HKI has developed an approach called Nurturing Connections to address gender inequality and malnutrition in Bangladesh. It uses participatory activities over 6 months to challenge norms that contribute to malnutrition. Results from piloting it showed increased decision making power for women and support from husbands. Lessons showed to maintain it as peer groups, provide refreshments, and retrain facilitators. It can be adapted to other contexts like aquaculture training by integrating discussions on empowering women's roles and benefits. The approach aims to transform discriminatory gender norms through addressing attitudes of all household members.

1. HKI’s Approach to Gender in
Bangladesh
Institutionalizing Gender in Nutrition and Agriculture Interventions
International Women’s Day, 9th March 2014, Dhaka
Ramona Ridolfi, Gender Advisor, HKI Bangladesh rridolfi@hki.org

2. • Section 1: HKI’s Gender Interventions in Bangladesh
• Section 2: Nurturing Connections Curriculum – A New Integrated Gender and
Nutrition Package
• Section 3: Results and Lessons Learnt
• Section 4: Adaptation and Next Steps
TABLE OF CONTENTS
Presentation overview
2

3. Photo © HKI / Hannah Taylor
SECTION 1: HKI’s GENDER INTERVENTIONS IN BANGLADESH
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4. HKI’s Diabetic Retinopathy programs in Chittagong and Dhaka since 2011
adopted an “Intensive Case Management” (ICM) package to work with entire families in
identifying and overcoming barriers to women’s healthcare.
SECTION 1: HKI’s GENDER INTERVENTION IN BANGLADESH
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From a “Focus on Women”…
Eg: REAL Project (2008-2010) in
cyclone Sidr-affected area: livelihood
opportunities and assets for extreme
poor and widowed women.
To Testing Innovative Approaches…
Eg: PLB (Project Laser Beam, since
2011) in Satkhira: gender messages in
nutrition and courtyard sessions;
mid-project assessment for women’s
decision-making on child nutrition.

5. To a Gender Transformative Approach…
BEAM (2011-2013) in Nilphamari: has a specific integrated nutrition and
gender intervention package that challenges discriminating gender norms in the
household which contribute to malnutrition.
- Nurturing Connections Manual
M2W2 Scale-up (2013-2015): Meaningfully engages men, women and
community leaders in planning to improve nutrition and increase women’s access
to markets.
1000 Most Critical Days Project (MCDP, 2013-2015): in Khulna District,
implemented in partnership with Save the Children, uses Nurturing Connections.
SECTION 1: HKI’s GENDER INTERVENTION IN BANGLADESH
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6. Photo © HKI/ Mushfiq Fahad Ameen
SECTION 2: NURTURING CONNECTIONS CURRICULUM
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7. • Inspired by Stepping Stones
– A training package developed by researcher Dr Alice Welburn in Uganda
between 1993-95 to for HIV prevention through peer and community
groups.
• Draws on HKI’s previous nutrition interventions
– Materials include nutrition and gender integrated activities to empower
women and improve their health and that of their children.
• Aims to challenge intra-household inequalities that contribute to
food insecurity and malnutrition
– The curriculum builds skills in communication, assertiveness and
problem-solving while discussing nutrition and food security.
SECTION 2: Nurturing Connections CURRICULUM
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8. • Behaviour Change is not a rational path: comes from within and requires time to
develop
• Recognises that malnutrition cannot be addressed without challenging unequal
gender relations and opening up communication and dialogue about taboo subjects
• Recognises the power of group dynamics
• Works with both men and women and with different age groups, both separately and
together
• Uses participatory methodologies that enable all community members, including
those who are not literate, in their own peer groups first and then together.
SECTION 2: Nurturing Connections CURRICULUM
The Nurturing Connections Approach: characteristics
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9. • The “Blocks”
1) Let’s Communicate;
2) Understanding Perceptions and
Gender;
3) Negotiating Power;
4) Acting for Change.
• The “Community Sessions”
One at the end of each Block, brings
together husbands, FILs, wives and MILs
to discuss the main learnings in each
Block in a mediated community setting.
SECTION 2: Nurturing Connections CURRICULUM
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10. SECTION 2: Nurturing Connections CURRICULUM
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Design of the Activity:
1. Begins with an action or
experience.
2. The action is followed by a
reflection: “What happened?
What does it mean? Why did it
happen?”
3. From the reflection we draw a
learning and we name it.
4. The learning leads to planning:
“Now what? What will we do to
change the situation?

