A Qualitative Assessment of the Effectiveness of the “Incentive Package” Piloted in Shahjahanpur, Bogra under “Alive and Thrive” Program


Bangladesh is one of the countries with a high rate of infant malnutrition and the major cause is inappropriate breastfeeding and complementary feeding practices. To improve the situation, both GO/NGO organizations are working intensively on the issue. In pursuance of this, AED and BRAC became partners in the Alive and Thrive project (A&T) for improving infant and young child feeding (IYCF) practices through motivation and counseling by BRAC’s volunteer community health workers as frontline workers during 2009-2013. The study aimed to assess the “incentive package” implemented in the study area through the frontline health workers of BRAC. A qualitative research design used in-depth interviews, informal discussions, narratives and focus group discussions to gather relevant data. Findings reveal that in spite of heavy work load and unstable market situation from price hike, SSs were not too much demoralized and continued to work because of the incentive package. All the performance indicators of the SS showed improvement. The implication of this for program is discussed.

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Mukta, U. , Ahmed, S. , Sayka, U. and Haque, M. (2014) A Qualitative Assessment of the Effectiveness of the “Incentive Package” Piloted in Shahjahanpur, Bogra under “Alive and Thrive” Program. Open Access Library Journal, 1, 1-15. doi: 10.4236/oalib.1100884.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Faruque, A.S.G., Ahmed, A.M.S., Ahmed, T., Islam, M.M., Hossain, M.I., Roy, S.K., Alam, N., Kabir, I. and Sack, D.A. (2008) Nutrition: Basis for Healthy Children and Mothers in Bangladesh. Journal of Population Nutrition, 26, 325-339.
[2] World Health Organization (WHO) (2002) Global Strategy for Infant and Young Child Feeding, Annex 2. World Health Organization, Geneva, 30 p.
[3] Fred, G.L., Clark, S.J., Lohr, J.A. and Sorenson, J.R. (1995) Prediatritian Involvement in Breast Feeding Promotion: A National Study of Residents and Practioners. Prediatrics, 96, 490-494.
[4] Haider, R., Ashworth, A., Kabir, I. and Huttly, S.R. (2000) Effect of Community-Based Peer Counselors on Exclusive Breastfeeding Practices in Dhaka, Bangladesh: A Randomized Controlled Trial. Lancet, 56, 1643-1647.
[5] Pelto, G.H., Santos, I., Gonçalves, H., Victora, C., Martines, J. and Habicht, J.P. (2004) Nutrition Counseling Training Changes Physician Behavior and Improves Caregiver Knowledge Acquisition. Journal of Nutrition, 134, 357-362.
[6] Penny, M.E., Creed, K.H.M., Robert, R.C., Narro, M.R., Caulfield, L.E. and Black, R.E. (2005) Effectiveness of an Educational Intervention Delivered through the Health Services to Improve Nutrition in Young Children: A Cluster-Randomized Controlled Trial. Lancet, 365, 1863-1872.
[7] Jones, G., Steketee, R.W., Black, R.E., Bhutta, Z.A. and Morris, S.S. (2003) How Many Child Deaths Can We Prevent This Year? Lancet, 362, 65-71.
[8] Kanani, S. and Gadre, S.A. (2003) The Study of Care Giving Behaviors Related to Feeding Practices in Children (3 - 36 Months) with a Focus on the Comparative Scenario in Rural and Urban Areas of Vadodara City. Department of Foods and Nutrition, The M.S. University of Baroda, Vadodara.
[9] AED (2005) Academy for Educational Development. Training Methodologies and Principles of Adult Learning. TOT-Adult Learning.
[10] Khan, S.H., Chowdhury, A.M.R., Karim, F. and Barua, M.K. (1998) Training and Retraining Shasthyo Shebika: Reasons for Turnover of Community Health Workers in Bangladesh. Health Care Supervisor, 17, 37-47.
[11] Ahmed, S.M. (2008) Taking Healthcare Where the Community Is: The Story of the Shasthya Sebikas of BRAC in Bangladesh. BRAC University Journal, 5, 39-45.
[12] Rahman, M., Sulaiman, M. and Tasmeem, S. (2007) Getting to Know Shasthyo Shebikas: A Case Study of Tangail. BRAC Research and Evaluation Division, Dhaka.
[13] Rahman, M., Tasneem, S. and Ahmed, S.M. (2007) Research Note on “Incentive Mechanism for Shasthya Shebikas in Nilphamari: An Economic Perspective”. BRAC Research and Evaluation Division, Dhaka.
[14] Schmidt, R.E., Bell, J.B. and Scanlon, J.W. (1979) Evaluability Assessment: Making Public Programs Work Better. Human Services Monograph Series, 14, Washington DC, 4-5.
[15] Joseph, W.S. (1994) Assessing the Feasibility and Likely Usefulness of Evaluation. In: Wholey, J.S., Hatry, H.P. and Newcomer, K.E., Eds., Handbook of Practical Evaluation, Jossey-Bass, San Francisco, 15-39.
[16] UNICEF (2006) UNICEF 2006 Report Card on Nutrition. UNICEF, New York.
[17] UNICEF (2006) Progress for Children: A Report Card on Nutrition. UNICEF, New York.
[18] WHO (2006) Workers Are Not Just Individuals but Are Integral Parts of Functioning Health Teams in Which Each Member Contributes Different Skills and Performs Different Functions. WHO, Geneva.
[19] Ahmed, S.M., Hossain, M.A., Chowdhury, A.M.R. and Bhuiya, A.U. (2011) The Health Workforce Crisis in Bangladesh: Shortage, Inappropriate Skill-Mix and Inequitable Distribution. Human Resources for Health, 9, 3.
[20] Haider, R., Kabir, I. and Ashworth, A. (1999) Are Breastfeeding Promotion Messages Influencing Mothers in Bangladesh? Results from an Urban Survey in Dhaka, Bangladesh. The Journal of Tropical Pediatrics, 45, 315-318.
[21] BDHS (2007) Bangladesh Demographic and Health Services. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and Macro International, Dhaka and Calverton.
[22] CFPR/TUP (2004) Towards a Profile of the Ultra Poor in Bangladesh: Findings from CFPR/TUP Baseline Survey. BRAC and Aga Khan Foundation Canada, Dhaka and Ottawa, 200 p.
[23] Herzberg, F., Mausner, B. and Snyderman, B. (1959) The Motivation to Work. Wiley, New York.
[24] Herzberg, F. (1966) Work and the Nature of Man. World Publishing, New York.
[25] Ockene, I.S., Hebert, J.R., Ockene, J.K., Merrian, P.A., Hurley, T.G. and Saperia, G.M. (1996) Effect of Training and a Structured of Office Practice on Physician-Delivered Nutrition Counseling: The Worcester-Area Trial for Counseling in Hyperlipidemia (WATCH). American Journal of Preventive Medicine, 12, 252-258.
[26] Santos, I., Victora, C.G., Martines, J., Goncalves, H., Gigante, D.P., Valle, N.J. and Pelto, G. (2001) Nutrition Counseling Increases Weight Gain among Brazilian Children. Journal of Nutrition, 131, 2866-2873.
[27] Mitchelman, D.F., Faden, R.R., Gielen, A.C. and Buxton, K.S. (1990) Pediatricians and Breastfeeding Promotion: Attitudes, Beliefs and Practices. American Journal of Health Promotion, 4, 181-186.
[28] Connell, J.P., Kubisch, A.C., Schorr, L.B. and Weiss, C.H. (1995) New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts. The Aspen Institute, Washington DC.

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