GPAF COMMUNITY PARTNERSHIP PROPOSAL FORM (Round 2)The proposal documentation provides detailed information about your proposed project. This information is used to assess the strengths and weaknesses of the initiative and will ultimately inform the DFID funding decisions. It is very important you read the GPAF Community Partnership Window Guidelines for Applicants and related documents before you start working on your Proposal to ensure that you understand and take into account the relevant funding criteria. Please also consider the GPAF Proposals - Key Strengths and Weaknessesdocument which has been adapted from the document prepared following the appraisal of full proposals submitted to GPAF Innovation and Community Partnership windows, and identifies the generic strengths and weaknesses of proposals submitted in relation to the key proposal appraisal criteria.

How?:You must submit a Microsoft Word version of your Proposal and associated documents by email to gpafcommunity@tripleline.com. It should be written in Arial font size 12. We do not require a hard copy.

When?:All Proposal documents must be received by the GPAF Fund Manager (Triple Line/Crown Agents)on or before 23:59GMTon Thursday 3rdOctober2013. Proposal documents that are received after the deadline will not be considered.

What?:You must submit the following documents:

1. NarrativeProposal :Please use the form below. The form has been designed to allow you to record all theinformation required to assess your proposed project. Please note the following page limits:

Sections 1 – 8 : Maximum of 15 (fifteen) A4 pages Section 9 : Maximum of 3 (three) A4 pages per partnerPlease do not alter the formatting of the form and guidance notes. Proposals that exceed the page limits or that have amended formatting may not be considered.

2. Logical framework: All applicants must submit a full Logical Framework/Logframeand Activities Log. Please refer to the GPAF Logframe Guidance and How-To-Note and use the Excel logframe template provided.

3. Project Budget:Applicants must submit a full project budget with the Proposal. Please refer to the GPAF Community Partnership Window Guidelines for Applicants and Financial Management Guidelines and the notes on the budget template. The Excel template has three worksheets/tabs: Guidance Note; Budget; and Budget Notes. Please read all guidance notes and provide full and detailed budget notes to justify the budget figures.

4. Your organisation's governance documents: e.g. Memorandum and Articles of Association, Trust Deed, Constitution. We need this to check your eligibility. If you have any doubts about your eligibility please contact us immediately.

5. Organisational Accounts:All applicants must provide a copy of their most recent (less than 12 months after end of accounting period), signed and audited (or independently examined) accounts.

6. Project organisational chart/organogram: All applicants must provide a project organisational chart or organogram demonstrating the relationships between the key project partners and other key stakeholdersPlease use your own format for this.

7. Project Schedule or GANTT chart: All applicants must provide a project schedule or GANTT chart to show the scheduling of project activities (please use your own format for this).

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Before submitting your Proposal, please complete the checklist below to ensure that you have provided all of the necessary documents.

CHECKLIST OF PROPOSAL DOCUMENTATIONPlease check boxes for each of the documents you are submitting with this form.All documents must be submitted by e-mail to: gpafcommunity@tripleline.com

Mandatory items for all applicants CheckY/N

Proposal form (sections 1-8) Y

Proposal form (section 9 - for each partner) Y

Project Logframe and Activity Schedule Y

Project Budget (with detailed budget notes) Y

Your most recent set of audited or approved organisational annual accounts

Y

Project organisational chart / organogram Y

Project bar or GANTT chart to show scheduling of activities Y

Please provide comments on the documentation provided (if relevant)The Memorandum and Articles of Association are also submitted as requested on Page 1. We only have the Memorandum in a pdf with the original Articles. The Articles were updated in 2012 and are submitted in a separate pdf,

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GLOBAL POVERTY ACTION FUND (GPAF) – COMMUNITY PARTNERSHIP WINDOW PROPOSAL FORM

SECTION 1: INFORMATION ABOUT THE APPLICANT1.1 Lead organisation name Women and Children First (UK)

1.2 Main contact person Name:Ros DaviesPosition: Chief Executive Officer (CEO)Email:r.davies@womenandchildrenfirst.org.ukAlternative email address: N/ATel: 020 7700 6309 ext. 202

1.3 2nd contact person(If applicable)

Name:Position:Email:Alternative email address:Tel:

1.4 Please use this space to inform of any changes to the applicant organisation details provided in your Concept Note(including any more up to date income figures)

SECTION 2: BASIC INFORMATION ABOUT THE PROJECT2.1 Concept Note Reference No. INN-06-CN-1292

2.2 Project title Improving maternal and newborn health for 20,449 women of reproductive age and 5,500 neonates in Bangladesh

2.3 Country(ies) where project is to be implemented

Bangladesh

2.4 Locality(ies)/region(s) within country(ies)

Bogra district

2.5 Duration of project(in months) 30months

2.6 Anticipated start date of project(not before 01 April 2014)

01 April 2014

2.7 Total project budget? (In GBP sterling)

£249,843

2.8 Total funding requested from DFID (in GBP sterling and as a % of total project budget)

£249,843

100%

2.9 If you are not requesting the full amount from DFID, please list the amounts and sources of any other funding (In GBP sterling and as a % of total project

Source:N/A

£

%

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funds)

2.10 Year 1 funding requested from DFID(In GBP sterling)

£93,177

2.11 Please specify the % of project funds to be spent in each project country

Bangladesh: 74%UK: 26%

2.12 Have you approached any other part of DFID to fund this project?

NOIf Yes, please state which fund or department:

2.13 ACRONYMS(Please list all acronyms used in your Proposal in alphabetical order below, spelling out each one in full. You may add more rows if necessary)

ANC Antenatal care NMR Neonatal Mortality Rate

BADAS Diabetic Association of Bangladesh

PCP Perinatal Care Project

GOB Government of Bangladesh PLA Participatory Learning and Action

HDI Human Development Index RCT Randomised Control Trial

MCWC Maternal and Child Welfare Centre

RMNCH Reproductive, Maternal, Newborn and Child Health

MMR Maternal Mortality Ratio WCF Women and Children First (UK)

MNH Maternal and Newborn Health WRA Women of Reproductive Age

MOHFW Ministry of Health and Family Welfare

SECTION 3: CAPACITY OF THE APPLICANT ORGANISATION3.1 EXPERIENCE:Please outline your organisation's experience that is relevant to the proposed

areas of work

Women and Children First UK (WCF) is an international NGO working to improve the health and wellbeing of women and children in poor communities, with a focus on pregnancy and the first month of life. WCF has a successful 11 year track record of managing and delivering over twenty major maternal and newborn health programmes, mostly focusing on demand side interventions,with partners in Bangladesh, Ethiopia, India, Malawi, Nepal and Uganda. WCF plays a critical role in supporting local partners byproviding technical assistance and building partners’ capacity in mobilising communities, policy analysis, advocacy and communications and project and financial management. WCF and the Perinatal Care Project (PCP) have worked together since 2002. A project within BADAS - the second largest health service provider after the government (see Section 9) – PCP has direct experience of implementing large multi-year community-based interventions funded by a range of donors including Big Lottery Fund, EC, Saving Newborn Lives, Wellcome Trust and WHO, the results of which have been published by peer reviewed international journals. BADAS has very strong relationships with government bodies under the MOHFW at all levels. PCP’s work in Bogra since 2002 has resulted in strong links with field level government staff, particularly at community clinics, union health and family welfare centres and upazila health complexes.

3.2 FUNDING HISTORY:Please describe your organisation's main sources of funding, with an indication of the amounts received and the purpose of the funding.

Big Lottery Fund:Strategic Grant, Improving MNCH in low-income countries (India and Bangladesh), £803,876, 2008-2013; Planning Grant MCH project (Uganda), £10,000 2013

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Comic Relief: Improving MNCH (Malawi), £387,945, 2010-2013; Planning Grant (Ethiopia) – £53,338, 2012; Improving maternal, newborn and child health (Malawi), £175,734, 2013 - 2015

UNFPA: MDG 4 and 5 advocacy (UK), $10,000, 2013 Conservation Food and Health: Jut: increasing the uptake of family planning in Mumbai’s slums

(India), $50,000, 2012-2013 The Health Foundation: Improving MNH (Malawi), TA provision, £42,000, 2007-2012 Ernest Kleinwort Charitable Trust: Unrestricted funding, £25,000, 2013 DFID: Improving Maternal MNH in Nkhotakota (Malawi), £249,911, 2013-2016 (provisional)

3.3 CHILD PROTECTION (projects working with children and youth (0-18 years) only)What is your organisation's capacity and experience in relation to child protection? How will you work with your partner(s) to ensure children are kept safe?

