Name of the project: Improving access to integrated Sexual and Reproductive Health and Rights (SRHR) and HIV information and response services addressing human rights of female sex workers [Sukh Pakhi].

Programme Area: Enhance access to comprehensive Sexual and Reproductive Health and Rights (SRHR) services, including HIV and gender-based violence (GBV) information and response services, while upholding the human rights of these specific populations.

Duration: January 2024 to December 2024

Funded by: FCDO

Supported By: United Nations Population Fund (UNFPA)

Implementation area of PHD: Rajbari [Dualatdia brothel under Goalondo Upazila], Tangail [Kandapara brothel], Faridpur [C&B Ghat and Rothkhola brothel], Jeshore [Marwari Mandir and Babu Bazar brothel]) and Manikganj [For floating sex workers] Districts.     

Target audience:  3,220 floating and brothel based sex workers.  

 

UNFPA offered technical and financial assistance to PHD in crafting a community-driven initiative for brothel and floating female sex workers, their offspring, and their clients within and outside brothels, known as “Sukhpakhi”. The primary objective is to enhance access to comprehensive Sexual and Reproductive Health and Rights (SRHR) services, including HIV and gender-based violence (GBV) information and response services, while upholding the human rights of these specific populations.

The project encompasses various SRHR components such as HIV testing and counseling, STI screening, cervical carcinoma screening, behavior change communication, community Squad initiative activation to address GBV, Income Generating Activities (IGA) via a community-led social marketing approach, outreach initiatives by Change Agents (Peers), and monitoring efforts. Coordination and advocacy leadership are also emphasized to fortify referral services for health, social safety nets, ART adherence, mental health and psychosocial support (MHPSS), general ailment management, and maternal and child health services (ANC/PNC, institutional delivery, safe MR), as well as TB and diabetic screening.

Several innovations are integrated to ensure high-quality service delivery and to mainstream interventions for sex workers. These innovations include:

(i) Establishing Comprehensive Service Centers (CSCs) branded as "Sukhpakhi" to serve as a hallmark of quality, promoting healthier practices among female sex workers and their clients. (ii) Relocating all SRHR service centers for brothel-based sex workers outside, but in close proximity to brothels, to assess the feasibility of providing services for the targeted populations from centers outside brothels. (iii) Introducing Strip (ICT) tests for syphilis screening as a Point of Care (POC) to minimize the risk of antimicrobial resistance to antibiotics, and utilizing Rapid test kits for HIV testing services. (iv) Decentralizing cervical cancer screening at government facilities. (v) Providing leadership skill development training for CBO leaders and change agents focusing on GBV and mental health. (vi) Capacity building for change agents to facilitate effective group education. (vii) Reinforcing referral and MHPSS services through local-level coordination. (viii) Conducting Hepatitis B&C screening. (ix) Collaborative advocacy and coordination efforts to strengthen referral services, facilitate enrollment in social safety net support, and create a non-stigmatized and non-discriminatory environment for female sex workers at government facilities, along with legal aid services. (x) Implementing social marketing initiatives for lubricants and fragrant condoms by CBOs as a cafeteria choice.

 

SDG focus:

SDG 3: Good Health and Wellbeing

SDG 5: Gender Equality

SDG 10: Reduced Inequalities

SDG 16: Peace, Justice, and Strong Institutions

SDG 17: Partnerships for the Goals

Name of the project:

Improving Women and Girl’s Resilience to Climate Change (IWGRCC)”.

 

Program Area:

Enhance capacity of health service providers, awareness and resilient of women, girls and the community on climate change and its impact on sexual and reproductive health and rights in selected Unions of Bhola (Char fashion Upazila) and Bagerhat (Mongla Upazila) to through better preparation and improving availability and utilization of health care services by the targeted community.

Duration: July 2023 to December 2024 

Funded by: UKaid

Supported By: United Nations Population Fund (UNFPA)

Implementation area of PHD:  Bhola (4 unions in Char fashion upazila) and Bagerhat District (4 unions in Mongla upazila). 

Target audience: Front-line health care service providers at govt. structures, adolescent girls, pregnant and lactating mothers, women of reproductive age, and community vulnerable due to climate change affect.

