This document provides a report on Monitoring Results for Equity Systems (MoRES) conducted in 2014 in Bagerhat and Satkhira districts of Khulna division in Bangladesh. It summarizes the government and UNICEF collaborations on various programs including local capacity building, health, nutrition, child protection, education, water and sanitation. It then describes the MoRES methodology which monitored indicators like iron folic acid supplementation during pregnancy, birth registration, immunization coverage and others. The results found improvements in these indicators after corrective actions were implemented based on the bottlenecks identified. The document concludes by acknowledging support from all partners and stakeholders for achieving positive changes for children.

1. Report on
Monitoring Results for Equity Systems
(MoRES) - 2014
Published by: District Convergence Coordination Committee (DCCC)
Office of the Deputy Commissioner, Bagerhat and Satkhira District
Supported by: UNICEF

2. Published by: District Convergence Coordination Committee (DCCC)
Office of the Deputy Commissioner, Bagerhat and Satkhira District
Supported by: UNICEF
Report
on
Monitoring Results for Equity Systems
(MoRES) - 2014

3. 02 Report on Monitoring Results for Equity Systems (MoRES) - 2014
Overall Coordination for MoRES Implementation
Mr. Md. Sukur Ali, Deputy Commissioner, Bagerhat
Mr. Nazmul Ahsan, Deputy Commissioner, Satkhira
Mr. Arif Nazmul Ahsan, ADC-General, Bagerhat
Ms. Mosammat Momotaz Begum, UNO, Ashasuni Upazila, Satkhira
Mr. Abu Syed Md. Monjur Alam, UNO, Shyamnagar Upazila, Satkhira
Mr. Md. Tabibur Rahman, UNO, Mongla Upazila, Bagerhat
Mr. Md. Abdul Halim, UNO, Sarankhola, Bagerhat
Mr. Abu Zafar Md. Asif Iqbal, DCAO, Satkhira
Technical Support from UNICEF
Mr. S. M. Nazmul Ahsan, Health Officer and Office in Charge, UNICEF Khulna Zone Office
Mr. Jamil Hassan, Child Protection Officer, UNICEF Khulna Zone Office
Ms. Sharmin Shafique, Nutrition Officer, UNICEF Khulna Zone Office
Mr. Md. Aman Ullah, Programme Officer (Planning and Monitoring), UNICEF Khulna Zone Office
Published On
December 2014
Cover Photo Credit
© UNICEF/BANA2013-01024/Kiron
Graphics Design & Layout
Ankur, Khulna
Printing & Binding
Procharoni Printing Press
65, Sir Iqbal Road, Khulna, 041-810957

4. 03Report on Monitoring Results for Equity Systems (MoRES) - 2014
1 Acronyms and abbreviations 4
2 Background 7
3 Government and UNICEF collaborations in Khulna Division 7
3.1 Local Capacity Building and Community Empowerment (LCBCE) 7
3.2 Health 8
3.3 Nutrition 8
3.4 Child Protection 9
3.5 Education 9
3.6 Water, Sanitation and Hygiene 10
3.7 Communication for Development 10
4 Monitoring Results for Equity System (MoRES): 11
4.1 Iron Folic Acid 11
4.2 Birth Registration 12
4.3 Expanded Programme on Immunization 12
4.4 Methodology 13
4.5 Data collection 14
4.6 Bottleneck Analysis 15
4.7 Corrective Actions 16
5 MoRES Results 16
5.1 MoRES Results of BR 17
5.2 MoRES Results of EPI 18
5.3 MoRES Results of IFA 18
6 Major Challenges 20
7 Conclusion 20
8 Annexes 20
8.1 Corrective Action Plan on Birth Registration (BR), Bagerhat 21
8.2 Corrective Action Plan on Birth Registration (BR), Satkhira 22
8.3 Corrective Action Plan on Health, Bagerhat 23
8.4 Corrective Action Plan on Health, Satkhira 24
8.5 Corrective Action Plan on IFA, Bagerhat 25
8.6 Corrective Action Plan on IFA, Satkhira 26
Table of Contents