WCF doesn’t work directly with children and youth, but has a Child Protection Policy and is developing a policy for working with vulnerable people which it will share with PCP. We will discuss PCP’s child protection policy with them, ensuring all team members are aware of it and monitor its application on an ongoing basis.

3.4 FRAUD:Are you aware of any fraudulent activity within your organisation within the last 5 years? How will you minimise the risk of fraudulent activity occurring in future?

No. WCF has a Financial Policy and Procedures Manual which has a comprehensive description of internal controls which are applied by the Finance Officer and monitored regularly by the CEO. An operating budget is agreed by the Board at the beginning of each year and management accounts and a cash flow forecast, including information on use of restricted funds clearly set out per project, are prepared 1/4ly. These are distributed to the Finance Committee who scrutinise them on receipt and meet quarterly to discuss any issues arising. The organisation is audited annually by a respected firm of auditors who are experienced in working with charities. WCF also has an Anti-Bribery and Corruption Policy and Value for Money Statement, reflected in its MOUs with partners.

SECTION 4: FIT WITH GPAF COMMUNITY PARTNERSHIP WINDOW4.1 CORE SUBJECT AREA - Please identify between one and three core project focus areas

(insert '1' for primary focus area; '2' for secondary focus area and; '3' for tertiary focus area)

Agriculture Health (general) 2

Appropriate Technology HIV/AIDS / Malaria / TB

Child Labour Housing

Climate Change Income Generation

Conflict / Peace building Justice

Core Labour Standards Land

Disability Livestock

Drugs Media

Education & Literacy Mental Health

Enterprise development Reproductive Health / FGM 1

Environment Rural Livelihoods

Fisheries / Forestry Slavery / trafficking

Food Security Water& sanitation

Gender 3 Violence against women/ girls/children

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Governance

Other: (please specify)

4.2 Which of the Millennium Development Goals will your project aim to address? Please identify between one and threeMDGs in order of priority (insert '1' for primary MDG focus area; '2' for secondary MDG focus area and; '3' for tertiary MDG focus area)

1. Eradicate extreme poverty and hunger 3

2. Achieve universal primary education

3. Promote gender equality and empower women

4. Reduce child mortality 1

5. Improve Maternal Health 2

6. Combat HIV/AIDS, malaria and other diseases

7. Ensure environmental sustainability

8. Develop a global partnership for development

4.3 Explain why you are focusing on these specific MDGs.Are the above MDGs “off track” in the implementing countries? If possible please identify sub-targets within not just the national context but also related to the specific geographical location for the proposed project. Please state the source of the information you are using to determine whether or not they are “off track”. Your response should also inform section 5.3.

Bangladesh is on track to meet MDGs 4 and 5. However, at current rates of progress this achievement will miss out newborns and the poorest women, nationally and especially in the poor district of Bogra. Although Bangladesh has achieved parity in school enrolment and there has been improvement in the social and political empowerment of women (Bangladesh MDG Report 2012), women are still not empowered in relation to accessing maternal and neonatal services so they often do not seek appropriate skilled care (in a timely fashion) during ante-natal, delivery and post-natal periods. The district is acutely affected by poor MNH with district level data indicating a worse situation in this region than the national average, particularly regarding newborn deaths (NMR 35/1000 live births, national average 26, PCP district data); the proportion of births attended by medically trained personnel (26% NIPORT 2011; national average 32% BDHS 2011); institutional deliveries (24% ibid.; 29% ibid.) and post natal care visits by trained health personnel (14% ibid.; 27% ibid.). Utilisation of health facilities in the district remains particularly low (see section 5.3).

4.4 Please list any of the DFID’s standard output and outcome indicators that this fund will contribute to? Please refer to the DFID Standard Indicators document on the GPAF website.Please note that if you are using the standard indicators, these also need to be explicit in your logframe.

Proportion of births attended by skilled health personnel

SECTION 5: PROJECT DETAILS5.1 PROJECT SUMMARY: maximum 5 lines - Please provide a brief and clear project summary

includingthe overall change(s) that the initiative is intending to achieve, who will benefit, and the approach proposed to achieve the change. (This is for dissemination about the fund and should relate to the outcome statement in the logframe. Please avoid jargon).

WCF and PCP will empower rural women to access quality maternal and newborn health services in Bogra district. Direct beneficiaries are 20,449 women and 5,500 newborns.We will combine i. published evidence that mobilising communities through PLA women’s groups reduces maternal and newborn mortality;ii. PCP’s experience of working with community health committees and clinics and

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iii. Advocacy to strengthen the health system and improve maternal and newborn health services.

5.2 PROJECT DESIGN PROCESSDescribe the process of preparing this project proposal. Who has been involved in the process and over what period of time?Were representatives of the target group consulted, and if so, how?If a consultant or anyone from outside the lead organisation and partners assisted in the preparation of this proposal please describe the type of assistance provided.

WCF and PCP have been active in Bogra since 2002 and have gained deep understanding of the community’s needs. We have planning this project since late 2012, based on requests from the community to set up a new project in the ex-control areas of a Randomised Control Trial (RCT) which achieved a 38% reduction in newborn death rates in the intervention areas (Fottrell et al, 2013) (see section 5.4). WCF and PCP drafted the concept note and full proposal in 2013. Consultation with communities has been ongoing since operations started in 2002 but a more thorough consultation to inform this project design was doin in 2013 with: PCP staff (head office and districts), community clinic staff, existing WG’s members in the intervention areas, upazilla and district health authorities, UCL staff and WHO (in relation to a similiar project).The proposal was written by WCF’s Head of Policy and Advocacy and PCP’s Project Director and Project Manager, including during a PCP visit to the UK in September 2013. We have also sought support from UCL to develop indicators and adapt the existing RCT M&E system. The proposal was reviewed by WCF’s Chief Executive and Finance Manager.

5.3 PROJECT CONTEXT / PROBLEM STATEMENTDescribe the context for this project. What specific aspects of poverty is the project aiming to address? Why have these particular project locations and communities been selected and at this particular time? What gaps in service delivery have been identified that necessitate the intervention that you are proposing?

This project is needed to address the poor state of maternal and newborn health (MNH) in Bogra district in northern Bangladesh. Bangladesh is a densely populated country of almost 150 million people, 35% of whom live in rural areas. Bangladesh ranks 146 th among nations on the HDI (UNDP, 2011). Despite impressive economic growth rates of around 6-7% in recent years Bangladesh remains a poor country with 26% of the population living below the poverty line (World Bank, 2010). Bangladesh is on track to meet both MDGs 4 and 5 but at current rates of progress this achievement will miss out newborns and the poorest women. Bangladesh has the sixth largest number of newborn deaths globally with around half of under-5 deaths occurring in the first month of life (Countdown 2015). Despite impressive reductions in maternal mortality the national MMR remains high at 194/ 100,000 (Bangladesh Maternal Mortality Survey, 2011).There are significant inequities in coverage of and access to maternal health interventions such as antenatal care visits and skilled birth attendance and, despite government efforts, 68% of deliveries are still performed at home (Countdown 2015, 2013 Update). Located in northern Bangladesh in Rajshahi Division, Bogra district has a total population of 3,400,874 and the majority (2,730,486 people) live in rural areas. The female literacy rate, at only 45%, is below the national average of 49% (Population and Housing Census 2011). Administratively Bogra is organised into 12 upazilas (sub-districts), 110 unions and 2,618 villages. This project will be implemented in three unions of two upazilas covering a total population of 96,985 (PCP household survey, 2011). We will focus on Bogra for the following reasons:1. The district is acutely affected by poor MNH compared to national averages: the NMR (35/ 1,000 live births) is higher than the national average (26/ 1,000 live births); the proportion of births attended by medically trained personnel (26% NIPORT 2011; national average 32% BDHS2011), institutional deliveries (24% ibid.; 29% ibid.) and post natal care visits by trained health personnel (14%, ibid.; 27% ibid.).2. Despite the existence of two medical college hospitals, one district hospital, four Maternal and Child Welfare Centres,11 upazila health complexes, 38 union sub-centres, 61 union health and family welfare centres, 358 community clinics and two NGO clinics utilisation of health facilities in the district is still low. This is due to a lack of awareness and knowledge among women and their families about good MNH care and the benefits of skilled medical MNH care, distance to travel to appropriate health