The purpose of the project is to develop a resilient community to address climate shocks and its impact on girls and women’s health through enhancing awareness and preparedness to respond the climate induced vulnerabilities and risks in particularly on Sexual and Reproductive Health services and Rights (SRHR) simultaneously by strengthening capacity of front-line health care service providers linked with Upazila and upwards level  govt. health-structures to serve the better services in particularly during disaster and post disaster stage.

PHD is working to improve the sexual and reproductive health services in local communities, with a particular focus on diseases related to climate change affect includes maternal, newborn and reproductive health and the rights of the women and girls those are more vulnerable due to climate change affect.  The project is committed to raising awareness and mobilizing the community for their better preparedness and resilient to absorb the climate induced vulnerability and minimize the risks of adolescents, pregnant and lactating mothers, women of reproductive age those remains lack of knowledge and limitation in accessing the services, unprotected and at high risks.

The project will achieve 5 objectives likely:

Objective 1: Capacity of service providers are enhanced and prepared for better serve / respond to the vulnerable community affected by Climate change.

Objective 2: Communities are oriented on and prepared for the health impacts of climate change.

 

Objective 3: Communities have improved capacity on adaptations for coping the health impacts due to climate change impacts.

Objective 4: Communities are supported to make preparation plans to respond natural disasters.

Objective 5: Adolescents oriented on climate change and the health impacts of climate change.

Name of the project: BDG Strengthening resilience and social cohesion of Rohingya and host communities in Cox's Bazar through integrated social services and improved livelihoods

Duration: November 2022 to December 2024

Funded by: BMZ

Supported by: Save the Children

Implementation area of PHD: All unions of Ukhiya and Teknaf except Saint Martin in Cox’s Bazar District. 

Other Implementing Partners of the Project:

CNRS and BITA

Target audience:

Children Under Five (including those with disabilities), Mothers, New-borns,     Adolescent, Family caregivers, Men and women of reproductive age, Elderly people who are at risk with physical/ mental impairments and disproportionately underrepresented in accessing and/or utilizing services because of their age or gender.

Direct beneficiaries # 85,256

Indirect beneficiaries # 249,855

PHD will work to ensure intermediary support of all stakes in all the union of the respective upazilas so that they can work as advocates in regard to project activities. PHD will use community-level project events to involve influential community decision-makers – including the local elite, elected officials and religious representatives and create an empowering environment for women and children to learn behaviours that promote good health. The aim is for influential community members not only to support the projects that create such an environment, but also to use their standing in the community to act as intermediaries and advocates. With the project interventions, PHD aims to mobilize communities and, working hand-in-hand with local authorities, ensure that everyone has a comparable level of knowledge and can voice their concerns as a community. These efforts aim to serve as motivation to promote proper maternal, new born and child health (MNCH) and ASRH behaviours.

PHD will implement health activities in coordination with the local health and family planning administration. This platform forms the basis for coordination and cooperation through synergistic pooling of information gained from the various projects according to their respective advantages of the individual NGOs and projects they implement in the upazila.

The project focuses on four sub-objectives to empower vulnerable families in the host communities in Cox's Bazar. The project activities are integrated within these four objectives.

PHD will closely work for Sub-goal 1: Vulnerable girls, boys, women and men have improved access to quality primary health care, including improved access to MHPSS services and referrals.

Program Area:

  • Psychosocial counselling for mental health and psychosocial support in the project area
  • Involvement of Community Health Workers
  • Training and capacity building for project health workers and community health workers in MNCH, ASRHR, SRHS, GBV, nutrition, IMCI, PFA and referral of MHPSS patients
  • Training, meetings and orientations in community groups (mothers' group, youth group)
  • Health messages, awareness raising and dissemination of information in different ways (interactive folk theatre, street theatre, road show presentations, folk songs, etc.)
  • Develop, contextualize and print IEC and BCC materials on hygiene, nutrition and health education, including COVID-19 prevention
  • Training and capacity building for government health service providers
  • Referral of patients to higher level facilities

Name of the project: “Sexual and Reproductive Health and Gender Based Violence prevention and response service (SRH&GBVP)

Programme Area: Improved

availability and utilization of primary

and secondary health care services

including comprehensive integrated

sexual reproductive health services,

maternal health, psychosocial support and

AY Adolescents services for catchment

populations of targeted facilities in

Noakhali district.

