BANGLADESH

	FY 1998 Actual	FY 1999 Estimate	FY 2000 Request
Development Assistance	$35,200,000	$28,150,000	$37,800,000
Child Survival and Disease	$19,650,000	$15,600,000	$18,100,000
P.L. 480 Title II	$37,650,000	$18,595,000	$24,992,000

Introduction

USAID assistance reduces the proportion of Bangladeshis living below the poverty line by meeting four Strategic Goals: Open Markets and Broad-based Economic Growth; Reduced Fertility and Improved Family Health; Democracy and Good Governance; and Humanitarian Response. USAID development assistance in Bangladesh serves U.S. Interests. It promotes the long-term political and economic viability of this moderate Islamic country, and increases export and investment opportunities for U.S. business. It serves U.S. global interests in stabilizing world population, protecting human health and promoting environmentally responsible growth.

The Development Challenge

Bangladesh is the world's eighth largest country, one of the most densely populated -- 125 million people in an area the size of Wisconsin -- and prone to natural disasters. Some 56 million Bangladeshis, 45% of the population, still live below the poverty line. USAID's programs focus on major constraints to development: population pressure; widespread malnutrition; overall poor health as reflected by high infant, child and maternal mortality; a fragile democracy; low agricultural production/productivity; an inadequately functioning market economy; and inadequate policies and expertise for development of the energy sector (gas).

USAID's long-term commitment to reduce fertility in Bangladesh has improved maternal/child health, reduced the burden on the domestic resource base, and contributed to world wide population stabilization. The total fertility rate dropped to 3.3 births per woman in 1996/7 from over 6.3 in 1974; contraceptive prevalence has risen from 8% in 1974 to 49% in 1997. Results in improving family health have been similarly positive: infant mortality dropped from 112 per 1,000 in 1986 to 82 per 1,000 by 1996/7; child mortality (children from 1 - 5 years of age) dropped from 59 per 1,000 live births in 1986 to 37 per 1,000 in 1996; and the percentage of infants vaccinated by one year of age increased from only 5% in early 1986 to 54% by early 1998.

USAID/Bangladesh's integrated family planning and health program aims to further reduce fertility and improve family health. It provides: high-quality and efficient service delivery; social marketing of family planning and health products; efficient operation of family planning logistics; information and communication programs; operations research; quality assurance initiatives to further improve service delivery; and an integrated package of reproductive and child health services. The program helps control HIV/AIDS through condom social marketing, peer education among high-risk individuals, and information and education. In addition, USAID is working on a diarrheal disease surveillance initiative.

Bangladesh faces an enormous challenge in assuring food, energy, shelter, and other essential goods and services are available to a population that could surpass 200 million by the year 2035. High levels of malnutrition persist. USAID improves nutritional status by increasing agricultural productivity and household incomes through new technologies and improved rural infrastructure; helping orient Government of Bangladesh (GOB) food and agricultural policies towards a greater reliance on the private sector; and helping small and microentrepreneurs to obtain financing and operate profitably. USAID provides food grains to the poor through Food for Peace Programs, especially P.L. 480 Title II. More than 700,000 households have benefited from assistance in growing vitamin rich fruits and vegetables for consumption and sale from 1992 through 1997; 75,000 fish ponds were established from 1994 through 1997; more than 10,000 kilometers of farm-to-market roads have been rehabilitated from 1995 through 1998; about 155,000 additional electrical connections for small businesses and irrigation were made from 1993 to 1997: overall some 18 million additional rural people now have access to electricity; and 5.3 million new jobs have been created as a result of rural electrification programs supported by USAID. Some 105,000 micro and small enterprises have been assisted from 1990 through 1997.

Business and commerce face serious policy, infrastructure, and institutional constraints, such as lack of an adequate power supply and a shaky financial system. USAID and the U.S. Department of Energy (DOE) will jointly explore technical assistance possibilities for legal, policy and regulatory reform of the energy sector; for designing strategies to promote South Asia regional cooperation on energy issues; and for assessing potential impacts of global climate change. USAID will also build on past efforts to help bring affordable credit to development of medium sized enterprises.