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facilities, high out of pocket payments, lack of trained health staff and inadequate supplies of medicines andequipment and other logistical problems, poor referral systems, lack of ownership and weak accountability and communication skills of health staff.3. We have been operating successfully in partnership in Bogra since 2002 (with data going back to 2004) and have strong systems and community presence in place.4. There are no other initiatives for stimulating PLA-based community mobilisation for MNH in the area.Health is intricately connected to broader poverty and the health of women and children is critically important to almost every area of human development and progress.  Poor maternal health contributes directly to poverty - if mothers are unhealthy or die the whole family economy suffers due to medical expenses, loss of earnings/production, children are less likely to attend schooland have reduced future economic prospects. Patriarchy and gender inequality are important determinants of many MNH problems with Bangladesh ranking low on the Gender Equity Index. Poor people’s health must be improved to address poverty and improving health contributes to economic development. This project will address MDGs 3, 4 and 5 by improving the beneficiaries’ knowledge, empowering women to seek skilled MNH care and changing MNH behaviour at community level.

5.4 ANTICIPATED IMPACTON POVERTY(within the lifetime of the project)Please describe the anticipated real and practical impact of the project in terms of poverty reduction and changes to the lives of people within the beneficiary communities identified in 5.5, within the lifetime of the project.

The goal is to inform, empower and mobilise women and communities so that they are better prepared to manage pregnancy and childbirth, wherever it occurs, and are able to actively seek quality MNH services when needed. This will impact on poverty within the project lifetime by reducing the maternal mortality and morbidity and related costs of emergency health care. Better health will increase women’s prodiuctivity and the likelihood their children will receive optimum care and education. The project design is based on the successful implementation of an RCT with partners at UCL’s Institute for Global Health (IGH) and PCP in Bangladesh. Implementing and evaluating a community-based intervention in three districts in Bangladesh we have successfully achieved a 38% reduction in newborn death rates (Fottrell et al, 2013). We also know from other similar community-based studies in South Asia and Africa that it is possible to reduce newborn death rates by up to 45% and maternal mortality rates by up to 55% (Prost et al, 2013) using this approach. We propose to develop a new project by expanding and adapting the RCT intervention into the ex-control areas in one district. We hypothesise that we will be able to achieve: an increase in the proportion of births attended by skilled health personnel from 25% at baseline to 31%; an increase in the proportion of pregnant women who received at least three antenatal care check ups by a formal provider from 44% at baseline to 53% (PCP data sources from the three proposed unions of Bogra district 2009-2011). We also anticipate that the intervention’s impact on birth preparedness, community solidarity and practical solutions to improve access to care and post-partum support mechanisms will lead to reductions in maternal mortality (MMR from 104/ 100,000 live births to 73) and in newborn mortality (NMR from 35/1000 live births to 24), relative to baseline levels. At community level, the project will, through women’s groups, health service strengthening and advocacy: (1) Help community members to recognise and act on their priority MNH needs and ensure they create demand for comprehensive MNH services; (2) Empower poor rural women to make their own decisions regarding MNH; (3) Empower communities to better understand the causes of ill health and to make better informed choices about access to health care services by enhancing their participation in service delivery, mobilisation and use of community resources for health promotion; (4) Develop the capacity of local leadership to ensure that they lead and implement community activities and have full ownership.

5.5 TARGET GROUP (DIRECT AND INDIRECT BENEFICIARIES)Who will be the direct beneficiaries of your project and how many will be expected to benefit directly from the anticipated poverty-reducing changes within the lifetime of the project?Please describe the direct beneficiary group(s) under a) below, differentiate where possible and provide numbers for each sub-category and then provide a total number in b).

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DIRECT: a) Description Women of reproductive age (WRA); newborns

b) Number 20,449 WRA; 5,500 newborns

Who will be the indirect (wider)beneficiaries of your project and how many will benefit within the lifetime of the project? Please describe the indirect beneficiary group(s) and numbers on each category under a) and then provide a total number in b).

INDIRECT: a) Description 20,449 WRA will disseminate knowledge to girls (10-14 years) and older women (49 years+) who will in turn inform others. These groups form approximately 15% of the total population of approximately 100,000.

b) Number 35,449

5.6 PROJECT APPROACH / METHODOLOGYPlease provide details on the project approach (or methodology) proposed to address the problem(s) you have defined in section 5.3.How will the project work at the community level? Please justify the timeframe and scope of your project and ensure that the narrative relates to the logframe and budget.If this project is based on similar project experience, please describe the outcomes achieved and the specific lessons learned that have informed this proposal.

Women’s groups using PLA and focusing on MNH can dramatically reduce maternal and newborn deaths and catalyse improvements in the demand, delivery and quality of maternity services. Based on the three delays model (delays in i. deciding to seek care, ii. reaching the place of care and iii. receiving adequate care once there) we will use a three pronged approach - PCP’s community based demand side intervention will reduce the first and second delays and health system strengthening and advocacy will address the third delay.Prong 1 - Women’s groups: The main approach focuses on the establishment of 194 women’s groupsthrough which we willmobilise communities for better MNH care. The women’s groups will be led by facilitators who are local WRA with at least high school level education, recruited and trained by PCP. These facilitators will convene a cycle of around eight monthly meetings on MNH and each facilitator will be responsible for four women’s groups. She will guide the women’s groups through a four-phased community action cycle, in which she will activate and support the groups to identify and prioritise MNH problems (phase 1), plan strategies to address these problems (phase 2), and implement (phase 3) and self-evaluate (phase 4) these strategies. At the end of phase 2 and the start of phase 3 community meetings will be held to engage the wider community in the development and implementation of the strategies. The facilitators will use picture cards and flip charts to stimulate discussion and will receive training in participatory communication methods and in basic MNH. Coverage is an important element of a successful PLA approach. From our own previous project experience in Bangladesh with one women’s group per 1414 population, newborn mortality fell by just 7% (Azad et al, 2010), but when scaled to one women’s group per 300 population, mortality reduced by 38% (Fottrell et al, 2013). Based on this, and learning from other projects in South Asia and Africa, we have opted for coverage of one women’s group per 500 population(Prost et al, 2013; Fottrell et al, 2013). The women’s groups develop the strategies, which vary between groups and settings depending on local priorities. Examples of popular strategies include MNH awareness raising, emergency funds and transportation.Prong 2 - Health system strengthening: PCP will build links between the women’s groups and community health committees and clinics to strengthen the referral system. PCP will do this by encouraging women’s groups’ facilitators and members to participate in government mandated health committee meetings at the union, upazila and district levels to ensure optimum utilization of existing health facilities and to ensure that health committee members are aware of and address the MNH issues facing women in the community.Prong 3 – Advocacy: We will advocate for improved quality services and for increased participation of rural women in the health committees (above). We will also focus on sharing local MNH information, data and case studies with government staff, NGOs, CBOs, Imams and teachers.

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5.7 SUSTAINABILITY OF BENEFITSHow will you ensure that the poverty reduction benefits for the beneficiary population will be sustained?