5. 04 Report on Monitoring Results for Equity Systems (MoRES) - 2014
AWP : Annual Work Plan
AHI : Assistant Health Inspector
ANC : Ante Natal Care
BCO : Bangladesh Country Office
BR : Birth Registration
CBOs : Community Based Organizations
CRC : Convention on the Rights of the Children
CS : Civil Surgeon
CSOs : Civil Society Organizations
DCCC : District Convergence Coordination Committee
DGHS : Directorate General of Health Service
DGFP : Directorate General of Family Planning
DIO : District Information Officer
DRRO : Disaster Relief and Rehabilitation Officer
DSS : Department of Social Services
DWA : Department of Women Affairs
ERD : Economic Relations Division
EPI : Expanded Programme on Immunization
FPI : Family Planning Inspector
FWA : Family Welfare Assistant
FWV : Family Welfare Visitor
GoB : Government of Bangladesh
HA : Health Assistant
HI : Health Inspector
IFA : Iron Folic Acid
IMCI : Integrated Management of Childhood Illness
IYCF : Infant and Young Child Feeding Practices
LCBCE : Local Capacity Building and Community Empowerment
LGIs : Local Government Institutions
ToR : Terms of Reference
UCCC : Union Convergence Coordination Committee
UNDAF : United Nations Development Assistance Frame work
UP : Union Parishad
UzCCC : Upazila Convergence Coordination Committee
UzP. : Upazila Parishad
UNO : Upazila Nirbahi Officer
PIO : Project Implementation Officer
L3M : Level Three Monitoring
MoRES : Monitoring Results for Equity Systems
NILG : National Institute of Local Government
PCR : Programme Component Result
NDPD : National Disaster Preparedness Day
ToT : Training of Trainers
WHO : World Health Organization
Acronyms and abbreviations1

6. 05Report on Monitoring Results for Equity Systems (MoRES) - 2014
The Local Capacity Building and Community Empowerment (LCBCE) program aims to enhancing the capacity of
Local Government Institutions (LGI), Civil Society Organizations (CSO), Community-Based Organizations (CBO)
and networks in inclusive bottom-up and participatory planning and monitoring for social development targeted
to children and women. It will strengthen coordination mechanism for inter-sector programme synergy, and
strengthen local systems for results-based monitoring and reporting. The LCBCE programme is implemented in
Mongla and Sarankhola upazila of Bagerhat district by the District Convergence Coordination Committee-DCCC.
The main responsibility of the DCCC is to facilitate and promote local level planning and monitoring, and local
ownership of the sectoral interventions to ensure convergence and synergies of development interventions
targeted to children and women.
Towards the realization of the commitment of the Government of Bangladesh for monitoring for result as
highlighted in the Sixth Five Year Plan of the GOB, UNICEF is promoting decentralized approach for the identifica-
tion and removal of bottlenecks to effective coverage of proven interventions for the realization of the rights of
children and women. This approach is referred to as Level Three Monitoring – L3M/MoRES (Monitoring Results for
Equity Systems)
Monitoring Results for Equity System -L3M conducted at two unions Chandpai of Mongla and Southkhali of
Sarankhola upazila in 2013 by the local trained volunteers under the leadership of LGIs. Data collected on 5
tracers. (i) Iron Folate Supplementation during pregnancy, (ii) Birth Registration within 45 days of birth, (iii) Full
Immunization Coverage for Children under the age of one year, (iv) Pre-schooling for children aged 5-6 years and
(v) SafeWater Supply from the selected household and analysis the data in details. Bottlenecks and gaps identified
based on said 5 tracers and accordingly develop a MoRES corrective action plan through validation workshop.The
MoRES Corrective action plan officially handover to concern department to implement the plan and they took it
positively. We provided special support to selected two unions within existing government structure of human
support in union level. Provided two days training to the UP representatives, health and family planning staffs at
Chandpai and Southkhali union. They provided effective service on immunization, intake IFA and received ANC
service by the pregnant women and birth registration. After one year data was collected on the said three tracer
(EPI, BR, IFA) by trained volunteers by following the same procedure. UNICEF Khulna zone office analyzed the post
intervention data and it was compared with the base line data. Finally we got outstanding positive result and I
believe that same output can be possible if UCCC is functional and establish good coordination mechanism
among the UP, GO and NGOs.
I would like to acknowledge the support and cooperation of all department/partners and stakeholders who
contributed to implement the MoRES corrective action plan for achieving the positive change in the lives of
children. Special thanks to UNICEF for providing technical and financial support. I believe that the development
process is running in both participatory and consultative way. I hope that all stakeholders/departments will
continue their full support for better life of children and women.
(Md. Sukur Ali)
Deputy Commissioner
Bagerhat
Message