USAID's democracy program improves the quality of elections, makes local elected bodies more responsive, advocates the interests of women and the poor, develops alternative family dispute resolution mechanisms, and strengthens labor organizations representing garment workers. USAID has supported 23 nongovernmental organizations (NGOs) addressing local level democracy and human rights issues for women and the rural poor. Women and the poor have been empowered through on-going legal awareness training and alternative dispute resolution programs, and by USAID's support in creating the Bangladesh Independent Garment Workers Union Federation (BIGUF), the first independent, democratically organized union federation in Bangladesh. Public interest litigation activities have opened the way for class-action law suits on behalf of certain classes of citizens, including the poor. Civil society voter education and election monitoring in 1997 helped raise voter turnout and significantly broadened participation in local government elections. Since 1997, USAID has shifted the focus to training the new generation of elected officials. USAID's democracy activities are being expanded to have more impact on national policy related to local government.

Support for humanitarian assistance includes disaster preparedness under a P.L. 480 Title II development assistance (DA) funded program with CARE, plus Mission administration of other U.S. Government (USG) contributions. In response to the worst flooding in Bangladesh's history, the United States was the largest contributor to the 1998 relief effort. The U.S. contributed $134 million: 45 percent of all donor assistance. Flood assistance included 700,000MT of U.S. Department of Agriculture (USDA) wheat, emergency and medical supplies from USAID’s Office of Foreign Disaster Assistance (OFDA), and increased USAID support for vaccinations, vitamin A distribution and oral rehydration therapy. This and other donor assistance helped Bangladesh avoid predicted widespread starvation, epidemics, and the spread of diarrheal disease.

Other Donors

In 1998, USAID and the donor community pledged $1.8 billion for development activities in Bangladesh, of which the United States contributed 4.2%. Most major donors are represented in Bangladesh. The five largest are the World Bank, the Asian Development Bank (ADB), Japan, the European Union (EU) and USAID. USAID leads several local consultative groups which meet regularly on the major sectors.

FY 2000 Program

USAID will continue its leadership role in family planning and health/child survival activities, but will also: (1) address constraints to establishing a market economy, particularly those relating to financial markets and development of the energy (gas) sector; and (2) expand activities to consolidate the democratic structure in Bangladesh, particularly at the local level, and to support political and human rights. Support for humanitarian assistance, including disaster planning and mitigation, will continue, as will P.L. 480 Title II development efforts in support of rural infrastructure.

BANGLADESH

FY 2000 PROGRAM SUMMARY

(in thousands of dollars)

AID Mission Director, Gordon H. West

USAID Strategic & Special Objectives	Economic Growth & Agriculture	Population & Health	Environment	Democracy	Human Capacity Developmnt	Humanitarian Assistance	TOTALS
S.O. 1 - Fertility Reduced & Family Health Improved -DA -CSD	--- ---	24,500 12,600	--- ---	--- ---	--- ---	--- ---	24,500 12,600
S.O. 2 - Enhanced Household Income and Food-based Nutrition (Formerly Food Security) -DA -CSD -P.L. 480/Title II	6,800 --- ---	--- 5,500 ---	4,500 --- ---	--- --- ---	--- --- ---	--- --- 24,992	11,300 5,500 24,992
S.O. 3 - Broadened Participation in Local Decision Making & More Equitable Justice, Especially for Women -DA	---	---	---	2,000	---	---	2,000
Totals - DA - CSD - P.L. 480/Title II	6,800 --- ---	24,500 18,100 ---	4,500 --- ---	2,000 --- ---	--- --- ---	--- --- 24,992	37,800 18,100 24,992

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ACTIVITY DATA SHEET

PROGRAM: BANGLADESH
TITLE AND NUMBER: Fertility Reduced and Family Health Improved, 388-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000: $24,500,000 DA; $12,6000,000 CSD
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2004

Summary: The purpose of this strategic objective (SO) is to lower fertility and reduce infant, child and maternal mortality. The SO's major objectives include lowering fertility from approximately 3.4 live births per woman in 1993/4 to 2.8 in 2004 and reducing infant mortality from 82 per 1,000 live births in 1996/7 to 72 per 1,000 in 2004. Population density and growth affect the ability of Bangladesh to feed itself, create jobs, and provide health, education, and other public services. High fertility and mortality increase the vulnerability of poor households to reduced incomes and quality of life. Although fertility and infant and child mortality rates have declined substantially over the last two decades, further efforts are needed to achieve replacement level fertility and eventual population stabilization, and to reduce mortality rates to acceptable levels.

