The levels of stunting, underweight, wasting, and childhood anemia are very high in Bangladesh, as are levels of maternal chronic energy deficiency and maternal and child anemia. A combination of poor maternal nutrition and postnatal factors cause child undernutrition, which in turn can have far-reaching consequences for national and global development, as well as individual health. Studies in Bangladesh show that infant and young child feeding (IYCF) practices, a critical determinant of child nutrition, are poor. Interventions to address them at a large scale are urgently needed, including behavior-change counseling for early and exclusive breastfeeding, age-appropriate complementary feeding and micronutrient supplementation, provision of micronutrient supplements or fortified complementary foods, hygiene interventions, and nutritional management of severe-acute undernutrition.

Alive & Thrive (A&T) seeks to develop scaled-up models for preventing child undernutrition by improving IYCF practices. Funded by the Bill & Melinda Gates Foundation, A&T’s interventions focus on achieving behavior change through existing service-delivery platforms, especially the health worker network of BRAC, the largest nongovernmental organization in Bangladesh. This brief focuses on A&T’s use of BRAC’s Essential Health Care (EHC) program in 2009–2011 as its operational platform. During this time, 9,000 managers, mid-level staff, workers, and volunteers were trained in interpersonal counseling, and an IYCF-oriented social mobilization strategy reached 15 million people.

This brief is one of series on scaling up in agriculture, rural development, and nutrition.