Duration: January 2023 to December 2024

Funded by: From the people of Japan

Supported By: United Nations Population Fund (UNFPA)

Implementation area of PHD: Noakhali (Sadar & Hatiya Upazila) District    

Target audience: Coverage Approximate 4,76,857 populations: Adolescents, women of reproductive age, pregnant and postpartum women, women at risk and survivors of gender-based violence.

SDG focus: SDG 3: “To ensure healthy lives and promote well-being for all at all ages”.

 

 

 

Noakhali is one of the most vulnerable districts in Bangladesh, 1 out of 3 people living below poverty line (BBS 2016). The district lags in various Sexual and Reproductive Health (SRH) indicators compared to national averages (BDHS 2017-18). The EmOC performance report of 2021 reveals a concerning 30% unmet need in the Chittagong division, where Noakhali is located. The only government facility offering 24/7 Comprehensive Emergency Obstetric and Newborn Care (CEmONC) services, the 250-bed General Hospital, is strained due to increased patient influx from the Rohingya crisis. Sadar and Hatiya Upazila, in particular, lack sufficient 24/7 safe facility delivery and other essential SRH services at the union level, posing a serious concern for community well-being. In response, Partners in Health and Development (PHD), in collaboration with the Directorate General of Health Services (DGHS) and the Directorate General of Family Planning (DGFP), is executing the "Sexual and Reproductive Health and Gender-Based Violence Prevention and Response Service project." This initiative is financially supported by from the people of Japan through the United Nations Population Fund (UNFPA). The project aims to deliver equitable Sexual and Reproductive Health (SRH) care and Gender-Based Violence (GBV) response services to communities in the Sadar and Hatiya Upazila of Noakhali district.

Through this project, PHD has strategically deployed a diverse team, including medical doctors, midwives, community mobilizers, support staff and other managerial staffs in all working areas for maintaining coordination with government officials to ensure quality SRH&GBV services at the Union, Upazila and District level facilities. The project strengthens the health system, providing 24/7 Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC) services, emphasizing MNCAH and SRH, including family planning and GBV response in hard-to-reach areas. Capacity building for service providers, enhancement of Monitoring and Evaluation (M&E), and logistics supply chain systems are priorities. The project has specialists working to strengthen EmONC services and midwives contributing to evidence-based maternity care practices and the initial stabilization of PPH and eclampsia cases.

The project will work to achieve 5 project objectives likely-

Objective1: Functional 24/7 high quality CEmONC services at Noakhali 250 Bed District Hospital

Objective2: Improved provision of high quality basic and emergency obstetric services at Hatiya Upazila

Objective3: Enhanced availability of integrated SRH information and services, including post-partum family planning & contraception

Objective4: Improved availability of health service response and psychosocial support for gender-based violence

Objective 5: Capacity building to develop skilled health service providers and Stake holder mobilization utilize community cedars.

Name of the project: Lifting Healthy, Empowered and Protected Girls and Women in Cox’s Bazar

Programme Area:

  • Improve the individual and collective agency and resilience of adolescent girls and young women to exercise their SRH and protection rights
  • Strengthen health systems to provide sex- and age-responsive quality health and protection services
  • Enhance the capacity of local women's rights organizations (WROs), including girl-led organizations (GLOs), and youth-led organizations (YLOs) on evidence-based advocacy for gender- and adolescent-responsive and inclusive (GARI) health and protection services while advocating for long-term change for evidence-based GARI SRH, SGBV and MHPSS services and programming
  • Improved, integrated SRHR outcomes for girls have shown to contribute to better lifelong outcomes in education, protection, livelihoods and overall wellbeing

Duration: June 2022 to November 2024  

Funded by: Global Affairs Canada (GAC)

Supported by: Plan International Bangladesh

Implementation area of PHD: Seven Unions (i.e. Khuruskul, Jhilonga, Chowfoldondi, Eidgaon, PM Khali, Jalalabad, and Vharuakhali) of Cox’s Bazar Sadar and two unions of Teknaf (i.e. Teknaf Sadar and Sabrang) subdistrict under Cox’s Bazar District. 