The beneficiary communities are important partners and the majority of the project will be implemented through existing community structures/ actors (women’s group facilitators, health committeesetc). These are considered to be the most appropriate to engage to ensure local relevance, acceptance, ownership, cost effectiveness and longer term sustainability.Women’s groups – by using a PLA approach sustainability is integrally addressed because communities identify local problems, devise local solutions and mobilise the resources required locally. The funding for PCP’sMNH RCT on women’s groups in Bogra, Faridpur and Moulavibazarceased in early 2013 and anecdotal evidence indicates that most of the groups are still meeting and their strategies, especially emergency funds, are still functioning. Evidence from another WCF partner in Nepal also demonstrates that 75% of the women’s groups continue to meet and function five years after external funding ceased. Devising strategies for reaching health facilities and establishing village funds appear to be important mechanisms for sustaining post-project benefits. We also hypothesise that there are intergenerational benefits as many of the community children and adolescents attend the groups with their relatives.Health system strengthening - We will work within existing community structures which will contribute to a high potential for sustainability. We will support the upazila health complex at the sub-district level and district MCWC, general hospital and medical college hospital to continue to support community-facility linkage including after the project has ended.Strengthened linkages and improved communication with community health committees and clinics, healthcare providers and the community will result in increased confidence of local women in using facilities. We anticipate this will congtribute to the community being more likely to access MNH care and servicesin the longer term.Advocacy: we will combine i. opening a channel for community leaders to press for improved MNH services, holding service providers to account; ii. Astrategic approach contributing to the implementation of GOB’s MNCH policies iii. ensuring lessons learnt are shared with decision makers.

5.8 SCALING-UP AND REPLICABILITYWhat is the potential for future continuation, replication or larger-scale implementation of the proposed intervention? Please provide details of any ways in which you see this initiative leading to accessing other funding or being scaled up by others in the future. Describe how and when this may occur and the factors that would make this more or less likely.

There is a high likelihood of successful continuation. OurMNH work elsewhere in Bangladesh has generated positive results and is gaining interest from others - e.g.PCP is in discussions with Helen Keller International and BRAC re potential collaboration and scale up.Our support for theupazila health complex at the sub-district level and MCWC, general hospital and medical college hospital, linking communities and health staff at the community clinics, will contribute to the likelihood of project gains being maintained. The advocacy element of the project will enablePCP and the communities to advocate at the local level for continued improvements for services and community MNH support using locally generated data and case studies. Women’s group members elsewhere have been elected on to community clinic committees and to stand on the local union parishad (rural administration) and are influencing local MNH issues on the basis of what they have gained from PCPs women’s groups and it is likely this will happen during this project.The model proposed is based on a methodology that has already been replicated and tested for scale up, achieving significant results in Bangladesh (Nahar et al 2012), India and Malawi. PCP itself has implemented the approach at scale in Bangladesh with a significant effect on newborn mortality rates (Fottrell et al, 2013). . The model is highly attractive for replication and scale up elsewhere due to its demonstrated cost-effectiveness (ibid) and potential for saving maternal and newborn lives. When extrapolated to rural areas ofthe 75 countries where more than 95% of all maternal and child deaths occur, the overall impact of the women’s group’s intervention compares well to others and could save an estimated 283,000 newborn deaths and 41,100 maternal deaths each year (Prost et al, 2013).

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5.9 CAPACITY BUILDING, EMPOWERMENT & ADVOCACYIf your project includes capacity building, empowerment and/or advocacy components, please explain how these elements will contribute to the achievement of the project's outcome and outputs? Please also refer to the Additional guidance for GPAF Initiatives focused on Empowerment & Accountability

This project builds the capacity of communities to organise and mobilise to take individual, group and community action to address the structural and intermediary determinants of health. Capacity building, empowerment and advocacy are all central to the project, addressing the elements of choice, challenge and change. WCF will provide ongoing advocacy support and build PCP’s capacity to work in a gender sensitive way gender capacity (see section 5.10). Output one directly focuses on empowering women (in groups) to recognise and address MNH challenges and access appropriate care. The women are provided with relevant information so that they can make individual informed decisions regarding the importance of attending ANC visits and PNC; birth preparedness including good nutrition; how, why and where to deliver at a health facility; and how to engage wider male and family support. MNH will improve through behaviour change including improved hygienic home delivery practices, newborn thermal care and breastfeeding practices (Fottrell et al, 2013). Output two will strengthen community capacity (linking women’s groups with community health committees and clinics) to support mothers and their families within the community to challenge and claim their rights and entitlements. Women’s group facilitators and members will be encouraged to participate in health committee meetings at the union, upazila and district levels to ensure optimum utilisation of existing health facilities and to ensure that health committee members are aware of and address the MNH issues facing women in the community. Output three will build community capacity to advocate for improved quality services and for increased rural women’s participation in health committees. We will share local MNH information and case studies with government staff, NGOs, CBOs and local leaders ensuring that evidence, best practice, community voices and datareach decision makers.5.10 GENDER AND SOCIAL INCLUSION

How was the specific target group selected and how are you defining social differentiation and addressing any barriers to inclusion which exist in the location(s) where you are working? Please be specific in relation to gender, age, disability, HIV/AIDs and other relevant categories depending on the context (e.g. caste, ethnicity etc.). How does the project take these factors into account?

The project is aimed specifically at WRAandpregnant women, and is designed to meet the MNH needs of women and their newborns through increased empowerment, critical consciousness and decision-making abilities. The PLA project design is widely seen as a valuable contributor to women’s individual and collective empowerment. All women in the community will be encouraged to join the groups, particularly WRA and especially newly married as well as newly pregnant women – who benefit most from the intervention in the short term, while non-pregnant WRA will benefit in future pregnancies. It is expected that other women will also join (sisters, mothers, and mothers-in-law); in addition to the community meetings men have also been known to join in and assist where appropriate.We have direct experience in Bangladesh of increasing participation of pregnant women in women’s groups from 3% to over 30% (see Section 5.6). This is an important factor – the participation of at least one third of pregnant women in the communitycoupled with adequate population coverage has been shown to lead to reductions in maternal mortality by up to 55% (Prost et al, 2013). We will undertake home visits to target the more marginalised members of the community including adolescent girls and disabled girls and women to provide greater community support. Evidence from India also indicates that working with women’s groups successfully reaches the most marginalised and excluded women in the community (Houweling et al, 2013).1. Gender – Although we believe it is important that the facilitators are female, especially when

addressing sensitive MNH issues, improving MNH requires input from the whole community. We will work with men and boys, sensitising husbands, fathers, and brothers to the issues and engaging them through specific inclusive activities within the women’s groups’ action cycle. We will also engage the support of males within the traditional leadership and existing community structures at

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the project outset and through community meetings. The initial community sensitisation meetings, during the project start up phase, will involve key male and female community leaders. This is essential to ensure buy-in to the project and ensure that where necessary women are permitted to attend by male relatives (particularly husbands) and because men are often key to implementing the women’s group solutions e.g. they will ride the bicycle ambulance. The project will benefit from a systematic gender analysis to ensure men are engaged the most appropriately. A WCF genderexpertwill conduct training with the PCP team in gender analysis and planning to improve programming and advocacy.

2. Age – Mothers-in-law and older women can act as a barrier to younger women attending and/ or participating fully in the women’s groups. To address this PCP has developed a system of “secret mothers” who work specifically with younger women one-to-one and encourage older women to engage with younger group mothers.

3. Class – the members of the women’s groups and community health committees are from the same community so there is little class differentiation so this has not been a significant challenge.

4. Disability – Where a disability could prevent a woman leaving the home women’s group members conduct home visits to provide them with the required support.

5. HIV/ AIDS – Bangladesh is a low HIV prevalence country, with HIV mostly confined to at risk populations who are not targeted by this project. As such women’s groups do not specifically focus on HIV and AIDS. However, the role of women’s groups in fostering empathy and understanding while tackling MNH problems within the community could indicate potential for addressing the stigma associated with HIV in Bangladesh by using this approach.

6. Cultural practices – In some areas improving MNH is hindered by cultural practices such as arranged and child marriages. Bangladesh has one of the highest rates of child marriagein the world, with 20% of girls becoming wives before their 15 th birthday (BBC News, 2012). Women in early pregnancy (i.e. first trimester) are often not allowed to participate in the women’s groups by family members or because they themselves fear the evil eye, believed to cause miscarriage. By working within community structures and where necessary conducting home visits to support younger more vulnerable girls and early pregnancies, we will provide information to the wider family about the disadvantages of such practices, especially related to the increased health risks.

