively. The most common services received from NGOs were credit (68%), suggestions (16%), and relief/aid (4%). The most common services received from Grameen Bank were credit (99%) and suggestions (13%). The most common services received from Local Service Providers were suggestions (75%), credit (65%), suggestions (16%), medicines (71%) and relief/aid (12%). Regarding access to common property, the highest proportion of households has access to river/canals, followed by roadside sloping and beels/haors. Access to Khas land is lowest.
Disasters and crises Overall, 78% of households reported that they did not experience a natural disaster in the previous year. The highest proportion of disasters experienced in the last 12 months was wind damage, floods, excessive rain and storms. Among those who experienced a natural disaster, the highest proportion of households reported partial damage to their house, followed at a distance by loss of working days and full damage to their house. For those affected, the mean asset loss per disaster was reported at Taka 3,017, and the mean number of working days lost reported by the 26.5% of affected households was 10. The most common coping strategies used by respondents to recover from a natural disaster were: taking out a loan from friend/neighbor (41%), taking loan from a moneylender (31%), adjusting meals (25%), using savings (25%), accepting help from others: (24%), purchasing on credit (21%) and taking a loan from NGO (11%). Respondents were also asked the same range of effect and coping strategy questions for a range of household crises, not caused by natural disasters. Only 16.7% reported the occurrence of such crises in the last 12 months. The most common types of household crises reported were illness of income earners (57.2% of cases where a household crisis was reported) and illness of other household members (32% of cases where a household crisis was reported). The main effects of the household crises were asset/income loss and working days lost. The mean loss of assets for the survey population was just under Taka 5,000. The mean number of working days lost for the survey
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population was 36. The mean number of working days lost due to illness was also 36 (mode=15). The most common coping strategies used by respondents to cope with household crises were: took out a loan from friend/relative (42.7%), took out a loan from moneylender (36.0%), made adjustment to meals (27.8%), accepted help from others (20.6%), purchased goods on credit (18.4%), used savings (11.7%), took out a loan from an NGO (11.1%), took a grain loan (10.4%), ate famine foods (8.2%), and accepted aid (5.4%)
Family authority and decision making The highest proportion of decisions is made by the husband after discussion with the female household member. It is also apparent that women have greater involvement in certain household decisions such as minor household purchases, childrens clothing and education, medical expenses and in spending money that they have directly earned. Women have less involvement in expenditures that relate to livelihoods, higher value assets, loans/savings and events such as weddings and ceremonies and shelter in case of disasters. The proportion of decisions made without any involvement by the female is low for almost all decision types, except salish decision making. Overall, a higher proportion of women agree that the husband should help with household chores if the female is working; and that they have the right to express their opinion, even when they disagree with their husband. The proportion of women overall who disagree with the statement that it is better to send a son to school than a daughter is also significantly higher. However, it is interesting to note that despite the more liberal attitudes about family life expressed by women, the proportion of women who agree that a wife should tolerate being beaten is significantly higher that the proportion who disagrees.
Child nutrition, antenatal care and family planning Of the total number of respondents, 70 percent did not have any children < 2 years of age. Of those who did, 29 percent had one and 1 percent had two < 2 children. Virtually every mother breastfed her child (99.5%) and 45% of overall mothers initiated breastfeeding with the first hour of birth. The average age for introducing solid/semi-solid foods (weaning) was just over 5 months age. Overall, 35.5% of mothers took iron or folic acid supplements. The majority of mothers did not change the amount of food that they consumed during their last pregnancy; 16% increased their food intake and 33% decreased their food intake. The majority of women also did not change the amount of rest they took after the last birth. Only 23% took more rest than usual. Overall, mothers attended on average 1 ANC session. Qualitative data shows that there are very few periodic medical checkups during pregnancy due to lack of knowledge, lack of money, and difficulties in communicating with the medical centers. Overall, the majority of births were attended by Traditional Birth Assistants. Less than 1% of births were attended by a doctor. Only 7.4% of mothers reported suffering no illnesses in the last 12 months. The highest proportion of women suffered from cold attacks, followed by gastric complications and anemia. The lowest proportion of women suffered from Typhoid. Only 5.8% of children did not suffer any illnesses in the last 12 months. The highest proportion of children suffered from cold attacks, diarrhea and pneumonia. The lowest proportion of children suffered from skin diseases and other illnesses. For households currently with a child 2 years of age or under, 81.8 % of the oldest child in this age group has received at least one immunization. For those children who did receive immunizations, 72.9% have immunization cards. For those children who needed antihelmintics, 47% received them. 57.7%
xvii
of < 2 children are underweight: 39.4% are moderately underweight and 18.3% are severely underweight. Underweight is a composite index of height-for-age and weight-for-height. A child can be underweight for his/her age because s/he is stunted, wasted or both. In general, an underweight prevalence of > 30% is considered to be very high.
Status of female-headed households Almost 15% of the households sampled had female heads of household. When comparing femaleand male-headed households across Districts and Haor type, the following observations can be made: female-headed households have significantly lower per capita monthly income levels than male-headed households there are no significant differences in per capita expenditures between female- and maleheaded households, except in deep Haor areas where expenditures in female-headed households are significantly lower female-headed households have significantly lower food consumption scores than maleheaded households female-headed households have a significantly higher coping strategy index score in Kishoreganj and Sunamganj, and in deep Haor areas
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1.0
1.1
INTRODUCTION
Food security and poverty context in Bangladesh
Food security exists when all people, at all times, have physical and economic ac cess to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy 2 life . Food security is said to have four main pillars: availability, access, utilization and stability with regards to the availability and access dimensions of food security. Table 1: Four main pillars of food security
Availability Access The availability of sufficient quantities of food of appropriate quality, supplied through domestic production or imports (including food aid). Access by individuals to adequate resources (entitlements) for acquiring appropriate foods for a nutritious diet. Entitlements are defined as the set of all commodity bundles over which a person can establish command given the legal, political, economic and social arrangements of the community in which they live (including traditional rights such as access to common resources). Utilization of food through adequate diet, clean water, sanitation and health care to reach a state of nutritional well-being where all physiological needs are met. This brings out the importance of non-food inputs in food security. To be food secure, a population, household or individual must have access to adequate food at all times. They should not risk losing access to food as a consequence of sudden shocks (e.g. an economic or climatic crisis) or cyclical events (e.g. seasonal food insecurity). The concept of stability can therefore refer to both the availability and access dimensions of food security
Utilization
Stability
In Bangladesh, there has been significant progress in improving the gross food availability, in particular through cereal self sufficiency and improvements in land productivity. However, food access and utilization continue to remain critically low, especially among the poorest and disaster affected. According to the 2005 Joint UN/GoB MDG report, Bangladesh was home to over 60 million food 3 insecure people (GoB-UN 2005). Income inequality and chronic poverty are the primary causes for wide-spread food-insecurity. This is compounded by the population growth of around 2 million individuals annually combined with a reduction of around 82,900 hectares of tillable land annually due to infrastructure and housing development, and industrialization. About a third of the population lives below the lower poverty line with seriously imbalanced diets and extremely inadequate intake of fats, protein and micronutrients. While poverty is one of the main underlying causes of food insecurity of many people, it has manifested in wide scale malnutrition of various types. In recent decades, malnutrition has become a major public health concern in Bangladesh, affecting the well being of the majority of the population, particularly the children, adolescent girls and pregnant/lactating women in the ultra-poor households. The 2005 Joint UN/GoB MDG report states that nearly half the children are underweight or stunted, with 13 to 19 percent being severely underweight or stunted in terms of being more than three standard deviations below the relevant NCHS standards. Another 2005 report by Hellen Keller International4 states that almost 40 percent of under-5 children in rural Bangladesh are reported as stunted and 46 percent are reported as underweight, indicating that chronic under-nutrition is widespread. A 2009 study found that prevalent macro malnutrition problems (NIPORT, 2009), particularly in under-5 children include underweight (46%), stunting (36%) and wasting (16%) and maternal under nutrition measured by BMI (32%). This
2 3
World Food Summit, 1996 49.6% people live in poverty (below US$ 1 per day). 4 Bangladesh in Facts and Figures: 2005 Annual Report of the Nutritional Surveillance Project, Hellen Keller
suggests that children in Bangladesh suffer from short-term acute shortfall in food intake as well as longer-term under-nutrition. It is important to note that there are also large differences in child malnutrition rates across economic groups. Child malnutrition is pervasive among the poor. More than 60 percent of the children 6-71 months old suffering from stunting, belong to the bottom consumption quintile. In Bangladesh, there is an important spatial dimension to poverty and food insecurity creating disproportionate affects on people in disaster risk prone areas, such as char lands, Haors and coastal areas. In 2009, the GoB/WFP/WB undertook a joint vulnerability assessment to prioritize development initiatives and resources in areas of highest food security needs (BBS, 2009), based on upazila-level population estimates of individuals living below the lower poverty line, which is defined as food calorie consumption of less than 1805 Kcal/person/day. The assessment identified six geographical areas/clusters with 145 highly food-insecure and poverty-prone upazilas. The six identified clusters were (i) The North-West disaster area (ii) The North-Central Chars (iii) The Drought Zone (iv) The Haor Basin (v) The Coastal Zone and (vi) Chittagong Hill Tract.
1.2
Background of the FSUP-H project
CARE Bangladesh has a longstanding and reputable program on food security. After the successful completion of the Integrated Food Security Program (IFSP) in 2003, CARE initiated the Strengthening Household Ability to Respond to Development Opportunities (SHOUHARDO), which was implemented during 2005-2009. The SHOUHARDO design was the largest development program in Bangladesh at the time, and was designed to be consistent with CAREs Unifying Framework for 5 Poverty Eradication & Social Justice. FSUP-H is part of the program approach of CARE-B and the design of the project is based on the analysis of underlying causes of poverty (UCP) and social injustice at multiple levels and, theories of change (ToC) around three long term programming areas of CARE-B: marginalized women, extreme poor people, and people living in environmental and geographical vulnerable areas. Design of FSUPH has taken into account the lessons learnt from SHOUHARDO and other projects like FOSHoL, SETU etc. and is aligned with CARE-Bs long-term programming strategy for the Haor region. The FSUP-H project aims to make a sustainable impact on the lives of the four CARE Bangladesh impact groups: (a) most socially, economically and politically marginaliz ed women, (b) lowest category of the wellbeing ranking especially those people trapped in a set of unequal power relations, (c) most marginalized groups in urban areas (the project will indirectly contribute to this by reducing migration), and (d) most vulnerable people and communities prone to disasters and environmental changes. FSUP-Hs overall objective aligns with the objectives outlined in the EC Country Strategy Paper for Bangladesh (2007-2013) where poverty, gender inequality and access to food ar e prioritized. Projects overall focus on the reduction of poverty and food insecurity fits well with the Millennium Development Goals, especially Goal One: to eradicate extreme poverty and hunger, Goal Three: to promote gender equality and empower women, and it also addresses Goal Five: to improve maternal health.
SHOUHARDO a Title II program of USAID, Final Evaluation Report, December 2009, TANGO International
1.3
Implementation framework of the FSUP-H project
The FSUP-H project constitutes an intra-CARE partnership between CARE International UK and CARE Bangladesh. CARE International UK is the formal project lead and holds overall contract responsibility and accountability to the European Commission. CARE Bangladesh is responsible for day-to-day management of project implementation. CARE Bangladesh implements the project with three national partners: Assistance for Slum Dwellers (ASD); Peoples Oriented Program Implementation (POPI); and Sabalamby Unnayan Samity (SUS). The overall objective of the project is to reduce extreme poverty and food insecurity in the Haor region of Northeast Bangladesh. The specific objective is to sustainably improve food access and utilization and reduce vulnerability for women and their dependents in ultra poor households in Sunamganj, Netrokona and Kishoreganj Districts The project has four specific results: e) Increase inclusion and capacity of 55,000 ultra poor HHs with focused attention to women headed ultra poor HHs and their dependents, to actively engage with development processes with greater support from their communities and local level institutions, f) 55,000 ultra poor households (particularly women) have additional economic opportunities and income, improving their access to food and household food security round the year, g) 55,000 ultra poor households have reduced vulnerability to food insecurity and poverty and improved resilience to quick and slow onset disasters, and h) Improve and equitable utilization of food as well as reduced malnutrition among women and their dependents in 55,000 ultra poor households.
1.4
FSUP-H site and impact group selection
Among the six clusters of highly food insecure and poverty prone areas stated in section 1.1, CARE Bangladesh identified the Haor basin as the target area for its FSUP-H project. The Haor is a wetland ecosystem in northeastern Bangladesh that is a saucer shaped shallow depression in the land that is also known as a back swamp. The Haor is a remote and difficult area that is flooded every year during the monsoon. It remains under water for 6-8 months of the year, turning Haor settlements mostly built on earthen mounds into islands. Villages are regularly washed away, which plays a large role in driving people to migrate to urban centers. Some of the most extensive seasonally flooded areas in South Asia are located in the Bangladesh Haor region. During the dry season most of the water drains out, leaving small shallow lakes or may completely dry out by the end of dry season. This exposes rich alluvial soil, extensively cultivated for rice. In selecting the Haor region, CARE Bangladesh took into account the seasonal dimensions and sociopolitical factors that particularly increase the vulnerability of the Haor population. There are two related seasonal dimensions to food insecurity in the Haor: the high exposure to cyclic climatic shocks such as flooding, flash flooding and erosion; and the single-season food production and consequent seasonal variation in food availability and pricing as there is only one annual rice harvest in the Haor area. In the hoar area, there are traditionally two food-insecure lean seasons, January to mid-April (between rice planting and harvest) and mid-July to September (during the monsoon). The first is particularly severe for rural landless people because it coincides with the pre-harvest period of low employment opportunities in agriculture. In addition, socio-political factors such as gender, age, ethnicity and religion determine peoples
position in society, their relationships to those in power, and access to resources and services, and are equally important determinants of food insecurity in Bangladesh. In recent years, poor people have increasingly lost their fishing rights in the Haors or rivers which had been their only source for livelihoods and food-security for decades. These water bodies have now been taken over by powerful people with political connections who control the majority of water bodies and only allow poor people to fish for a payment of daily fees and a percentage of sales proceeds for a certain period. Moreover the Haor region is considered socially conservative and im poses strict restrictions on womens mobility. The harsh physical environment further impedes their movement. Poor women are marginalized because of male-dominated systems and structures, unequal gender power relations, and limited choices and opportunities. Wage discrimination is a significant contributor to food insecurity for women in the Haors who earn approximately half the daily wage of their male counterparts for the equal work, and even then are severely affected by the seasonality of work availability. The absence of health services and transportation facilities affects especially pregnant women severely The Haor region covers Sunamganj, Habiganj and Moulvibazar districts and Sylhet Sadar Upazila, as well as Kishoreganj and Netrokona districts outside the core Haor area. Based on a vulnerability 6 assessment of all the Union Parishads in the Haor region , CARE found Kishoreganj, Netrokona and Sunamganj had the largest number of communities in the highest vulnerability categories, and selected these 3 districts for project implementation. Due to the remote location and difficult physical conditions, government services are almost absent. Within the three project districts, CARE Bangladesh undertook a rigorous selection process during the start up phase of the FSUP-H project to identify 55,000 ultra poor households as the main project target group, with an important focus on the women in these households. By October 2009, the project team had completed 672 community WBAs and selected 645 communities in 94 unions of 17 upazilas in the three project districts. Based on this selection, the project team collected information from 55,000 households and developed individual household profiles. These profiles captured key information such as: sex of household heads, household size, primary and secondary occupation of household heads, occupation of women in the households, homestead and cultivable land size, number of livestock and poultry, types of latrine used, tube well ownership, NGO involvement and loan status.
2.0
2.1
FSUP-H BASELINE STUDY