7. Aims of the Local Capacity Building and Community Empowerment (LCBCE) program are to enhance the capacity
of Local Government Institutions (LGI), Civil Society Organizations (CSO), and Community-Based Organizations
(CBO) and to create networks in inclusive bottom-up and participatory planning and monitoring for social devel-
opment. Strong coordination mechanism for inter-sector programme synergy and results-based monitoring and
reporting system has established by it. In close collaboration with the district level representatives of Govern-
ment Departments and CSOs/NGOs, the District Convergence Coordination Committee – DCCC have been imple-
menting the LCBCE programme at Ashasuni and at Shyamnagar upazila of Satkhira district. To facilitate and to
promote local level planning and monitoring the local ownership of the sectoral interventions to ensure conver-
gence and synergies of development interventions targeted at children and women through effective coordina-
tion of multi-sectoral interventions.
UNICEF Bangladesh and DCCC conducted L3M/MoRES (Monitoring Results for Equity System) in two unions at
Budhata of Ashasuni upazila and at Munshigonj of Shyamnagar upazila under Satkhira district focusing on five
tracer interventions along the life cycle of the child i.e. (i) Iron Folate Supplementation during pregnancy, (ii) Birth
Registration within 45 days of birth, (iii) Full Immunization Coverage for Children under one year of age, (iv)
Pre-schooling for children aged 5-6 years and (v) Safe Water Supply, in 2013. Data were collected on aforesaid five
tracers from the selected households and afterward all the data were analysed the data in details. Bottlenecks and
gaps were identified based on 5 tracers and a MoRES corrective action plan was developed accordingly through
MoRES validation workshop. To take necessary actions, the MoRES Corrective action plan was officially handed
over to concerned department and relevant all departments of GOB also took it positively. We provided special
support to selected two unions within existing government structure of human resource at union level. After the
implementation of the corrective actions, second round of data were collected on the same tracers following the
same methodology. Finally we received outstanding positive result in selected unions and I believe that same
output can be achieved if Union Convergence Coordination Committee (UCCC) is functional and a good coordi-
nation mechanism among the UP, GO and NGOs is established.
I would like to acknowledge the support and cooperation of all departments/partners and stakeholders who
contributed to implement the MoRES corrective action plan for achieving the positive changes of childrens life.
My special thanks to UNICEF for providing technical and financial support. I believe that the development process
is having a good momentum in both participatory and consultative way. I look forward for the support of all
stakeholders / departments to be continued for the sake of children and women.
(Nazmul Ahsan)
Deputy Commissioner
Satkhira
06 Report on Monitoring Results for Equity Systems (MoRES) - 2014
Message

8. 07Report on Monitoring Results for Equity Systems (MoRES) - 2014
In Bangladesh, UNICEF as part of the UN System is committed to supporting the Government of Bangladesh
(GOB) to achieve the Millennium Development Goals (MDGs) with equity, through the United Nations Develop-
ment Assistance Framework (UNDAF) 2012 – 2016 to accelerate access to basic social services through
geographic targeting. Within the UNDAF and the broader context of the Sixth Five Year Plan of the GOB, UNICEF
as well as the UN has placed major emphasis on bottom-up participatory planning and monitoring across differ-
ent programme components in the 20 UNDAF districts where the social indicators and development situation of
children and other vulnerable populations illustrate a wide disparity compared to other parts of the country.
Towards the realization of the commitment of the Government of Bangladesh for monitoring the result as
highlighted in the Sixth Five Year Plan of the GOB, UNICEF is promoting decentralized approach for the identifica-
tion and removal of bottlenecks to effective coverage of proven interventions for the realization of the rights of
children and women. This approach is referred to as Level Three Monitoring – L3M.
In 2013, UNICEF Bangladesh conducted L3M in two unions of Bagerhat and two unions of Satkhira district focus-
ing on five tracer interventions along the life cycle of the child i.e. (i) Iron Folate Supplementation during
pregnancy, (ii) Birth Registration within 45 days of birth, (iii) Full Immunization Coverage for Children under the
age of one year, (iv) Pre-schooling for children aged 5-6 years and (v) Safe Water Supply.
The Government of the People’s Republic of Bangladesh
is committed to achieving the Millennium Development
Goals (MDGs) putting well-being of children and women
as an integral part of national development. Government
of Bangladesh and UNICEF Bangladesh includes a new
programme component entitled Local Capacity Building
and Community Empowerment-(LCBCE) in the current
Country Programme 2012-2016. In response to Sixth
Five Year Plan, under this component, Government of
Bangladesh and UNICEF seeks to enhance the capacity
of Local Government Institutions (LGIs), Civil Society
Organizations (CSOs), and Community-Based Organizations (CBOs) and networks in inclusive bottom-up and
participatory micro planning for social development and Disaster Risk Reduction (DRR). It will strengthen coordi-
nation mechanisms for inter-sector programme synergy, and strengthen local systems for results-based monitor-
ing and reporting in the convergence district.
Background2
Government and UNICEF Collaborations in Khulna Division3
3.1 Local Capacity Building and Community Empowerment (LCBCE)