USAID's service delivery support through its NGO partners will directly benefit about 15-20% of the population. Mass media communications programs will reach about 40% of the population. National level assistance that benefits all Bangladeshis provide: social marketing of key health products, distribution systems for maternal and child health/family planning commodities, immunization including polio eradication, disease surveillance, and quality assurance.

Key Results: Five intermediate results are necessary to achieve this SO: (1) service delivery: increased use of high impact family health services; (2) information: increased capabilities of individuals, families and communities to protect and provide for their own health; (3) quality: improved quality of information, services, and products; (4) institutional and systems support: strengthened local service delivery organizations and support systems for high impact family health services; and (5) sustainability: improved sustainability of family health services.

Performance and Prospects: Performance over the past year has exceeded expectations. The program is expanding access to high impact family health services (including immunization and diarrheal disease treatment) and family planning services through community level clinic sites managed by local NGOs, technical assistance to governmental health institutions and private sector entities such as the Social Marketing Company and private providers. USAID also supports HIV/AIDS prevention activities and polio eradication. These services are targeted to under-served groups and low-performing geographical areas. In 1998, USAID supported the operation of almost 250 clinics and over 9,000 monthly "satellite" clinics providing services to approximately 20,000,000 persons. During the upcoming year, the program will further expand services in slums and other under-served areas and design new programs to better serve hard-to-reach groups such as men with sexually transmitted diseases and young adults.

USAID assistance expanded public access to health information and identified self-help actions for individuals and communities. New information and communication materials helped the GOB to design a national strategy for changing health behavior. In the coming year USAID will help implement a variety of information campaigns and initiatives, including a televised educational drama series, to promote high quality family health services.

In 1998, USAID helped design three new health service delivery standards, develop two training curriculums, and fund the training of about 700 service providers. In addition, the program implemented quality assurance programs for all essential health services including family planning, maternal health care, child survival and HIV/AIDS. The program also strengthened support systems to ensure availability of essential pharmaceutical supplies, access to relevant and accurate information, and improved planning, monitoring and decision-making. In 1999 and 2000, USAID will expand training and quality assurance programs, including the promotion of rational drug use, to all USAID-supported NGOs.

Finally, in 1998, the program enhanced programmatic, institutional and financial sustainability through training, technical assistance and phasing over of responsibility for management and implementation to Bangladeshi partner organizations. Measures to improve cost-effectiveness and cost-recovery are being tested and implemented at all levels. Operations research is being used to identify implementation problems, test and scale up improved service delivery approaches. In addition, USAID is actively involved in policy dialogue with the GOB to improve the cost-effectiveness and quality of services. In 2000, USAID will support the formulation of a cost recovery policy for USAID-supported NGOs and help many of them design strategic plans.

Possible Adjustments to Plans: There is no plan for any major program adjustments.

Other Donor Programs: The GOB provides the majority of all funding for the national family planning and health program, with a FY 1997/8 budget of approximately $400 million. The GOB supports the delivery of family planning and health services through its rural and urban infrastructure of facilities and personnel. The World Bank and its consortium of nine bilateral and five multilateral donors support the delivery of essential health and family planning services primarily through the government sector, with targeted interventions in such areas as nutrition, communicable disease control, and strengthening of government training. Annual expenditures approach $80 million. The United Nations Children's Fund provides approximately $8 million of annual support for specific child survival and selected maternal health activities. Since 1995, under the Common Agenda initiative, the Japanese Government has provided or committed over $15 million for the immunization program (primarily vaccines), the expansion of family planning services through local governments, and support of NGOs. After the World Bank and its partner consortium, USAID is the second largest donor in the population/health sector.