Other Implementing Partners of the Project:

Mukti Cox’s Bazar, Hope Foundation and SKUS

Target audience:

LEAP will directly reach total 97,773 people, where 60,578 Adolescents Girls and Young Women (AGYW) age between 10-24 Years and 37,196 Adolescent Boys and Young Men age between 10-24 years old.  The project will also indirectly reach total 1,02,591 people including 53,861 females.

Cox’s Bazar district is lagging the national average for development indicators, with 32.7% of people living below the poverty line and a literacy rate of 39.8% in 2019. The population of Cox’s Bazaar is 2.82 million (2022). Women and girls in Cox’s Bazar are facing deteriorating sexual and reproductive health and rights (SRHR) and protection. Families, especially women and girls in Cox’s Bazar, are exposed to threats from criminal groups, trafficking, violence, child abuse and neglect as well as child, early and forced marriage (CEFM). Incidences of CEFM have increased during the pandemic due to the disruption of education and economic activity as well as rising food prices. There are still gaps in the outreach of safe and quality gender-based violence (GBV) services and referral mechanisms. Mental health and psychosocial support (MHPSS) services are non-existent. Poor mental health can be associated with risky sexual behaviour and substance abuse, resulting in negative impacts on the SRHR of adolescent girls and young women, including heightened vulnerability to unintended pregnancy, unsafe abortion, sexually transmitted infections (STIs) and sexual and reproductive gender-based violence (SGBV). Harmful social, gender and patriarchal norms, attitudes and behaviours present in both host community and camp settings disempower women and girls. Unequal power relations, compounded by the impacts of COVID-19, confine women and girls with the burden of unpaid care work, increase their risk of intimate partner violence (IPV), hinder their access to and control over resources, exclude their participation in family and community decision-making and limit their mobility, which makes them vulnerable to GBV and restricts their SRHR. Use of Long-Acting Reversible Contraceptive (LARC) is 8.6% nationally, 6.2% in Chottagram division, and 5.39% in Rohingya camps. The contraceptive prevalence rate is low due to lack of widespread, deep rooted stigma, misconception and societal expectations of women and girls.

Considering the local context and set key assumptions, the project has set an objective to advance the realization of sexual and reproductive health and rights (SRHR) of adolescent girls and young women (AGYW) in all their diversity in Cox's Bazar host communities and refugee camps. For achieving the ultimate outcome LEAP set following three interconnected pillars as intermediate outcomes which will cover the ‘Demand’, ‘Supply’ and ‘Accountability’. Firstly, the project will improve individual and collective agency and resilience of adolescent girls and young women to exercise their SRHR and protection rights (1100). Secondly, health systems will be strengthened to provide GARI SRH, SGBV and MHPSS services to adolescents and young people, particularly girls and young women (1200). Finally, the project will work to enhance capacity of local stakeholders (WROs/GLOs and YLOs) to advocate for evidence-based and accountable GARI SRH and SGBV services and policies (1300).

In partnership with three local implementing partners and one key technical partner, LEAP project will directly reach a 97,773 Adolescents Girls and Young Women (AGYW) age between 10-24 years and Adolescents Boys and Young Men (ABYM) age between 10-24 years while indirectly it will reach 102,591 adult men (25+) and women (25+ years) across the host and refugee communities which includes 2 unions each in Ukhiya and Teknaf, 7 unions each in Ramu and Cox’s Bazaar Sadar district and 3 camps in Ukhiya. A range of activities have been used to arrive at these figures that includes CHW monthly home visits, CoC sessions, parenting sessions, men’s club meetings and other community sensitisation activities. The project will reach a total of 2,792 intermediaries.

