The Saving Bangladesh’s Babies’ Brains (SB3) programme strives to enhance and scale up early childhood development services throughout Bangladesh. This initiative delivers psychosocial stimulation based on the Reach-Up curriculum, focusing on undernourished children (mid-upper arm circumference (MUAC) score <13.5cm) aged 6-24 months. Launched in 2020, the programme collaborates with the Primary Health Care Services of the Ministry of Health and Family Welfare. It operates in over 600 community clinics, benefiting approximately 10,000 children across 21 upazilas (sub-districts) within four districts of Bangladesh.
This Thrive project aims to identify the challenges and strengths of implementing the programme at scale, document examples of best practices, and determine how the programme can be adapted to align more effectively with existing government health services.
The ongoing implementation of the SB3 programme by icddr,b, one of the world’s leading global health research institutes, in collaboration with community clinics, stands out as a noteworthy example of successfully incorporating early childhood development programmes into the established health service through government infrastructure. This presents a unique opportunity to analyse the specific elements of the programme or the existing government infrastructure essential for achieving successful expansion and integration into government services. It also allows for exploring the challenges associated with scaling up and integrating such programmes into the existing system.
This project will be implemented in three phases. The gathered data will be utilised to design and test delivery strategies to enhance the quality of implementation and fidelity.
Phase 1: We will conduct a thorough process evaluation employing qualitative and quantitative methodologies to identify the strengths and challenges in the current programme and develop effective strategies to enhance the programme based on the findings.
Phase 2: We will test the most promising strategies in a subset of community clinics to evaluate whether they are feasible, well-received, and have initial effectiveness.
Phase 3: We will conduct a cluster-randomised controlled trial employing a type II effectiveness-implementation hybrid design to test the effectiveness of the strategies identified in Phase 2 of the project. The objective is to assess the influence of practical strategies on participant outcomes (such as child development and parenting practices) and implementation outcomes (including adoption, fidelity, and reach).
This project aims to identify strategies that lead to improved programme quality and that are perceived as acceptable and feasible by frontline health workers and their supervisors, as this will affect the programme’s sustainability. It seeks to facilitate integration and long-term sustainability within the existing health system network before progressing to a larger-scale rollout, and it will also advance the global state of knowledge in integrating early childhood development services into government systems.