Rationale of the study
The main purpose of the survey was to generate baseline information and data on food security status, poverty and vulnerabilities of the impact groups. By providing a benchmark the baseline survey provided an opportunity to collect follow-up data and information over the life of the project to measure effect and impact of project interventions/activities. This allowed FSUP-H staff to understand to what extent the project contributes to improving food security and poverty level. The information and data generated by the survey will be useful in: (1) designing future similar projects; and (2) scaling up the current project; and (3) to track impact-level changes and livelihood trends over time.
SHOUHARDO Haor Region: Union Selection Process, CARE 2005; Md, Raquibul Hasan, Village Selection Survey; An Elaboration of the Process, CARE 2005.
2.2
Objectives of the study
The objective of the study is to better understand the current food insecurity, poverty and vulnerability situation of the program impact group, and to establish baseline values of indicators for intended outcomes against which future change can be measured in terms of: a) behavior, b) systemic capacity and c) impact on the socio-economic conditions of target households such as number of food insecure months, income and expenditure. The specific objectives of the survey were to: a) Assess socio-economic characteristics of the households; b) Identify the level of food insecurity, diversity of food consumptions and prevalence of malnutrition (including infant & child feeding practices) of the households; c) Assess current ability of program HHs to participate in the development process and access to different services; d) Understand the natural crisis/shocks experienced by the households and coping mechanisms (resilience); e) Validate the needs and priorities of project participants, communities and institutions identified in the project proposal. f) Gather and analyze information for the purpose of in-depth learning and to assist the project in modifying appropriate interventions, refining the Logframe and M&E plan.
2.3
Scope of the study
The scope of the survey is not limited to indicator measurement requirements of the project. The survey will also seek to better understand livelihood issues of the ultra poor households of the hoar regions. The study will also explore different aspects of household food security (availability, access and utilization patterns), households exposure to development processes and their ability to negotiate for services and rights, vulnerability to climate changes etc. The study will produce household-level analysis by district and Haor type.
3.0
3.1
STUDY METHODS
Study design
The baseline survey utilized a combination of quantitative and qualitative methods. These methods were in part complementary, so that each type of information could contribute to an overall understanding of households. The quantitative methods involved a detailed household-level survey, while the qualitative methods utilized mixed tools.
3.2
Quantitative study design
The study collected data on a variety of subjects and issues by administering a structured questionnaire at the household level with the key woman of the household and/or her spouse as respondent. For collecting anthropometric data from children aged 6-23 months, standard weight and height scales were used. The household questionnaire was divided into ten sections, each covering a different aspect of livelihoods or subjects relevant to CARE FSUP programming objectives. The following topics were covered:
Section A: Identification area identification, religion and ethnicity. Section B: General Information on household members includes elements of household demographics, education, disabilities, marital status, primary and .secondary occupations Section C: Economic Security includes housing characteristics, ownership of assets, household expenditures, income and employment, and loans. Section D: Food Security includes information on food consumption, months of food sufficiency, and household food access. Section E: Water and Sanitation access to clean water and latrines. Section F: Health Practices and Illness data on hand-washing behaviors, illnesses. Section G: Participation Information on household participation in development processes and access to services and common property Section H: Natural Disasters types of disasters that have impacted the household in the previous year and their effect on the household. Section I: Family Authority and Decision-making decision-making at the household level and attitudes about family life. Section J: Child nutrition, Antenatal Care and Family Planning information on breastfeeding practices, food consumption during antenatal care, child food consumption, antenatal care and family planning, immunizations, and anthropometrics of children 6-24 months.
The quantitative methods employed random selection criteria in order for the results to be generalized at the household level to both District and Haor type (moderate and deep; discussed below). The baseline study was not designed to be generalized by Haor type within Districts, as this would have resulted in an unmanageable sample size for the household survey. The questionnaire for the household survey was developed jointly by CARE Bangladesh, DMA and TANGO staff, and was based in part on questions posed in similar food security baseline surveys in Bangladesh and elsewhere. Technical input by DMA and CARE Bangladesh both before and during training ensured that questions were relevant, culturally appropriate, well-translated, and the listed response codes were correct. Draft instruments were pre-tested in approximately fifty households during enumerator training, which took place in Mymensingh in January 2010. The final questionnaire is attached as Annex 1. A multi-stage sample design was used for the household survey. The first stage was a stratification based on three districts Kishoreganj, Netrokona, and Sunamganj - where FSUP is implementing its program. The justification for using stratification at this level was to use the baseline to inform CARE Bangladesh of the major differences among Districts in order that program adjustments could be made and that future studies could disaggregate changes by location. The first sampling stage also included a second stratification of the entire project are into two types of Haor moderate and deep. Each of the three districts has both types of Haor area, and they are found in different Upazilas (subdistricts). The third stage of sampling was the selection of clusters (villages) within each Haor type in each District using probability proportional to size selection methods. A limited number of clusters (20 per strata) were selected due to two factors the relatively small geographical variation of Haor areas within each district and the expected magnitude of intra-cluster variation being relatively large compared to inter-cluster variation, which made it more reasonable to sample more households within clusters to reduce error. The fourth and final stage of the sampling process was the selection of households. In each cluster a fixed number of households were randomly selected from a sampling frame of the households.
Systematic random sampling was used with a randomly selected starting point (household number on the list) and a sampling interval when lists or maps were not available. The survey used no replacement and instead sample sizes were upwardly adjusted to account for non-replacement assuming a non-response rate of 5 percent. The formula used to calculate the baseline sample size was the following: n = deff(z/standard error) (p) (1-p) Where: n = sample size deff = design effect z = standard score corresponding to a given confidence level (z = 1.645 for the 95% confidence level) Standard error = acceptable error level p = expected proportion of the population expressing a particular characteristic (1-p) = expected proportion without the characteristic This formula is only appropriate for baseline measurements of multi-variable surveys. It establishes variation and expected proportions of key variables which subsequent surveys can use to base sample sizes required for estimating differences in means or proportions. In applying this formula p was given a value of .5, as this maximized the influence the proportion of the population with any given characteristic had on the size of the sample. For the baseline survey, z was fixed at 1.645 (95% confidence limit) and p was set at 0.5. The two remaining variants were the design effect and the standard error. The term deff is the design effect. This provides a correction for the loss of sampling efficiency resulting from the use of cluster sampling instead of simple random sampling, and the gain of sampling efficiency resulting from stratification. It is the factor by which the sample size must be multiplied by in order to produce survey estimates with the same precision as a simple random design would. Ideally, an estimate of deff for the indicators of interest could be obtained from a prior survey in a given setting, providing some insight on the similarity or homogeneity among households in the clusters. Short of this, typical values from surveys conducted elsewhere are normally used. When clustering is the only sampling stage prior to the random selection of households, a default value of 2.0 is commonly used. However, for this survey there was an additional stage of stratification. Stratification actually increases the efficiency of sampling by accounting for variation in the sample even before the sample is drawn. Thus, it usually has a design effect of less than 1.0. Combining the two stages stratification and clustering usually results in a design effect between 1.0 and 2.0. In the case of Bangladesh households, it is assumed a priori that inter-household variation is small compared to that of population-based surveys that are district-wide. Thus a design effect (deff) of 1.6 was used, mainly due to the fact that two stages of stratification were employed. Table 2 provides estimated sample sizes using variants of deff and standard error. As can be seen, for a given standard error the design effect raises the required sample size by modest amounts. However, at a given deff, changes in the standard error have a profound effect on sample size (because it is the denominator of a squared term). For the CARE Bangladesh FSUP survey it was recommended that a sample size of 316 households per strata, or 1,896 total households be selected (there are six strata 3 districts by 2 Haor types). Data was collected from 16 randomly selected households in each of twenty clusters within each stratum. Data was collected from 1,920 households. After data cleaning, 28 households were removed from the sample due to incomplete
interviews or other inadequacies, for a final tally of 1,892 households. Table 3 provides a breakdown of the sample by District and Haor type. Table 2: Illustrative sample sizes for stratified random sampling using variants of deff and standard error. Sample Design Standard Sample Size Effect Z Error TERM P 1-P Size *1.05 1 1.645 0.05 1082.41 0.5 0.5 271 284 1.2 1.645 0.05 1082.41 0.5 0.5 325 342 1.4 1.645 0.05 1082.41 0.5 0.5 380 400 1.6 1.645 0.05 1082.41 0.5 0.5 434 455 1.8 1.645 0.05 1082.41 0.5 0.5 488 512 2 1.645 0.05 1082.41 0.5 0.5 542 570 1.6 1.6 1.6 1.6 1.6 1.645 1.645 1.645 1.645 1.645 0.04 0.05 0.06 0.07 0.08 1691.26 1082.41 751.67 552.25 422.81 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 676 434 302 221 170 710 455 316 232 178
Subsequent surveys to estimate change from the baseline survey will utilize the following formula: n = deff [(Z1 + Z2) * (sd1 + sd2 ) / (X2 - X1) ] This formula takes into account the magnitude of change that can be detected with 95 percent confidence given the expected standard deviations for the indicators of interest. Table 3: Sampling statistics of 1,892 households by District and Haor type District Sample Sizes Kishorega Netrokona nj # of Households Surveyed 628 634 % of Households Surveyed 33.2 33.5 Number of <2s Measured 146 124 By Haor Type Moderate # of Households Surveyed 947 % of Households Surveyed 51.1 Number of <2s Measured 227
2 2 2 2
Sunamganj 630 33.3 132 Deep 945 49.9 175
The study collected data from 16 randomly selected households from each village/community. The households included in the sampling frame, and thus eligible to be sampled, represented 55,000 extreme poor households in the Upazilas and who are the ultimate beneficiaries of FSUP (about 25% of all households in the area). The Field Researchers collected data directly from the one of the female participants from the household and from her spouse (if available). If the wife was not available on the day of interview, the enumerator went on to the next randomly selected household. For households with children between the ages of 6 and 23 months anthropometric data (height, weight
and age) was also collected on the same day using enumerators trained specifically for this function and using appropriate scales and measuring boards. Quantitative data collection took place from January 13 through February 16, 2010 using Personal Digital Assistants (PDAs); small hand-held computers that provide facilities for taking notes, storing data and retrieving information, and running survey software. PDAs are pen-based and use a stylus to tap selections on menus and enter printed characters. TANGO International used The Survey System (TSS) software package to build the FSUP-H baseline questionnaire because it is one of the few software packages that will accommodate non-Roman characters. The Bangla TSS questionnaires were then transferred to the PDAs using a series of .xml files. When doing the interview, enumerators read each question off the screen, just as if they were using paper questionnaires. Each household was stored as an independent record. The Team Leader or Supervisors downloaded data from enumerators each day and stored that days data on an SD memory card or laptop using a unique file name. A copy of the data remained on the PDA for the entire survey as a back-up. The use of PDAs gives significant benefits over traditional paper-based surveys. Using PDA-based questionnaires greatly reduces survey error, especially data entry error. In a PDA-based survey, as data is being entered it is subject to validation, i.e. it is controlled on the spot for possible errors (numbers out of range, percentages that do not add up to 100%, etc.) and some questions may be enabled or disabled on the basis of replies to the previous questions. In addition, all logic rules, such as skips to other questions or avoids, are controlled by the PDA and not by the enumerator. Such rules are automatic, taking the enumerator to the next relevant question. This is particularly useful in complex, multi-indicator surveys such as the FSUP-H baseline. Using PDA-based survey instead of paper based questionnaire reduces the time needed for data collection and processing. Once data is collected with paper-based surveys, each questionnaire then has to be entered into a database by a data-entry clerk, and then cleaned of errors by a data analyst. With a PDA-based survey there is no need for a subsequent data entry process since the data is entered directly into a data file. This greatly reduces data entry errors (these are the largest single source of error for a survey). Finally, PDA based surveys dont need to use paper and ink. This is environmentally friendlier. In addition it reduces the logistics burden of carrying many questionnaires around the field and then storing them in the office. Data cleaning and analysis was undertaken as a 2-step process. The first round of data cleaning and analysis was undertaken by DMA in March 2010, the second and final round of cleaning and analysis was undertaken by TANGO International in April 2010. During the data cleaning process, 28 respondent files (1.5 percent) were discarded because of incompleteness/inadequacies. The final sample size was 1892 respondents.
3.2
Qualitative study design
Qualitative data collection was organized by 3 teams made up of CARE and partner staff. Each team included at least one female facilitator. Field research was guided by CARE colleagues from the Social Development Unit (SDU) under overall coordination by the FSUP-H M&E Coordinator and with inputs from the CARE Program Quality Unit in CBHQ. The qualitative work focused on three main themes: 1. Maternal Child Health and Nutrition (MCHN) 2. Participation in Economic Activities 3. Participation in Development Activities Data collection started on 10 February 2010 and lasted for 10 days. During this time, each team undertook qualitative field work in 2 villages in the same district: one in the deep Haor, and one in the moderate Haor. Villages were selected based on a degree of convenience in accessing the village, and representativeness of the project objectives and main intervention areas. The teams spent 5 days on data collection in each village; 4 days of qualitative work and 1 day to finalize reporting. Data was recorded as hand-written notes and was transferred to structured reporting templates on the same day it was collected. Data cleaning and analysis was undertaken as a 2-step process. The first round of data cleaning and analysis using top-line methodology was undertaken by CARE Bangladesh in February 2010, additional analysis was undertaken by TANGO International in March 2010 for integration of findings into this report. The data collection tools and guidelines, and qualitative findings are attached as Annex 2. Table 4: Qualitative techniques applied for the baseline survey A. Focus group discussions (FGD) x 24 Semi-structured group discussions with 5-10 6 per village, different combinations possible participants; male or female, no mixed; 1 facilitator with Time: 1-1.5hr same gender as the FGD participants; 2 note takers/observers, ideally also same gender as FGD participants; use of participatory mapping (Venn diagram, social mapping) and ranking (problem, preference and wealth ranking) techniques B. Key informant interviews (KII) x 30 In each village, 4 semi-structured interviews with 5 per village individuals in the village and minimum of 1 external KII Time: 1hr at union/upazilla level; 1 facilitator and 1 note taker C. In-depth interview (IDI) x 12 Unstructured interviews. Individuals selected from 2 per village FGDs; 1 interviewer only. Focus was to collect rich Time: 1-2hrs human interest stories to complement/add to FGD findings. D. Trend analysis (TA) x 4 TA included two techniques: seasonal calendar (1Organized in 4 villages only (2 deep, 2 1.5hrs) and daily pattern mapping (1-1.5hrs). Both moderate) techniques were undertaken with females. Time: 2-3hrs
10
Picture 1: Baseline enumerator using the PDA for a household interview
11
4.0
DEMOGRAPHIC CHARACTERISTICS
The FSUP baseline survey included basic demographic information on 1,892 households and 8,957 individuals. The vast majority of respondent households in the survey are Muslim (85.7%), followed by Hindu (14.1%) and Other (0.2%). Kishoreganj has a significantly higher proportion ( p=.000) of Muslims (91.2%) than Netrokona (80.6%) and Sunamganj (85.4%). There is also a significant difference by Haor type (p=.000), with Moderate Haor having a higher proportion of Muslim households (90.4%) than Deep Haor (81.1%). Virtually all households (99.9%) are Bengali. The gender ratio found in the study is 96, which means that there are 96 males for each 100 females, and the proportion of the sample that was 51.1 percent. This ratio portrays the opposite picture regarding the male female ratio compare to the national level statistics for same category (i.e. nationally male-female ratio is 104 males for each 100 females. Source: Statistical Pocketbook, BBS, nd 2004) but matches exactly the ratios found in the FoSHoL-CARE baseline study 2 cycle. For the overall population, the average age of Head of Household is 42.7 years. Table 5 shows that in Kishoreganj heads of household are significantly younger, but there is no difference by Haor type. Almost 15 percent of sampled households are female-headed, but Netrokona has a significantly higher proportion of female-headed households (17.4%). Again there is no difference by Haor type. Female heads of households are significantly older (p=.000) than their male counterparts averaging 48.2 and 41.7 years old, respectively. In terms of household size the average for the study population is 4.8 people per household, however Sunamganj has a significantly higher household average size at 5.3. Female-headed households are significantly smaller than male-headed households (3.1 and 5.0, respectively). The smaller household size for female headed households is a function of several factors. First, they are older than their male counterparts, so the chance of having younger children is smaller, and the chance that at least some of their children have married and moved out of the household is greater. Also, they are less likely to have a counterpart male adult in the household. As a result, even though many are still of reproductive age, their chances of having more children of their own are small. Table 5: Key demographic characteristics of the population, by District and Haor type By District Average age HHH (yrs) Overall Moderate Deep Overall Moderate Deep Overall Moderate Deep Kishoreganj 40.0*** 40.5 39.5 4.6 4.5 4.6 14.6 15.2 14.0 Moderate 42.3 4.8 14.4 Netrokona 43.7 44.1 43.3 4.4 4.3 4.4 17.4** 18.5 16.3 Sunamganj 44.3 44.3 44.2 5.3*** 5.3 5.3 12.1 11.4 12.8 Deep 43.0 4.7 15.0
Household Size
% female-headed HHs
By Haor Type Average age HHH (years) Household Size % female-headed households
*** denotes p=.000; ** denotes p=.050
12
Only about 2 percent of individuals are reported to be disabled, and there are no significant differences among the three Districts or by Haor type. Eighty five percent of household heads are married; there is no significant difference between Haor types. Only about 1 percent of the household heads was never married; 12 percent were widowed; and 2 percent were divorced/ separated female household heads. The proportion of widowed household heads is significantly higher in deep Haors in Netrokona. Figure 1 shows the age distribution for the study population. The average age of the study population is 22.2 years old. The median age is 16 (half of the population is below 16 years of age and half of the population is above 16 years of age). There is a slight but obvious skewness in favor of females between the ages of 18 and 30, and a slight bias of males in the ages between 35 and 45. Other than these two anomalies ages are fairly equally distributed by gender. The modal (most common age) age is 0 (infants between birth and one year old). Just over 21% of the population is under 5 years old, and about 4 percent is over 60 years old. Figure 1: Age distribution of study population, by sex
Sex Male
100
Female
100
80
80
Age, in years
Age, in years
60
60
40
40
20
20
400
300
200
100
100
200
300
400
Frequency
Frequency
Table 6 shows the demography and dependency ratios of FSUP-H households. On average, survey 7 households have about 2.3 adults of working age (1560 years); 0.8 children under age 5; 1.4 children between the ages of 5 and 14 years, and only 0.2 elderly persons above 60 years. Three types of dependency ratios are presented in the table: child aged and total. The total dependency ratio is defined as the ratio of the number of members in the age groups 0 14 years and
7
This is the notion of working age commonly used by demographers (see, for instance, Shryock et al. 1976). The actual working age of individuals of course depends in part on their standard of living and can often be lower, especially for the poor.
13
above 60 years to the number of members of working age (15 60 years). The ratio is expressed in a percentage. The total dependency ratio has strong and negative correlation with household income. High dependency ratios mean a higher burden on household income. For the FSUP-H respondents, the total dependency ratio is 114.5%, which can be considered high. Adult members of working age have more children to support than aged household members. Table 6: Demography and dependency ratios, by District and Haor type District Haor Type Characteristic SunamKishoreganj Netrokona Deep Moderate ganj Number of household members in the age group 0-4 years 0.8 0.7 0.9 0.8 0.8 5-14 years 1.3 1.3 1.6 1.4 1.4 15-60 years 2.2 2.2 2.5 2.4 2.3 Over 60 years 0.2 0.2 0.2 0.2 0.2 Demographic composition (percent) 0-4 years 5-14 years 15-60 years Over 60 years Total Dependency ratio (percent) Child (0-14) dependency ratio Aged (>60) dependency ratio Total dependency ratio 104.2 8.7 112.9 100.9 8.0 108.9 112.4 9.3 121.7 104.8 8.1 112.9 105.2 11.0 116.2 105.0 9.5 114.5 18.2 28.9 49.4 3.5 100.0 16.4 28.7 49.9 4.9 100.0 17.0 30.8 48.2 4.0 100.0 17.1 29.7 49.4 3.8 100.0 17.3 29.4 48.8 4.5 100.0 17.2 29.5 49.1 4.1 100.0
Total
0.8 1.4 2.3 0.2
14
5.0
5.1
LIVELIHOODS AND ECONOMIC SECURITY