Immediate outcomes of the project are;

Outcome 1: Adolescent girls and young women are empowered with knowledge and skills to overcome social and structural barriers related to GE, SRHR, SGBV prevention and protection, MHPSS and autonomous decision-making capacities to make informed life choices

Outcome 2: Adolescent girls and women empowered through increased social capital to overcome gender, cultural and intersectional barriers to SRHR mental health, and SGBV

Outcome 3: Enhanced capacity of community and facility-based service providers and government decision makers to deliver gender and adolescent responsive integrated (GARI) SRH, SGBV and MHPSS services to adolescent girls and women

Outcome 4: Improved availability of appropriately resourced facilities to provide GARI integrated SRH, SGBV and MHPSS services

Outcome 5: Enhanced capacity of women rights organizations (WROs) and youth led organization (YLOs) to conduct evidence-based advocacy to improve SRHR, SGBV and mental health services

Outcome 6: Enhanced accountability, decision making and participation in community-based structures

Outcome 7: Communities in Cox’s Bazar benefit from strengthened ISCG coordination mechanisms dedicated to humanitarian/development nexus interventions, by leveraging the experience and perspective of international and national NGOs

Name of the project: BDG Strengthening resilience and social cohesion of Rohingya and host communities in Cox's Bazar through integrated social services and improved livelihoods

Duration: November 2022 to December 2024

Funded by: BMZ

Supported by: Save the Children

Implementation area of PHD: All unions of Ukhiya and Teknaf except Saint Martin in Cox’s Bazar District. 

Other Implementing Partners of the Project:

CNRS and BITA

Target audience:

Children Under Five (including those with disabilities), Mothers, New-borns,     Adolescent, Family caregivers, Men and women of reproductive age, Elderly people who are at risk with physical/ mental impairments and disproportionately underrepresented in accessing and/or utilizing services because of their age or gender.

Direct beneficiaries # 85,256

Indirect beneficiaries # 249,855

PHD will work to ensure intermediary support of all stakes in all the union of the respective upazilas so that they can work as advocates in regard to project activities. PHD will use community-level project events to involve influential community decision-makers – including the local elite, elected officials and religious representatives and create an empowering environment for women and children to learn behaviours that promote good health. The aim is for influential community members not only to support the projects that create such an environment, but also to use their standing in the community to act as intermediaries and advocates. With the project interventions, PHD aims to mobilize communities and, working hand-in-hand with local authorities, ensure that everyone has a comparable level of knowledge and can voice their concerns as a community. These efforts aim to serve as motivation to promote proper maternal, new born and child health (MNCH) and ASRH behaviours.

PHD will implement health activities in coordination with the local health and family planning administration. This platform forms the basis for coordination and cooperation through synergistic pooling of information gained from the various projects according to their respective advantages of the individual NGOs and projects they implement in the upazila.

The project focuses on four sub-objectives to empower vulnerable families in the host communities in Cox's Bazar. The project activities are integrated within these four objectives.

PHD will closely work for Sub-goal 1: Vulnerable girls, boys, women and men have improved access to quality primary health care, including improved access to MHPSS services and referrals.

Program Area:

  • Psychosocial counselling for mental health and psychosocial support in the project area
  • Involvement of Community Health Workers
  • Training and capacity building for project health workers and community health workers in MNCH, ASRHR, SRHS, GBV, nutrition, IMCI, PFA and referral of MHPSS patients
  • Training, meetings and orientations in community groups (mothers' group, youth group)
  • Health messages, awareness raising and dissemination of information in different ways (interactive folk theatre, street theatre, road show presentations, folk songs, etc.)
  • Develop, contextualize and print IEC and BCC materials on hygiene, nutrition and health education, including COVID-19 prevention
  • Training and capacity building for government health service providers
  • Referral of patients to higher level facilities

Name of the project: Women Led Climate Resilience (WLCR)

Programme Area: Climate resilience, Health, Sexual and Reproductive Health

Duration: July 2022 to July 2023  

Funded by: Pathfinder International

Supported by: Pathfinder International

Implementation area of PHD: Mollar Char, Kamarjani & Gidari of Sadar Upazila, Holdia, Ghuridaho, Vorodkhali of Saghata Upazila and Gojaria, Fazlupur, Fulchori of Fulchori Upazila

Target audience: Pregnant women and adolescent girls

Purpose: The purpose of this program is to provide solutions to the problems caused by climate change which has caused repetitive flooding and erosion which has adversely affected the livelihoods of women and girls in Gaibandha.