5.11 VALUE FOR MONEY (VFM)Please explain why you believe that the proposed project would offer optimum value for money. How have you determined that the proposed approach is the most cost efficient way of addressing the identified problem? Please ensure that your completed proposal and logframe demonstrate the link between activities, outputs and outcome, and that the budget notes provide clear justifications for the inputs and budget estimates.

This £249,843 projectwill improve knowledge of best practice MNH care in the community, change behaviour and reduce newbornand maternal death rates. This intervention is highly cost effective according to World Bank and WHO criteria – the cost effectiveness of the RCT this project is based on was US $220 to $393 per year of life lost averted. (Fottrell et al, 2013). Poverty at the community level will be reduced because the project design focuses specifically on the prevention of MNH problems (through hygiene, infant feeding, social supportetc) and the underlying causes of mortality which affect women, men, boys and girls (e.g. social isolation, poor nutrition, dangerous traditional practices, delays in seeking care). The community level solutions are virtually cost-free for the target groups, once they have taken them on board. We will work within existing community structures which will contribute to a high potential for sustainability. Our successful experience of working in partnership on similar projects suggests it is low risk, including the potential for corrupt activities. In addition this project delivers value for money in the following ways:a. Economy – we will minimise the cost of inputs by: working with incentivised women’s group

facilitators instead of paid facilitators; minimising start up costs – PCPis familiar with the approach, having delivered such an intervention before and has already streamlined its management team. Existing staff are familiar with this project methodology and have strong relationships in Bogra already, and we will use and adapt pre-existing M&E systems.We will adapt existing training and

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meeting manuals and other materials so set up costs will be low and quotes for all capital purchases will be obtained before purchase.

b. Efficiency – we will maximise the number of communities reached by: working with community volunteers (women’s groups members) while also providing the required coverage to achieve results; working with existing systems;locating the project within the communities; working with traditional leaders to develop and implement the project ensuring buy-in and community ownership; monitoring the women’s groups’ strategies and disseminating learning and best practice from the project using appropriate methods. Improving the MOH’s referral systems and raising staff/management awareness will also improve efficiency.

c. Effectiveness - The impact on MNH and death rates is highly cost effective (as above). The health system strengthening and advocacy elements of the project empower the communities to use the community MNH data to demand better quality services and hold decision makers to account.

5.12 COUNTRY STRATEGY(IES) AND POLICIESHow does this project support the achievement of DFID’s country or regional strategy objectives? How would this project support national government policies and plans related to poverty reduction or other key sectoral areas?

This project directly supports DFID’s focus on reducing deaths in childbirth and overall support for RMNCH (Bangladesh operational plan, 2011-2015). The project is aligned with DFID’s support for basic social services, in particular to improve maternal health, including through continued support for civil society provision for the poorest and most marginalised. The project supports DFID’s focus on improving the social status of women, especially relating to reproductive health and DFID’s specific focus on ensuring that 1.2m births will be assisted by 2015. Through the women’s groups and community health committees and clinics we will also include information on vouchers for poor pregnant women to deliver in facilities (supported by DFID). Our scientifically proven and published evidence base also supports DFID’s focus on scaling up tried and tested approaches and modalities. Data from the 2010 Bangladesh maternal mortality survey show significant progress over the last decade and our own data also demonstrates a general increase in institutional deliveries, indicating that some GOB evidence based strategies are working to a certain extent (DFID 2012) (see Section 5.3). The rights-based comprehensive National Maternal Health Strategy (2001) is currently under review, and will be integrated into the third Health Population and Nutrition Sector Development Program (HPNSDP).A maternal health strategy taskforce has been developed, and a series of consultation processes have taken place to draft the new maternal health strategy which is now in its final stages. Learning from the RCT, which this project is based on, has been fed into this consultation process. If the timing of the new maternal health strategy permits we will also endeavour to use learning from this project to inform GOB policy implementation.The current Ministry of Health and Family Welfare (MOHFW) Health Population and Nutrition Sector Development Programme(HPNSDP) (2011-2016)focuses on demand creation and improving access to and utilization of MNCH services to reduce morbidity and mortality, particularly among infants, children and women and improve the nutritional status of women and children. This project supports the delivery of the HPNSDP and we will endeavour to use project learning to influence the development of the post 2016 HPNSDP where possible. In 2009 the National Neonatal Health Strategy and Guidelines (NNHS) were developed under the stewardship of the MOHFW, underscoring the GOB’s commitment to achieve MDG 4. This strategy acts as the GOB framework for strengthening neonatal services to reduce neonatal mortality and morbidity. PCP chaired one of the NNHS working groups, and this project’s focus on newborns will support its delivery.5.13 ENVIRONMENT

Please specify what overall impact (positive, neutral or negative) the fund is likely to have on the environment. What steps have you taken to assess any potential environmental impact? Please note the severity of the impacts and how the project will mitigate any potentially negative effects.

The project is not expected to have negative environmental impacts. The project’s own carbon

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footprint will be minimised by use of electronic communications and mobile phone data collection and locating the project team near to the communities. International travel will be minimal.

SECTION 6: PROJECT MANAGEMENT AND IMPLEMENTATION6.1 IMPLEMENTING PARTNERS

Please provide a list of all organisations to be involved in project implementation including overseasoffices of the applicant and any partners starting with the main partner organisation(s). Please only include those partners that will be funded from the project budget. Please provide full details for each of the partners in section 9.

Women and Children First (UK); Perinatal Care Project (PCP) of the Diabetic Society of Bangladesh

6.2 PROJECT MANAGEMENTPlease outline the project implementation and management arrangements for this project.This should include: A clear description of the roles and responsibilities of the applicant organisationand each

of the partners. You must also provide an organogram (in a separate document) of the project staffing and partner management relationships.

A clear description of the added value of each organisation (including the applicant). An explanation of the human resources required (number of full-time equivalents, type,

skills, background, and gender).

WCF will be responsible for overall contract management and ensuring the project is delivered efficiently and effectively. WCF will provide support and technical assistance on project delivery, advocacy and gender analysis. WCF will monitor project progress at a distance monthly and receive and check quarterly financial and narrative reports, processing financial claims and transferring funds in a timely fashion and providing feedback to PCP as appropriate. Monitoring visits will be carried out once a year. WCF will disseminate learning from the project in the UK and more widely. WCF will manage the final evaluation. WCF’s value added is to: provide design expertise; facilitate PCP’s understanding of DFID sector priorities and VFM; use its expertise in gender analysis to maximise male involvement, support advocacy strategy development and messaging to influence MOHFW, civil society, multilateral organisations, think tanks and research bodies; provide guidance and support for the development of advocacy materials to be used for influencing; share cutting edge research and relevant learning from other WCF programmes and other leading practitioners in MNH to inform PCP’s delivery of the programme and own capacity development; and work with PCP to mitigate any risks to success encountered during project delivery. Human resource requirements are:1 Programme Manager (0.20 FTE, existing role, female) – overall project management (including financial), technical assistance, reporting to DFID. Over 10 years experience managing policy and programmes in Africa and Asia. MSc in Development Studies (specialisation gender); 1 Technical Advisor (20 days) for advocacy and gender analysis training and ongoing support; 1 Administrator (0.05 FTE, existing role, female) – administration associated with the project; 1 Accountant (0.02 FTE, existing role, female) – budgeting and financial reporting; 20+ years organisation and project accounting.PCPwill be responsible for overall project design and project execution, including recruitment and management of staff, coordination with other stakeholders and partners, implementation of project activities and reporting. PCP value-added: PCP will use its 11 year partnership with the MOH, its relationship with the community, position on various technical working groups and excellent contacts to facilitate project coordination and implementation. PCP has experience of implementing women’s groups and health system strengthening interventions to deliver results and is well known locally for generating high quality evidence, also used in advocacy efforts.Human resource requirements are:1 Project Director (0.15 FTE, existing role, female)-strategic guidance, overseeing implementation and evaluation, advocacy, supervision of key staff and budget; Project Manager (0.15 FTE, existing, male) – Coordination of activities, overseeing progress, advocacy and report preparation; Field

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Surveillance Manager (0.20 FTE, existing, male) – Coordination of monitoring and surveillance activities including field data collection using mobile phones; Participatory Women’s Group Manager (0.20 FTE, existing, female) – Coordination of women’s groups activities including trainingfield staff; Finance &Accounts Assistant Manager (0.15 FTE, existing, male)- budgeting and financial reporting; Office Assistant (1.00 FTE, existing, male)- Assist in office management tasks; Process Evaluation Officer (0.20 FTE, new, female)- Documentation, analysis of monthly process evaluation reports and conduct qualitative study (FGDs and in-depth interviews); District Manager (1.00 FTE, male) – Management of the project activities in Bogra and coordination of activities between district and head office; Women’s Group Coordinator (1.00 FTE, new, female) – Supervision of the women’s group supervisors and facilitators; Monitoring Coordinator (1.00 FTE, new, male) – Supervision of Monitors and quality checking of data collection; Women’s Group Supervisors (1.00 FTE, 3 newfemales)- Assist the community facilitators to organize the women’s group meeting and provide training; Monitors (1.00 FTE, 3 new females)- Interview the mothers on mortality and gather data on delivery and newborn care practices;Office Assistant (1.00 FTE, new, male)- office duties.