Occupational patterns
The primary occupation of surveyed household members reflects the principle livelihood strategies of households in the Haor region. The survey collected data on the primary and secondary occupations of all household members eight years of age and older, with a recognition that many have access to multiple occupations in rural Bangladesh. Tables 7a and 7b show the primary and secondary occupations for adults aged 8 years and older by Haor type and District, respectively. What the data by Haor type and District show is that there are few distinct differences in occupational trends in the Haor region sampled. As expected for the FSUP subpopulation, few households engage in agriculture on their own fields; less than 1 percent overall. This is a direct result of the extensive degree of landlessness among the ultra poor in Bangladesh. Sharecropping is more prevalent in the moderate Haor (3.8% versus 1.6%). Agricultural and non-agricultural labor are the two main livelihood opportunities for FSUP households, and together account for half of primary occupations, with no significant difference between Haor types (table 7a). Other important livelihood activities, in order of predominance, are fishing, petty trade, and housemaid/servant. Together, these five livelihood activities account for almost 65 percent of primary occupations for men and women together. In terms of differences between moderate and deep Haor areas, table 7a shows that sharecropping and fishing opportunities differ, with sharecropping being more prevalent in the moderate Haor areas and fishing being more prevalent in the deep Haor areas. Picture 2: Agricultural day labor - males
The majority of respondents reported having no secondary occupation. This would be expected for livelihoods such as salaried employees, business owners, many skilled laborers, etc., but not for those who rely heavily on day labor opportunities. However, over 46 percent of agricultural and nonagricultural day laborers have no secondary occupation/activity, suggesting that these individuals and
15
households have very low resiliency and could benefit greatly from diversifying their basic livelihood skills. Among those with secondary occupations, agricultural and non-agricultural day labor opportunities are the most common occupational categories for those whose primary activities are in areas such as petty trade, sharecropping, and fishing. Livestock husbandry is slightly more important as a secondary occupation in the moderate Haor areas, but again there is very little difference in livelihood patterns between the two Haor types. Table 7a: Primary and secondary occupations for individuals aged 8 years and older, by Haor type. Adults 8 years and older Adults 8 years and older Deep Haor Moderate Haor Occupational Categories Primary Secondary Primary Secondary occupation occupation occupation occupation
Men Women Men Women Men Women Men Women
No secondary occupation Own agriculture (crop production) Sharecropper Own agriculture and sharecropper Livestock husbandry Agricultural laborer Non-agricultural laborer Housemaid/servant Skilled labor
8
64.8 1.1 1.7 0.6 0.9 36.5 14.9 3.0 2.5 3.6 2.1 7.8 3.6 10.5 0.9 0.5 0.0 0.5 3.8 1.3 4.2 0.1 0.1 0.0 1.0 1.3 3.0 6.0 0.5 1.0 0.1 1.2 0.0 0.2 0.1 0.6 69.8 0.7 7.1 1.5 5.8 0.3 1.0 0.3 0.1 12.6 8.8 0.1 0.3 0.1 0.8 1.3 0.6 7.5 0.4 0.1 0.0 0.0 0.2 0.5 0.1
89.2 0.0 0.1 0.0 0.4 0.2 0.9 1.1 0.2 0.0 0.1 0.2 0.0 0.1 0.0 0.1 6.4 0.1 0.1 0.7 0.1 1.5 4.6 0.9 0.6 37.9 15.1 2.5 2.6 4.2 2.9 7.0 6.5 3.4 0.2 0.2 0.0 0.5 4.2 0.9 4.3 0.4 0.0 0.0 1.2 0.3 3.7 5.0 0.2 1.0 0.8 1.5 0.1 0.1 0.0 0.4 69.6 0.8 7.6 1.0 6.3
66.0 0.6 1.3 0.1 0.5 10.4 8.6 0.1 0.5 0.2 1.3 0.8 1.5 6.8 0.4 0.2 0.0 0.1 0.1 0.2 0.2
85.7 0.1 0.1 0.0 1.7 0.1 1.4 1.3 0.1 0.0 0.1 0.3 0.1 0.0 0.0 0.2 8.0 0.1 0.1 0.5 0.2
Salaried employment (GOB-NGO) Business Petty business Rickshaw/van pulling Fishing (including fish culture) Fishing laborer Natural resource collection Housewife Beggar Unemployed Other Unable to work
There are also many similarities in terms of primary and secondary opportunities by District, as Table 7b shows. Agricultural laborer is less important in Sunamganj compared to Kishoreganj and Netrokona, but non-agricultural opportunities appear greater. Together, however, these two forms of day laborer comprise approximately half of primary occupations for men and women combined in
16
each of the three districts. Sharecropping is significantly more common in Sunamganj and salaried employment is more common in Netrokona. Petty business is a more common primary occupation in Kishoreganj. In all three Districts about nine percent of respondents over 16 years of age are unable to work, but not surprisingly the mean age of this category is 67 years. As with the disaggregation by Haor type, agricultural and non-agricultural day labor opportunities represent the most common secondary occupational categories for those whose primary activities are in areas such as petty trade, sharecropping, and fishing. Petty business is slightly more important as a secondary occupation in Kishoreganj, but again there are very few important differences in livelihood patterns among the three Districts. Table 7b: Primary and secondary occupations for individuals aged 8 years and older by District. Adults 8 years and older Adults 8 years and older Adults 8 years and older Kishoreganj Netrokona Sunamganj Occupational Categories Primary Secondary Primary Secondary Primary Secondary occupation occupation occupation occupation occupation occupation
Men Women Men Women Men Women Men Women Men Women Men Women
No secondary occupation Own agriculture Sharecropper Own agr and sharecropper Livestock husbandry Agricultural laborer Non-agricultural laborer Housemaid/servant Skilled labor Salaried employment Business Petty business Rickshaw/van pulling Fishing (inc. fish culture) Fishing laborer Natural resource collection Housewife Beggar Unemployed Other Unable to work
62.8 1.2 1.2 0.9 0.1 38.5 13.8 1.4 2.7 3.3 2.9 12.0 7.6 5.5 0.3 0.0 0.0 0.4 3.8 1.3 3.1 0.2 0.0 0.0 1.3 1.6 3.7 4.4 0.6 0.9 0.9 1.6 0.1 0.1 0.0 0.6 69.5 0.9 6.1 0.6 7.0 0.2 0.6 0.1 0.0 12.3 9.3 0.0 0.1 0.1 1.7 2.2 2.4 7.2 0.5 0.0 0.0 0.0 0.1 0.3 0.1
88.1 0.1 0.2 0.0 1.4 0.2 1.3 1.3 0.1 0.0 0.2 0.4 0.1 0.1 0.0 0.0 5.7 0.1 0.1 0.4 0.2 1.0 1.5 1.0 1.1 46.9 6.9 3.3 2.6 5.5 3.3 4.3 4.3 6.8 0.5 0.4 0.0 0.9 4.1 0.8 5.0 0.4 0.0 0.0 1.1 0.5 2.4 7.9 0.1 1.9 0.6 1.9 0.0 0.1 0.0 0.9 68.1 1.2 6.8 0.4 5.9
67.2 0.5 1.8 0.2 0.3 8.7 6.8 0.2 0.8 0.2 0.7 0.8 0.6 9.8 0.5 0.0 0.0 0.1 0.3 0.2 0.1
86.7 0.0 0.0 0.0 1.8 0.2 0.5 1.4 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.4 8.1 0.0 0.1 0.7 0.1 1.4 6.1 0.4 0.9 27.9 23.2 3.4 2.4 3.0 1.4 6.4 3.7 8.5 0.9 0.6 0.0 0.2 4.0 1.2 4.4 0.1 0.1 0.0 1.0 0.4 4.1 4.3 0.3 0.3 0.0 0.6 0.0 0.2 0.1 0.0 71.3 0.3 8.9 2.6 5.4
66.1 0.6 1.1 0.3 0.6 13.2 9.7 0.2 0.3 0.1 0.8 0.3 0.2 4.9 0.2 0.4 0.0 0.0 0.1 0.5 0.2
87.5 0.0 0.0 0.0 0.1 0.2 1.6 0.8 0.3 0.0 0.1 0.3 0.0 0.0 0.0 0.1 7.8 0.3 0.0 0.8 0.2
When comparing between men and women, table 7a and 7b show similarities by District and Haor. The majority of women are housewives. Non-agricultural laborer and housemaid/servant are the most
8
Includes blacksmith, potter, porter, cobbler, carpenter, weaver etc.
17
common primary occupations for women but account for less than 10% across all Districts. Most women reported having no secondary occupation. Qualitative data showed that while men primarily earn income through agricultural and non-agricultural day labor, fishing and petty trade; the majority of women do so through homestead activities such as fish processing / preparation of goods for market, making handicrafts, and livestock and poultry rearing. When asked about preferences for income generating activities, some important differences can be noticed with the main occupations reported. Men indicated agriculture, cow rearing, fishing and bamboo handicraft. Women indicated poultry and livestock rearing, shop keeping, agriculture and small business. Furthermore, there were indications that ultra poor households have high rates of child labor. Children were found to assist with fishing, livestock and poultry rearing, brick making, paddy harvesting and vegetable cultivation. Picture 3: Agricultural day labor - females
In addition to the monetary benefits, community members identified other benefits of participation in economic activities at the individual, household and community levels. At the individual level, community members identified skills improvement, and improved social status as a key benefit. Women stated increased mobility and communication as key benefits. Greater involvement of women in economic activities was also seen as a way to better deal with lean periods when the males migrate to sell labor. It was also mentioned that involvement of women in economic activities improved education of children and reduce child labor, although others stated that it in fact contributed to child labor. At the household level, reduced dependency on money lenders, improved household status, increased food intake and diversity, better loan repayment, better home maintenance, reduced family conflict over money and improved education for children were all seen as important benefits. At the broader community level, increased employment opportunities for neighbors/friends and others, increased access to essential goods due to newly established shops, improved womens decisio n-
18
making in community issues, establishment of community schools, reduced dependency on middle/rich class, reduced dependency on selling labor to other communities, and increased community dignity all seen as important benefits Community members also many identified costs of participation in economic activities including: travel costs (in some cases as high as 150-200 Taka), wage days lost for skill training, and the need for initial investments require high interest loans (perpetuating the debt cycle). There were also costs identified that were specific to women, such as: wives are beaten if household chores are not completed, children are not properly cared for and do not attend school regularly in absence of mothers, and women are robbed of wages while traveling home from work. The time spent at meetings/training and undertaking economic activities reduces time available for the traditional household responsibilities of women. Although women participating in economic activities attempt to distribute some of their household duties to other household members such as their husband or relatives, this is rarely successful and often children end up doing the work. Community members indicated that they would like to expand their economic activities, particularly in the areas of cow rearing, other poultry and livestock rearing, fish culture, small shop keeping, small business and homestead gardening. Males indicated additional preferences for cash-for-work, rickshaw pulling and rice cultivation. Females indicated additional preferences for handicrafts (such as bamboo products) and nursery development. In expanding their economic activities, community members identified the following main barriers: lack of technical knowledge, support from GoB such as livestock and fishery departments, capital, credit, production materials such as quality seeds, access to water bodies; social kinship; and - for women - the prevailing social structures that prohibit many women from participating in economic activities without the h usbands consent, particularly with respect to participation in agriculture and fishing. Picture 4: Cow rearing by ultra-poor households
19
5.2
Household employment and income/expenditure
Closely linked to occupations and livelihoods are economic indicators of households, such as income, other cash sources, asset ownership, debt and savings. Together these elements of economic security reveal how resilient households are to economic shocks and natural disasters. One of the first indicators of economic resiliency is the number of income earners per household. For the survey population, each household had on average only 1.35 income earners. This can be considered quite low but there could be seasonality factors due to the timing of the survey. Kishoreganj and Netrokona had 1.31 and 1.29 income earners per household, respectively, while Sunamganj had a small but statistically higher average (p=.000) of 1.45 income earners. Statistically, the deep Haor areas had more income earners than the moderate Haor areas (1.39 versus 1.32, respectively). The data by Haor type and District show that the main household income sources align closely with the primary occupations, as was expected based on number of income earners and main occupations. Casual agriculture labor is the main income source across Haor areas and Districts, followed by casual non-agricultural labor. Income from crop and animal sales is low overall. There are few distinct differences in income sources between deep and moderate Haor regions sampled. The main exception is the sale of fish/aquatic animal, which is significantly higher in the deep Haor. In turn, sale of agricultural produce is higher in moderate than deep Haor areas. Income sources such as salaried work, small business, petty trade and rickshaw/van pulling are more prevalent in deep Haor areas. Table 8: Income sources for previous 30 days, by Haor type Deep Haor Income Sources (multiple response) N % of Responses Selling vegetables 2 0.2 Selling livestock/poultry/birds Selling agricultural produce Selling fish/aquatic animals Self-employed (carpenter, barber, etc.) Salaried Casual labor (agriculture) Casual labor (non-agriculture) Rickshaw/van pulling Small business Petty trade Remittances/Pensions/Savings Renting/leasing out property Relief assistance from GoB or NGO Selling HH assets Begging Total 5 13 106 35 63 544 288 45 129 6 5 1 5 13 56 1316 0.5 1.4 11.4 3.8 6.8 58.3 30.9 4.8 13.8 0.6 0.5 0.1 0.5 1.4 6.0 141.1%
Moderate Haor N % of Responses 0 0.0 5 28 26 37 83 501 276 82 140 7 10 2 0 15 38 1250 0.5 3.0 2.8 4.0 9.0 54.3 29.9 8.9 15.2 0.8 1.1 0.2 0.0 1.6 4.1 135.6%
20
When comparing income sources among districts, sale of fish/aquatic animals is higher in Sunamganj than in the other districts. Casual non-agriculture labor and begging are also significantly higher in Sunamganj, while casual agriculture labor is higher in Netrokona. Small business and rickshaw/van pulling are highest in Kishoreganj. Table 9: Income sources for previous 30 days, by District Kishoreganj Income Sources % of (multiple response) N Responses Selling vegetables 0 0.0 Selling livestock/poultry/birds Selling agricultural produce Selling fish/aquatic animals Self-employed (carpenter, barber, etc.) Salaried Casual labor (agriculture) Casual labor (non-agriculture) Rickshaw/van pulling Small business Petty trade Remittances/Pensions/Savings Renting/leasing out property Relief assistance from GOB or NGO Selling HH assets Begging Total 6 15 39 22 41 318 157 60 134 3 2 0 2 6 24 829 1.0 2.4 6.3 3.5 6.6 51.3 25.3 9.7 21.6 0.5 0.3 0.0 0.4 1.0 3.9 133.7
Netrokona % of N Responses 1 0.2 3 12 39 28 55 399 132 31 65 6 5 2 2 16 22 818 0.5 2.0 6.4 4.6 9.0 65.4 21.6 5.1 10.7 1.0 0.9 0.3 0.3 2.6 3.6 134.1
Sunamganj % of N Responses 1 0.2 1 14 54 22 50 328 275 36 70 4 8 1 1 6 48 919 0.2 2.2 8.6 3.5 8.0 52.5 44.0 5.8 11.2 0.6 1.3 0.2 0.2 1.0 7.7 147.0
Table 10a shows the mean and median monthly income and expenditure per capita. The mean monthly per capita income is 800 Taka overall. The per capita income is significantly lower in Sunamganj than in the other districts. When comparing between Haor types, the mean per capita income in the deep Haor is significantly higher than in the moderate Haor, but the median per capita income in the deep Haor is significantly lower than in the moderate Haor. Mean monthly expenditure per capita is 1,419 Taka, and the median monthly expenditure per capita is 1,099 Taka. When comparing across haor type, the median monthly per capita expenditure is significantly lower in the moderate Haor.
21
Table 10a: Key income and expenditure data for households, by District and Haor type District Haor Type Income/expenditure SunamVariable Kishoreganj Netrokona Deep Moderate ganj Mean monthly per capita c a 845 880 674 821 779 income (Taka) Median monthly per capita income (Taka) Mean monthly household expenditures per capita (Taka) Monthly median household expenditures per capita (Taka) 750 750 614
b
Total
800 717
700
750
1,255
1,583
1,478
1,487
1,353
1,419
1,115
1,097
1,071
1,136
1,059
1,099
Letters denote significant differences among Districts or between Haor types for a given variable. Significance levels for comparisons: a = .10; b = .05; c = .00
Figure 2a shows the mean values of annual per capita income. For the survey population overall, the mean annual per capita income is 9,599 Taka. Annual per capita income in Kishoreganj and Netrokona are 10,136 Taka and 10,567 Taka, respectively with no significant differences. However, nnual per capita income in Sunamganj is significantly lower at 8,090 Taka. Figure 2a: Mean values of annual per capita income, by District
Table 10b shows detailed expenditure data, by District and Haor type. Data is presented in three categories, namely: daily, monthly and annual expenditure. The majority of daily expenditure is on food purchases (72% of daily expenditure). The purchase of tobacco products is the next highest daily expenditure (8%), followed by hiring manual labor from others and purchasing fuel (including gasoline, kerosene, and fire wood). The remainder of the daily expenses goes to daily allowance for children, transportation and beverages.
22
It is interesting to note that the single highest monthly expenditure item is cell phone cards (48% of monthly expenditure). The second highest monthly expenditure item is medical expenses (including fees, medicine and travel) (36%). The single highest item annual expenditure is clothing for household members (51% of annual expenditure), followed by social/religious events (14%) and household goods (11%), on average. Expenditure on fishing or fish raising, agricultural equipment/input, and livestock and poultry rearing accounted for less than 10% of annual expenditure each. Table 10b: Detailed expenditure data, by District and Haor type District Expenditures in Taka SunamKishoreganj Netrokona ganj N 628 634 630 Daily Expenditures c 131.7 Food purchases 99.8 107.5 b 5.3 Daily allowance for children 3.8 4.4 Transportation 4.2 3.8 6.4 Cigarettes 7.3 7.8 19.4 c 1.0 Beverages 0.2 0.5 Fuel (livelihood) 0.5 0.1 2.2 b 4.7 Manual labor 11.3 16.6 c 15.6 Kerosene oil 4.2 4.4 c 6.0 Wood fuel 1.7 3.4 Total: 132.2 152.1 189.5 Monthly Expenditures Shelter rental Insurance Utilities Education Child care Medical/dental care Medicine Medical travel Cell phone cards Transportation Loan payment Total Yearly Expenditures Clothing Livelihood equipment Agr equipment/inputs Fishing/fish-raising Household goods Livestock/poultry Social/religious events Dowry payment Total: 1,765.0 244.2 127.0 265.3
a
Haor Type Deep 947 117.8 4.7 4.8 8.4 0.6 1.3 11.5 4.5 4.6 158.2 9.5 2.8 b 7.4 a 62.2 21.0 61.8 276.1 c 18.4 500.2 16.8 22.5 998.7
c
Total
Moderate 945 108.2 4.4 4.7 14.6 0.6 0.3 10.2 c 11.7 2.8 157.5 4.8 a 5.1 16.6 40.4 b 28.6 63.1 b 212.8 20.7 c 363.0 20.1 20.9 796.1 1892 113.0 4.5 4.8 11.5 0.6 1.0 10.9 8.1 3.7 158.1 7.1 3.9 12.0 51.3 24.8 62.5 244.5 19.5 430.6 18.4 21.7 896.3
18.1 4.1 a 17.2 45.5 17.2 c 100.5 c 333.5 c 27.0 433.6 14.2 c 28.7 1,039.6
2.9 3.2 12.6 52.8 18.5 45.4 228.6 15.4 a 372.3 20.7 4.2 776.8
c b
0.4 4.5 6.1 55.7 c 38.7 41.8 171.8 16.3 486.4 20.4 32.2 874.3
1845.1 162.8
1577.7 266.6 273.1

b
1716.2 214.4 155.7 470.8 330.7 55.8 508.4

b
1742.8 234.3 222.3 204.1

c
1729.5 224.4 189.0 337.6 356.6 67.1 457.3 66.9 3428.4
166.8 340.1 583.8

c
407.1 234.1 23.0

a b
250.1 94.3
c
382.6 78.4 406.2 43.3 3314.0
83.9 456.4 93.3 3734.2
487.2 57.8 3290.9
428.6 49.4 3259.6
90.4 3542.4
23
Figure 2 shows that median per capita monthly expenditures (including daily, monthly and annual expenditures) are significantly higher than median per capita income. This is likely due to several factors. First of all, there is the seasonality of the data collection; February falls in a lean period, which is characterized by lower income and high lending. More information on lending and other coping strategies is provided in section 5.4. Secondly, respondents have the tendency to overestimate expenditure and underestimate income. It is important to note here that accurate income and expenditure data collection requires very detailed questioning. The income and expenditure data presented is this report, while indicative of income and expenditure levels, is most useful for assessing trends over time and relative change between baseline and endline measurements. Figure 2b: Median values of monthly household cash income and expenditures per capita, by District and Haor type
5.3
Income in peak and lean seasons
Figure 3 clearly shows that there are significant differences between mean monthly income during peak and lean seasons. When comparing peak season income levels across districts and between Haor types, there are no significant differences in mean monthly income levels among districts, and between Haor types. When comparing lean season income levels across districts and between Haor types, the mean monthly income level in Sunamganj is significantly lower than in the other two districts. When asked for the main reasons that cause a lean period of income for a household, many respondents found it difficult to clearly express the reasons for this. After probing, 82 percent of those mentioned no opportunity for other/alternative work as a reason, 81 percent mentioned poor health of the main income earner, 72 percent identified seasonal work, and 18 percent identified inability to work due to bad weather/disaster. There were very few differences among districts and between Haor types.
24
Figure 3: Average monthly incomes during peak and lean seasons, by District and Haor type
5.4
Coping strategies for lean seasons
Table 11 and table 12 show the top ten ways of coping with lean periods by District and Haor type, as per respondents answers from a multiple choice list of 31 possible responses. Overall, adjusting meals is the main coping mechanism (60.1%), followed by taking loans from friends/relatives (50.6%), and taking loans from money lenders (35.6%). When comparing across districts (table 11), a higher number of households take loans from friends/relatives in Kishoreganj than in the other Districts. Percentage of households taking loans from a moneylender is highest in Sunamganj. Adjusting meals is lower in Kishoreganj than in the other two Districts, while eating famine foods is higher in Sunamganj. Accessing savings is higher in Netrokona than in the other two districts.
25
Table 11: Top ten ways of coping with lean periods, by District Kishoreganj Netrokona Coping Mechanisms % of % of (multiple response) N N Responses Responses 404 Adjusting meals 342 54.5 63.7 Taking loans from friends/relatives Taking loans from a money lender Purchasing goods on credit Accessing savings Taking loans from an NGO Relying on relief/aid Eating famine foods Reducing treatment costs Temporarily migrating Total
407 188 187 146 86 62 37 55 52 1721
Sunamganj % of N Responses 391 62.1

275 283 217 129 141 105 137 17 44 1888
64.8 29.9 29.8 23.2 13.7 9.9 5.9 8.8 8.3 274.0
275 203 197 257 120 128 19 66 40 1819
43.4 32.0 31.1 40.5 18.9 20.2 3.0 10.4 6.3 286.9
43.7 44.9 34.4 20.5 22.4 16.7 21.7 2.7 7.0 299.7
When comparing between deep and moderate Haor types, table 12 shows few distinct differences. Adjusting meals and informal lending are the main coping mechanisms in both Haor areas. Table 12: Top ten ways of coping with lean periods, by Haor type Deep Haor Moderate Haor Coping Mechanisms % of % of (multiple response) N N Responses Responses 543 Adjusting meals 594 62.7 57.5 Taking loans from friends/relatives Taking loans from a money lender Purchasing goods on credit Accessing savings Taking loans from an NGO Relying on relief/aid Eating famine foods Reducing treatment costs Temporarily migrating Total
516 313 286 267 220 155 94 78 62 2794
Overall % of N Responses 1137 60.1

957 674 601 532 347 295 193 138 136 5428
54.5 33.1 30.2 28.2 23.2 16.4 9.9 8.2 6.5 295.0
441 361 315 265 127 140 99 60 74 2634
46.7 38.2 33.3 28.0 13.4 14.8 10.5 6.3 7.8 278.7
50.6 35.6 31.8 28.1 18.3 15.6 10.2 7.3 7.2 286.9
Respondents were also asked about selling advance labor, separately from the multiple choice question described in tables 11 and 12 above. Selling labor in advance is another coping strategy used by households during lean periods. Qualitative data shows that advance labor is usually sold at reduced wage levels. Overall, 7% of households had at least one member who sold labor in advance. There was no significant difference between Haor types but there were significant differences among Districts: Kishoreganj 5.4%, Netrokona 4.9%, Sunamganj 10.8% (p=.000).
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5.5
Migration
Tables 11 and 12 show that temporary migration was not a common coping strategy to deal with lean periods. However, migration for employment purposes is relatively common in areas with a high degree of seasonal work, such as the FSUP-H project area. In moderate Haor areas, 38.5% of households had somebody migrate in the last 12 months for employment purposes; in deep Haor areas this was 32.3%. Moderate Haor areas also had a significantly higher average number of household members migrating out of the village in the previous 3 months: 0.43 persons versus 0.36 persons for Deep; (p=.018). There were no differences when comparing among districts. About 75% of those who migrated were heads of household, while about 20% were sons/daughters. About 70% migrated to urban areas and 30% to other rural areas. There were no differences when comparing these values among district or Haor type. While migration went on throughout the year, there was more migration for employment purposes from August to October. Table 13 shows the types of work performed by those migrating out of the household. Agricultural contract labor and agricultural day labor are by far the most common types of work. When comparing across districts, agricultural contract labor is higher for migrant workers from Sunamganj than in the other two districts. In Netrokona, agricultural day labor is higher. In Kishoreganj, salaried employment is higher than in Netrokona and Sunamganj. While it is still mainly men who migrate for agricultural contract and day labor, qualitative data showed that an increasing number of women also migrate for economic purposes, with many young females migrating to work in garment factories. Table 13: Type of work performed by those migrating out of the household within the last 12 months, by District and Haor type District Haor Type Total (N=672, multiple response) Kishoreganj Netrokona Sunamganj Deep Moderate Agricultural contract labor 37.1 39.5 57.8 42.3 46.0 44.3 Agric. day labor Non-agric. day labor Salaried empl - fixed business Salaried employee Maid/servant Other 31.9 1.6 17.1 9.2 4.8 4.3 53.3 3.8 2.4 1.0 8.6 9.5 26.1 2.4 4.7 0.5 2.8 7.1 32.6 3.6 11.1 5.2 3.9 7.5 40.3 2.7 6.6 2.7 6.6 5.2 36.8 3.1 8.6 3.9 5.4 6.3
5.6
Loans
Table 14a shows that 78% of households overall held at least 1 current loan over the last 12 months. When comparing across Haor types, a significantly higher number of households in moderate Haor areas (80%) held loans than in deep Haor areas (75%). There were no significant differences when comparing among districts. The average number of loans per household overall was 1.4. When comparing across Haor types, the average number of loans per household was significantly lower in deep Haor areas (1.2) than in moderate Haor areas (1.5). There were no significant differences when comparing among districts.
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The average loan amount was 6,652 Taka. When comparing across Haor types, the average loan amount per household was significantly lower in deep Haor areas (6,346 Taka) than in deep Haor areas (6,938 Taka). When comparing across districts, the average loan amount in Sunamganj was significantly lower than in the other districts. Overall, the outstanding loan amount at the time of the interview was 5,393 Taka, which is about 81% of the average loan amount - indicating a very high debt burden on households. In Sunamganj, the outstanding loan amount was significantly lower than in the other districts. There were no significant differences between Haor types. Picture 5: Grameen Bank office
There was no significant difference in loan source among moderate and deep Haor areas, with the majority of loans (41%) taken from money lenders, NGOs (24%), and friends/relatives (23%). Only 6% of loans were taken from Grameen Bank and 4% from clubs/CBOs. Informal money lenders give loans without collateral but instead charge higher interest rates. The high level of lending from informal sources such as money lenders largely explains the high interest rates found in this survey.
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Table 14a: Key loan data for households, by District and Haor type District Loan Variable SunamKishoreganj Netrokona ganj N Households with a loan (%) Average number of loans per HH Average loan amount (Taka) Outstanding loan amount (Taka) 80 1.5 7,148 5,732 74 1.1
b
Haor Type Deep Moderate
Total
79 1.4 5,880 4,448

b c
75 1.2
c
80
78 1.4 6,652 5,393 81.1
1.5
a
6,944 6,103
6,346 5,284
6,938 5,482
Outstanding as a % of average 80.2 87.9 75.6 83.3 79.0 loan amount Letters denote significant differences among Districts or between Haor types for a given variable. Significance levels for comparisons: a = .10; b = .05; c = .00
Table 14b shows that overall interest rates were 51%. The overall interest rates in Sunamganj were significantly higher than in the other districts, and the rates in deep Haor areas were significantly higher than in moderate Haor areas. Interest rates of money lenders were the highest, followed by friends/family, NGOs and the Grameen bank. It is interesting to note that while Grameen bank maintains a unified interest rate of 20% throughout the country, the survey data shows a range of 1420%. Table 14b: Detailed interest rate data for loans, by District and Haor type District Haor Type Interest Rate SunamKishoreganj Netrokona Deep Moderate ganj N 628 634 630 947 945 Overall Interest rate (%) Moneylenders NGOs Friends/relatives Banks Grameen Bank GOB Clubs/CBOs 46 79 13 63 11 14 12 39 45 55 15 55 8 20 9 57 62
c
Total
1892 51 84 19 56 10 18 11 16
59
44 94 23 43 8 21 14 50
112 25 37 13 19 13 55
75 17 65 11 14 10 43
Table 14c shows that, overall, 35% of loans over the 12-month recall period were taken by women. Almost all women (98%) had taken a loan from the Grameen Bank, which reflects the Grameen Banks policy of lending to women. The proportion of women who took a loan from NGOs is also high (88%), for similar reasons. The proportion of women taking loans from moneylenders is the lowest among all loan sources.
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Table 14c: Loan source for women, by District and Haor type District Loan source SunamKishoreganj Netrokona ganj Loans to Women (%) Moneylenders NGOs Friends/relatives Banks Grameen Bank GOB Clubs/CBOs 29 11 84 20 33 96 0 12 32 7 86 24 29 100 0 10 43 12 92 21 50 98 50 33
Haor Type Deep 39 12 90 21 33 98 50 13 Moderate 30 9 82 21 33 97 50 12 35 10 88 21 33 98 50 12
Tables 15 and 16 show that the most common reasons for taking out a loan were consumption purposes (food, clothing etc), followed by medical treatment and non-agricultural purchases. Lending for consumption purposes was higher in deep Haor areas than in moderate Haor areas. Very few households reported taking out a loan for productive purposes such as the purchase of agricultural tools/equipment, purchase of agricultural inputs, land leasing or mortgaging or livestock purchases. Table 15: Reasons for taking out a loan, by Haor type Deep Haor Reason for Loan % of (multiple response) N Responses 18 Purchase agricultural tools/equipment 2.4 Purchase agricultural inputs Land leasing or mortgaging Livestock purchases Non-agricultural purchases Medical treatment/medicine Consumption (food, clothes, etc.) Education House repair/construction Marriage/social Total
60 27 11 249 436 975 31 115 43 1965
Moderate Haor % of N Responses 15 2.2