9. 08 Report on Monitoring Results for Equity Systems (MoRES) - 2014
The LCBCE programme is implemented in 20 districts with a view to addressing disparities in access, utilization
and quality of essential services for children, adolescents and women for focused interventions identified in the
United Nations Development Assistance Framework (UNDAF) 2012 – 2016.
In Khulna Division, LCBCE programme is being implemented in six upazilas of Khulna, Bagerhat and Satkhira
districts. The upazila are Dacope and Rupsha of Khulna, Mongla and Sarankhola of Bagerhat and Ashasuni
and Shyamnagar of Satkhira district.
Main partners of LCBCE: Under the direct leadership of Deputy Commissioner, LCBCE is being implemented in
these Districts. The District Convergence Coordination Committee – DCCC, Upazila Convergence Coordination
Committee – UzCCC and Union Convergence Coordination Committee are responsible to implement the LCBCE
programme.
3.2 Health
By improving the health and nutrition of women and children, UNICEF seeks to prevent child death. Bangladesh
is one of few developing countries on track to achieve Millennium Development Goal 4: to reduce the under-five
mortality rate. UNICEF works in public health facilities and with local communities to strengthen maternal and
neonatal health services and encourage women to seek treatment. In order to reduce rates of childhood death,
UNICEF supports immunization-EPI, Integrated Management of Childhood Illness (IMCI), Joint GoB-UN Maternal
and Neonatal Health Initiative (MNHI), Special Care New born Unit (SCANU), Maternal and Perinatal Death Review
(MPDR), Community Support System (ComSS) and injury-prevention programmes in Bagerhat and Satkhira
District.
Main partners of Health programmes in Khulna zone: DGHS, DGFP, WHO, UNFPA and Civil Society Organizations
(Partners in Health and Development-PHD, Center for Injury Prevention and Research, Bangladesh-CIPRB).
3.3 Nutrition
UNICEF seeks to improve nutrition across the entire lifecycle – from infancy, through childhood, adolescence, and
the child-bearing years. For that UNICEF adopts an integrated approach to nutrition programming, combining
both nutrition-specific interventions and nutrition-sensitive approaches, focusing on the most disadvantaged.
Our focus is on the first 1,000 days of life, which is the most crucial time to meet a child’s nutritional requirements
and prevent the long and short-term consequences of under nutrition. UNICEF supports the scale up of nutrition
interventions, such as promotion and protection of exclusive breastfeeding, delivery of vitamin and micronutri-
ent supplementation and community prevention and management of malnutrition, within the broader context
of the principles of the Scaling Up Nutrition movement. UNICEF provides support to strengthen capacity for the
protection of the nutritional status of children in humanitarian situations.
UNICEF works with the Government to deliver vitamin A supplements to all children between the ages of one and
five. Vaccination campaigns provide a platform to deliver other nutritional services, including deworming, and
the promotion of breastfeeding and sound eating habits. Further advice on infant and child feeding is available at
public health facilities where UNICEF trains staff in nutrition counselling. For two decades, UNICEF has supported
salt-iodization as means of preventing iodine deficiency disorders. To address high levels of anaemia among
pre-school children, adolescent girls and mothers, UNICEF works to encourage families to eat foods rich in iron
and folic acid. The programme also provides micronutrient powder that can be sprinkled over meals. Adoles-
cents, pregnant and lactating women in the community receive deworming and iron folate tablets.
Major partners of Nutrition in Khulna zone: DGHS, DGFP and NGOs (CARE-Bangladesh, World Vission
Bangladesh)

