Over the next three years, GAIN and BSR will work together to improve women's nutritional health in Dhaka, Bangladesh, through education, behavior change, and better access to health services for girls in late adolescence (15-19 years) and women of reproductive age working in the garment industry.
This commitment will provide direct services to the women, including food supplementation, health and nutrition services, and how to advocate for better maternity protection and child care facilities in the workplace. Improving the nutritional health of female workers benefits the women, their families, especially their new born babies, infants and young children, as well as business. Return-on-investment in nutrition will result in a reduction of absenteeism and work accidents, and an increase in workforce productivity and retention. For women, this will lead to better health and higher income when paid per working day / product output. This will allow women to overcome the cost barrier to accessing healthier food and the partners will be exploring different models in which the costs of the healthier foods will be carrier or at least shared by the employers and international buyers. This includes designing the project design so that the main investments on healthier food will be made by factory managers where food or snacks are provided. The pilot will allow us to build the business case which will then make it easier for scaling up these investments by factory management in Bangladesh. Other models to be explored include where fortified foods could be offered at the workplace for subsidized costs, in line with the model BSR use for sanitary napkins distribution. Moreover, as the implementation costs of their education workplace programs (HERproject) are already fully covered by the private sector, international brands but also their suppliers, they aim to explore on how this model could work for the nutrition intervention beyond the education component.
The training component also works with the workers themselves to explore possible changes in practices that allow women to feed themselves and their children better without incurring impossible costs.
The program will also involve behavior change interventions developed by GAIN and BSR (and delivered by NGO partners whose costs are fully covered by private sector contributions), that will include training of peer educators and peer-to-peer outreach sessions with the female garment workers dealing with issues around maternal nutrition and health, infant feeding practices hygiene, safe water and sanitation, but it will also include activities related to improving access to appropriate health and nutrition services via the factory clinic and nurse (e.g. counselling, referrals) and empowering them to demand for these services.
In addition to nutritional supplements such as energy-dense and iron-rich foods or food supplements, target groups will receive training on 6 topics related to sexual and reproductive health, including personal hygiene, menstrual hygiene, maternal care, STI's and HIV, family planning as well as on nutrition and eating habits for themselves as well as on important child feeding practices.
This will be complemented with improved access to hand-washing stations and safe drinking water. Attention is being paid to workplaces that enable women to work with improved relationships between workers and management, and appropriate systems are in place to attend to women's health needs (e.g. the onsite clinic offers sexual and reproductive products). Availability and quality of day care facilities will be reviewed and needs and wants of female factory workers will be assessed and recommendations for improvements will be made.
Promoting the appropriate utilization of existing nutrition and health services, through improved access, connection or referral, is a key part of the program. Workplace clinics and onsite health care providers are also included in the training. All are critical to the empowerment of women, as is the impact improving nutrition will have on the women's productivity and incomes (i.e. of those paid per working day/ product output). Typical additional products facilitated by the program are sexual and reproductive related such as sanitary napkins. Food with higher nutritional value will also be an add-on and key element of the program. They also work together with the factory nurses to raise their awareness and competences related to sexual and reproductive health needs of women workers, which is critical given that a large percentage of factory employed nurses are not nurse educated and typically have community health training only.
Q1: Factory selection - to be nominated by HERproject participating brands based on a set of criteria defined by the partners.
Q2: Situational assessment and tools development - to be completed in 15-20 factories based on a set of tools developed by the partners.
Q3 and Q4: Capacity building and pilot in 4 factories - the in-factory pilot activities include training of peer educators, outreach activities implemented by the peer educators and factory management meetings.
After Q4: Mid-term review - based on pilot results to decide how to take best model forward
Q5-Q8: Roll-out best model to 25 factories - with factories nominated by HERproject participating brands based on a set of criteria defined by the partners.
Q5-Q8: Advocacy for improved workplace health and nutrition - targeted at national government and business associations.
Q2-Q8: Project monitoring and evaluation
Rates of malnutrition in Bangladesh are among the highest in the world. More than 54% of preschool-age children, equivalent to more than 9.5 million children, are stunted, 56% are underweight and more than 17% are wasted (meaning thin, having a low weight for their height). Bangladeshi children also suffer from high rates of micronutrient deficiencies, particularly vitamin A, iron, iodine and zinc deficiency.
Malnutrition among women is also extremely prevalent in Bangladesh. More than 50 percent of women suffer from chronic energy deficiency and studies suggest that there has been little improvement in women's nutritional status over the past 20 years (Food and Agriculture Organization of the United Nations (FAO), Bangladesh, 2010).
This commitment will target women working in the garment industry in Dhaka, Bangladesh. The garment industry is one of Bangladesh's biggest sources of income and employs 2.4 million people of which 84% are women. Almost half of these women are mildly to severely anemic and their children suffer various forms of malnutrition (Research Gate, Anemia among Garment Factory Workers in Bangladesh, 2013). The workplace will serve as a critical entry point for improving the nutrition of female workers in late adolescence (15 - 19 years) and women of reproductive age.