76 8 10 158 358 819 16 96 22 1578
N
33 136 35 21 407 794 1794 47 211 65 3543
Overall % of Responses 2.3 9.5 2.4 1.5 28.5 55.5 125.5 3.3 14.8 4.5 247.8
8.1 3.6 1.5 33.6 58.8 131.4 4.2 15.5 5.8 264.8
11.0 1.2 1.5 23.0 52.0 119.0 2.3 14.0 3.2 229.4
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Table 16: Reasons for taking out a loan, by District Kishoreganj Reason for Loan % of (multiple response) N Responses 16 Purchase agricultural tools/equipment 3.3 Purchase agricultural inputs Land leasing or mortgaging Livestock purchases Non-agricultural purchases Medical treatment/medicine Consumption (food, clothes, etc.) Education House repair/construction Marriage/social Total
56 17 9 138 330 604 14 59 22 1265
Netrokona % of N Responses 13 2.8

26 11 9 125 252 541 21 73 20 1091
Sunamganj % of N Responses 4 0.8

54 7 3 144 212 649 12 79 23 1187
11.6 3.5 1.9 28.6 68.5 125.3 2.9 12.2 4.6 262.4
5.7 2.4 2.0 27.3 55.0 118.1 4.6 15.9 4.4 238.2
11.0 1.4 0.6 29.4 43.3 132.4 2.4 16.1 4.7 242.2
Qualitative data clearly showed the impact that high interest rates are having on households. These high rates perpetuate the household debt cycle, which leads to use of loans for day-to-day consumption purposes and prevents productive investments as can be seen from the very high debt burden in Table 14 and loan uses described in Tables 15 and 16. Many community members specifically mentioned the high interest rates of NGOs and even called it exploitative. Households that have no choice but to take loans at these high interest rates, often end up taking additional loans and selling land to pay their weekly installments. It was stated that the credit provided by NGOs is not suitable for the needs of ultra poor, who instead require soft or even interestfree loans. Soft loans are preferred over current NGO credit arrangements that require weekly installments, which are hard to maintain. It was also mentioned that there is an important gender dynamic to NGO credit. Although loans are given to women, decisions regarding loan use and repayment are frequently made by men who are not properly trained to optimize business opportunities or manage household income/expenditures.
5.7
Assets
Assets are an integral component of livelihoods, and the accumulation and sale of assets reflect important economic characteristics of households. Each respondent was questioned about ownership of fifty-four different assets, divided into six asset classes domestic, productive, land, animal, resource and financial. Asset ownership is a powerful economic indicator to monitor over time as it reflects household-level decision-making regarding where to invest additional resources. Table 17 shows results for 16 domestic assets. Relatively few assets differed significantly by Haor type, but there was greater ownership of cupboards, lanterns and mobile phones in deep Haor, and
31
greater ownership of showcases in moderate Haor. Kishoreganj had significantly greater ownership of six assets, including both gold and silver jewelry, suggesting that household domestic asset ownership is greater in this District. In contrast, domestic asset ownership is least in Netrokona. Table 17: Average number of domestic assets owned, by District and Haor type District Haor Type Domestic assets Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Chairs Beds Cupboards Tables Showcases Dressing tables Watches Clocks Lanterns Radios TVs Cassette players Electric fans Mobile phones Gold jewelry (ana) Silver jewelry (ana) 0.27 1.07 0.16 0.13
c b c
Total 1892 0.37 1.00 0.09 0.16 0.11 0.00 0.07 0.03 0.55 0.02 0.01 0.01 0.02 0.12 0.88 5.27
0.35 1.01 0.03 0.15

b
0.48 0.91
b b
0.38 0.98 0.10

b
0.35 1.01 0.07 0.15 0.13

b
0.07 0.19
b
0.16 0.10 0.00 0.08 0.03 0.64

c
0.17
0.07 0.00 0.06 0.02 0.38 0.01 0.00 0.00 0.02 0.10 0.77 4.00
0.09 0.00 0.07 0.03 0.48 0.03 0.01 0.01 0.00 0.13 0.82 4.34
0.01 0.08 0.04 0.80

c
0.01 0.06 0.03 0.47 0.01 0.00 0.01 0.02 0.10 0.88 5.08
0.01 0.02 0.01 0.04

b
0.02 0.02 0.01 0.03 0.14

b
0.13 1.05
b c
0.88 5.47
7.50
Letters denote significant differences among Districts or between Haor types for a given asset. Significance levels for comparisons: a = .10; b = .05; c = .00
Productive assets include various types of transportation and livelihood equipment, and are an important indicator of a households investment in livelihood opportunities. Overall the ownership of productive assets in the survey population was very low. Generally, far less than one out of ten households owned any of the productive assets (Table 18). Productive assets related to fishing (boats and nets) were significantly more common in deep Haor, while boats and bicycles were more commonly owned in Kishoreganj. Aside from these differences there was little differentiation among Districts.
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Table 18: Average number of productive assets owned, by District and Haor type District Haor Type Productive assets Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Boat Motorcycle Rickshaw/van Bicycle Sewing machine Shallow/hand-tube well Power tiller Paddle thresher Spray machine Plough Fishing nets Other 0.04
c
Total 1892 0.07 0.00 0.02 0.02 0.01 0.03 0.00 0.00 0.00 0.02 0.33 0.12
0.08 0.00 0.01 0.01 0.00 0.01 0.00 0.00 0.00 0.02 0.32 0.25
0.10 0.00 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.02 0.45 0.07
0.09
0.05 0.00 0.02 0.04

b
0.00 0.02 0.04

b
0.00 0.01 0.00 0.01 0.02 0.00 0.00 0.00 0.01 0.48
c
0.01 0.07 0.00 0.01 0.00 0.01 0.21 0.03
0.01 0.04
a
0.00 0.00 0.00 0.02 0.18 0.03
0.20
Land assets, measured in decimals, are provided in Table 19. Land ownership varies greatly among sampled households, so differences between Haor types or among Districts have to also be large to be significantly different. Between Haor types, only homestead land differs significantly and ownership is greater in moderate Haor than in deep Haor (3.44 and 2.32 decimals per household, respectively). Significantly less homestead land is owned in Kishoreganj compared to Netrokona and Sunamganj. Netrokona has more land leased in, while Kishoreganj has more land leased out. Netrokona households also averaged 1.48 decimals of other land thought to be different from the six categories of land pre-coded in the survey. Overall ownership of agricultural land is highest and averaged 4.05 th decimals per household, or less than 1/20 of one acre. Table 19: Average number of land assets owned, by District and Haor type District Haor Type Land assets (in decimals*) Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Homestead land Agricultural land Land lease - IN Land lease - OUT Haor land Pond/ditch Other land 1.98
c
Total 1892 2.88 4.05 3.26 2.80 0.30 0.08 0.55
3.49 4.94 1.72

b
3.16 3.73 4.85 0.92 0.44 0.15 0.11
2.32 3.53 3.07 1.51 0.36 0.03 0.54
3.44
3.49 3.21 2.23

b
4.58 3.45 0.76 0.25 0.13 0.55
0.26 0.33 0.06 1.48

c
0.14 0.02 0.04
*100 decimals is equal to 1 acre
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Chickens were the most common animal asset owned, averaging 1.48 per household (Table 20). Ownership of chickens was also significantly higher in Kishoreganj where it averaged 1.70 per household. Ducks were the second most common animal asset and averaged 0.68 per household, but were significantly more common in deep Haor, and significantly less common in Sunamganj than in Kishoreganj or Netrokona. Cows were the third most commonly owned animal asset but were least common in Kishoreganj. Table 20: Average number of animal assets owned, by District and Haor type District Haor Type Animal assets Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Cows Buffalo Goats Sheep Chickens Ducks Pigs Other 0.20
b
Total 1892 0.26 0.00 0.10 0.01 1.48 0.68 0.00 0.01
0.27 0.00 0.08 0.00 1.43 0.73 0.00 0.00
0.30 0.00 0.09 0.02 1.30 0.49

b
0.25 0.00 0.09 0.01 1.53 0.80

b
0.27 0.00 0.10 0.01 1.42 0.56 0.00 0.01
0.00 0.12 0.00 1.70

b
0.81 0.00 0.02
0.00 0.00
0.00 0.01
Ownership of some resource assets, which included timber and fruit trees, bamboo, and medicinal plants (mostly for use against cough and fever, used in lieu of adequate health care service), was fairly common in surveyed households. Bamboo trees were the most commonly owned resource asset and averaged just over three trees per household, but were significantly more common in moderate Haor areas, and significantly less common in Kishoreganj, where ownership of timber and fruit trees was also significantly less compared to the two other Districts. Table 21: Average number of resource assets owned, by District and Haor type District Haor Type Resource Assets Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Timber trees Fruit trees Bamboo trees Medicinal plants Others 0.42 0.87 1.65
c b
Total 1892 0.68 1.20 3.04 0.07 0.08
0.63
0.99
0.65 1.16 1.74 0.01 0.10
0.71 1.23 4.34

c
1.40 3.55 0.02 0.06
1.30 3.87 0.03 0.15

b
0.15 0.01
0.12 0.15
The last asset category was financial assets and results are shown in Table 22. Cash with NGOs averaged 495 Taka per household and was the most common financial asset measured. Households in deep Haor had significantly more cash with NGOs (587 Taka compared to 403 Taka in moderate Haor), but significantly less loans or credits given to others. Very few households had any cash at banks but there was a slightly higher amount in Kishoreganj, where cash on hand was also significantly higher. Cash with NGOs was highest in Sunamganj.
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Table 22: Average financial assets owned, in Taka, by District and Haor type District Haor Type Financial Assets Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 Cash at bank Cash w/ NGO Insurance Cash on hand Loan/credit to others Other 2.39
b
Total 1892 3.23 495.36 55.32 141.54 88.40 32.80
0.00 456.53 57.82 90.89 75.21 59.76
7.32 612.67
a
5.91
0.54 403.38
a
416.86 62.49 203.40 187.42

c c
587.14 38.80 121.79 56.90 20.85
45.64 130.85 2.96 14.23
71.86 161.33 119.96

a
24.20
44.78
Picture 6: Jack fruit trees
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5.8
Housing characteristics
Table 23 shows the housing characteristics of households. The majority of all houses have floors made of mud (99.9% and 0.1% made of brick), walls made of straw/jute or corrugated iron sheets/tin/wood, and roofs made of corrugated iron. Less than 1% of all houses have brick walls and only 1 house in Kishoreganj had a concrete roof. Total square feet of living space is 175ft and the average number of rooms is 2 across all strata. About 10 percent of households share their living space with their cattle, mostly for safety of the animals in absence of more than one housing structure. When comparing across districts, the proportion of houses using corrugated iron/tin/wood building materials is significantly higher than in the other districts. The proportion of houses with mud walls is significantly higher in Sunamganj. Total living area was significantly higher in Sunamganj and sharing of living space with cattle was significantly higher in Netrokona than in the other districts. When comparing across Haor region, the proportion of houses with mud or straw/jute walls was significantly higher in moderate Haor than in deep Haor. Table 23: Housing characteristics, by District and Haor type District House characteristics Kishoreganj Netrokona Sunamganj Wall Material N Brick CI sheet/tin/wood Mud Bamboo Straw/jute/etc. Roof Material CI sheet/tin Straw/jute/etc. Other Total area (square feet) Average number of rooms Share with cattle (%) 196 0.3 56.4
c
Haor Type Deep Moderate 220 0.4 34.1 4.2 8.7 52.7 87.1 12.4 0.5 242 0.6 32.9 10.7
c
Total 565 0.5 33.5 7.5 8.5 50.1 86.0 13.3 0.7 174.5 2.0 9.5
166 0.5 24.4 5.5 7.9 61.7 83.1 16.2 0.6 170.2 2.1 11.8
b
203 0.6 19.8 16.3

c
0.5 5.9 36.9 91.4 7.8

b b b
11.7 51.4 83.7 15.7 0.7 179.7 2.0 7.6

a
8.4 47.4
a
85.0 14.1 0.8 176.3 2.0 10.4
0.7 173.6 2.0 9.1
172.6 2.0 8.7
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Picture 7: Housing made of jute and straw
Picture 8: Housing made with corrugated iron
37
6.0
6.1
FOOD SECURITY
Food consumption score
The Food Consumption Score (FCS) is widely used now by the World Food Program and endorsed 9 by FANTA as a measure of diet diversity and quality, and is derived by weighting various food groups based on their protein value and assigning a score for each food group consumed by the household during the recall period. Points for the FSUP baseline study are assigned as follows: Table 24: Food consumption score Food Group Cereals: Pumpkin, squash carrots, sweet potatoes : White potatoes, white yams: Dark green leafy vegetables: Other vegetables: Papayas, mangoes: Other fruits: Meat: Eggs: Fresh or dried fish/shellfish: Legumes/pulses: Milk/Dairy: Oil/fats: Sugar/honey: Total Possible:
Score 2 points 2 points 2 points 3 points 1 point 3 points 1 point 4 points 4 points 4 points 3 points 4 points 0.5 points 0.5 points 34.0 points
The thresholds used for the FSUP study are: 0-4 is poor, 4-8 is borderline food security and 9+ is acceptable food security. These are modified from the World Food Programs Comprehensive Food Security and Vulnerability Assessment Guidelines and are specific for the FSUP study. Future measurements of the FCS within FSUP should use the same food group weights and the same thresholds. Table 25 shows the responses organized by thresholds. The highest proportion of sampled households with acceptable FCS values is located in Kishoreganj, and the highest proportion of sampled households with poor FCS values is located in Sunamganj. When comparing among deep and moderate Haor areas, the highest proportion of sampled households with acceptable FCS is located in deep Haor areas, and the highest proportion of households with poor and borderline FCS values is located in moderate Haor areas. One of the reasons for the higher score in deep Haor areas is the higher consumption of fish (which scores 4 points) in those areas. However, it is also important to note that the scores provided in Table 25 relate to the timing of the data collection, particularly the difference in food consumption in peak and lean seasons, as will be elaborated on below.
Food Aid and Nutritional Technical Assistance Project of USAID.
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Table 25: Proportion of sampled households by FCS threshold values District FCS Thresholds Kishoreganj Netrokona Sunamganj Poor (0-5) 8.3 16.9 23.5 Borderline (6-8) Acceptable (9+) 23.4 68.3 36.1 47.0 34.8 41.7
Haor Type Deep Moderate 14.1 18.3 30.0 55.9 32.9 48.8
Total 16.2% 31.5% 52.3%
The mean FCS values are shown in Figure 4. Overall, FCS values are higher than 8 and can be considered acceptable. When comparing among Haor areas, the deep Haor area has a significantly higher FCS value than the moderate Haor area. When comparing among districts, Kishoreganj has a significantly higher FCS value than the other two districts; with Sunamganj having the lowest FCS value overall. Figure 4: Mean FCS values, by District and Haor type
When analyzing by food group, the responses show that almost all household members (99%) consumed cereals; mostly rice and in few cases wheat flour/puffed rice. The second most frequent (71%) food group consumed was fresh and dried fish. This high level of fish consumption can be partly attributed to the timing of data collection, which was undertaken at a time when the water levels were dropping, and fish catch and drying was high. The third most frequent food group was other vegetables (55%). This can be explained by the fa ct that data collection was undertaken in the harvesting season of various types of indigenous vegetables, which were then available at relatively lower prices. The fourth most frequent food group (54%) was white potatoes and white yams, followed by oil/fats (42%), dark green leafy vegetables (30%) and p umpkin, carrots, squash, or sweet potatoes (20%). The remaining food groups were all < 5%.
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6.2
Food intake
Figure 5a shows the households reporting enough food by month. It is important to focus on the overall shape of the curve here, as there will be some respondent error in terms of their recall relative to the mid-points between the months, as shown in the figure below. The figure shows two distinct lean periods in terms of insufficient food. The first lean period is from April to June, with the leanest period in April-May (13%), the month of Baishak in the Bengali calendar. The second lean period is from November to February with the leanest period in Dec-Jan (12%), the month of Payush in the Bengali calendar. In both periods, almost 90% of households in the sample report insufficient food. The recovery from the insufficient food period in April to June is notable longer than for the second lean period - with another smaller decrease in August-September (31%) before reaching a peak at 63 percent in OctNov. The highest number of households report sufficient food in March-April (82%), with a very sharp decrease between the Bengali months of Chaitra and Baishak. It is important to note that the lean period shown here slightly differs from lean seasons in other food insecure areas in Bangladesh, because the harvesting season of the boro rice in Haor areas takes place slightly earlier than in other areas. Figure 5a: Proportion of households reporting enough food, by month and Haor type (1)
Figure 5b below shows that in the period June-July to Oct-Nov, the proportion of households reporting enough food is lower in deep Haor areas than in moderate Haor areas. The figure also shows a higher number of households in deep Haor areas reporting sufficient food in the period January to May. This matches the FCS value findings, which show that households in the deep Haor areas have a significantly higher FCS value for the period in which the data was collected: January to February.
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Figure 5b: Proportion of households reporting enough food, by month and Haor type (2)
Figure 6 shows the mean number of lean months, by District and Haor type. Overall, the mean number of lean months is 4.3. When comparing across Districts, there are significant differences among all Districts, whereby Sunamganj has the highest mean number of lean months and Kishoreganj has the lowest number. When comparing across Haor types, the number of lean months in moderate Haor areas is significantly higher than in deep Haor areas. Figure 6: Mean number of lean months, by District and Haor type
41
Figure 7 compares frequency of three square meals taken among Districts. Overall, the mean value for
households that take 3 meals per day most of the time is 14%. The mean values for most of the time and often combined is 56.3 %. Households with the highest frequency of taking three square meals per day are
located in Kishoreganj. Households with the lowest frequency of taking three square meals per day are located in Sunamganj. Figure 7: Frequency of three 'square meals' taken a day in 12 months, by District
Figure 8 compares frequency of three square meals taken among deep and moderate Haor areas. Households with the highest frequency of taking three square meals per day are located in deep Haor areas. Households with the lowest frequency of taking three square meals per day are located in moderate Haor areas. Figure 8: Frequency of three 'square meals' taken a day in 12 months, by Haor type
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6.3
Coping strategies
Households were asked to indicate how they dealt with food insecurity. Questions D4 - D11 with a 12 month recall asked respondents whether households had to replace rice with grains, skip meals, reduce food intake, run out of food, worry about where food would come from, purchase rice in bulk to use it sparingly, purchase food on credit and/or borrow food/take donated food. Response categories for these questions ranged from Most of the time to Never. Presenting all the data in a table would make meaningful interpretation difficult so a coping index was created for questions. The index was computed by giving Most of the time a value of 5, Often a value of 4, etc. The highest possible score would be 40. A high score indicates that households in specified areas avail themselves of a broad range of coping strategies to deal with food insecurity; the higher the index value is - the higher the assumed stress on households. This Index is suggested as a useful monitoring tool for FSUP-H. Overall, the coping index score of almost 24 indicates a moderately-high level of stress on households due to food insecurity. Comparison across Haor types shows that the coping index score is significantly higher in deep Haor areas than in moderate Haor areas. Coping index scores in Kishoreganj and Sunamganj are statistically the same but Netrokona shows a significantly lower score than the other two Districts. Bulk purchases of rice, running out of food and reducing personal food intake were the top 3 coping strategies, both overall and when disaggregated by district and Haor 10 type . Figure 9: Coping Index for households, by District and Haor type
10
Excluding question D8; although indicative of household stress and, therefore, included in the Index, worrying is not a meaningful coping strategy
43
6.4
Trend analysis
Table 26 shows the results of a trend analysis/seasonal calendar undertaken in 4 villages: 1) Chorpara village, Itna Upazilla, Kishoreganj (deep Haor), 2) Sutarpara village, Sutarpara Union, Karimganj Upazilla, Kishoreganj (moderate Haor), 3) Boali village, Khaliajhury Upazilla, Netrokona (deep hoar), 4) Khurshimul village, Mohanganj Upazilla, Netrokona (moderate Hoar). As part of this qualitative exercise, community members were asked to describe selected occurrences and activities during the 12 months of the year, and to score the intensity of occurrences/activities. A higher number indicates higher intensity as perceived by community members. In Kishoreganj, scores were assigned on a scale from 0-10; in Netrokona on a scale from 0-5, which were subsequently multiplied by 2 for the purpose of this analysis. As a result, lower intensity in the 0-1 range on the 10scale may not be properly reflected for the Netrokona villages. Table 26 : Seasonal calendar
Months Bangla month Apr-may Baishak MayJun Jaisti JunJul Ashar JulAug Sravon AugSep Bhadra SepOct Ashin OctNov Kartic NovDec Agrah ayan Dec-Jan Payush JanFeb Magh FebMar Falgun Mar-Apr Chaitra
Rainfall Village 1 Village 2 Village 3 Village 4 Food crisis Village 1 Village 2 Village 3 Village 4 Disease Village 1 Village 2 Village 3 Village 4 Migration Village 1 Village 2 Village 3
Village 4 Male level of work Village 1 Village 2 Village 3 Village 4