10. 09Report on Monitoring Results for Equity Systems (MoRES) - 2014
3.4 Child Protection
UNICEF advocates for the protection rights of all children
and works to safeguard the most vulnerable children.
UNICEF child protection section works to prevent
child marriage, dowry and other forms of abuse and
exploitation through adolescent programmes at centres
around Bangladesh. By supporting institutional reform,
strengthening child services and piloting protection
networks, UNICEF works for the rights of vulnerable
children. UNICEF targets vulnerable and excluded
children in support of the Government’s effort to achieve
universal birth registration in Bangladesh. With support of UNICEF, Department of Social Sercvices (DSS) and
Ministriy of Women and Children Affairs (MoWCA) is providing Conditional Cash Transfer (CCT) for Orphan and
Vulnerable children with a condition to stop child labour and child marriage and continuing the schooling of the
children. EECR Project of MoWCA and UNICEF provided stipend, a one off cash payment given to adolescents as
part of the adolescent empowerment programme to help adolescents put into practice the life skills obtained
from LSBE and other club activities to further enhance their chance to act as agents of social norm change i.e.
child marriage.
Main partners of Child Protection in Khulna zone: Department of Women and Child Affairs, Local Government,
Department of Social service, Bangladesh Police, Rupantar, Jgorani Chankra Foundation (JCF), Jagrata Juba
Shangha (JJS), Centre for Injury Prevention and Research Bangladesh (CIPRB).
3.5 Education
Primary education for every boy and girl in Bangladesh is
a priority for UNICEF. UNICEF succeeded to mainstream
the provision of pre-primary services to ensure children
in Bangladesh have access to pre-primary education.
UNICEF aims to achieve quality education for all children
by making primary schools more inclusive, child-friendly
and effective. UNICEF recognizes the importance of
education as the first step in breaking the poverty cycle.
UNICEF recognizes the importance of addressing the
psycho - social needs of adolescents. Succeeded to
mainstream Life Skills Based Education into the curriculum and teacher training schemes in secondary educa-
tion. Main partners of education in Khulna zone: Department of primary and mass education, BRAC, Jagoroni
Chacro Foundation – JCF, CARITAS-Bangladesh and World Vision.

11. 3.6 Water, Sanitation and Hygiene
UNICEF is working with the Government of Bangladesh
and sector partners, to increase the demand for, and
benefit from, increased and more equitable utilisation of
improved water and sanitation facilities, and practice key
hygiene behaviours of households, communities and
schools in districts across Bangladesh UNICEF is working
with a range of government institutions, universities,
research organisations, NGOs and community groups to
pilot new technologies to ensure safe water where
traditional water points are not feasible, due to low
water levels, flooding and arsenic contamination. These
new technologies, which include Managed Aquifer Recharge- MAR
Bangladesh has made huge progress in sanitation over the last 25 years through reducing open defecation from
32% in 1990, to 3% today. UNICEF supports this through social mobilisation of households and communities on
the importance of using and maintaining improved latrines through a number of approaches including CATS and
SLTS (Community Approaches to Total Sanitation and School Led Total Sanitation) and SanMark (Sanitation
Marketing). Using a range of communication channels, UNICEF supports the dissemination of key messages on
hygienic behaviour in households, communities and schools, through the training of government health workers
and mass media campaigns
Main partners of Water, Sanitation and hygiene in Khulna zone: Department of Public Health Engineering-
DPHE, CARITAS, Oxfam, Care-Bangladesd, iDE, AAN, EPRC and WASH United.
3.7 Communication for Development
Addressing harmful social norms and household behav-
iours that stand in the way of children’s survival and
development is a priority for UNICEF. We work on
“UNLOCKING THE POTENTIAL” of communities for
improved child wellbeing through behaviour and social
change communication
Since January 2012, the Government of Bangladesh-
UNICEF through ‘Engaging Communities for Social and
Behaviour Change’ programme has employed a system-
atic, evidence-informed mix of approaches to support
deprived community members practice key life-saving
care and protective behaviours, raise their demand for quality social services and promote social change.
Main partners of C4D in Khulna zone: Partnership developed for social change supporting the set-up of a multi-
sectorial social norm change forum at national level, and social norm change chapters at district and upazila
(sub-district) levels, to create opportunities for dialogue, networking and coordination. The partnership with
“Department of Women and Child Affairs”, Department of Mass communication (DIO), Community Radio Nalta,
Betar Bangladesh-Khulna, Rupantar – NGO
10 Report on Monitoring Results for Equity Systems (MoRES) - 2014