6.3 OTHER ACTORSInclude details of any other key stakeholders or collaborative partners who will have a role in the project (but will not be funded from the project budget). How does this intervention link to or integrate with other programmes especially those of other government agencies?

PCP’s workin Bogra since 2002 has resulted in strong links with field level government staff, particularly at community clinics, union health and family welfare centres and upazila health complexes – we will work with each of these partners to implement the project. The beneficiary communities will also be important partners and the majority of the project will be implemented through existing community structures/actors (women’s group facilitators, health committees, community clinics etc). We have collaborated with the Bangladesh Neonatal Forum and Bangladesh Perinatal Society to develop our programmatic resources (flip chart and training materials). This project links to/ integrates with the following programmes operating in Bogra district: i. BRAC - which is selling subsidised clean birth delivery kits in the project area; ii. USAID funded NGO Health Service Delivery Project (NHSDP), working with a partner NGO (BAMANEH) offering MNCH services from their static and satellite clinics; and iii. Saving Newborn Lives (SNL) and the Maternal and Child Health Integrated Program (MCHIP) of Save the Children to help us to exchange ideas and engage in advocacy efforts.We also aim to continue our collaboration with the Civil Surgeon, Directorate General of Health Services (DGHS) and Directorate General of Family Planning (DGFP) including the Deputy Director at the district headquarters to ensure buy-in and to share lessons learned nationally.

6.4 NEW SYSTEMS, STRUCTURES AND/OR STAFFINGPlease outline any new systems, structures and/or staffing that would be required to implement this project. Note that these also need to be considered when discussing sustainability and project timeframes.

At the PCP Dhaka office, existing staff except a newly recruited Process Evaluation Officerwill manage and implement this project. The PCP Bogra district office closed in June 2013 (as the RCT came to an end) so we will recruit new field staff. We anticipate that some of the applicants for these new district positions may be former PCP Bogra district staff but we will conduct an open and competitive recruitment process. The main system changes concern 1. Using mobile phones for data collection rather than using questionnaires (saving time and avoiding human error); 2.Using incentivised facilitators instead of paid facilitators and 3. Ensuring a population coverage of one women’s group per 500 population (as above). We have reduced the project to 30 months because we feel this will include adequate time to conduct all the training necessary, to implement the women’s groups and health system strengthening interventions and allow time for advocacy and dissemination.

SECTION 7: MONITORING, EVALUATION, LESSON LEARNINGThis section should clearly relate to the project logframe and the relevant sections of the budget.

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Please note that you will be required to undertake a project evaluation towards the end of the funding period to assess the impact of the fund. Please allow sufficient budget for monitoring and evaluation (M&E) and note the requirements for external and independent evaluation.7.1 How will the performance of the project be monitored? Who will be involved? What tools and

approaches are you intending to use? How will your logframe be used in M&E? What training is required for M&E? How will you ensure that beneficiaries and other stakeholders have opportunities to feed back on project implementation?

We will monitor the performance by using monthly process evaluation reports that will gather detailed information about the intervention including women’s group activities. The PCP district office will send the report to head office and the process evaluation officer will be responsible for analysing the information and providing feedback to respective teams for further improvement of the women’s groups’ intervention. The Process Evaluation Officer will also conduct focus group discussions(FGD) and in-depth interviews with the beneficiaries to assess the effectiveness of the project. Case studies will be collected by the project staff.The M&E team will use an existing low-cost prospective surveillance system to record all deaths during pregnancy up to 6 weeks post-partum and all births and their outcomes (live birth, stillbirth, neonatal death) in the three project implementation unions. This process of birth and death surveillance will provide the essential information to measure trends in mortality rates (total, early neonatal mortality and late neonatal mortality), stillbirth rate, perinatal mortality rate and pregnancy-related mortality rate throughout the period of implementation. The Field Surveillance Manager and Data Manager at the Dhaka Office will be responsible for monitoring activities with the help of M&E staff in the field. The District Manager will conduct regular field visits, document the findings and compile monthly and quarterlyreports. Staff from the Dhaka officewill conduct fieldvisits and share the findings with the field staff to reduce any gaps. A quarterly performance review meeting will be held to monitor progress and improve performance, including monitoring phone calls with WCF.Field level M&E staff will be provided the necessary training on mobile phone data collection.No other M&E training will be needed because existing staff are familiar with the M&E system.We will prepare periodic reports based on the qualitative and qualitative data collection and share the findings with the beneficiaries and stakeholders to improve performance.

7.2 Please use this section explain the budget allocated to M&E, and to demonstrate that there is adequate budget provision to support the M&E processes described in 7.1. The budget must include provision for an independent external evaluation.

The M&E budget covers costs for the Process Evaluation Officer, Field Surveillance Manager and Data Manager at the head office and for the Monitoring Coordinator and Monitorsat the district office and key informants. We have successfully used Traditional Birth Attendants (TBA) to identify women that give birth and deaths of WRA within a geographical area of around 200 households. An adequate budget has been allocated for qualitative study (FGDs and in-depth interviews). Costs have also been allocated for purchasing mobile phones and for training of M&E staff on mobile phone data collection and for database development. An independent external evaluation has been budgeted for.

7.3 How will lessons from your project be identified and learned, and disseminated to a wider audience? - Please explain how the learning from this project will be used within your organisation and disseminated to others.

Identifying and sharing lessons learnt is a key component particularly for advocacy. Lessons and key changes will be identified through community open days and testimonies. We will document case studies illustrating Bogra specific MNH challenges and solutions – of particular interest to local decision makers. Learning will be disseminated at community open days; district and national level dissemination events in the final year of the project; using the WCF and PCP websites (www.womenandchildrenfirst.org.uk; http://www.badaspcp.org/); we will produce a final evaluation report and disseminate this to key stakeholders including MOH; through the quarterly WCF newsletter; using the WCF Facebook and Twitter pages (@WCF_UK); through WCF partners in Africa and Asia; andwe will encourage local journalists to visit the project areas to generate media interest. Internally,

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lessons and learning will be shared at staff and board meetings (quarterly) for both PCP and WCF.

SECTION 8: PROJECT RISKS AND MITIGATION8.1 Please outline the main risks to the success of the project indicating if the potential impact and

probability of the risks are high, medium or low. How will these risks be monitored and mitigated? If the risks are outside your direct control, is there anything you can do to manage their potential effects? If relevant, this may include an assessment of the risk of engagement to local partners. The risk assessment for your programme needs to clearly differentiate the internal risks and those that are part of the external environment and over which you will have less (or little) control. (You may add extra rows if necessary - as long as you do not exceed the overall page limits).