Female level of work Village 1 Village 2 Village 3 Village 4

The descriptions provided by community members for the selected activities/occurrences over a 12month period match quite closely across the 4 villages, and are reported below based on qualitative data collected.
44
The lean season ended in the first half or April and April-May is a busy period for households; during this time they earn most of the income to pay back informal loans taken during the lean season, socalled logni. Men undertake agricultural day labor and are very busy completing the ri ce harvest before the monsoon begins. Other work for men includes reaping, thrashing, and straw drying. Women undertake the collection of rice from the fields, rice winnowing, boiling, drying and storing (including making pulp rice muri); and cow paddy/straw drying and storing. Children often help with the collection of rice. At the same time, women are also harvesting ground nuts, sweet potatoes and are making cow dung coils as fuel for cooking in addition to their regular household chores. In Boali village, community members stated that men get paid 10-12 mounds of rice for harvesting per season and women get 3-4 mounds of rice, one saree and 2 meals of food at end of the season. During this period, storms start increasing in intensity and frequency. Picture 9: Women supporting household income through produce sales
During the period May- June, men continue the reaping and harvesting of rice and women continue collection of rice from the fields, rice winnowing, boiling, drying and storing, and drying/storing of cow dung and straw. At this time, men also do earth work and homestead raising to protect their homes, and repair their houses, boats and nets. In this month, fishermen in Chorpara village take dadon, conditional informal loans. This is a period of heavy rainfall. Many people suffer from colds, fevers, coughs and influenza. In the period June-July, men are mainly involved with fishing and the ongoing reparation of their fishing nets and boats. In Sutarpara, women also help with these reparations. Fish catches are not good and because of high waves in this period they cannot go out onto the water every day; fishing
45
only earns the men about 150-200 Taka per day. To meet the income shortfall, many men take logni and dadon from local Mohajonee for 5-6 months at average interest rates for 50%. Some men also undertake short migration to Sylhet and Dhaka for contract labor on earth work and rickshaw pulling. Men spend a lot of time playing cards and gossiping while women sew Kantha and make bamboo handicrafts. In this period, community members report heavy rainfall and many suffer fevers, headaches and influenza. In July-August, there is sufficient fish to catch and men intensify their fishing in rivers and Haors. However, Chorpara village reports that there is less fish than before. Fishing earns the men on average 250-300 Taka per day. Women primarily sew Kantha. There is heavy rainfall in this period and community members suffer from influenza, fevers and coughs. In the period August-September, most of the men continue fishing the rivers and Haors. In Khurshimul village, men also work on separating jute fibres. If men observe that there are sufficient fish to be caught, they take dadon and try their fortune with the potential of earning 250-300 Taka per day. If they observe limited number of fish, men migrate to Sylhet or Dhaka for contract labor. During the period, women are not involved in income-generating work. The rains are decreasing community members report diarrhea and dysentery. September-October marks the start of the peak fishing season and men are very busy. Income from fishing is reported to be same as previous months: 250-300 Taka per day. Women do no incomerelated work. Diarrhea and dysentery cases are increasing. There are also some cases of jaundice reported. Picture 10: Men fishing in the peak season
46
In October-November, the fishing season is winding down. Men remain busy fishing but fish availability decreases; women do not do income-related work. Average income from fishing is reported as lower than previous months: 200-250 Taka per day. The ultra poor people in the villages migrate to Dhaka, Chittagong, Sylhet, Bhairab, Ashuganj, Aliganj, and Volaganj to do contract labor. To meet transportation and other expenses, villagers from Boali village report having to take 6-month loans from money lenders at 200% annual interest rates. In some cases, the entire household migrates to do work such as brick making earning 60-70 Taka per day / household member. This period marks the beginning of a food crisis and the ultra poor reduce start reducing food intake eating two rice meals/day and one roti meal. There is increased incidence of water-borne diseases such as diarrhea, dysentery and jaundice. Fever, coughs and malaria are also reported. As a result of water levels in the Haor dropping in this period, open latrines are becoming separated from water bodies. Picture 11: Non-agricultural day labor
In the period November-December, there are very limited opportunities for income-generating work in the villages. Many households migrate to do contract labor such as brick making. Men and women that remain behind start preparing paddy seed beds and planting seeds as agricultural day. Many ultra poor are forced to take logni. The villages in Netrokona report no income-related activities at all. Overall, the food crisis continues and the ultra poor reduce continue to reduce food intake eating two rice meals/day and one roti meal. In the period December-January, the main source of income is agricultural day labor, if available. Men are becoming increasingly busy transplanting rice, sowing sweet potato and groundnuts. The women work on uprooting rice seedlings and preparing them for transplantation. Community members in
47
Chorpara village also report that some ultra poor women catch fish. The villages in Netrokona report no income-related activities at all. The food crisis continues and food intake is reduced to one or two meals per day. Many people suffer from fevers and colds, and community members in Sutarpara report pneumonia among children. In the period January-February, the main source of income is still agricultural day labor, if available. Men continue rice transplantation, work on developing paddy irrigation, and weeding; earning them about 150 Taka/day. Women harvest potatoes and receive 5kg out of every 40kg that they harvest as payment. In Chorpara village some women continue to catch fish. Some households migrate to areas where they can sell labor. The food crisis continues and most of the ultra poor households do not take more than 2 meals per day. In the period February-March, there are no opportunities for men to earn income in the villages. Most of the households migrate to areas where they can sell their labor. Women in Netrokona are reported to harvest groundnuts, chili, and sweet potato, and to do earth work. Food rationing to a maximum of two meals per day continues and some households have to go without any meals on some days. Community members report that there are an increasing number of storms in this period. In the first half of March-April, there are still no income-generating opportunities with the exception of some earth work that men are involved in. Migration to sell day labor remains common. The food crisis continues for another 2-3 weeks and reduced food intake during this time is still very common. There are heavy rainfall and storms. April marks the end of the lean season. Picture 12: Non-agricultural day labor - mat making
The patterns shown in table 26 and the accompanying qualitative descriptions of the different periods match the peak and lean periods shown in figures 5 and 6. The most severe food crisis occurs in the period October to February, after which there is a relatively quick recovery in April when the rice harvest starts. Adjusting meals and informal lending are the most common coping strategies in lean periods, which correspond with tables 11 and 12 in Section 5, and the top 3 coping strategies in described in Section 6.3.
48
7.0
7.1
WATER AND SANITATION

Drinking, cooking and washing water sources
Table 27 shows the drinking water sources by District and Haor region. Hand tube wells are the most common water source followed by shallow tube wells and deep tube wells. Overall, 97% of households depend on the various types of tube wells for drinking water. Almost no households draw drinking water from open water sources such as ring wells, ponds and rivers/canals. When comparing across Haor types, significantly more households in deep Haor areas use hand tube wells than in moderate Haor areas. In turn, in moderate Haor areas, significantly more households use shallow tube wells that in deep Haor areas. When comparing across Districts, the proportion of households using hand tube wells in Kishoreganj is significantly higher than in the other two districts. The proportion of households using shallow tube wells is significantly higher in Netrokona; the proportion of households using deep tube wells is significantly higher in Sunamganj. Table 27: Drinking water sources, by District and Haor type District Drinking Water (% of HHs) Kishoreganj Netrokona Sunamganj N 628 634 630 Hand tube well Tara pump Deep tube well Shallow tube well Ring well/ indara Pond River/canal 72.8
c
Haor Type Deep Moderate 947 64.7

c
Total 1892 62.8% 0.2% 11.7% 22.9% 0.6% 0.4%
945 60.8 0.3 10.8 25.5

b
59.9 0.2 8.5 29.5

c
55.7 0.0 19.5

c
0.5 7.2 19.1 0.3 0.2
0.1 12.7 20.4 0.1 0.1
20.2 1.6 1.0
0.0 0.0
1.2 0.6
0.0 1.9 2.1 1.9 0.7 1.3% Letters denote significant differences among Districts or between Haor types for a given water source. Significance levels for comparisons: a = .10; b = .05; c = .00 Table 28 shows the cooking water sources by District and Haor region. Hand tube wells are the most common water source followed by rivers/canals and shallow tube wells. Deep tube wells and ponds are the next most common water sources for cooking. Almost no households draw cooking water from tara pumps and ring wells. When comparing across Haor types, significantly more households in moderate Haor areas use hand and shallow tube wells than in deep Haor areas. In turn, in deep Haor areas, significantly more households use river/canal water for cooking that in moderate Haor areas. When comparing across Districts, the proportion of households using hand tube wells in Kishoreganj is significantly higher than in the other two districts. The proportion of households using shallow tube wells is significantly higher in Netrokona; the proportion of households using deep tube wells is significantly higher in Sunamganj.
49
Table 28: Cooking water sources, by District and Haor type District Cooking Water (% of HHs) Kishoreganj Netrokona Sunamganj N Hand tube well Tara pump Deep tube well Shallow tube well Ring well/ indara Pond River/canal 628 56.7
c
Haor Type Deep Moderate 947 34.7 0.0 7.3 12.2 0.4 7.2 38.0
b
Total 1892 41.4% 0.2% 7.7% 17.3% 0.8% 7.1% 25.5%
634 35.5 0.2 5.8 20.7

a
630 32.1 0.0 12.9

c
945 48.0
c
0.5 4.3 16.9 0.3 1.6 19.7
0.3 8.0 22.4

c
14.4 2.1 8.1 30.5
0.0 11.7 26.2
1.2 7.1 12.9
Letters denote significant differences among Districts or between Haor types for a given water source. Significance levels for comparisons: a = .10; b = .05; c = .00
Table 29 shows the washing water sources by District and Haor region. Most households reported open water sources for washing. River/canals are the most common water source followed by hand tube wells and ponds. Almost no households use water from tara pumps, ring wells and deep tube wells for washing. Picture 13: Woman uses hand tube well as the water source for washing
50
When comparing across Haor types, significantly more households in moderate Haor areas use hand, deep and shallow tube wells, and ponds than in deep Haor areas. In turn, in deep Haor areas, significantly more households use river/canal water for washing that in moderate Haor areas presumably, due the almost year round access to this water source. When comparing across Districts, the proportion of households using hand tube wells in Kishoreganj is significantly higher than in the other two districts. The proportion of households using ponds is significantly higher in Netrokona; the proportion of households using river/canals is significantly higher in Sunamganj. Table 29: Washing water sources, by District and Haor type District Washing Water (% of HHs) Kishoreganj Netrokona Sunamganj N 628 634 630 Hand tube well Tara pump Deep tube well Shallow tube well Ring well/ indara Pond River/canal Other 45.1
c
Haor Type Deep Moderate 947 22.1 0.0 2.1 7.8 0.0 17.6 49.8
c
Total 1892 26.5% 0.1% 2.8% 11.5% 0.6% 20.2% 38.0% 0.1%
945 31.0
c
17.5 0.0 1.6 14.5 0.2 29.2

b
17.1 0.0 4.0 7.3 1.7 18.7 51.0

c
0.3 2.9 12.6 0.3 12.7 26.0 0.2
0.2 3.5 15.1

b c
1.1 22.9
a
37.1 0.0
26.1 0.1
0.2
0.1
Letters denote significant differences among Districts or between Haor types for a given water source. Significance levels for comparisons: a = .10; b = .05; c = .00
Figure 10 shows the distances to various drinking water sources by District and Haor type. Overall, the mean distance to water sources is slightly higher than 200 meters (205m). There is no significant difference between the distance to drinking water in deep and moderate Haor areas. When comparing across districts, the distance to drinking water is significantly higher in Sunamganj than in the other districts. Figure 10: Distances to sources of drinking water, by District and Haor type
(N=1892)
51
Figure 11 shows the distances to various cooking water sources by District and Haor type. Overall, the mean distance to water sources is higher than 200 meters (216m), and slightly higher that the distance to drinking water sources. There is no significant difference in the distance to cooking water among districts. When comparing across Haor types, the distance to cooking water sources is significantly higher in deep Haor areas. Figure 11: Distances to sources of cooking water, by District and Haor type
(N=1892) Figure 12 shows the distances to various washing water sources by District and Haor type. Overall, the mean distance to water sources is less than 200 meters (185m). When comparing across districts, there is no significant difference between distance to washing water sources in Kishoreganj and Netrokona. However, the distance to washing water is significantly higher in Sunamganj than in the other two districts. (dry season) When comparing across Haor types, the distance to washing water sources is significantly higher in deep Haor areas. Figure 12: Distances to sources of washing water, by District and Haor type
(N=1892)
52
7.2
Arsenic testing
Of the households that reported tube wells or tara pumps as a source for drinking, cooking or washing water, 45% of households in Kishoreganj reported that the tube wells / tara pumps were tested for arsenic, which is significantly lower than in Netrokona and Sunamganj where 53% of households reported that the tube wells / tara pumps were tested for arsenic. When comparing across deep and moderate Haor type, 55% of households in moderate Haor areas reported that the tube well/tara pumps were tested for arsenic, versus a significantly lower 45% in moderate Haor areas. Of the tube wells/tara pumps that were tested, 12%, 18% and 11% were found to contain arsenic in Kishoreganj, Netrokona and Sunamganj, respectively. The 18% in Netrokona is significantly higher than the percentages in the other two districts. When comparing across Haor types, the percentage of tube wells/tara pumps that contained arsenic was significantly higher in deep Haor areas at 17% than the 11% in moderate Haor areas. Table 30: Tube wells/tara pumps tested for arsenic, by District and Haor type District Haor Type Kishoreganj Netrokona Sunamganj Deep Moderate Tested (%) Yes No Do not know Has arsenic (%) No arsenic (%) 45.2
c
Total 50.5 33.7 15.8 14.1 85.9
N 933 623 293 132 814
53.4 34.2 12.4 18.7

c
52.9 30.3 16.8 10.7 89.3
45.8
55.1 32.4 12.5 11.2 88.8
36.4 18.4 12.7 87.3
35.0 19.2 17.6

c
81.3
82.4
Significance levels for comparisons among Districts/across Haor type: a = .10; b = .05; c = .00
7.3
Sanitation
The most common type of latrines used by adult men and women are ring slab/offset latrines (with the seal broken) and hanging/open latrines, followed by uncovered pit latrines and then open defecation. Overall, the use of hygienic latrines such as ring slab/offset latrines (with the seal intact), septic latrines, covered pit latrines and locally adapted hygienic latrines is very low in the project area. Qualitative data confirms that few households have a sanitary latrine. Shoes are seldom worn when visiting the latrine. When comparing across districts, the use of hanging/open latrines and ring slab/offset latrines (with the seal broken) is significantly higher in Kishoreganj than in the other districts. There are no significant differences across Haor types, and there are no significant differences in latrine use by adult men and women.
53
Table 31: Types of latrines used by adult men and women, by District and Haor type District Haor Type Latrine Type Kishoreganj Netrokona Sunamganj Deep Moderate N Ring-slab/offset latrine (water seal) Ring-slab/offset Latrine (seal broken) Men Women Men Women Men Women Men Pit latrine (covered) Pit latrine (uncovered) Women Men Women Men Septic latrine Women Men Hanging/open latrine Locally adapted hygienic latrine Women Men Women Men Open defecation Women 562 581 2.7 2.8 49.3 49.1
c c
Total 1892 1577 1.6 1.6 37.2 37.4 0.6 0.7 11.1 11.4 0.2 0.1 44.6 44.8 0.1 0.2 4.5 3.7
504 529 1.6 1.5 30.6 31.4 0.2 0.2 12.5 13.0 0.0 0.0 52.0 52.2 0.4 0.4 2.8 1.3
459 467 0.4 0.4 29.8 29.8 0.2 0.2 14.4 14.6 0.2 0.0 48.8 49.0 0.0 0.0 6.1 6.0
782 810 1.0 0.9 34.9 35.6 0.4 0.4 11.3 11.0 0.0 0.0 47.3 47.3 0.0 0.1 5.1 4.8
743 767 2.3 2.5 39.7 39.4 0.8 1.0 11.0 11.7 0.4 0.3 41.7 42.2 0.3 0.3 3.8 2.6
1.2 1.5 7.3 7.2 0.4 0.3 34.5 34.8

b b
0.0 0.2 4.6 4.1
Significance levels for comparisons: a = .10; b = .05; c = .00
Similar to adults, the most common types of latrines used by boys and girls 5-15 years of age are ring slab/offset latrines (with the seal broken) and hanging/open latrines. For boys and girls, this is followed by open defecation and then uncovered pit latrines the opposite to adults. Overall, the use of hygienic latrines such as ring slab/offset latrines (with the seal intact), septic latrines, covered pit latrines and locally adapted hygienic latrines is very low. Picture 14: Ring slab latrine
54
When comparing across districts, the use of ring slab/offset latrines (with the seal broken) by boys and girls is significantly higher in Kishoreganj than in the other districts. For hanging/open latrines, the use by girls is significantly lower in Kishoreganj than in the other districts, and significantly higher for boys in Sunamganj than in the other districts. Open defecation by boys is significantly higher in Netrokona than in the other districts. There are no significant differences across Haor types. Table 32: Types of latrines used by boys and girls 5-15 years of age, by District and Haor type District Haor Type Latrine Type Kishoreganj Netrokona Sunamganj Deep Moderate N Ring-slab/offset latrine (water seal) Ring-slab/offset Latrine (seal broken) Boys Girls Boys Girls Boys Girls Boys Pit latrine (covered) Pit latrine (uncovered) Girls Boys Girls Boys Septic latrine Girls Boys Hanging/open latrine Locally adapted hygienic latrine Girls Boys Girls Boys Open defecation Girls 348 366 2.9 2.7 45.1 46.7
c c
Total 955 951 1.5 1.7 33.0 34.8 2.1 0.6 12.0 11.4 0.3 0.2 38.3 39.9 0.1 0.1 14.1 11.4
282 280 1.1 1.8 24.5 24.6 0.0 0.0 15.2 12.9 0.0 0.0 35.8 43.6 0.4 0.0 23.0
b
325 305 0.3 0.3 27.4 29.8 0.3 0.3 14.8 15.7 0.3 0.0 46.2
a
482 476 1.0 0.8 30.7 33.4 0.2 0.4 13.7 11.3 0.0 0.0 39.4 41.0 0.0 0.0 14.9 13.0
473 475 1.9 2.5 35.3 36.2 1.1 0.8 10.4 11.4 0.6 0.4 37.2 38.7 0.2 0.2 13.3 9.7
1.4 1.4 6.9 6.6 0.6 0.5 33.0 32.8

a
44.9 0.0 0.0 10.8 8.9
0.0 0.3 10.1 9.0
17.1
Enumerators were also asked to personally verify that the latrines used by respondents were functioning and to describe their condition and cleanliness. Ninety percent of latrines observed were found to be functional, all showed signs of use, 63 percent of latrines were considered relatively clean, and for 55 percent latrines the surrounding area was considered clean. However, for these questions there were only 40 responses/observations each, which is not in any way representative for the study population. Reasons for this could be the distance from the interview location to the latrine area, which may have been inconvenient for the enumerator to cover in the allotted interview time.
55
Picture 15: Open defecation facilities
56
8.0
8.1
HEALTH PRACTICES AND ILLNESS

Hand washing
Overall, the majority of respondents wash their hands before eating but less than half do so before preparing food and only one-third wash their hands before feeding children. The majority of respondents wash their hands after defecation but only one-third of respondents do so after cleaning a babys bottom. Qualitative data shows that hand washing with soap and ash after defecation is uncommon. When comparing across districts, hand-washing behavior before food preparation is significantly higher in Netrokona than in the other districts. Hand washing after cleaning babys bottoms and before feeding children is significantly lower in Netrokona. There are no significant differences across Haor types. Table 33: Hand-washing behaviors among the FSUP baseline study households, by District and Haor type (1) District Haor Type Total When are hands washed Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 1892 Before food preparation Before eating Before feeding children After defecation After cleaning babies bottoms Other Do not wash hands 49.7 91.9 38.2 96.5 43.3 13.7
c
59.0
40.6 94.4 40.6 98.4 38.9 7.9 0.0
49.0 91.0 35.7 94.6 35.1 9.7 0.0
50.6 91.4 33.5 94.0 34.4 8.5 0.0
49.8 91.2 34.6 94.3 34.7 9.1 0.0
87.4 25.1
c
88.0 22.1
c
5.7 0.0
0.0
The use of ash or clay for hand washing is most common followed by use of only water. The use of soap is least common, which is confirmed by qualitative data. When comparing across districts, the use of water only is significantly higher in Sunamganj, the use of ash or clay is significantly higher in Netrokona, and the use of soap is significantly higher in Kishoreganj. When comparing across Haor types, the use of water only is significantly higher in moderate Haor, the use of ash or clay is significantly higher in deep Haor. There are no significant differences in use of soap between deep and moderate Haor types. Table 34: Hand-washing behaviors among the FSUP baseline study households, by District and Haor type (2) District Haor Type Total Hands normally washed with Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 1892 Water only Ashes or clay Soap 33.9 48.1 18.0
c
32.6 58.7 8.7

c b
42.9
34.0 53.7
c
38.9
36.5 50.3 13.3
44.0 13.2
b
46.8 14.3
12.2
57
8.2
Illness among adults and health-seeking behavior
The average number of illnesses cited per household was 2.4: 2.4 for Kishoreganj, 2.5 for Netrokona and 2.2 for Sunamganj. The average number of illnesses reported by households in deep and moderate Haors was 2.4 for both Haor types. Only 2.6% (49 households) experienced no illnesses at all in the last 12 months. The most common illness experienced by adults during the previous 12 months is a cold attack, followed by gastric illness and diarrhea. There are no significant differences among districts and between Haor types. Table 35: Top ten illnesses experienced by adults in households during the previous 12 months, by District and Haor type District Haor Type Total Illness (multiple response) Kishoreganj Netrokona Sunamganj Deep Moderate Number of Responses 1521 1611 1364 2265 2231 4496 Cold attack Gastric illness Diarrhea Dysentery Anemia Rheumatic fever High/low blood pressure Typhoid fever Skin diseases Asthma Other 77.9 46.2 21.3 20.1 13.9 8.1 4.6 9.9 8.9 4.9 11.6 90.4 44.0 30.4 14.2 19.1 9.5 9.6 8.7 6.2 6.3 5.7 61.7 41.6 17.0 16.5 17.8 15.6 6.3 2.2 4.4 4.3 10.2 76.9 43.4 23.8 19.4 17.6 11.4 5.4 6.8 7.1 5.0 8.4 76.5 44.4 22.1 14.4 16.2 10.7 8.4 7.1 5.9 5.4 9.8 76.7 43.9 22.9 16.9 16.9 11.0 6.9 6.9 6.5 5.2 9.1
Other illnesses, cannot be disaggregated into individual illnesses, and therefore are not included in the top ten illnesses.
Table 36 shows that medicine shops and village doctors are the most common treatment sources for household members. Other treatment sources not reflected in table 36 include private paramedics/ LMA, Union Health Center, District Hospital, Homeopath, Kabiraj, untrained doctor, and Ojha/Jhar Fuk; each accounted for less than 2%. Table 36: Usual treatment source for household members, by District and Haor type District Haor Type Treatment sources Kishoreganj Netrokona Sunamganj Deep Moderate 628 Medicine shop Village doctor Upazila Health Center Private MBBS Private clinic 23.1
c
Total
634 40.7 33.0 14.0 4.4 2.1
630 41.7 35.1 5.4

c
947 31.4 35.9

b
945 39.0
c
1892 35.2 33.5 11.2 8.2 2.9
32.3 14.2 14.2

c
31.0 10.7 6.9 3.0
11.7 9.6
b
6.2 3.2
3.5
2.9
58
Picture 16: Village medicine shop
Picture 17: Union Health Center
59
9.0
9.1
PARTICIPATION AND ACCESS