12. In 2010, UNICEF launched a re-focus on equity under the premise that equity focused programming is not only
right in principle but that it is right in practice. The UNICEF framework for Monitoring Results for Equity Systems
(MoRES) outlines four level of programme monitoring.
Level 1: monitoring involves disaggregated and equity
based analysis of the situation of children, including
review of policies, strategies and plans in all sectors as
they affect the realization of the right of the child.
Level 2: monitoring involves the monitoring of
programme inputs (cash, supplies and contracts) and
outputs as part of routine monitoring of activities /
interventions.
Level 3: monitoring involves the identification and removal of bottlenecks (in enabling environment,
supply, demand and continuity of use) towards effective coverage of intervention.
Level 4: monitoring involves periodic surveys and impact evaluation of programme / intervention.
To analyse bottleneck in coverage of intervention,‘Tanahashi’outlined different stage from resource allocation to
achievement of desired result. Other relevant information especially by the World Health Organization on the
concept of effective coverage, its definitions and application in the measurement and management of health
systems and services performance are available for reference. Within a defined geographic group / target popula-
tion, the classification of different coverage stages thus allow for the measurement of gaps in coverage levels
across five levels”
Availability: The relationship of the volume and type of existing services to the volume of clients and their needs
Accessibility: The relationship between the location of services and the location of clients
Utilization: The relationship between the volume of initial contacts with the service and the volume of clients
Adequate Coverage: The relationship between the volume of full services provided and the volume of clients
Effective Coverage: The relationship between the volumes of full services provided with quality and the volume
of clients
4.1 Iron Folic Acid
Stunting remains high in Bangladesh at 41%. Maternal under nutrition and inadequate IYCF are key underlying
causes. Maternal under nutrition and anaemia may contribute up to 50% of stunting, as undernourished mothers
give birth to low weight babies that will not reach their full growth potential. Therefore prevention and control of
micronutrient deficiencies among adolescent girls and PLWs, including iron deficiency, is critical to growth and
development of infants. Considering these, IFA has been taken as the tracer for nutrition programme coverage.
Key strategy:
1. To strengthen coverage and quality of IFA supplementation to pregnant women through ANC services.
2. To strengthen IFA supplementation provided through ANC services from GoB Health and Family Planning
programmes (correct dosage as per national anemia control strategy).
Analysis and monitoring of the following different coverage levels helped in understanding supply and demand
side constraints.
11Report on Monitoring Results for Equity Systems (MoRES) - 2014
Monitoring Results for Equity System (MoRES)4

13. 12 Report on Monitoring Results for Equity Systems (MoRES) - 2014
4.2 Birth Registration
In Bangladesh, according to the Birth and Death Registration Act, the father, mother or guardian of a child are
responsible for submitting information relating to the birth of the child within 45 days of the child’s birth. Acquir-
ing a birth certificate is the right of every child born in the country. Birth registration is important because it
validates the existence of the child, but also its right to health services, schooling, and protection from child labor,
child trafficking, child marriage and other forms of exploitation. Registering the baby in time is also important for
gathering statistics to inform fact-based planning, monitoring and budgeting.
While doing the MoRES exercise, the survey done of 4 unions in Bagerhat and Satkhira used the below defining
for tanahashi graph.
4.3 Expanded Programme on Immunization (EPI)
EPI is the largest and nationwide intervention to save all children from deadly diseases and disabilities through
vaccination. It has great impact in reducing mortality and morbidity of under five children. Considering this
importance, EPI is taken as a tracer for estimation of programme coverage.
The following indicators were used to determine the level of coverage.
Level of Coverage Indicator
Target All pregnant women
Availability % of pregnant women for whom sufficient quantities of IFA tablets have been
procured and supplied
Accessibility % of pregnant women who have access to ANC services providing IFA supplementation
Utilization % of pregnant women who received at least 30 IFA tablets from ANC 1
Adequate coverage % of pregnant women who received at least 100 IFA tablets from 4 ANC visits
Effective Coverage % of women who consumed at least 100 IFA tablets during last pregnancy
Level of Coverage Indicator
Target All the children aged 0-1 year old.
Availability % of birth registration units that have adequate resources and staff.
Accessibility % of parents know how and where to report births to obtain a birth certificate.
Utilization % of children born in the last 12 months whose parents applied for birth registration.
Adequate coverage % of children born in the last 12 months who were registered, were actually
provided with a birth certificate.
Effective coverage % of children under the age of one had their births registered with a
certificate issued within 45 days.
Level of Coverage Indicator
Target Eligible children for vaccination
Availability Proportion of wards with no stock out of vaccines for the past 6 months
Accessibility Proportion of HH having access to Immunization Outreach sites including health
facilities for immunization services within half an hour
Utilization Proportion of children age 12-23months who received Pentavalent 1
Adequate coverage Proportion of children age 12-23 months who received Pentavalent 3
Effective coverage Percentage of children age 12-23 month fully immunized according to vaccination
calendar timeline. (fully vaccinated Children under 12 means number of children
eligible for vaccination received BCG, OPV 4, Pentavalent 3 and MCV 1)