Principal Contractors, Grantees or Agencies: USAID implements activities through U.S. and local private firms, universities, and NGOs. The major partners are the International Center for Diarrheal Disease Research, Bangladesh for operations research; the Partnership for Child Health Care for child survival activities; the AVSC International for quality improvement activities; the John Snow Incorporated Research and Training Institute for urban family planning and health service delivery and logistics management; and Pathfinder International for rural family planning and health service delivery.

Selected Performance Measures:

	Baseline (1993/4)	Target (2000)	Target (2004)
Total Fertility Rate	3.4	3.1	2.7
Infant Mortality Rate	87/1,000 live births	78/1,000	72/1,000
Child (Children 1-5 years) Mortality Rate	50/1,000	35/1,000	30/1,000
Pregnancies attended by trained provider	25.7%	35%	50%
NGO Cost Recovery (operating costs covered by program generated revenue)	6%	11%	20%

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ACTIVITY DATA SHEET

PROGRAM: BANGLADESH
TITLE AND NUMBER: Enhanced Household Income and Food-based Nutrition, 388-SO02
STATUS: Continuing
PROPOSED OBLIGATION & FUNDING SOURCES: FY 2000: $11,300,000 DA; $5,500,000 CSD; $24,992,000 P.L. 480 Title II
INITIAL OBLIGATION: FY 1996 ESTIMATED COMPLETION DATE: FY 2003

Summary: This strategic objective utilizes DA and child survival and disease funding to focus on both economic growth and nutrition levels through improved efficiency and diversification in agricultural production, and development of related rural industries and infrastructure. In addition, SO activities work with the GOB and the donor community to use P.L. 480 food programs to improve rural infrastructure, promote natural disaster preparedness and feed those most in need.

The economy of Bangladesh is extremely fragile. Although Bangladesh is approaching self-sufficiency in rice production, its concentration on rice and corresponding lack of agricultural diversification cause two major problems: poor diets that produce widespread malnutrition, especially among women and children, and an almost total absence of diversified employment and income generation in rural areas. Moreover, the country’s farmers are constantly threatened by a variety of natural disasters that cause major setbacks. Ready-made garment factories dominate the export sector but there are very few small and medium sized enterprises to absorb the two million new entrants to the labor market each year. While recent discoveries of natural gas are extremely important for Bangladesh's future development, the country currently suffers from critical shortages of power and energy.

Key Results: Four major intermediate results are necessary to achieve this SO: (1) an increase in the number of households producing fish, poultry, fruit and vegetables; (2) an increase in the reach of rural roads and electricity/power and a more flood-proof environment for rural villages; (3) better management of food resources to increase benefits for the poor; and (4) more effective financial and managerial services for enterprise development.

Performance and Prospects: The result of the combined efforts of Bangladeshis, USAID and other donors has been a remarkable evolution in Bangladesh from a famine-prone country in the early 1970s, to a country capable of managing food emergencies in the 1990s. Food production has doubled since 1971. Productivity in fisheries, vegetables, poultry and other high value agricultural subsectors has grown over the past several years. USAID-supported home gardening and fish culture activities have enabled 775,000 households to produce, consume and sell more nutritious food between 1992 to 1997. Over 10,000 kilometers of farm-to-market roads have been rehabilitated from 1995 through 1998, creating both jobs and greater access to markets and services. About 18 million rural people now have access to electricity, generating more than five million jobs in the rural areas. The GOB has reoriented its large public food system away from competition with the private sector and towards helping the poor with safety net food programs the private sector cannot provide. Over 31,000 small and microenterprises have benefited from increased access to credit made available directly through USAID-funded programs from 1992 through 1997, while thousands more have received loans from the Grameen Bank, and other local NGOs such as the Bangladesh Rural Advancement Committee (BRAC) and Proshika.

Possible Adjustment to Plans: Given the critical importance of the power sector for Bangladesh's development, USAID will build on its successful work in rural electricity and small power generation to establish a special objective in collaboration with the U.S. Department of Energy and the Bangladesh Ministry of Energy. The Mission will also begin planning for an increased effort in the financial market sector, which is critical for enterprise development. Medium sized enterprises will not grow and prosper in Bangladesh until the financial system improves. Investigation over the next few months will determine whether a new special objective is also needed for this initiative.