Participation in development
Participation in the development process is overall low at 4.5% of all households, which was too low for meaningful analysis. In Kishoreganj it is 4.9 percent, in Netrokona 7.3 percent, and in Sunamganj it is 1.1 percent. Participation in Sunamganj is significantly lower than the other two Districts (p=.000), and in Kishoreganj it is significantly lower than in Netrokona (p=.044). Participation averages at 4.4 percent in both Deep and Moderate Haor. Respondents were also asked who in the household participated but only 186 responses were received from 174 households (a few households identified more than one person participating) 9.2% of all respondents. Among the 186 responses, household head was mentioned as the most common household member involved in development processes. Females (spouses plus female heads of household) accounted for 15.1% of the 9.2%, or about 1.6% of the overall population. Overall, the responses are too low for meaningful analysis. More than 30% of responses were for the category other, which may have been used to record the option all household members, instead of checking all multiple response boxes. Table 37: Household members involved in development processes Responses Household member involved (multiple response) N Percent Household head 91 48.9% Spouse Son/daughter Father/mother Daughter/son-in-law Grandson/granddaughter Other TOTAL 20 12 4 1 1 57 186 10.8% 6.5% 2.2% 0.5% 0.5% 30.6% 100.0%
Note: Female participation included 8 female heads of household plus spouses. There could also be other females participating (e.g., mothers) but the data does not allow for disaggregation at this level.
When asked about the type of development institution that the household member was involved/engaged in, while participating in local development processes in the last 12 months, only 162 responses were collected. Again, this cannot be meaningfully disaggregated by district and Haor type. Nonetheless, statistical testing among Haor types showed no significant difference. Among the 162 responses, the Masjeed or religious committee was the most common response (24%) followed by participation in NGOs (19%) as village group members, which is often a prerequisite to receiving microcredit. Almost 22 percent of respondents who answered this question stated that they did not know the type of development institution the household was involved with. Again this may indicate that there were multiple institutions involved and respondents found it difficult to recollect which ones exactly.
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Table 38: Type of development institution/person that HH members were involved with Type of development institution involved Responses (multiple response) N Percent Union Parishad Chairman/Counselor 3 1.9% Union Parishad Standing Committee Bazar Committee Masjeed or Religious Committee School/Madrasa Management Committee PTA Village Court/Salish NGO CBO Other DNK TOTAL 4 12 39 12 2 5 31 2 17 35 162 2.5% 7.4% 24.1% 7.4% 1.2% 3.1% 19.1% 1.2% 10.5% 21.6% 100.0%
When asked about the nature of household members involvement/engagement with the development institutions/persons stated in table 38, half (49.3%) of respondents reported that they had received services, which may support the idea that the 30% Other in table 37 was used to indicate participation by the entire household. Other types of participation were: volunteer (27.9%); committee member (19.3%); participant in activities (19.3%); and recipient of training (1.9%). Only 2 households received training: 1 in awareness on social issues, the other in awareness on H/N issues. Only 5% of households had experience with collective action in last 12 months. In Kishoreganj it was 6.5 percent, in Netrokona 6.6 percent, and in Sunamganj it was significantly lower at 3.5 percent (p=.019). Participation averaged 4.6 percent in Deep and 6.4 in Moderate Haor, but these values are not significantly different. Among the 5% of households that had experience with collective action, the main types of action were road construction/repair and Mosque construction/repair. Again, this cannot be meaningfully disaggregated by district and Haor type. Table 39: Type of collective action that households have participated in, by District and Haor type District Haor Type Total Collective Actions Sunam(multiple response) Kishoreganj Netrokona Deep Moderate ganj N 42 42 22 44 62 106 Road construction/repair Canal/pond digging Bamboo bridge construction Embankment construction/repair Graveyard construction/repair Mosque construction/repair Homestead raising/protection School construction/repair 59.5 0.0 2.4 7.1 4.8 31.0 4.8 4.8 35.7 4.8 9.5 9.5 9.5 61.9 7.1 4.8 54.5 0.0 0.0 4.5 0.0 31.8 9.1 4.5 27.3 0.0 11.4 13.6 6.8 59.1 4.5 6.8 64.5 3.2 0.0 3.2 4.8 32.3 4.8 4.8 49.1 1.9 4.7 7.5 5.7 43.4 4.7 5.7
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Picture 18: Community collective action to improve road infrastructure
9.2
Access to GoB services
Over two-thirds of households (68.7%) had accessed one or more GoB service providers in the previous year. Table 40 shows the types of GoB service providers used by households in the last 12 months. The most common service providers used were Union Parishad and Government Immunization Services, followed by Government Family Planning, Upazilla Health Services and Union Health Services. All other service providers listed in table 40 were 0.5% or less. Department of Fisheries, Department of livestock, Department of Cooperatives, and Government Vocational/ Educational Training all recorded zero responses.
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Table 40: Proportion of households using various types of Government service providers, by District and Haor type District Haor Type Total Service Provider Kishoreganj Netrokona Sunamganj Deep Moderate N 446 433 421 681 619 1300 Dept. of Agr. Extension (DAE) Government Land Office Dept. of Youth Development Dept. of Womens Affairs Government Family Planning Govt. Immunization Services Union Parishad BADC Seed Department Union Health Services Upazila Health Services 0.2 0.0 0.0 0.0 23.5
b
0.2 0.2 0.5 0.9 15.2 40.6 67.4

c
0.7 0.0 0.0 0.5 15.2 55.1 57.5

c b
0.4 0.1 0.3 0.6 18.2 39.6 61.5 0.0 10.6

c
0.3 0.0 0.1 0.4 17.9 52.0 53.0

c a
0.4 0.1 0.2 0.5 18.1 45.5 57.5 0.2 7.3 17.5
41.3 47.8 0.4 16.2

c
0.0 1.4 20.6
0.0 5.0 7.1

c
0.2 3.7 16.3
24.2
18.5
Figures 13 and 14 show the types of GoB service providers accessed by District and Haor type. When comparing across districts, Government Family Planning and Union Health Services was significantly higher in Kishoreganj than in the other two districts. Union Parishad was significantly higher in Netrokona. In Sunamganj, Government Immunization Services was significantly higher and Upazilla Health Services was significantly lower than in other districts. Figure 13: Types of service providers accessed, by District
(N=1300) When comparing across Haor types, Government Immunization Services was significantly higher in the moderate Haor, and Union Parishad and Union Health Services was significantly higher in the deep Haor.
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Figure 14: Types of service providers accessed, by Haor type
(N=1300)
Table 41 shows the types of services received by GoB service provider, by District and Haor type. For Union and Upazila Health Services, the most common service received is medication followed by suggestions. For Family Planning, suggestions, medicines and vaccinations are the main services received. For Government Immunization Services, vaccinations are the main services received, as was to be expected. Overall, training provided by GoB service providers is very low. Union Parishad was not included in the table because 95% of services provided were reported as Other. Other could refer to safety nets such as the government programs for supporting vulnerable populations: the Vulnerable Group Feeding (VGF) program, which provides food to low income and other vulnerable groups who cannot meet basic needs for survival due to natural disasters or socio-economic circumstances, such as age, illness or disease; and the Vulnerable Group Development (VGD) program, which aims to enable the poorest rural women and their family members to overcome food insecurity and their low social and economic status. These kinds of safety net programs were indicated in qualitative data collection as the main service that Union Parishads are known for. It is important to note that although these programs were highly valued, community members had concerns about the transparency and equity in recipient targeting. It is apparent that the majority of services provided are health related. Qualitative data confirmed the lack of services on economic activities. Community members particularly mentioned the need for more and better technical assistance in the areas of livestock rearing, fishery and agriculture.
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Table 41: Types of services received by GoB service providers, by District and Haor type District Haor Type Service Provider Kishoreganj Netrokona Sunamganj Deep Moderate Union Health Services N 95 7 38 100 40 Suggestions 26.5 33.3 54.5 26.4 54.2 Medicines 77.9 83.3 77.3 79.2 75.0 Vaccinations 32.4 0.0 31.8 30.6 29.2 Other 2.9 0.0 9.1 2.8 8.3 Upazila Health Services N Suggestions Medicines Vaccinations Other GoB Family Planning Formal training N Suggestions Medicines Vaccinations Other GoB Immunization Services N Informal training Suggestions Medicines Vaccinations Other 167 52.3 86.2 13.8 0.9 188 0.0 73.1 54.8 51.0 1.9 1.9 262 0.5 29.6 15.6 93.0 2.2 141 43.5 77.2 22.8 9.8 120 0.0 67.2 75.0 43.8 1.6 259 0.0 19.7 25.8 97.8 2.2 51 48.4 58.8 19.4 0.0 167 1.6 89.1 95.3 75.0 1.6 393 0.0 22.6 47.9 93.2 4.3 191 44.9 90.6 11.8 3.1 240 0.0 75.2 72.7 49.6 0.8 421 0.0 26.1 27.6 96.0 5.1 168 52.4 76.2 25.7 5.7 235 0.9 76.6 70.3 62.2 1.8 493 0.3 22.1 34.4 93.3 1.2
Total 280 33.3 78.1 30.2 4.2 718 48.3 84.1 18.1 4.3 475 0.4 75.9 71.6 55.6 1.3 914 0.2 23.9 31.3 94.5 3.0
Figure 15 shows the level of satisfaction with the services received through the various GoB service providers. For all service providers, the majority of respondents indicated they were satisfied or highly satisfied. Figure 15: Level of satisfaction with selected GOB services
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9.3
Access to other services
Respondent were also asked about services that they had received from non-government service providers. Overall 67% of households reported not receiving any services from other non-government service providers. When disaggregated by District, the number of households receiving no services from non-government service providers was significantly higher (p=.020) in Netrokona (78%) than in Kishoreganj (65%) and Sunamganj (58%). When disaggregated by Haor type, the number of households receiving no services from non-government service providers was also significantly higher (p=.000) in moderate Haor areas (74%) than in Deep Haor (60%). Overall, the three most common non-government service providers (for individuals who reported receiving services) were NGOs (76%), Grameen Bank (16%), and Local Service Providers (18%). Less than 1% of households reported receiving services from Commercial Banks, CBOs, input retailers/dealers and non-Government Vocational Education/Training, respectively. The most common services received from NGOs were credit (68%), suggestions (16%), and relief/aid (4%). The most common services received from Grameen Bank were credit (99%) and suggestions (13%). The most common services received from Local Service Providers were suggestions (75%), credit (65%), suggestions (16%), medicines (71%) and relief/aid (12%). Qualitative data collection showed that community expectations for economic and development activities primarily revolve around facilitating access to Khas water bodies, access to credit, and capacity development. Men and women share expectations around external support for increased participation in community decision making, improved flood protection and improved childrens education. While mens expectations focus mainly on economic opportunities and strengthened links to livestock and agriculture services; women expressed expectations around increased opportunities to have a voice in community affairs, improved health services and access to life skills training. Picture 19: Women engaged in alternative livelihood activities
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At present, the main sources of knowledge and skills for economic/livelihood activities are knowledge transfer from previous generations, and from relatives and neighbors. The little external assistance that ultra-poor households do receive comes primarily from NGOs. Examples mentioned by respondents included livestock and poultry rearing, credit groups, increased crop production, market development, homestead gardening. Women appear to be mainly involved in micro credit and men are also involved in earthwork, flood protection and infrastructure projects. Among the limited number of women who participate in income-related activities in deep haor regions, it was mentioned that a large number are widows and that access by married women with families is more difficult. NGOs also facilitate community participation in development/economic activities. This is valued by community members as the limited participation of the ultra poor in local committees is an apparent concern. Knowledge of economic and development opportunities appears to be low. The main sources of information about external assistance for economic and development activities are NGO workers. This information is often channeled to community members by village leaders and prominent community members such as school teachers, health workers and local elites; and does not reach everyone equally. Union Parishad officials are the main source of information for GoB development activities. It was noted that Union Parishad officials do not pass information to everyone; they prefer to share information with their supporters only. Similar to participation in economic activities, decision making around participation in NGO and GoB development activities is heavily influenced by the rich and politically powerful, as well as by kinship ties. Although the poor and ultra poor do participate in the development process, they have little voice regarding types and recipients of benefits, resource allocation and arbitration. Community members recognize the purposive targeting of women by NGOs and are very supportive of this. However, it is important to note that within the family the nature of participation by women is often still determined by male household members. Community members stated that the community benefits generated from participation in development activities are more important than monetary benefits. These benefits include reduced cost of travel, market and health care connectivity, improved drinking water, flood protection, improved access to other service providers, and improved school attendance/ reduced dropout rates. Non-monetary benefits generated at the individual and household level include improved social dignity for the ultra poor, increased womens participation and more joint decision-making between men and women. There are serious concerns about how benefits are distributed; with benefits going more to those with kinship relations and the economic means to bribe officials or invest in development activities. An example of the latter is the installation of village tube wells; the more well-off community members usually pay the security deposits for the wells and then end up controlling irrigation to the benefit of their own crops and those of their kin. Community members also mentioned the high fees provided to local experts hired for training, which in some cases come to 25% of the total available funds for the local project. There appear to be significant costs involved with participation in development activities. Similar to participation in economic activities, there are non-monetary costs associated with time away from home by women such as reduced care for children, and inability to do household chores, which causes stresses between husband and wife. At the same time there are monetary costs (primarily for males) as participation in development activities takes time away from work. There are also reports of food being stolen when males are away.
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There are also direct monetary costs involved in participating in development activities. To get VGD/VGF cards, community members commonly must take high interest loans to bribe Union Parishad members. Convincing Union Parishad members to allow their participation also requires a significant time investment and in some cases community members must also provide physical labor to help convince them. Power relations due to kinship and politics are considered the main barriers to access to development opportunities by the ultra poor. In addition, women face additional barriers due to their lack of access to information, their lack of confidence in speaking publicly and the ongoing discouragement by men (and some women as well) that prevents them from participating in community dialogues and meetings. To overcome these barriers, community members stated that there is an urgent need for capacity development on rights issues.
9.4
Access to common property
Table 42 shows the proportion of households that have various types of property available in their area, disaggregated by District and Haor type. Overall, Beel/Haor and canal/river are the most common land property types, followed by Khas land, roadside sloping and Khas ponds. Khas pond and Khas land are most common in Kishoreganj, and most common in Deep Haor. Roadside sloping and grazing land are both more common in Netrokona. Table 42: Proportion of households that have various property types available in their household area, by District and Haor type District Haor Type Total Types of property Kishoreganj Netrokona Sunamganj Deep Moderate N 628 634 630 947 945 1892 Khas pond Khas land Roadside sloping Embankments Railway grounds Beel/Haor River/Canal CBO water body Grazing land Forest Hills 11.5 32.8 3.3 7.3 0.5 74.7 78.0 5.7 2.9 1.3 0.3 2.4 18.8 18.3 0.6 0.2 92.7 88.8 1.3 10.9 0.2 1.1 4.1 9.4 0.2 1.7 0.2 74.4 88.4 1.1 4.1 0.2 0.2 7.4 32.5 6.2 3.6 0.4 84.3 91.7 6.3 6.0 0.1 0.1 4.6 8.0 8.4 2.9 0.1 77.0 78.5 5.7 5.9 1.0 1.0 6.0 20.3 7.3 3.2 0.3 80.7 85.1 6.0 6.0 0.5 0.5
Significance levels for comparisons: a = .10; b = .05; c = .00 Table 43 shows the proportion of available property that is accessible by households, which means they can use the resources for household or livelihood purposes. Railway, forest and hill land were excluded from the table due to an inadequate number of responses for meaningful analysis. Overall, the highest proportion of households has access to river/canals, followed by roadside sloping and beels/haors. Access to Khas land is lowest. When comparing across districts, access to Khas pond, road side sloping and river/canals is highest in Sunamganj with access to roadside sloping reported
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as 100%. Access to embankments and CBO water bodies is highest in Kishoreganj. Access to Khas land in Kishoreganj, and embankments in Netrokona and Sunamganj was reported as 0%. Table 43: Proportion of available property that is accessible by households, by District and Haor type District Haor Type Total Types of property N Kishoreganj Netrokona Sunamganj Deep Moderate Khas pond 116 12.5 18.8 64.3 7.0 55.6 25.9 Khas land Roadside sloping Embankments Beel/Haor River/Canal CBO water body Grazing land 385 138 64 1526 1613 115 113 0.0 23.8 40.8 31.8 68.2 52.8 33.3 15.1 46.6 0.0 50.0 66.6 37.5 21.7 23.3 100.0 0.0 46.3 79.2 15.5 19.2 8.1 50.8 11.8 45.4 76.5 39.3 17.5 9.2 30.8 53.3 40.9 65.6 16.7 28.6 8.3 43.5 31.3 43.3 71.5 28.7 23.0
Significance levels for comparisons: a = .10; b = .05; c = .00 Respondents were also asked what kind of activities household members were allowed to do on the properties they had access to. However, answers to common property uses allowed were quite varied, suggesting a need for clarification and awareness-building in this area. Qualitative data showed that community members specifically stated the restricted access to open Khas water for fishing purposes and restricted land access for rice cultivation as main barriers to economic development. Community members emphasized the need for increased advocacy by NGOs and other stakeholders for increased access to Khas land and water to increase participation of the ultra poor in economic activities. Picture 20: Government-owned Khas land
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10
10.1
DISASTERS AND CRISES

