Project Title- Provision of Comprehensive Primary Health Care Services to Rohingya Refugees in Cox’s Bazar

 

Area Coverage-                           

8 Rohingya Camps at Ukhiya Upazila of Cox’s Bazar District

 

Health Facility Coverage-         

Three (3) Primary Healthcare Centre (PHC)- i) 071 at Camp 8W and ii) 096 at Camp 10. Six (6) Health Post (HP)- i) 117 at Camp 12, ii) 183 at Camp 18, iii) 033 at Camp 3, iv) 032 at Camp 4, v) 134 at Camp 13, and vi) 165 at Camp 16

Joint Collaboration-                  

UNICEF Bangladesh with support of multi-donor agencies

 

Duration-         

Phase 1- 12 Months (16 September 2017 to 15 September 2019)

Phase 2- 20.5 Months (16 September 2019 to 31 May 2020)

Phase 3 - 7 Months (May 2020 to December 2020)

Phase 4 - 12 Months (January 2021 to December 2021)

Phase 5 - 12 Months (January 2022 to December 2022)

Phase 6 - 12 Months (January 2023 to December 2023)

Phase 7 - 12 Months (January 2024 to December 2024)

 

Population focus-               

Women, New-borns, Under 5 Children and Adolescents

Since 25th August 2017, targeted violence against Rohingya communities forced them to flee from their homes in Rakhine State of Myanmar. Around 671,000 Forcibly Displaced Myanmar Nationals (FDMN) crossed the border and sought safety in our country. The People of Bangladesh and the Government expressed resounding solidarity with these people. The situation incurred Heath Sector for immediate response with emergency Primary Health Care including SRH, MNCH Care, and Outbreak Preparedness. The collaboration between UNICEF and PHD initiated a response in line with the Joint Humanitarian Response Plan. Joint response to new Rohingya Settlements for MNCAH Services has three key components, i) Out-patients’ Services, ii) In-patients’ Services, and iii) Community Health Interventions.

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Objective

According to the Country Program Document (CPD) Output 1, UNICEF has committed to strengthen the quality of integrated service delivery and effective coverage in national and subnational health systems to support the well-being of children under 5 years and their mothers. It also includes people infected and affected by HIV, emergency and non-emergency situations in both rural and urban areas. The joint response has been intended for the emergency situation in Cox’s Bazar to provide life-saving basic assistance in Rohingya Camps.

Expected Outputs

  1. Improved Access for FDMN Women, Newborns, U5 children and Adolescents to Comprehensive Maternal, Newborn, Child & Adolescent Health and Nutrition (MNCAHN) Services
  2. Capacity of service providers in PHC and HP enhanced  for ensuring continuous care among the registered PWs, NBs and U5 Children
  3. Improved Referral services for General Patients, PWs with complication, Sick New-borns and U5 Children  to appropriate health services
  4. Quality Improvement (QI) Initiatives in PHCs and HPs in place and standardized
  5. Effective and efficient program management in place

Key Interventions

Component 1- Day-time Out-patients’ Service Delivery in HPs

PHD operates 6 HPs with adequate numbers of skilled workforces to deliver the following services-

  • Curative Care to male, female and children as per Bangladesh Essential Service Package (B-ESP)
  • EPI inclusion for Children under 2 according to the Government guidelines and supplies
  • MNSRH Care to women and adolescents, which covers- ANC/PNC, Family Planning, Distribution of IFA/Zinc/Calcium distribution, GBV/CMR/MR/PAC referral
  • C-IMCI Services to manage and refer sick New-born & Under 5 Children with Diarrhoea, ARI, Ear Infection and Fever
  • ORT and BF Care to diarrhoea patients and lactating mothers through separate corner in HP
  • PMTCT Care in selected HPs with counseling, screening, syndromic management, HIV tests and referral
  • Mini Pharmacy for dispensing medicines as per supply of drugs under ESP protocol
  • Lab Facilities in selected Health Posts with few strip-based investigations
  • Patient Registration, Management and Reporting as routine works
  • Referral Care to selected cases from HP to PHD’s PHCs and other appropriate facilities with dedicated ambulance including post-referral follow-up and patient back support
  • Limited special cares for children with ECD and for adolescents who are at risk of pregnancy
  • Generating evidences through HMIS for programme planning and implementation

Component 2- Out-patients’ and In-patients’ Service Delivery in PHCs

PHD operates 2 PHCs with adequate numbers of skilled workforces to deliver the following services-

  • Curative care to male, female and children including nutrition screening, first aid with stabilization and dressing, treatment of emergency cases, Inpatient curative care for mild and moderate conditions
  • MNH Services that include ANC, PNC, Normal Vaginal Deliveries (NVD), B-EMONC (Signal Functions), ENC including KMC services, Management of Low-birth weight, sepsis management, Post-abortion care, Postpartum FP, Td vaccination and IFA supplementation
  • Child Health and Immunization that include IMCI, Routine Vaccination (0-5 years), Growth monitoring, Participation in deworming & Vitamin A campaign (5-15 years)
  • Adolescent Health Care that include Adolescent Friendly Services, personal hygiene and sanitation, Td Vaccination and IFA supplementation
  • Gender-Based Violence (GBV) that include Provision of first line support and Clinical care for sexual violence (CMR) and facilitating referrals to other service providers
  • Maternal Nutrition and IYCF with skilled counselor for systematic detection of acute malnutrition among Children (6 to 59 months) and PLWs and for identifying and referring of SAM/MAM Cases to OTPs/TSFPs
  • Special services on communicable diseases, psychosocial advices, non-communicable diseases, Laboratory, Pharmacy, Waste Management and Infection Prevention
  • Referral Care for C-EmO & NC Cases and patients with severe sickness with dedicated 24/7 ambulance services including post-referral follow-up and patient back support
  • Semi-permanent minimum Infrastructure with 24/7 power supply, running water supply, medical waste management, Male/Female toilets, bathing facility, minimum 15 beds (5 Male, 5 Female & 5 New-born) for inpatient care, Delivery Room, Isolation room, breastfeeding corner and Doctor & Nurse Station

Component 3- Community Health Interventions at Camps

PHD engages 10 Community Health Workers (CHWs) per HP and 25 CHWs per PHC under the guidance of 5 Supervisors for promoting MNCH care at home and improving MNCAH care seeking behaviours among the targeted population through following interventions-

  • Register PLWs and their Children under 2 years of age from the catchment
  • Conduct household visits and group education sessions
  • Refer registered PWs to Health Facilities for ANCs
  • Refer PWs to Health Facilities for seeking Delivery Care, ENC, PNC and FP
  • Refer registered Children under 2 years of age for Routine Immunization
  • Promote Exclusive BFand IYCF practices
  • Refer suspected malnutrition cases to eHHealth Facilities for Nutrition Screening