Explanation of RiskPotential

impactHigh/Mediu

m/Low

ProbabilityHigh/

Medium/LowMitigation measures

Community may not respond/ be interested in engaging E

High Low Develop the project in line with requests from the community

Health staff atthe community clinics may be disinterested or disallowed from engaging with the project E

High Low Ensure health staff understand the benefits and identify means to motivate them

Increased demand cannot be met adequately at health facilities E

High Medium Advocate for improved quality services. Collect community data to enable facilities to respond better to community needs

PCP staff turnover may be high I Medium Low Ensure adequate budget for recruitment, orientation, training and follow up

PCP staff may be exposed to hostility from healthcare providers for advocating on behalf of communities I

Medium Low Ensure staff are well versed with messaging to justify their work

Community health committees may be unreceptive to women’s group member participation I

Medium Low Maximise opportunities through strong supportive individual members

Changes in the political environment including general strikescausing disruptionE

Medium Medium Strengthen existing structures which will remain in place despite political changes and allow sufficient time to implement project activities accounting for scheduling changes

Seasonal and weather disruption e.g. flooding E

Medium Medium Allow sufficient time to implement project activities accounting for scheduling changes

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SECTION 9: CAPACITY OFALL PARTNER ORGANISATIONS (Max 3 pages each)Please copy and fill in this section for each partner organisation identified in section 6.19.1 Name of Organisation Women and Children First (UK)

9.2 Address United House, North Road, London, N7 9DP

9.3 Web Site www.womenandchildrenfirst.org.uk

9.4 Registration or charity number (if applicable)

1085096

9.5 Annual Income (from latest set of approved accounts)

Income (original currency): £948,579Income (£ equivalent): £948,579Exchange rate: N/AStart/end date of latest set of approved accounts (dd/mm/yyyy)From: 01/01/2012To: 31/12/2012

9.6 Number of existing staff 4.2 FTE

9.7 Proposed project staffing staff to be employed under this project (specify the total full-time equivalents - FTE)

Existing staff Programmes Manager 0.2 FTEAdministrator 0.05 FTEAccountant 0.02 FTE

New staff Technical Advisor (20 days)

9.8 Partner organisation category (Select a maximum of two categories)

Non-Government Org. (NGO) x Local Government

Trade Union National Government

Faith-based Organisation (FBO) Ethnic Minority Group or Organisation

Disabled Peoples’ Organisation (DPO) Diaspora Group or Organisation

Orgs.Working with Disabled People Academic Institution

Other... (please specify)

9.9 A) SUMMARY OF EXPECTED ROLES AND RESPONSIBILITIES OF THIS PARTNER, ANDB) AMOUNT OF BUDGET (GBP) MANAGED BY THIS PARTNER

A): (i) Providing Technical Assistance to include: Facilitating PCP’s understanding of DFID sector priorities (RMNH) and how to deliver VFM

within the project Facilitating learning process, including an annual stakeholder consultation and development

of operations research, and ensuring learning is fed into plans for following project year Using its expertise to train PCP and provide ongoing support in advocacy and development of

related advocacy materials to influence decision makers Using its expertise to train PCP in gender analysis and planning to improve programme and

advocacy performance Sharing relevant learning from other WCF programmes and other leading practitioners in

MNH to inform PCP’s delivery of the programme and own capacity development Working with PCP to mitigate any risks to success encountered during project delivery

(ii) Responsibility for overall contract management and project administration, including: Ensure the project is delivered as per proposal, log frame and budget Ensure reports are properly prepared and submitted to DFID in a timely fashion

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Process financial claims and transfer fundsB): Amount of budget allocated to WCF : £64,695 Percentage of budget allocated to WCF : 26%9.10 EXPERIENCE: Please outline the experience of your partner in relation to their role and

responsibility in this fund (including technical issues and relevant geographical coverage)

WCF has managed 20 major donor funded international programme and advocacy contracts and has been engaged in international programmes with governments, NGOs and other stakeholders since 2002. Our work spans both the demand and supply side of health systems and MNH is one aspect of our technical repertoire.Programmes which demonstrate our expertise and successes on the demand side include: Improving maternal and newborn health in low income countries, India and Bangladesh:

2008-2013. The portfolio of projects in this strategic programme is working towards coverage of effective interventions in three districts in Bangladesh and two states in India and to influence maternal and child health policy and practice in Asia and Africa through international and national workshops with policymakers. The project resulted in a 38% reduction in newborn death rates in Bangladesh (Fottrell et al, 2013) and a 31% reduction in newborn death rates in India (Tripathy et al, 2013) as well as improved home delivery practices and increases in antenatal care visits (ibid.). WCF has led on the development a “Good Practice Guide” to facilitate spread and scale up of the women’s groups methodology by other actors which has been taken up by actors including NGOs, academic institutions and technical agencies in Asia, Africa and the Americas.

Improving maternal and newborn health through health system strengthening and community mobilization, Malawi: 2010 – 2015. In collaboration with the Directorate of Nursing Services at MOH Ntcheu, Malawi. 144 women’s groups have been led by Health Surveillance Assistants trained to facilitate the groups as part of their ongoing duties, thus ensuring a high level of sustainability. The local WCF project manager was successful in promoting HSAs running groups and group facilitation is now included in the MOH HSA training curriculum. The project has built the District Hospital’s capacity to collect data on maternal and newborn health which is now instrumental in hospital decision-making. A low cost population level data collection system has been established to support health service planning as well as an informal referral service to ensure the timely provision of skilled care. A high level of commitment has been gained from the Traditional Authorities in the district.

Improvement in the quality of maternal and newborn care, Malawi: 2006-2012. WCF provided technical assistance to the community intervention arm of this 6-year programme which combined community mobilisation with quality improvement (QI) in health facilities. 802 women’s groups led by volunteer community-based facilitators achieved a 16% reduction in perinatal mortality in community intervention (CI) areas and a 22% reduction in newborn mortality in areas where CI was coupled with QI (Colbourn et al, 2013).

Two programmes have also worked to improve care, make it more accessible and sustain outcomes on the supply side beyond the end of a funded programme: Improving maternal, newborn and child health for the poorest in Mumbai (India) through

promoting access to quality basic health services: 2010-2011. This DFID funded project improved the provision of basic health service delivery for women and children in slum areas in Mumbai. The project, delivered by SNEHA with technical support for project delivery, advocacy and communications provided by Women and Children First, facilitated scale up of the provision of free MNH services through health posts, established MNH referral systems across Mumbai, and improved MNH state policy and implementation through advocacy and communications.

Perinatal Training and Resource Centre, Nepal: 2002-05. In collaboration with the Nepal Training Institute, this project established a national Perinatal and Resource Training Centre in Kathmandu, developed training materials on safe motherhood and essential newborn care, and designed training courses for all cadres of staff approved by government. In addition, all cadres of staff in Makwanpur district were trained in safe motherhood and essential newborn care.

9.11 FUNDING HISTORY Please provide a brief summary of your partner(s) funding history.19

Funding sources for the last 12 months include: DFID – Improving Maternal and Newborn Health for 52,976 Women and 11,517 Neonates in

Nkhotakota District, Malawi - £249,911 – 2013 – 2016 (subject to due diligence) Big Lottery Fund - £10,000 Planning Grant to plan an MCH project in Gulu District with AMREF

Uganda - 2013 Big Lottery Fund - Strategic Grant, Improving maternal, newborn and child health in low-income

countries (India and Bangladesh) - £803,876 – 2008-2013 Comic Relief - Improving maternal, newborn and child health (Malawi) – £387,945 – 2010-2013 Comic Relief - Improving maternal, newborn and child health (Malawi) -£175,734 – 2013 - 2015 Comic Relief - Organisation Development Grant (UK) – £39,160– 2011-2012 Comic Relief - Planning Grant (Ethiopia) – £53,338– 2012 UNFPA - MDG 4 and 5 advocacy (UK) - $10,000 - 2013 Conservation Food and Health - Jut: increasing the update of family planning in Mumbai’s slums

(India) - $50,000 – 2012-2013 The Health Foundation – Improving maternal and newborn health (Malawi) - £42,000 for TA

provision – 2007-2012 Ernest Kleinwort Charitable Trust – Unrestricted funding - £25,000 - 12 months from May 20129.12 CHILD PROTECTION (funds working with children and youth (0-18 years) only)

What is this partner's capacity and experience in relation to child protection? How will you work with your partner(s) to ensure children are kept safe?

Not applicable for this project, but WCF has a Child Protection Policy, available on request.9.13 FRAUD: Has there been any incidenceof any fraudulent activity in your partner organisation

within the last 5 years? How will you minimise the risk of fraudulent activity occurring?