Natural disasters: effects and coping strategies
Overall, 78% of households reported that they did not experience a natural disaster in the previous year. In both Netrokona and Sunamganj, 81% experienced no disaster, and in Kishoreganj significantly fewer (71%) experienced no disaster. In deep Haor, 75% of households did not experience a disaster, while in moderate Haor the proportion was significantly higher (p=.022) at 80%. Table 44 provides data for those households that did experience a natural disaster. The highest proportion of disasters experienced in the last 12 months were wind damage, floods, excessive rain and storms. Wind damage is locally called Aphal; strong winds that damage standing crops, cause soil erosion and uproot trees. Table 44: Disasters experienced by households in the last 12 months, by District and Haor type District Haor Type Total Type of natural disaster Kishoreganj Netrokona Sunamganj Deep Moderate N 181 122 121 233 191 424 Flood (flash/monsoon) Drought Storm River erosion Excessive rain Water logging Land slide Wind damage Soil erosion 37.6 2.2 18.1 0.0 44.2 12.7 0.6 50.8 1.1 29.5 0.8 18.0 1.6 3.3 15.6 0.0 45.1 5.7 28.1 3.3 26.4 5.0 22.3 8.3 0.0 17.4 0.8 38.6 1.7 17.6 3.4 25.3 14.6 0.4 46.8 3.4 25.1 2.6 24.1 0.0 27.2 9.4 0.0 40.9 1.0 32.5 2.1 20.5 1.9 26.2 12.3 0.2 39.6 2.4
Picture 21: Damage to buildings as a result of natural disasters
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Respondents, who reported experiencing a natural disaster in the last 12 months, were subsequently asked what the effect of that particular disaster was on their household. The highest proportion of households experienced partial damage to their house, followed at a distance by loss of working days and full damage to their house. Table 45: Proportion of households experiencing various consequences of a natural disaster in the last 12 months, by District and Haor type District Haor Type Total Effect of natural disaster Kishoreganj Netrokona Sunamganj Deep Moderate N 184 124 123 238 193 431 Loss of working days Damaged house fully Damaged house partially Damaged poultry and livestock Loss of productive assets Crop loss Loss of HH goods Loss of trees Tube well damage Latrine damage Other 54.3 6.5 66.8
c c a
7.3 16.1 72.8 7.3 0.0 1.6

c
4.1 14.6 74.0 0.0

c
31.1
20.7 12.4 61.1 2.6 0.0 7.8

b
26.5 11.6 70.3 5.6 0.5 5.1 3.7 8.6 0.2 6.0 2.1
10.9 77.7 8.0

b c
8.2 1.1 5.4 3.3 13.6

b
0.0 8.1 0.0

c
0.8 2.9 4.2 6.7 0.0 8.0

a
8.1 8.1 0.0 5.6 5.6
3.1 10.9 0.5 3.6 1.6
1.6 0.0 0.8

c
0.5 9.8 1.1
0.0
2.5
Figure 16 shows the mean asset/income loss reported by households who experienced a disaster in the last 12 months, disaggregated by district and Haor type. The mean asset loss per disaster was reported at around Taka 3,017. There are no significant differences among districts but the asset loss in moderate Haor is significantly higher than in deep Haor. Figure 16: Mean asset loss from households experiencing asset loss in a natural disaster in the last 12 months, by District and Haor type
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Figure 17 shows the mean number of working days lost reported by the 26.5% of households who indicated this effect in table 45, disaggregated by district and Haor type. The mean number of working days lost is 10. When comparing across districts, the mean number of working days lost is significantly higher in Kishoreganj than the other two districts. There is no significant difference across Haor types. Figure 17: Mean number of working days lost from households experiencing a natural disaster in the last 12 months, by District and Haor type
The most common coping strategies used by respondents to recover from a natural disaster were: taking out a loan from friend/neighbor (41%), taking loan from a moneylender (31%), adjusting meals (25%), using savings (25%), accepting help from others: (24%), purchasing on credit (21%) and taking a loan from NGO (11%).
10.2
Household crises: effects and coping strategies
Respondents were also asked the same range of effect and coping strategy questions for a range of household crises, not caused by natural disasters. Only 16.7% reported the occurrence of such crises in the last 12 months ranging from 16-19% among Districts and across Haor type, with no significant differences. The most common types of household crises reported were illness of income earners (57.2% of cases where a household crisis was reported) and illness of other household members (32% of cases where a household crisis was reported). All other responses were less than 5%. The main effects of the household crises were asset/income loss and work days lost. Figure 18 shows the mean loss of assets, disaggregated by district and Haor type. The mean loss of assets was just under Taka 5,000. Comparison among districts shows that asset loss was significantly higher in Netrokona than in Sunamganj. There is no significant difference across Haor types.
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Figure 18: Loss of assets among households experiencing household crises in the last 12 months, by District and Haor type
(N = 306)
Figure 19 shows the mean number of working days lost, disaggregated by district and Haor type. The mean number of working days lost was 36. Comparison among districts and across Haor types showed no significant differences. Figure 19: Loss of work days among households experiencing household crises in the last 12 months, by District and Haor type
(N = 306)
Figure 20 shows the mean number of working days lost as a result of illness of either income earner or other household members, disaggregated by district and Haor type. The mean number of working days lost due to illness was 36 (mode=15). Comparison among districts shows that the number of working days lost due to illness is significantly higher in Netrokona than in Sunamganj. There are no significant differences across Haor types.
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Figure 20: Average number of days lost due to illness for those households with an ill member designated as a household crises in the last 12 months, by District and Haor type
(N=305)
The most common coping strategies used by respondents to cope with household crises were (n=316): took out a loan from friend/relative (42.7%), took out a loan from moneylender: (36.0%), made adjustment to meals (27.8%), accepted help from others (20.6%), purchased goods on credit (18.4%), used savings (11.7%), took out a loan from an NGO (11.1%), took a grain loan (10.4%), ate famine foods (8.2%), and accepted aid (5.4%)
10.3
Climate change
Qualitative data collection included some exploratory questions around climate change in qualitative data collection, the findings of which are by no means robust. Community members reported increased temperatures, more extreme storms, irregular flash floods and irregular/infrequent rainfall. They inferred multiple linkages between these changing weather-related characteristics and livelihood impacts such as reduced crop and fishing yields, less migratory birds, increased insect infestation and crop disease, and reduced soil fertility. On e common example mentioned was that climate variability has reduced ability to predict flash flood; previously crops could be harvested prior to flash flood It was noted that in the last ten years the water levels of the Haor have been reduced significantly and sedimentation has increased; beels and marshlands were filling up, which negatively affected fishery and agricultural practices due to lack of water in the dry season. In addition, the increased irrigation required as a result of the reduced rainfall and lower water levels make agricultural practices more costly; reducing profits derived from agriculture. As a result of these changes, many poor and ultra poor households can no longer rely on daily fishing labor as the main source of income but must now do agricultural day labor and poultry rearing to make a living. Overall, community members noted limited capacity to adapt to these changes, particularly for the ultra poor.
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In addition, community members highlighted man-made problems that compounded the problems considered to be caused by climate variability. For example, the use of insecticides on crop land reduced fishing yields and also decreased day labor opportunities for pulling weeds. To address the impacts of climate change, community members stated the need to organize development activities that focus on river dredging, promotion of more resilient crops and agricultural practices, and provision of training on climate change and how to adapt. Picture 22: Social mobilization around community issues
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11
11.1
FAMILY AUTHORITY AND DECISION MAKING

Household decision making
Tables 46 to 49 show the types of decision making for 12 different types of household decisions, disaggregated by Haor type and district. All questions were answered by a female household member. The highest proportion of decisions is made by the husband after discussion with the female household member. It is also apparent that women have greater involvement in household decisions such as minor household purchases, childrens clothing and education, medical expenses and in spending money that they have directly earned. Women have less involvement in expenditures that relate to livelihoods, higher value assets, loans/savings and events such as weddings and ceremonies and shelter in case of disasters. The proportion of decisions made without any involvement by the female is low for almost all decision types, except salish decision making. Tables 46 and 47 show that when the data is disaggregated by Haor type, the proportion of decisions made by the husband after discussion with the female household member is significantly higher in deep Haor than moderate Haor areas for many of the decisions. For several decisions, the proportion of women not involved in decision making is significantly higher in moderate than in deep Haor. It is important to note that a relatively high number of women answered not applicable (not listed in tables below) to the various decision types, which could be interpreted that they were uncomfortable responding. Table 46: Household decision making, by Haor type (1) Haor Type Decision Deep Moderate Overall Buying small food items, groceries, toiletries Can decide alone 20.3 20.2 20.3 Decide w/ husband or other adult male 14.2 14.7 14.4 a Husband decides after discussion 58.1 53.4 55.8 c Not involved in decision 7.4 11.7 9.5 Buying clothing for yourself and your children Can decide alone 13.2 15.1 14.2 Decide w/ husband or other adult male 14.4 13.1 13.8 b Husband decides after discussion 65.8 59.3 62.5 c Not involved in decision 6.6 12.5 9.6 Spending money that you yourself have earned Can decide alone 24.6 25.7 25.1 Decide w/ husband or other adult male 6.9 9.3 8.1 a Husband decides after discussion 63.5 58.6 61.1 Not involved in decision 5.0 6.5 5.7 Buying or selling major household assets (land, livestock, crops) Can decide alone 11.6 10.9 11.3 Decide w/ husband or other adult male 16.5 19.2 17.8 b Husband decides after discussion 65.2 60.7 63.0 Not involved in decision 6.8 9.1 7.9 Buying or selling jewelry Can decide alone 5.4 8.0 8.6 Decide w/ husband or other adult male 13.0 12.0 12.5 Husband decides after discussion 72.1 71.6 71.8 Not involved in decision 5.8 8.4 7.1
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Use of loans or savings Can decide alone 10.3 Decide w/ husband or other adult male 14.4 Husband decides after discussion 70.5 Not involved in decision 4.8
10.4 12.8 69.3 b 7.5
10.3 13.6 69.9 6.2
Table 47: Household decision making, by Haor type (2) Haor Type Decision Deep Moderate Overall Expenses for your childrens education Can decide alone 12.5 14.2 13.3 Decide w/ husband or other adult male 10.8 10.3 10.5 Husband decides after discussion 73.3 70.1 71.7 Not involved in decision 3.4 5.5 4.5 Expenses for your childrens marriage Can decide alone 9.8 9.7 9.7 a Decide w/ husband or other adult male 17.9 26.7 22.1 c Husband decides after discussion 69.7 58.1 64.2 a Not involved in decision 2.6 5.6 4.0 Medical expenses for yourself or your children Can decide alone 13.6 16.9 b 15.3 Decide w/ husband or other adult male 14.2 11.5 12.8 Husband decides after discussion 70.0 68.9 69.5 Not involved in decision 2.1 2.8 2.4 Expenses for family planning (contraceptives) Can decide alone 6.2 5.9 6.1 Decide w/ husband or other adult male 6.2 6.4 6.3 Husband decides after discussion 83.6 81.8 82.7 Not involved in decision 3.9 5.9 4.9 To move to shelter during time of disaster Can decide alone 11.2 11.2 11.2 Decide w/ husband or other adult male 24.8 24.8 24.8 c Husband decides after discussion 54.5 48.4 51.5 b Not involved in decision 9.4 15.5 12.4 Actively participate and involved in salish decision making c Can decide alone 4.9 8.3 6.8 c Decide w/ husband or other adult male 7.4 11.8 9.8 b Husband decides after discussion 19.0 23.3 21.4 c 6 Not involved in decision 68.8 56. 62.0 Tables 48 and 49 show that when the data is disaggregated by district, the proportion of decisions made by the husband after discussion with the female is significantly lower in Netrokona than in the other two districts. Correspondingly, the proportion of decisions wherein the female is not involved at all is significantly higher in Netrokona for many decision types. However, it is interesting to note that the proportion of decisions that females can make on their own is also significantly higher in Netrokona than in the other two districts for several of the decision types.
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Table 48: Household decision making, by District (1) District Decision Kishoreganj Netrokona Sunamganj Buying small food items, groceries, toiletries b Can decide alone 16.1 23.1 21.5 b Decide w/ husband or other adult male 12.9 21.5 8.5 c Husband decides after discussion 68.2 39.5 60.4 c Not involved in decision 2.8 15.9 9.6 Buying clothing for yourself and your children c Can decide alone 12.7 19.0 10.8 c Decide w/ husband or other adult male 11.4 21.9 7.8 c Husband decides after discussion 72.3 44.0 71.6 c Not involved in decision 3.6 15.2 9.9 Spending money that you yourself have earned c Can decide alone 20.7 41.6 15.4 a Decide w/ husband or other adult male 7.2 11.8 5.7 c Husband decides after discussion 68.0 44.7 67.4 b Not involved in decision 4.1 1.9 11.4 Buying or selling major household assets (land, livestock, crops) b Can decide alone 12.1 15.6 6.7 a Decide w/ husband or other adult male 12.8 22.4 19.0 b Husband decides after discussion 69.1 51.5 66.7 Not involved in decision 6.0 10.5 7.7 Buying or selling jewelry Can decide alone 9.3 11.0 6.5 b Decide w/ husband or other adult male 10.5 25.6 6.7 b Husband decides after discussion 75.0 52.4 80.2 Not involved in decision 5.2 11.0 6.5 Use of loans or savings a Can decide alone 9.9 13.1 8.0 c Decide w/ husband or other adult male 9.9 21.5 9.4 c Husband decides after discussion 75.6 58.0 75.9 Not involved in decision 4.6 7.3 6.6
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Table 49: Household decision making, by District (2) District Decision Kishoreganj Netrokona Sunamganj Expenses for your childrens education Can decide alone 11.8 15.9 12.7 b Decide w/ husband or other adult male 9.4 18.5 5.7 c Husband decides after discussion 76.9 60.8 75.0 c Not involved in decision 1.8 4.8 6.6 Expenses for your childrens marriage b Can decide alone 10.2 17.5 5.2 b Decide w/ husband or other adult male 17.1 22.1 26.8 c Husband decides after discussion 70.2 54.5 63.6 Not involved in decision 2.5 5.8 4.5 Medical expenses for yourself or your children c Can decide alone 14.3 19.9 11.5 c Decide w/ husband or other adult male 8.4 22.3 7.5 c Husband decides after discussion 75.4 55.3 78.1 Not involved in decision 1.8 2.6 3.0 Expenses for family planning (contraceptives) c Can decide alone 6.1 3.0 8.3 b Decide w/ husband or other adult male 5.9 13.0 1.8 c Husband decides after discussion 87.0 78.5 81.1 Not involved in decision 1.0b 5.5 8.8 To move to shelter during time of disaster c Can decide alone 10.6 16.8 6.3 b Decide w/ husband or other adult male 20.0 28.0 26.1 c Husband decides after discussion 62.0 39.5 53.6 Not involved in decision 7.3 15.7 13.9 Actively participate and involved in salish decision making c Can decide alone 10.8 7.9 1.9 b Decide w/ husband or other adult male 16.5 5.7 9.1 c Husband decides after discussion 20.1 14.9 30.7 c Not involved in decision 52.5 71.5 58.3
Qualitative data supports the quantitative findings around household decision making presented in the tables above. Qualitative data also shows a trend of an increasing role of women in household decision making. For example, womens participation in economic activities is increasingly jointly discussed, although it is important to note that men still make the final decision and many women believe that the men often know best. Profit and loss decisions vary by household. There is also indication of increased independence in household processes. For example, womens freedom of movement appears to be expanding. Previously women shopkeepers relied on their husbands to acquire shop stocks, now more women are able to acquire the goods themselves. External contact (like with NGOs) appears to have been an important factor in these trends.
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11.2
Family life attitudes
Tables 50 to 51 show the attitude about family life, disaggregated by Haor type and district. All questions were answered by a female household member. Overall, a higher proportion of women agree that the husband should help with household chores if the female is working; and that they have the right to express their opinion, even when they disagree with their husband. The proportion of women overall who disagree with the statement that it is better to send a son to school than a daughter is also significantly higher. However, it is interesting to note that despite the more liberal attitudes about family life expressed by women, the proportion of women who agree that a wife should tolerate being beaten is significantly higher that the proportion who disagrees. When disaggregated by Haor type, Table 50 shows that a significantly higher proportion of women in deep Haor agree that the husband should help with chores if the wife is working and married women should be allowed to work outside the home. However, a significantly higher proportion of women in deep Haor also agree that a wife should tolerate being beaten and that it is better to send boys to school instead of girls. Table 50: Attitudes about family life, by Haor type Attitudes about family life N= Agree Disagree DNK Agree Disagree DNK Agree Disagree DNK Agree Disagree DNK Agree Disagree DNK Agree Disagree DNK Haor Type Deep Moderate 947 945 49.2 45.8 47.7 52.2 3.1 2.0 b 66.1 60.5 27.8 34.5 6.1 5.0 b 53.1 46.3 42.2 4.6 66.8 28.7 4.4 c 83.5 14.6 1.9 b 27.1 66.8 6.0 49.0 4.7 66.0 29.1 4.9 74.3 23.3 2.4 21.1 72.4 6.6 Total 1892 47.5 49.9 2.5 63.3 31.1 5.5 49.7 45.6 4.7 66.4 28.9 4.7 78.9 18.9 2.2 24.1 69.6 6.3
The important decisions in the family should be made only by men If the wife is working outside the home, then the husband should help her with household chores Married women should be allowed to work outside the home The wife has a right to express her opinion even when she disagrees with her husband A wife should tolerate being beaten by her husband in order to keep the family together It is better to send a son to school than a daughter
When disaggregated by district, Table 51 shows mixed results. A significantly higher proportion of women in Netrokona agree that the important decisions in the family should only be made by men. There are significant differences among the three districts in the proportion of women who agree with the statements that the husband should help with chores if the wife is working and married women should be allowed to work outside the home; whereby the highest proportion of women who agrees is in Kishoreganj and the lowest proportion is in Sunamganj. The proportion of women who agree that the wife has a right to express her opinion even when she disagrees with her husband is also significantly lower in Sunamganj.
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Although findings indicate that Sunamganj is the most conservative of the three districts, it is important to note that the proportion of women who agrees that it is better to send a son to school than a daughter is significantly lower in Sunamganj than in the other two districts; whereby Kishoreganj shows the highest proportion of women who agrees. In contrast, Kishoreganj shows a significantly lower proportion of women who agree that a wife should tolerate being beaten by her husband in order to keep the family together
Table 51: Attitudes about family life, by District District Attitudes about family life Kishoreganj N=628 The important decisions in the Agree 41.6 family should be made only by Disagree 55.3 men DNK 3.2 c If the wife is working outside the Agree 76.3 home, then the husband should Disagree 18.6 help her with household chores DNK 5.1 c Married women should be allowed Agree 62.1 to work outside the home Disagree 31.8 DNK 6.1 The wife has a right to express her Agree 68.9 opinion even when she disagrees Disagree 24.7 with her husband DNK 6.4 b A wife should tolerate being Agree 75.6 beaten by her husband in order to Disagree 21.5 keep the family together DNK 2.9 Agree 33.3 It is better to send a son to school Disagree 62.9 than a daughter DNK 3.8
Netrokona N=634 c 58.2 40.4 3.2 c 66.6 30.6 2.8 c 47.5 50.3 2.2 70.3 26.7 3.0 80.3 17.8 1.9 22.9b 68.8 8.4
Sunamganj N=630 42.7 54.3 3.0 c 47.1 44.1 8.7 c 39.7 54.6 5.7 c 60.0 35.4 4.6 80.8 17.5 1.7 16.2 77.1 6.7
11.3
Daily time patterns of men and women
Qualitative data collection was organized to gain a better understanding of daily time spending of men, women involved in work and women who stay at home. Graphic representations are added in annex 3. Figure 20 below provides one example from a moderate Haor village in Kishoreganj. It is important to note that the data collected is specific to the month of February around the time when agricultural day labor, primarily in rice fields, is coming to an end. Patterns will likely be different in other seasons. Men typically start their day between 5-6am. The first thing they do is pray, put the cow to field and clean the shed. Men then usually put in 1-2 hours of work in the rice fields such as transplantation, weeding, fertilizing and irrigation before taking breakfast between 8-9am; followed by more work in the rice fields until taking a 1-2 hour lunch break around 1pm. They return from the fields between 5-6pm, feed the cow and put it to shed. The time between 6-8pm is commonly spent resting or gossiping, wandering around or going to the market. Dinner is taken around 8-9pm after which men go to sleep. Income derived from a typical day describe above ranges between 150-200 Taka per day. In some cases men get 200 Taka, excluding meals or 150 Taka including 3 meals, although 200 Taka including meals is also reported.
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Women who stay at home get up at the same time as their husband, between 5-6am. They start the day by fetching water, sweeping the house and the courtyard, cleaning the cooking pot, helping the husband put the cow out, and cooking breakfast. If there are school-going children in the household, they are sent to school after breakfast. After breakfast, the women start a range of household chores, including: coiling dung for fuel, collecting vegetables and fish, collecting firewood, washing clothes, cleaning pots and cooking meals. Women usually bath before preparing lunch and take two rest periods. One in late morning and one after serving lunch, during which time they gossip and stitch kantha. Children are washed between 5-6pm and preparations are made for dinner. Before dinner, the women spend about one hour with the children to help them learn. After dinner, the women stay up longer to clean the cooking pot and house, and to pray before going to bed around 10pm. Women who are involved in income-generating activities get up around 4am to give them enough time to complete the first chores of the day. If breakfast and dinner are provided by the employer, they then work from 5am to around 7pm. If not, they work from 8am to 5pm. Lunch is almost always included. After work they must fetch water, clean the cooking pot, feed the children and cook dinner for their husband. After dinner they prepare the bed for their husband and do some small household chores before going to sleep at around 10pm. Women commonly spend around 12-13 hours working and about 2-3 hours doing household chores. Payment for women varies and can range from 50-100 Taka for uprooting rice seedlings without meals to proportions of the harvest. Figure 21: Daily time use of men and women
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12
12.1
CHILD NUTRITION, ANTENATAL CARE AND FAMILY PLANNING