14. 13Report on Monitoring Results for Equity Systems (MoRES) - 2014
I. Most deprived Unions in
the most deprived upazillas
from among the least
performing districts are
identified
VI. Select weakest links in
the chain of determinants
as priority bottlenecks
VII. For each priority bottle-
neck, identify key
constraints and corrective
actions
VIII. Implement corrective
actions
IX. Measure every 6 months
changes in corrective
actions
V. Assess means of verifica-
tion and data sources.
Collect data and assign
values to indicators
IV. For each intervention,
define levels of coverage
and related indicators
II. Measure prevalence of
“problem” in the selected
union
III. Select high-impact
interventions
4.4 Methodology
During implementation of MoRES several steps were followed. Those are as bellows:
4.4.1: District level Sensitization Workshop: The main
purpose of district sensitization workshop was to brief on
Monitoring Results for Equity System (MoRES) for better
understanding and creating a responsive work environ-
ment among stakeholders to ensure synergistic impact of
interventions on the lives of children and their families.
The workshop participants were all DCCC members and
some local elites and selected UP chairmans. Details
implementation procedure of MoRES exercise and
involvement of GOB and local government were
discussed in the workshop. All the participants got clear
conception on above issues and disseminated the
information to the upazila and union level.
4.4.2: Sampling
A multi- stage sampling informed by the child deprivation index (CDI) was used for the sampling. The CDI ranking
was based on four key indicators of (i) access to skilled birth attendants, (ii) net attendance ration (NAR) in second-
ary education, (iii) access to improved sanitation and (iv) female adult literacy rate to explore deprivation among
children.
• District Selection: Bagerhat and Satkhira district were selected for L3M based on the CDI ranking considering
the social indicators and development situation of children and other vulnerable populations which illustrate
a wide disparity compared to other parts of the country.
• Upazilla Selection: Upazilla selection in the districts was performed by CDI ranking and the most deprived
among all the upazilas.

15. 14 Report on Monitoring Results for Equity Systems (MoRES) - 2014
• Selection of Union: Union level selection was based on joint analysis with local government officials of the
deprivation for children and other vulnerable population, focused on marginalized population groups,
vulnerability to emergency and political commitment to drive system based change. Considering the criteria
we selected Chandpai and Southkhali union of Bagerhat and Budhata and Munshigonj union of Satkhira
district.
• Village Selection: Systematic random sampling was undertaken in the identification of villages in the union
to be included in the exercise. The listing of all villages in the Union was done from the 2011 National Census.
The number of villages to be selected was fixed at 25% of the total number of villages in the selected union,
with the minimum number of village to be included in the exercise set at 3 villages, except where the number
of households in the villages was too small to constitute a reliable sample. Segments were formed where the
selected village had more than 250 households
4.4.3: Community Engagement
Prior to embarking on the exercise, the purpose of L3M
was discussed with local partners, at the district, Upazila
and union levels. The Union Parisad (UP) Chairmans, all
members, secretary, Government Sectoral front line staff
members, teachers and members of the civil societies
including NGO personnel working in the union were very
critical to the success of the exercise and their under-
standing of the rationale, short and long term implica-
tions of the findings, clear message that allowed them
to understand their joint accountability in identifying
and removing bottlenecks. Community engagement
was vital for the ownership, partnership and resources including political will required to address the bottlenecks,
through‘corrective’actions that the L3M actions proposed.
4.5 Data collection
Data CollectionTools: There were three sets of data collection tools targeted at different levels of data sources in
the exercise. The household questionnaire was comprised of different modules for each tracer intervention, and
target household members with specific criteria. The second tool was the facility assessment checklist and the
third tool was the Focus Group Discussion (FGD).
Enlisting of Community Volunteers: Considering the volume and quality of work 20 community volunteers
(male 10 and female 10) were selected in each union for house hold listing and data collection on five tracer.
Training: UNICEF staff provided one day training to the volunteers on house hold listing and separate two days
training on data collection of five tracer.
House hold listing: House hold listing started from the north-west corner of the segment moving towards left
side and then proceeding southwards in a zig-zag or serpentine manner ensuring that no structure was left out.
Each household in the selected village / segment was provided with a unique number serially from 1 to 250 in
each village.