No. Women and Children First has a comprehensive Financial Policy and Procedures Manual which has a comprehensive description of internal controls which are applied by the Finance Officer and monitored regularly by the Chief Executive. The Board’s Finance and Administration Committee has ultimate oversight over finance and administration arrangement. An operating budget is agreed by the Board at the beginning of each year and management accounts and a cash flow forecast, including information on use of restricted funds clearly set out per project, are prepared monthly. These are distributed to the Treasurer and other members of the Finance and Administration Committee who scrutinise them on receipt and meet quarterly to discuss any issues arising. The organisation is audited annually by a respected firm of auditors who are highly experienced in working with charities. Women and Children First also has an Anti-Bribery and Corruption Policy which is reflected in its MOUs with partners.

SECTION 9: CAPACITY OF ALL PARTNER ORGANISATIONS (Max 3 pages each)20

Please copy and fill in this section for each partner organisation identified in section 6.19.1 Name of Organisation Perinatal Care Project (PCP) of BADAS

9.2 Address Room No- 390, BIRDEM Building122 KaziNazrul Islam AvenueShahbagh, Dhaka-1000, Bangladesh

9.3 Web Site http://www.badaspcp.org

9.4 Registration or charity number (if applicable)

N/A

9.5 Annual Income (from latest set of approved accounts)

Income (original currency): Tk. 54,259,000Income (£ equivalent): £452,158Exchange rate: £1=120 TkStart/end date of latest set of approved accounts (dd/mm/yyyy)From: 01/01/2012To: 31/12/2012

9.6 Number of existing staff 14 FTE

9.7 Proposed project staffing staff to be employed under this project (specify the total full-time equivalents - FTE)

Existing staff Project Director 0.15 FTEProject Manager 0.15 FTEField Surveillance Manager 0.20 FTEWomen’s Group Manager 0.20 FTEFinance &Accounts Assistant Manager 0.15 FTE

New staff Process Evaluation Officer 0.20 FTEDistrict Manager 1.00 FTEMonitoring Coordinator 1.00 FTEWomen’s Group Coordinator 1.00 FTEWomen’s Group Supervisors 1.00 FTE x 3Monitors 1.00 FTE x 3Office Assistant1.00 FTE

9.8 Partner organisation category (Select a maximum of two categories)

Non-Government Org. (NGO) Local Government

Trade Union National Government

Faith-based Organisation (FBO) Ethnic Minority Group or Organisation

Disabled Peoples’ Organisation (DPO) Diaspora Group or Organisation

Orgs. Working with Disabled People Academic Institution

Other... (please specify) A nonprofit voluntary socio-medical service organization. See details below.

9.9 A) SUMMARY OF EXPECTED ROLES AND RESPONSIBILITIES OF THIS PARTNER, ANDB) AMOUNT OF BUDGET (GBP) MANAGED BY THIS PARTNER

A): PCP will be responsible for overall project management and execution on the ground, including recruitment and management of staff, coordination with other stakeholders and partners, implementation of project activities and reporting. PCP will also ensure that the project is disseminated to all relevant stakeholders including advocating for further expansion into other vulnerable communities in Bangladesh.B): Amount of budget allocated to PCP : £185,147

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Percentage of budget allocated to PCP : 74%9.10 EXPERIENCE: Please outline the experience of your partner in relation to their role and

responsibility in this fund (including technical issues and relevant geographical coverage)

PCP is a project of the Diabetic Association of Bangladesh (BADAS).BADAS is a nonprofit voluntary socio-medical service organization registered with the Ministry of Social Welfare (MSW) under the Society’s Registration Act, 1860. BADAS has evolved as the second largest independent health care provider in Bangladesh after GOB, functioning as an extended arm of the GOB. BADAS has a close coordination with the GOB’s MOH, MSW, Ministry of Women and Children Affairs (MWCA) and MOF. The GOB provides development and financial support to BADAS through these Ministries, coveting approximately 8% of BADAS’ service provision costs. The bulk of BADAS’s income is from hospitals, laboratories and other services eg investigations. It subsidises services for poor diabetic patients by charging fees for those who are able to pay. Medical services are provided for all, not just diabetics.Roles and responsibilities between BADAS and GOB are set out in the following way: i. the GOB nominates three ex-officio members from the Ministry of Health and Family Welfare (MHFW), MSW and MOF to the BADAS governing national council – these members must be in the rank of at least Joint Secretary; ii. the development projects of BADAS, some of which are funded by the MOH and other ministries, are implemented under a joint project management mechanism approved by the GOB; iii. BADAS is required to align with GOB public health policy and health care initiatives. This relationship applies to the national, district, union and upazilla levels. Since BADAS is guided by the Society’s Registration Act to function as an autonomous body independent of governmental management, there is no need for a MOU with the MOH.PCP has been successfully delivering similar projects through two randomised control trials in the three districts of Bogra, Faridpur and Moulavibazar. Work started in 2002 and by 2009 PCP was managing the work in these three districts at scale (through 810 women’s groups in 18 unions). It has also contributed to strengthening local health services through training for doctors and TBA training in collaboration with professional bodies-Bangladesh Neonatal Forum and Perinatal Society of Bangladesh. It is currently engaged in a WHO funded project which is testing ways of delivering the women’s groups approach in a more streamlined manner than was the case during the RCTs and this project will benefit from that learning.PCP will bring its knowledge skills and expertise gained over the last 11 years. It has competent and committed team members who have substantial experience in project management, surveillance systems, data management, women’s groups intervention and field operations. Through its longstanding work in the field, it is very familiar with the context, the culture of the people the geographical areas proposed for the project, all of which will be of great benefit for the successful delivery of the project.PCP be responsible for managing the funds for implementing the project in 3 unions of Bogra district through its current financial management system and procedures. PCP will use its experience and skill to prepare financial reports as required. All financial activities are audited by recognized external audit firm each year. BADAS also conducts internal audit on regular basis.9.11 FUNDING HISTORY Please provide a brief summary of your partner(s) funding history.

PCP’s funding sources are: Big Lottery Fund Strategic Grant,Improving maternal, newborn and child health in low-income

countries (India and Bangladesh) £1,611,290 - 2008-2013 Wellcome Trust Strategic Grant-£361,000- 2010-2014 DFID & Economic & Social Research Council (ESRC), Build evidence to support equitable

improvement in newborn & maternal health in Asia and Africa (EquiNaM) -£21,622 - 2011-2014 European Commission, Genomic and lifestyle predictors of foetal outcome relevant to diabetes

and obesity and their relevance to prevention strategies in South Asian peoples (GIFTS) - £94,803- 2012-2014

WHO, Community Led Evidence-Based Action for Newborns (CLEAN) at Scale Through

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Participatory Women's Groups and Health Workers in Rural Bangladesh £157,260-2013-2016 Big Lottery Fund,Improving maternal, newborn and child health in low-income countries -

£333,000 - 2002-20079.12 CHILD PROTECTION (funds working with children and youth (0-18 years) only)

What is this partner's capacity and experience in relation to child protection? How will you work with your partner(s) to ensure children are kept safe?

PCP has worked safely with children and adolescent women since 2002. It has a Child Protection Policy, on which all project staff will be sensitised and supervised9.13 FRAUD: Has there been any incidenceof any fraudulent activity in your partner organisation

within the last 5 years? How will you minimise the risk of fraudulent activity occurring?

No. PCP follows the financial policy and procedures of BADAS, which comprehensively focuses on internal controls for managing all financial activities. PCP’s finance staff (Asst. Manager-Finance and Accounts) ensures that all financial activities are maintained as per the guidelines and procedures, which is regularly monitored by theBADAS Finance and Accounts Director. Both the Treasurer and Secretary General of BADAS approve all the financial transactions of PCP. Monthly and quarterly financial reports including the budget variance is prepared and submitted to the BADAS authority. PCP is audited annually by BADAS (internal) and also by a recognized external audit firm. Findings from the audit reports are shared with the responsible staff of the organization for further improvement and necessary actions, if required.

Project funding will be managed through BADAS-PCP bank accounts and project accountingsystem.

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