Harvesting Child Nutritional Gains through the Graduation Approach: Results from a Randomized Control Trial on BRAC’s Targeting the Ultra Poor (TUP) Program

This week’s webinar held on 7 September 2017, titled Harvesting Child Nutritional Gains through the Graduation Approach: results from Randomized Control Trial on BRAC’s Targeting the Ultra Poor (TUP) Program, debated the implications of the TUP graduation programme, developed by BRAC.  Lisa Hannigan (Director for Poverty and Social Transfers Section, Department of Foreign Affairs and Trade (DFAT), Australia) moderated the discussions, while Nazia Moqueet (Technical Specialist, BRAC USA) and Wameq A. Raza (Senior Researcher, BRAC Uganda) presented on BRAC. Mathew Tasker (Asia Regional Food Security and Livelihoods (FSL) advisor for Save the Children UK) participated as discussant.   

The event was hosted by socialprotection.org and organised by the Social Protection for Employment – Community (SPEC), in partnership with the Australian Department of Foreign Affairs and Trade (DFAT), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) and BRAC.

The recording is available here and the presentation here.

The graduation approach

The fight against poverty and malnutrition cannot rely on short term tools that deliver temporary solutions. As countries move towards establishing a social protection floor, they need to create and implement sustainable policies, ensuring progressive and long term social benefits. With this is mind, the graduation approach provides a suitable approach towards fighting poverty and malnutrition in a sustainable manner. Graduation in this context is defined as “a set of time-bound and sequenced interventions”.

Targeting the Ultra Poor

This approach was utilised by BRAC, during the implementation of their Targeting the Ultra Poor (TUP) project. BRAC is a non-governmental organisation (NGO), founded in 1972 in Bangladesh. It now has a presence in ten other countries. Ultra Poor people are defined as individuals who earn the lowest income, rendering them deprived of access to their basic needs and a decent life.

BRAC’s TUP project defines the ultra poor as follows:

• Chronically food insecure
• Disconnected from government services and markets
• Most vulnerable to health shocks and natural disasters
• Living in geographically isolated areas
• Lacking community acceptance, confidence, support systems
• Predominantly female-headed households

The TUP project therefore targets these individuals. The project was established in 2002 in Bangladesh and has already reached 1.7 million households. Pilot versions of the programme have been carried out in Afghanistan, Pakistan, South Sudan, and Uganda. By incorporating the graduation approach into the programme, BRAC is focusing TUP on four main areas:

• Social Protection
• Livelihoods promotion
• Financial inclusion
• Coaching

By performing interventions in these areas, BRAC aims to achieve economic and social improvements for ultra poor individuals within 24 months. The people will be benefit from access to quality nutrition, a reasonable income, sanitary facilities, social inclusion and progress in education.

According to BRAC’s specialists, these improvements are possible because of its holistic approach that prepares and sustains the community with:

• cash transfers to finance food consumption;
• home visits to provide professional coaching;
• home visits to provide basic health care;  
• and social integration through community actions.

The programme also provides broader access to mentoring and psychosocial support, as in the case for new mothers. The organisation aims to integrate the graduation approach to local social protection programmes, to expand coverage.

Children and nutrition

With respect to children, TUP has being able to avert the destructive spill over effects of malnutrition. By improving nutrition, TUP is preventing children from facing impairments to their cognitive development. For example, 53.3% of child beneficiaries in South Sudan are less vulnerable to being underweight.

Following the presentation on TUP by Moqueet and Raza, Tasker participated in the discussion, highlighting Save the Children UK’s actions to improve maternal nutrition, especially in the first 1000 days of pregnancy. The organisation is committed to aid and link multiple service providers, such as local governments, in order to empower social protection schemes addressing the needs of children.

The webinar closed with Hannigan moderating the Q & A session:   

• Communication on nutrition within the programme: Is it mixed between sanitation and nutrition, and is there tailored counselling for new mothers? Is it more concerned with psychosocial support or knowledge of nutrition?
• Cash transfers: is there anything in the graduation approach that is different when there is a focus on nutritional impacts being achieved? 
• What happens to the beneficiaries after the project? Are they integrated into government social protection programmes?
• Is there a difference between cash support and in-kind support, and what is their relative importance?

Watch the webinar recording here!

This blog post is part of the Linking Social Protection to Sustainable Employment webinar series, which brings together the summaries of webinars organised by DFAT and Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) on the topic. Please join the Online community Social Protection for Employment if you are interested in following the most recent discussions on the topic. If you have any thoughts on this webinar summary, we would love to hear from you. Please add your comments below!