Improving Birth Outcomes in Bangladesh

Women's weekly weight gain will be calculated by differencing women's weight obtained in the second and third trimester and dividing by the number of weeks between both measurements.

Total weight gain will be calculated by calculating the difference between women's third trimester weight and the weight obtained at the time of the census.

Dietary energy intake will be assessed using a 24-hour recall in the second and third trimester (18). EER will be calculated using each woman's basal metabolic rate (estimated from the woman's age, gender, and current weight), level of physical activity, and pregnancy trimester. Factors of 1.4 for low, 1.7 for moderate, and 2.0 for high physical activity will be used (19). Additional energy requirement for the second and third trimester of pregnancy (340-350 kcal/d and 452-500 kcal/d, respectively, depending on which reference will be used (20,21)) will be added to account for gestational weight gain and increases in basal metabolic rate.

The 24-hour recall data will be used to assess women's protein intake.

the mean of the probabilities of adequacy for 11 key micronutrients (iron, calcium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B-6, vitamin B-12, vitamin C, and folate) will be calculated using the 24h recall data. The estimated usual intake will be used to calculate the probability that the usual intake was above the EAR during pregnancy (25).

The difference between the date of birth and the first day of the last menstrual period (assessed in the first survey) will be used to calculate length of gestation.

Using the length of gestation, we will determine the proportion of children born before 37 weeks of gestation.

Prevalence of any emotional intimate partner violence in the past 6 months measured using the WHO Violence Against Women instrument (26)

Prevalence of any controlling behaviors in the past 6 months measured using the WHO Violence Against Women instrument (26).

Prevalence of any physical intimate partner violence in the past 6 months measured using the WHO Violence Against Women instrument (26)

Measured using women's Perceived Stress Scale score

Maternal attachment to their unborn child will be assessed during their 3rd trimester of pregnancy using the Prenatal Attachment Inventory

Maternal attachment to their infant will be assessed at 2 months (i.e., 61 days) postpartum using the Postpartum Bonding Questionnaire

Measured using men's Perceived Stress Scale score (27).

Birthweight will be assessed within 48 to 72 hours after delivery to avoid the influence of transitory neonatal weight loss that typically happens during the first days of life.

Birthweight will be assessed within 48 to 72 hours after delivery to avoid the influence of transitory neonatal weight loss that typically happens during the first days of life. Low birthweight will be defined as a weight below 2500g.

The Household Food Insecurity Access Scale will be used to measure household food security status.

Aggregate value of household food and non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described by Deaton and Zaidi (32).

Value of household food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described by Deaton and Zaidi (32).

Women's weekly weight gain will be calculated by differencing women's weight obtained at the census (before pregnancy) and second trimester and dividing by gestational age in weeks.

Women will be asked to report on their use of these supplements during pregnancy.

Antenatal care utilization will be assessed with respect to current recommendations in Bangladesh and with respect to the new WHO guidelines

Women's knowledge related to nutrition will be assessed using a set of questions developed for this study.

Postnatal care utilization will be assessed

We will measure women's weight at the 2-month postpartum visit.

Measured using women's spousal relationship modules developed for the survey.

Measured using women's decision-making modules adapted from pro-WEAI (34).

Measured using mobility modules adapted from pro-WEAI (34).

Measured using women's labor modules developed for the survey.

Measured using women's attitudes toward gender and intimate partner violence modules developed for the survey.

Measured using modules on women's social interactions and perceptions of neighborhood responses to intimate partner violence, developed for the survey.

Measured using women's responses on locus of control (35).

Prevalence of individual acts of intimate partner violence in the past 6 months measured using the WHO Violence Against Women instrument (26)

We will ask if the baby was delivered in a health facility

Women will be asked if a skilled birth attended the birth of the child

Women will be asked if a c-section was used to deliver the child

Using a similar approach as that use for pregnant women, husband's nutrition knowledge.

Weight of the husband will be assessed.

The length of the newborn will be assessed at the time of the birthweight assessment.

Length and weight at 2 mo postpartum

Women will be asked whether and how they breastfeed their newborn child. We will also assess if other liquids are provided to the child (36).

women will be asked whether and how they breastfeed their newborn child. We will also assess if other liquids and solid foods are provided to the child (36).

neonatal (within the first 1 month after birth) and infant (within the first 2 months after birth) mortality will be assessed through parental recall at the 2-month postpartum visit.

Value of household non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described by Deaton and Zaidi (32). The third-trimester assessment will be used to assess impact.

Quality of housing stock, measured using a module developed for the study context and collected through household enumerator observation during interviews.

Index of household asset ownership, measured using a module developed for the study context.

Measured with a module on income (Taka) from remittances received from relatives outside and within the country. The third-trimester assessment will be used to assess impact

A continuous measure on total household savings, calculated using reported savings of each household member 15 years of age or older.

A continuous measure on household loans, calculated using reported amounts of loans taken and outstanding amounts owed for each household member 15 years of age or older.

enrollment in the MCBP program