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Household characteristics data collection:The characteristics of all eligible household members in the selected
areas were collected using the data collection format. For each household visited, the household characteristics
that include name of each household member, sex, age in completed years, marital status and highest education
grade passed were recorded in the household characteristics format All the collected information entry was done
in excel sheet and submitted to Chief Field Operation UNICEF for the identification of sample household.
Household Survey/data collection: The household
questionnaire was administered to selected households
from the sample household, and information elicited
from eligible household members. Data collection
ensured a minimum sample size of at least 60 households
per intervention
Facility Assessment: At the facility level, the focus was
on administrative data and key informant interview of
service providers on specific question item related to
availability of services. In some instances, the assessment
was also include the exploration of the functionality of the service delivery system. Different assessment tools for
the different facility in each of the tracer intervention were available
Focus Group Discussion: During the household survey, research personnel conducted specific FGD based on
established criteria. A separate group was trained up for conducting FGD both as facilitators and note takers, and
they conducted the FGD in the field.
4.6 Bottleneck Analysis
District Convergence Coordination Committee – DCCC
organized a MoRES validation workshop where district
and upazila level all concerned GOB departmental heads
were present. UNICEF representatives presented a power
point presentation on MoRES data analysis and pointed
out the bottlenecks and service gaps. All the participants
performed group work on service gaps and provided
recommendations for corrective actions and accordingly
presented group findings. After open discussion, all the
participants finalized the service gaps and prepared an
action plan to minimize the gaps which called“MoRES
corrective Action Plan”. Deputy Commissioner Bagerhat and Satkhira officially handed over the“MoRES corrective
Action Plan”to concerned department at district level (Health, Family planning, primary education, Local Govern-
ment section, DPHE and UNOs) to take necessary action for implementation of MoRES action plan.

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4.7 Corrective Actions
Considaring the recommendation of MoRES validation
workshop, each union recruited on paid volunteer for
implementation of “MoRES Corrective Action Plan” with
the close coordination of GOB health and Family
planning union level staff, UP representatives, NGOs
working for the children and women. As part of MoRES
plan UNICEF provided training to the health and family
planning staff at four union where MoRES Corrective
action plan were implemented. The training sessions
were facilitated by Civil Surgeon, DD family planning,
UH&FPO, UFPO, HI and UNICEF representatives.
They also provided training to concerned UP representatives on implementation of MoRES corrective action plan
at union level. The health volunteer established a good coordination mechanism among health, family planning,
Ups and NGO representatives so that MoRES action plan could be implemented successfully. The DCCC provided
adequate support to implement MoRES corrective action plan at union level in six months.
MoRES Corrective Action plans of Bagerhat and Satkhira are at Annex (8.1-8.6)
After the implementation the corrective actions, local
government with technical support from UNICEF
collected the data from the same geographic location
using the same methodology to compare the results and
find the effectiveness of the corrective action.
After plotting data for all three tracer interventions
collected before and after the corrective actions in the
same graphs, a significant progress was found for those
interventions.
MoRES Results5

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5.1 MoRES Results of BR
in terms of Birth Registration, significant progress were made in the utilization and adequate coverage, which
means rate of application for birth registration and rate child below one-year child with birth certificate increased
dramatically.

19. Report on Monitoring Results for Equity Systems (MoRES) - 2014
5.2 MoRES Results of EPI
In terms of EPI the effective coverage (percentage of children complete four vaccines within 12 months).
5.3 MoRES Results of IFA
Considering the comparative analysis of IFA intake coverage level during pregnancy of women, progress were
made in all level of coverage including utilization, adequate coverage and effective coverage.
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Major Challenges6
Conclusion7
Annexes8
• Lack of Coordination among the union level GoB staff
and UP. representatives
• Less interest by the Union Digital Centre personnel to
BR without money even if the child’s age is below 2
years.
• Less interest to perform additional activities by the
union level staff though the activities are included in
his/her job area.
• Less supportive supervision in the field level.
• Vacant position of GoB staff at union level.
This is the first time GOB and UNICEF jointly performed the“Monitoring Results for Equity System”(MoRES) at four
union of Bagerhat and Satkhira district. We provided service to the community people in integrated way among
GoB relevant departments and UP representatives within our existing human resource structure and got signifi-
cant positive results. To sustain the progress achieved through implementation of corrective actions, district,
upazila and union level duty bearers should continue efforts that has already been proved effective. We believe
that we will get the same results from other unions through establishing effective coordination and integration
among the sectors and UP representatives.

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Annex-8.1:CorrectiveActionPlanonBirthRegistration(BR)-Bagerhat

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Annex-8.2:CorrectiveActionPlanonBirthRegistration(BR)-Satkhira

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Annex-8.3:CorrectiveActionPlanonHealth-Bagerhat

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Annex-8.4:CorrectiveActionPlanonHealth-Satkhira

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Annex-8.5:CorrectiveActionPlanonIFA-Bagerhat

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Annex-8.6:CorrectiveActionPlanonIFA-Satkhira

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