Other Donor Programs: While many donors are working in economic growth, USAID plays a lead technical assistance role in rural electrification (the World Bank and Japanese provide major capital input), agribusiness and food policy. USAID is the major donor in the rehabilitation of rural roads, followed by the World Food Program (WFP). The World Bank and Asian Development Bank focus on major roads. The United Nations Development Program (UNDP), United Nations Children's Fund, and the United Kingdom's Department for International Development all contribute to disaster preparedness and response activities, while USAID's major contribution is emergency food aid. The United States is the major food aid donor to Bangladesh. In the fisheries sector, USAID's $8 million contribution is 6% of the $128 million total contribution. Donor levels for improvements in vegetable production approach $48 million; with $11.3 million, USAID is the second largest donor.

Principal Contractors, Grantees, or Agencies: USAID implements activities in partnership with GOB ministries, universities and with U.S. international and local NG0s including: International Center for Living Aquatic Resources Management, Asian Vegetable Research & Development Center; International Maize & Wheat Improvement Center; Cornell University's Collaborative Research Support Program; Helen Keller International; International Food Policy Research Institute; International Fertilizer Development Center; Palli Karma Sahayak Foundation; Non-Formal & Adult Literacy Program; CARE; National Rural Electric Cooperative Administration; University of Maryland's Center for Institutional Reform & and the Informal Sector; and Grameen Bank.

Selected Performance Measures:

	Baseline (1995)	Target (2000)	Target (2003)
Number of households producing fish and vegetables	405,000	1,400,000	1,700,000
Kilometers of rural roads either constructed or rehabilitated	3,327	12,455	Note 1
Number of small, rural businesses using electricity	178,700	330,000	389,000
Percent of public food programs targeted	65%	90%	Note 2
Number of enterprises assisted	129,000	184,000	279,000
Note 1: Indicator will be revised for year 2003 Note 2: Indicator will be deleted after year 2000

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ACTIVITY DATA SHEET

PROGRAM: BANGLADESH
TITLE AND NUMBER: Broadened Participation in Local Decision-Making and More Equitable Justice, Especially for Women, 388-SO03
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY2000: $2,000,000 DA
INITIAL OBLIGATION: FY1996 ESTIMATED COMPLETION DATE: FY 2002

Summary: The SO encourages NGOs to address local level democracy/governance (DG) issues through sub-grants which strengthen the ability of the poor to advocate their own interests; enhance the quality of elections; improve the competence of local elected bodies; increase respect for legal rights of the poor; and improve local channels to resolve disputes. Policy direction and sub-grant oversight are determined jointly by a "Democracy Partnership" (DP), consisting of The Asia Foundation (TAF), BRAC and USAID. SO activities to assure the rights of women garment workers and address child labor are carried out by the American Center for International Labor Solidarity (ACILS). The SO will improve representation of the interests of the rural poor, and women in particular, regarding these problems.

Key Results: To achieve this SO, four intermediate results are targeted: (1) increased responsiveness of local elected bodies and government institutions; (2) enhanced quality of elections; (3) improved access to justice; and (4) strengthened garment workers' union.

Performance and Prospects: The DP structure includes sub-grants to 23 NGOs for local DG activities in 1400 unions or about 30% of all unions (a union is a unit of local government). During the past year, Bangladesh's protracted floods set back DG activities in many localities for several months, as NGOs and their beneficiaries focused on basic survival and relief priorities. In spite of the floods, important performance trends are emerging. Work on local DG issues has led sub-grantee NGOs to increasingly address national policy and legislation that has a local impact. They have engaged on such national issues as the roles of women union council members, proposed legislation for village courts, provisions of controversial legislation to establish Upazila (Thana) Councils, and violence against women and children.

The election outcomes of 1997 have created new opportunities for NGOs to work directly on building the capacity of union councils (UCs) and their members. The December 1997 elections brought many individuals into local elected bodies who had previously been outside the local power structure, including 14,000 women. During the past year, NGO sub-grantees have begun to respond to the demand for training and to work directly and actively with UCs.