MCHN characteristics
All questions in this section relate to < 2 children. The respondent is always the childs mother. Of the total number of respondents, 70 percent did not have any children < 2 years of age. Of those that did, 29 percent had one and 1 percent had two < 2 children. Table 52 provides an overview of Maternal Child Health and Nutrition characteristics, disaggregated by District and Haor type. Note that there were no significant differences between Haor types. Virtually every mother has breastfed her child (99.5%) and 45% of overall mothers initiated breastfeeding with the first hour of birth. The percentage of women who initiated breastfeeding after the first hour was significantly lower in Netrokona than in the other districts. The average age for introducing solid/semi-solid foods (weaning) was just over 5 months age, whereby the average age in Sunamganj was significantly lower at 4.6 months. Table 52 shows the proportion of women introducing solid/semi-solid foods for 0-3, 4-6, 7-9 and 10+ months. This data can be used to track change over time in the introduction of solid/semi-solid foods, based on project recommendations on proper weaning practices. Qualitative data showed that most women know the value of colostrums to newborn health. However, in some villages traditional practices and superstitions prevent mothers from providing colostrums to newborns. Nutritional information for newborns was usually obtained from the village doctor or health worker. Exposure to media is an additional source of nutritional info. Overall, 35.5% of mothers took iron or folic acid supplements. The proportion of mothers who took these supplements was significantly higher in Kishoreganj. Taking iron and folic acid during pregnancy varied by village; where health workers were present, use was common. Lack of knowledge and mother-in-laws who discourage use of both supplements presented barriers in other villages. The majority of mothers did not change the amount of food that they consumed during their last pregnancy; 16% increased their food intake and 33% decreased their food intake. Qualitative data showed that some mothers reduce food intake to two meals a day during pregnancy to keep the size of the baby smaller. A large baby during pregnancy makes it hard to work and the want to avoid the complicated delivery of a large baby as the hospital is far away and costly to access. Mothers do have some knowledge on food supplements during pregnancy primarily from health workers, media, and village elders. However, limited financial resources often prohibit taking more nutritious foods. Dietary diversity while breast feeding is also poor. The majority of women also did not change the amount of rest they took after the last birth. Only 23% took more rest than usual. Qualitative data indicated that the gender of the baby determines the amount of rest (this means a period of light work) for new mothers: 9 days rest for a male child; 7 days for female. After the 7-9 day period, women resume regular work and only rest while breast feeding. Qualitative data also shows that most women do not take rest during their pregnancy either. They continue to complete their daily activities, taking only a little rest after chores are done. Household and community members generally help take on some of the household chores if the pregnant mother becomes sick.
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Picture 23: Balanced meal taken by a pregnant woman
Overall, mothers attended on average 1 ANC session. Qualitative data shows that this is usually after 3 months of pregnancy. The proportion of mothers attending ANC was significantly higher in Kishoreganj than in the other Districts. Qualitative data shows that there are very few periodic medical checkups during pregnancy due to lack of knowledge, lack of money, and difficulties in communicating with the medical centers. Medical check-ups are only used for serious complications. Additional barriers to obtaining pre-natal care are: mother in law and some elders do not approve; and when the husband is unable to accompany wife to doctor, social norms prevent a woman from traveling alone.
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Table 52: MCHN characteristics by District and Haor type District Hand-washing Behaviors Kishoreganj Netrokona N= Average age solid/semi-solid food introduced (months) When breastfeeding initiated Age of introducing solid foods Within 1 hour (%) After 1 hour (%)
st
Sunamganj 202 4.6

b
Haor Type Deep Moderate 271 5.1 46.5 53.5 23.8 51.9
b
Total 564 5.1 45.4 54.6 26.9 48.1 21.4 3.6 35.5 15.9 51.4 32.7 0.9 22.6 66.4 11.0
196 5.4 45.4 54.6

b
166 5.3 55.4 44.6

c
293 5.1 44.4 55.6 29.4 45.1 20.7 4.8 36.5 14.7 52.6 32.8 0.9 22.9 65.2 11.9
37.1 62.9 43.9 25.9 25.8

c c b
st
0-3 months 4-6 months 7-9 months 10+ months
15.8 63.7 18.4 2.1 47.4

c
21.4 57.2 17.9 3.5 28.9 16.9 50.6 32.5 0.7 18.7 72.3 9.0
22.1 2.2 34.3 17.2 50.2 32.6 0.9 22.3 67.8 9.9
4.3 29.2 15.8 55.6 28.6 0.8 23.2 65.0 11.8
Took iron or folic acid supplements (%) Changes in amount of food consumed More (%) Same (%) Less (%)
15.2 47.7 37.1 1.2

c
Number of ANC sessions attended Amount of rest after last birth More than usual About the same Less than usual
25.4 62.9 11.7
Table 53 shows the different types of weaning foods used by mothers for their most recently born child, disaggregated by District and Haor type. On average, mothers in Kishoreganj used 2.2 different weaning foods, mothers in Netrokona used 1.8 weaning foods, and mothers in Sunamganj used 1.6 weaning foods. When comparing across Districts, the use of kichori, Soji/Sagu/Barli, and cow/goat milk is significantly lower in Sunamganj. The use of rice powder/soup is significantly lower in Kishoreganj; and the use of potato and egg is significantly lower in Netrokona. When comparing across Haor types, the use of Soji/Sagu/Barli is significantly higher in deep Haor; and the use of cow/goat milk, rice powder/soup and fruits/juices is significantly higher in moderate Haor. Qualitative data shows that nutrition-related information for newborns is obtained from the village doctor and health assistant.
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Table 53: Weaning foods used, by District and Haor type District Weaning Foods Kishoreganj Netrokona N Baby formula/Cerelac Khichori Soji/Sagu/Barli Cow/goat milk Rice powder/soup Potato Egg Banana/other fruits and juices 196 3.4 35.6 37.7 21.2 58.9
a
Sunamganj 202 2.1 16.4 25.7 2.9

b b c
Haor Type Deep Moderate 271 4.3 28.6 44.9

b
Total 564 2.9 26.6 34.3 13.9 68.3 14.9 4.6 23.0
166 3.1 27.5 39.7 17.6 69.5 4.6 0.8

c c
293 1.7 25.0 25.9 17.2 71.6

b c
9.8 64.3 15.7 3.2 19.5
77.1 17.1 3.6

b
21.9 8.9 28.8
14.2 5.6 25.9

b
22.1
17.9
Letters denote significant differences among Districts or between Haor types for a given weaning food. Significance levels for comparisons: a = .10; b = .05; c = .00
Table 54 shows birth attendance during the last delivery, disaggregated by District and Haor type. Overall, the majority of births were attended by Traditional Birth Assistants. Less than 1% of births were attended by a doctor. It is important to note that in the qualitative data collection most women reported that they had experienced a newborn die, many before the newborn was six months old. Qualitative data further shows that local doctors and health workers are used for small complications; hospital for serious complications. Most women have home births with traditional birth attendants or family assisting, even though they recognize these individuals are often untrained. Few can save money for emergency delivery. In the case of emergencies, community members will help to hire transport and cover costs; neighbors will help with childcare. Some women reported being reluctant to go to the hospital because doctors frequently will not attend to the ultra-poor. Many birth attendants are untrained. Hygienic practices during and after delivery are uncommon in most areas. Table 54: Who attended last delivery, by District and Haor type District Birth Attendee Kishoreganj Netrokona Sunamganj N Friend/relative TBA TTB Doctor FWV (nurse/paramedic/FWV) Other 197 11.7 67.0 19.3 0.5 1.5 0.0 166 9.0 47.0 40.4 0.6 3.0 0.0 203 2.5 76.8 16.7 1.5 1.0 1.5
Haor Type Deep Moderate 273 8.4 62.3 25.6 0.7 2.2 0.7 293 6.8 66.9 23.5 1.0 1.4 0.3
Total 564 7.6 64.7 24.6 0.9 1.8 0.5
For households currently with a child 2 years of age or under, 81.8 % of the oldest child in this age group has received at least one immunization. The proportions by District do not vary statistically (p=.136) nor do they vary by Haor type (p=.484). For those children who did receive immunizations, 72.9% have immunization cards. These cards are significantly more common in moderate Haor but do not vary significantly by District (p=.257). Of children 9 months and older, just over 50% were fully immunized, as verified through their immunization cards.
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Qualitative data shows that when health care workers come to villages, virtually all babies are immunized and receive their full dose of vaccines, although most mothers do not know about the different types of immunization or the benefits/risks of immunization. For those children who needed antihelmintics, 47% received them. The proportion of children receiving antihelmintics was significantly higher in Kishoreganj. Just over 47% percent of children received vitamin A supplements in the last 6 months, whereby the highest proportion of children received vitamin A supplements in Kishoreganj. Table 55: Child health and immunization, by District and Haor type District Child health and immunization Kishoreganj Netrokona Sunamganj N Oldest under 2 receiving at least 1 vaccination (%) Proportion of those immunized with immunization cards Proportion of children 9 months and older fully immunized Proportion receiving antihelmintics, if needed Proportion receiving vitamin A supplements 196 86.2 72.8 49.5 39.0 63.4
c
Haor Type Deep Moderate 220 80.6 79.8

c
Total 565 81.8 72.8 50.7 31.7 47.3
166 77.7 68.2 51.1 23.4

b
203 80.8 76.8 51.5 31.5

b
242 82.9 65.5 53.3 32.4 48.1
47.9 30.9 46.4
47.5
41.3
Table 56 describes the health issues of mothers with children under 2, disaggregated by District and Haor type. Overall, only 7.4% of mothers reported suffering no illnesses in the last 12 months. The highest proportion of women suffered from cold attacks, followed by gastric complications and anemia. The lowest proportion of women suffered from Typhoid. When comparing across districts, the proportion of women suffering from cold attacks, gastric complications and diarrhea is significantly higher in Kishoreganj than in the other districts. The proportion of women suffering from anemia is significantly higher in Netrokona; and the proportion of women suffering from cold attacks and dysentery is significantly lower in Sunamganj than in the other districts. When comparing across Haor types, the proportion of women suffering from four out of the seven listed illnesses is significantly higher in deep Haor than in moderate Haor. In turn, the proportion of women suffering no illnesses in the last 12 months is significantly lower in the moderate Haor. Qualitative data showed that physical weakness, anemia, abdominal pain, back pain, fever, bleeding and uterus complications are common for lactating mothers. Health care for complications are commonly addressed locally. Few have the resources to seek treatment at the hospital. Relatives/community members assist with household chores and childcare when mothers suffer complications. Information about complications is commonly obtained from NGO and GoB health workers, village doctor, TBA and village elders. Post-natal check-ups are rare due to limited knowledge, resources, and communication challenges. In some cases, mothers report that their
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mother-in-laws do not permit them to seek medical care. Use of Vitamin A supplements after giving birth varies. In some villages it is not taken even when distributed by health workers. Ultra poor and poor women do not take vitamin A supplements. There appears to be limited knowledge of the benefits of these supplements. Table 56: Health issues of mothers with children under 2, by District and Haor type District Haor Type Illnesses Kishoreganj Netrokona Sunamganj Deep Moderate N Proportion of mothers suffering no illnesses Cold attack Gastric complications Anemia Diarrhea Dysentery Rheumatic fever Typhoid 197 4.1 80.7 32.5
b b
Total 566 7.4 76.1 26.5 26.1 18.2 16.4 6.0 3.9
166 1.2 90.4 21.7 35.5

b
203 15.7 60.1

c c
273 5.1 79.9

b
293 9.6
b
72.7 26.6 25.9 14.7 13.3 8.2

b
24.6 21.7 13.8 11.8 10.8

b c
26.4 26.4 22.0 19.8

b b
22.8 24.4
b
16.3 17.5 3.6 4.2
20.3 3.0 6.6

b
3.7 5.1
a
1.0
2.7
Table 57 describes the health issues of children under 2, disaggregated by District and Haor type. Overall, only 5.8% of children did not suffer any illnesses in the last 12 months. The highest proportion of children suffered from cold attacks, diarrhea and pneumonia. The lowest proportion of children suffered from skin diseases and other illnesses. There are no significant differences between Haor types. When comparing across districts, the proportion of children suffering from cold attacks is significantly lower in Sunamganj than in the other districts; and the proportion of children suffering from diarrhea and skin diseases is significantly higher in Netrokona. Qualitative data shows that Children of two years commonly experience pneumonia, influenza, typhoid, hepatitis, pneumonia, cold, fever, chicken pox, measles and diarrhea. TBA, village elders and health workers provide advice to mothers about childhood disease and will lend money for childrens emergency treatment. In most cases there is no gender disparity with respect to health care for children, although in some villages it is common for male children to receive foods of higher nutritional quality and more of them.
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Table 57: Health issues of children under 2, by District and Haor type District Illnesses Kishoreganj Netrokona Sunamganj N Proportion of children suffering no illnesses Cold attack Diarrhea Pneumonia Dysentery Skin diseases Other 197 5.6 86.2 34.2 25.0 13.8 7.7 0.5 166 3.0 92.8 48.2
b
Haor Type Deep Moderate 273 7.0 86.4 36.3 23.1 15.8 8.1 1.8 293 4.8 86.0 38.7 24.3 12.7 8.2 2.4
Total 566 5.8 86.2 37.5 23.7 14.2 8.1 2.1
203 8.4 80.8

b b
32.0 23.2 12.3 4.4 3.4
22.9 16.9 13.3

a
2.4
Letters denote significant differences among Districts or between Haor types for a given illness. Significance levels for comparisons: a = .10; b = .05; c = .00
12.2
Anthropometric measurements
Table 58 shows the result of anthropometric measurements carried out with 398 children aged 6-23 months: 54% boys and 46% girls. The average age was 14.7 months, with no significant differences among districts, Haor types or gender. Weight-for-age (underweight) is a composite index of height-for-age and weight-for-height. A child can be underweight for his/her age because s/he is stunted, wasted or both. Weight-for-age is a useful tool in clinical settings for continuous assessment of nutritional progress and growth. Children whose weight-for-age is below minus two standard deviations from the median of the reference population are classified as underweight. Table 58 shows that 57.7% of < 2 children are underweight: 39.4% are moderately underweight and 18.3% are severely underweight. A prevalence of > 30% is considered to be very high. There is limited national data available for < 2 children; the majority of published data available for comparison reflects anthropometric scores for < 5. However, the 2004 BDHS sample for < 2 children in rural Bangladesh (< -2 SD) estimated stunting at 42.5%, wasting at 19.4% and underweight at 50.2%. Compared to such national data sets, the anthropometric scores for stunting and underweight in the Haor region appear high. When disaggregated by district, the proportion of children with moderate stunting is significantly lower in Netrokona than in Kishoreganj. The proportion of children with moderate wasting is significantly higher in Netrokona than in Kishoreganj, and significantly lower in Sunamganj than in Netrokona. The proportion of children with moderate underweight is significantly higher in Sunamganj than in Netrokona. When comparing across sex, the proportion of girls with severe stunting is significantly lower than boys. There are no significant differences across Haor type.
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Table 58: Anthropometric measurements HAZ WHZ stunting wasting Moderate Severe Moderate Severe District Kishoreganj Netrokona Sunamganj Haor Type Deep Moderate Sex of child Male Female Total Sample 32.1 37.7 34.7 26.5 7 17.5 22.4 9.8 9.8 9.8 0.5 0.0 0.3 41.3 1 26.8 34.8 34.7 34.7 20.3 22.0 25.0 22.5 22.2 8.4 4 14.6 3 6.8 9.2 10.2 0.7 0.0 0.0 0.0 0.4
WAZ underweight Moderate Severe 40.6 31.7 3 45.5 36.4 41.8 38.6 40.4 39.4 18.9 19.5 16.7 19.7 17.3 19.5 16.9 18.3
N 143 123 132 173 225 215 183 398
Notes: Moderate (-2.01 to -3.00 SD) Severe (< -3.00 SD) 1 Netrokona different from Kishoreganj at 0.05 significance level 3 Sunamganj different from Netrokona at 0.05 significance level 4 Netrokona different from Kishoreganj at 0.10 significance level 7 Female different from Male at 0.05 significance level
HAZ=Height-for-age z-score WHZ=Weight-for-height z-score WAZ=Weight-for-age z-score
The estimates in FSUP-H appeared reliable when compared with corresponding baseline estimates from the SHOUHARDO anthropometric surveys for < 2 in the Haor area, assuming no overlap in beneficiaries. Figure 21 shows that the 2006 pre-intervention values for the Haor region are very similar to the FSUP-H pre-intervention findings for the same area. A comparison between SHOUHARDO baseline and endline findings also shows the impact that effective interventions can have on child malnutrition. Figure 21: Comparison between SHOUHARDO and FSUP-H malnutrition levels
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13
STATUS OF FEMALE-HEADED HOUSEHOLDS
Table 60 provides an overview of key variables for female-headed households that provide a good overview of their food security and livelihood status, as compared to male-headed households. Almost 15% of the households sampled had female heads of household. When comparing female- and maleheaded households across Districts and Haor type, the following observations can be made: female-headed households have significantly lower per capita monthly income levels than male-headed households there are no significant differences in per capita expenditures between female- and maleheaded households, except in deep Haor areas where expenditures in female-headed households are significantly lower female-headed households have significantly lower food consumption scores than maleheaded households female-headed households have a significantly higher coping strategy index score in Kishoreganj and Sunamganj, and in deep Haor areas
Table 59: Key variables for female-headed households, by district and Haor type District Haor Type Collective Actions KishoNetro- SunamDeep Moderate reganj kona ganj N Female-headed HHs (%)
Monthly PC Income (Taka) Male HHH Monthly PC Income (Taka) Female HHH Monthly PC Expenditures (Taka) Male HHH Monthly PC Expenditures (Taka) Female HHH Food consumption score Male HHH Food consumption score Female HHH Coping strategy index Male HHH Coping strategy index Female HHH
Total
628 14.5 866 718

b
634 17.4 911

c
630 12.1 676 660 1488 1096 7.6 7.2 24.3 25.8
c
947 14.4 843

c
945 14.9 788 723 1411 1303 8.1 7.9 23.5 23.6
1892 14.6 816 707

c
732 1426 1344 8.3

b
692 1361
a
1242 1158 9.2

c
1327 1395 8.3

c
1123 8.6
c
8.4 24.2 26.3

c
7.7 22.6 22.4
7.7 23.9
c
7.8 24.2 23.5
25.7
Letters denote significant differences between gender of head of Household. Significance levels for comparisons: a = .10; b = .05; c = .00
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14
CONCLUSION AND RECOMMENDATIONS
The baseline study findings provide important information, which can be used by FSUP-H partners to measure impact-level changes in food security and livelihood trends over time. An overview of the relevant findings for the FSUP-H baseline logframe indicators that state baseline and endline surveys as means of verification is provided in table 60 below, including recommendations to improve the indicators. Table 60: Baseline values and recommendations for FSUP-H logframe indicators Objective indicators Relevant baseline finding Recommendation Overall Objective: At least 40% / Index to be developed by CARE of the targeted 55,000 ultraBangladesh using the livelihoods poor women have graduated and economic security baseline out of extreme poverty values Specific Objective: Prevalence Anthropometric findings for < 2 There was no malnutrition of chronic malnutrition among Stunting: moderate 34.7 / severe 22.4 measurement for adult women. women has decreased by <to Wasting: moderate 9.8 / severe 0.3 Revise this indicator to < 2. be determined by baseline> % Underweight: moderate 39.4 / severe 18.3 by 2013 Specific Objective: At least 70% The mean value for households that take 3 If CARE takes the 14% as the of households reported at least meals/day most of the time in the last 12 baseline value, then the 70% 3 meals/day, including during months is 14% (most of the time and often target is likely too high. lean periods combined is 56.3 %) Specific Objective: Reduced The mean asset loss per disaster, among CARE needs to determine a asset loss due to improved households who experienced a disaster in the realistic target based on intensity resilience to natural disasters last 12 months, was reported at around Taka of coverage by project activities and shocks 3,017. Indicator Result 1 Relevant baseline finding Recommendation At least 70% of individuals are 68.7% of households had accessed one or This indicator should be able to negotiate access to more GoB service providers in the previous reformulated around actual services with local government, year levels of access, as ability to service providers and local negotiate is hard to measure and leaders (in the areas of health, is a lower-level indicator. To livestock, agriculture, fisheries, make the indicator more social protection) meaningful, CARE could consider reformulating the indicator around particular services (see table 40), which are expected to be the focus of project interventions. At least 30% of women Participation in the development process was If CARE wants to keep this participate in any of the low at 4.5% of all households. The response indicator, we would suggest following: UP standing rate for this variable was too low for meaningful stating the baseline value as 1%. committees, SMC, PTA and analysis. Regarding participation of women: a local arbitration in project areas total of 186 responses were given from 174 households 9.2% of respondents. Females (spouses plus female heads of household) accounted for 15.1% of 9.2%, which is about 1.6% of the overall population.
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Indicators Result 2 % of women have increased income, particularly through rural sales networks and assemble markets At least 40% of women from ultra-poor households reduced debt from unsustainable sources (particularly moneylenders)
Relevant baseline finding Income data was collected at the household level. Per capita monthly income of femaleheaded households is 707 Taka. Almost all women (98%) had taken a loan from the Grameen Bank, which reflects the Grameen Banks policy of lending to women. The proportion of women who took a loan from NGOs is also high (88%), for similar reasons. The proportion of women taking loans from moneylenders is the lowest among all loan sources. Overall, daily expenditure on food is 113 Taka.
Recommendation Reformulate this indicator to capture per capita monthly income of female-headed households Perhaps this indicator could better be formulated around (female-headed) household debt burden. If the indicator is not changed, then CARE should consider which loan sources qualify as unsustainable. It is recommended to split this indicator into two separate ones: productive asset ownership and daily food expenditure.
% in productive utilization of income (% of expenditure on assets, % of expenditure on food) Indicators Result 3 No indicators measured by baseline, as per FSUP-H logframe
Less than 1 in 10 households own productive assets: an overview of household productive asset ownership is provided in table 18. Relevant baseline finding Recommendation Based on the baseline findings, the following indicators are suggested for tracking as proxies for household resilience to natural disasters and household crises: Mean value of asset loss (baseline = 3,017 Taka) Mean number of working days lost (baseline = 10 days) Combination of coping strategies applied by households (baseline values = see sections 10.1 and 10.2) Relevant baseline finding This survey utilized the Food Consumption Score (FCS) to measure food consumption and dietary diversity: 16.2% of households had poor FCS, 31.5% had borderline FCS and 52.3% had acceptable FCS. Overall, 45.4% of mothers initiated st breastfeeding with the 1 hour. 26.9% of mothers started weaning between 0-3 months, 48.1% between 4-6 months, 21.4% between 7-9 months and 3.6% after 10 months. 22.9% of household reported diarrhea in the last 12 months Overall, 35.5% of mothers took iron or folic acid supplements. No data was collected on vitamin A intake of pregnant women, only for children.
Indicators Result 4 % of households reporting increased food consumption and improved dietary diversity
Recommendation CARE needs to determine a realistic target based on intensity of coverage by project activities
Improved infant and young child feeding practices in 80% of VDCs (including exclusive breastfeeding, early initiation of breastfeeding, weaning)
It is recommended to reformulate this indicator as two separate indicators around breastfeeding and weaning.
% of household reporting reduced prevalence of diarrhea At least 80% of pregnant women from ultra-poor households received appropriate supplements (i.e. folic acid, iron and vitamin A) from government health services
/ It is recommended to reformulate the indicator around iron and folic acid supplements.
_______
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Food Security for the Ultra Poor Haor Baseline Study Report

FUNDED BY THE EUROPEAN UNION IMPLEMENTED BY BASELINE STUDY BY

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

List of Tables, Figures and Pictures

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Glossary of Bengali Terms

Glossary of English Terms

FSUP-H Baseline Report, June 2010

49.6% people live in poverty (below US$ 1 per day).

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Background of the FSUP-H project

FSUP-H Baseline Report, June 2010

Implementation framework of the FSUP-H project

FSUP-H site and impact group selection

FSUP-H Baseline Report, June 2010

FSUP-H BASELINE STUDY

FSUP-H Baseline Report, June 2010

Objectives of the study

Scope of the study

Quantitative study design

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Sunamganj 630 33.3 132 Deep 945 49.9 175

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Qualitative study design

FSUP-H Baseline Report, June 2010

Picture 1: Baseline enumerator using the PDA for a household interview

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

0.8 1.4 2.3 0.2

FSUP-H Baseline Report, June 2010

LIVELIHOODS AND ECONOMIC SECURITY

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Includes blacksmith, potter, porter, cobbler, carpenter, weaver etc.

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

Household employment and income/expenditure

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

FSUP-H Baseline Report, June 2010

1577.7 266.6 273.1

1716.2 214.4 155.7 470.8 330.7 55.8 508.4

1742.8 234.3 222.3 204.1

1729.5 224.4 189.0 337.6 356.6 67.1 457.3 66.9 3428.4

166.8 340.1 583.8