11. SECTION 2: Nurturing Connections CURRICULUM
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12. • Pilot testing the curriculum in Building Equity in Agriculture and
Markets (BEAM) Project
- 3 stakeholders groups: women; husbands/fathers-in law; mothers-in law
- 1 session every two weeks (2 hours a fortnight) over a six-month period
- 40 producer groups in Nilphamari and Kishoregonj upazilas, randomly chosen
- 20 facilitators (some facilitating alone, some in pairs, especially with MILs)
SECTION 2: Nurturing Connections CURRICULUM
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13. Photo © HKI/ Micaela Arthur
SECTION 3: RESULTS AND LESSONS LEARNT
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14. SECTION 3: BEAM BASELINE
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99%
89%
33%
96% 90%
35%
1%
11%
67%
4% 10%
65%
BL ML EL BL ML EL
you can delay household work sometimes, without
being punished
your husband's family will support you, if you have a
personal problem or difficulty
How confident are you that
With some difficulty Not at all confident
Fairly confident Very confident

15. SECTION 3: PRELIMINARY RESULTS FROM ENDLINE…
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33% 97% 1% 45%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baseline Endline Baseline Endline
Child health care family or relatives visit
Figure 1: Proportion of women who report having a say in decision making about
the given topics.

16. SECTION 3: PRELIMINARY RESULTS…
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Figure 2: Proportion of women who received assistance from their husbands
for household activities.

17. • Suggestions from HKI’s pilot test:
- The manual is NOT to be seen as a set of activities, separated from
other components
- Need organizational capacity and commitment
- Make it fun and provide refreshments for participants
- Maintain a register of participants
- When adapting, note important discussions, difficulties
- Retrain the facilitators, offer continuous support
SECTION 3: LESSONS LEARNT
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18. Photo © HKI/ Jeff Holt
SECTION 4: ADAPTATION AND CONCLUSIONS
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19. Training on Homestead fish culture
• Training is primarily focused on the technology and specific knowledge
and skills related to using it
• Integrate Nurturing Connections to address gender based constraints to
adopting and benefiting from the technology, such as around:
– Building self-confidence to use the technology
– Unequal distribution of fish and its benefits for women and children
– Intra-household negotiation over resources needed to use technology, and resulting
fish production & income
Maintain the approach in peer and community groups
SECTION 4: EXAMPLES OF ADAPTATION
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20. UNDERSTANDING OF NUTRITION AND INTRA-HOUSEHOLD POWER
(Flipchart from aquaculture manual, used to guide open discussion)
SECTION 4: EXAMPLES OF ADAPTATION
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- Indigenous small fish that can be found in ponds e.g. mola,
darkina, puti etc.
- These fish are rich in vitamin, iron and zinc as well as other
minerals
- Small fish is an important contribution to meeting the nutrition
needs of the family members especially the women and children
- Women members for the household can be directly involved in
fish culture

21. • Sharing workloads and benefits
- Do (unequal) power relations within
the household affect the ability of
women to make decisions that suit
their preferences (eg: around
investments) or allow them to receive
benefits in line with their
contributions?
- Encourage joint work on the pond and
in the household and equal sharing of
benefits.
- Block 3 of Nurturing Connections:
“Exploring Power Relations”
SECTION 4: EXAMPLES OF ADAPTATION
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22. • HKI has developed a GTA that:
a) Is Innovative: promotes the transformation of discriminating gender
norms and social habits.
Nurturing Connections targets all main decision-makers of the household, not just
women, with the aim of challenging and changing discriminating social practices.
b) Can be adapted for use in different contexts
NOTE:
Transforming habits and preference around food and care takes effort, research,
resources.
Behaviour Change, especially around gender, requires time – it involves
attitude change.
SECTION 4: CONCLUSIONS
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23. THANK YOU
“Although the world is full of suffering, it is also full of overcoming it.”
-Helen Keller
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