Although NGOs have increased their direct work this year with locally elected bodies (LEBs), there has also been an increase in actions advocating interests of women and the poor to local government. A shift is occurring from NGOs acting on behalf of beneficiaries to the beneficiaries representing their own issues before local government officials.

NGOs have improved access to justice this year by helping the poor, particularly women, become more aware of their rights vis-a-vis land and the family. Marriage registration is emphasized as a prerequisite to protecting those rights; a major research report addressing registration issues was completed. Sub-grantees have provided training to many NGOs not directly supported by USAID. Local mediation mechanisms have focused on improving quality of dispute resolution. ACILS reported positive steps (i.e., continued training of union leaders and increased/improved contact with the garment factory association) in strengthening a democratic garment workers union, despite a perceived growing undercurrent of hostility to unions within government. Though prospects for achieving specific targets is hard to assess, opportunities to address democracy issues continue to increase.

Possible Adjustments to Plans: Over the next two years, new mechanisms will be developed to use NGO field experience and other local level analysis to address national level policy issues, particularly related to LEBs. The SO will focus increasingly on democratic characteristics of LEBs; work with central government agencies responsible for LEBs; and strengthen constituencies for strong local government. Decisions will be made on whether to help develop LEBs in the Chittagong Hill Tracts (in the wake of the peace accords there) and the newly reconstituted Upazila Parishads (UZPs). As two or three general elections (municipalities, UZPs, and Parliament) will be held in 1999-2000, voter education and election monitoring will resume.

Though USAID is generally satisfied with the results being achieved, producing consistent and meaningful quantitative indicators for this SO has been particularly challenging, because of the decentralized activities and variations in the activities of NGO sub-grantees. During 1998 the foundation was laid for longer-term data to measure elements of democratic development in Bangladesh, by relying in part on independently collected and comparable sample survey data. This new data will first be reported in 1999 and will require readjustment of targets and indicators. Future indicators will include measures of confidence in local elected body responsiveness, in local electoral processes, and in local justice processes.

Other Donor Programs: Though USAID is the first donor to package its program as a "democracy" program, other bilateral and multilateral donors address human rights, democracy, or governance issues. These donors include several programs of the United Nations, Denmark, Norway, and Switzerland. Coordination with these donors occurs largely through local donor consultative groups on governance and gender. Total other donor support for the same areas of democracy and governance in which USAID is currently working is approximately $5 million annually. In FY 1998 the United States provided $2.133 million, or about 30% of the total funds, for activities in legal literacy, alternative dispute resolution, violence against women, child labor, and local government.

Principal Contractors, Grantees or Agencies: The two major SO grantees are TAF and ACILS. Local sub-grants through TAF are made to 21 Bangladeshi NGOs and two U.S.-based NGOs (CARE and International Voluntary Services, IVS). Though sub-grantees work extensively with local government, the SO does not currently fund activities of any Bangladesh central government agency. Small direct grants currently support specific activities of the Khan Foundation, Bangladesh National Women’s Lawyer’s Association, and Red Barnet; others are planned using Economic Support Funds (the South Asia Regional Democracy Fund) for Transparency International/Bangladesh and the National Democratic Institute (NDI).

Selected Performance Measures: During 1998, nearly 36,000 people received local level training related to legal awareness or local government. Approximately 2,400 significant local level actions were recorded advocating the interests of women or the rural poor. During 1997, 29,400 marriages had been registered in target communities, 3660 local elites and opinion makers had been reached by legal awareness programs, 2,185 local associations in target communities had advocated interests of women and the rural poor, and 3,010 women clients were assisted in alternative dispute resolution (ADR) cases. Comparable totals are not yet available for 1998. Indicators followed by "R" are being revised in 1999.

	Baseline (1996)	Target (2000)	Target (2003)
Number of LEBs using "best practices" (R)	0	50	75
Number of advocacy actions by NGO groups	0	2,300	6,800
Number of BIGUF members	3,962 (1995)	30,000	45,000
Number of mediation councils using improved ADR techniques (R)	2,015	3,500	5,000

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