Project brief:

Gaibandha, the northern district of Bangladesh, which is one of the districts most severely affected by flooding and erosion. Gaibandha belongs to the mainland region where more than 80 percent of people here are directly or indirectly involved with agricultural production and their livelihoods are adversely affected by a concentration of various. Repetitive floods and riverbank erosion increase the vulnerability of the natural resource bases of the area and affect the livelihood of the communities. There have been many initiatives on emergency response and building community resilience in the Gaibandha district, but few have focused on health and SRH needs. The sustainable community information and support mechanism has not to be seen as a major solution model for building a climate-resilient community that addresses women’s health issues and supports to access quality health services. PHD has been working on strengthening such a community support mechanism in its MNCHN interventions across the country and its experience.

Through the project, PHD would like to address the issue problem by;

  1. “Women-led Community Support System” that will work on empowering women and developing them as change agents and resilient leaders in the community support system structure.  Women UP members, CHWs, and other women group/ CBO leaders will be included as part of gender transformation initiatives.
  2. “Harmonizing Local Level Effort” will focus on local level partnership with other development actors to access the women group, CBOs, and ongoing supports. This block will facilitate the local government and local actors to coordinate and harmonize their effort to avoid overlapping and reach more vulnerable women.
  3. “Strengthening Local Health System” will focus on the capacity building of CHWs in delivering health, SRH, and GBV services during emergency responses and disasters. The project will mobilize the local health system towards more responsive service mechanism by revitalizing community support system and strengthening tracking and referral mechanism.
  4. “The local Government Led Sustaining Model” will mainly work on the sustainability of all the best practices under three building blocks. PHD’s expertise in local government sensitization will contribute to mobilizing the local government institutions from the inception phase of the project.

Name of the project: Midwifery-led health services for the islands people in Bangladesh

Programme Area: Primary Health Care with special emphasis on Maternal, New-born and Child Health

Duration: April 2022 to December 2024  

Funded by: Swedish Postcode Foundation

Supported by: Concern Worldwide

Implementation area of PHD: Char Kukri Mukri & Dhal Char union of Charfasson and South Sakichia & Hazirhat of Manpura upazila(s) of Bhola District

Target audience: 68,273 people living on these two remote islands

Purpose: To develop a community led model that improves the health status of the hard-to-reach and marginalized island communities by increasing accessibility, coverage, comprehensiveness and sustainability of the Union Health and Family Welfare Centre (UH&FWC).

Project brief:

The two islands (Monpura and Char Kukri Mukri), in Bhola District, Barisal Division have high rates of poverty, a high fertility rate and inhabitants lack access to inclusive, quality and affordable healthcare services. In particular, women have very limited access to maternal care and health facilities that may offer safe child delivery options. Although poor families spend high portions of their income on health, spending household income for women’s health is negligible due to traditional gender norms.

Under these two Upazila, the project will intensively work in South Shakuchia Union of Monpura Upazila and Char Kukri Mukri (CKM) island of Charfason Upazila. There is no functioning Union Health and Family Welfare Centre (UH&FWC) on either of the island. Thus, project will deploy Midwives and Medical assistants in these two UH&FWCs to provide ESP services following GoB guideline. Besides these two unions, the project will also provide limited-scale support at Dhalchar Union of Charfason Upazila and Hazihat Union of Monpura Upazila, as there is no active service provision there either, except a few community clinics.

The project will work with five specific output, likely;

Output 1: Increased availability of health services through skilled health service providers.

Output 2: Improved access and utilization of healthcare services.

Output 3: Increased quality of & accountability for essential health services.

Output 4: Increased demand through enhanced health behaviours.

Output 5: Sustainable health model tested and adopted

Name of the project: “Maternal, Neonatal, and Child Health (MNCH) and Nutrition Service Delivery for Bangladeshi Host Communities at Cox's Bazar District”

Programme Area: Maternal, Neonatal, and Child Health (MNCH) and Nutrition Service Delivery

Duration: Decmber 2021 to 30 December 2024

Funded by: World Bank

Managed by: UNICEF

Implementation area:

  1. CEmONC at two remote UHCs in Moheskhali and Kutubdia
  2. BEmONC services at 3 UHCs in Ramu, Pekua and Chakaria
  3. SCANU at the district hospital
  4. NSUs, KMC & lMCl services across 5 UHCs in Moheskhali, Kutubdia, Ramu, Pekua and Chakaria
  5. Quality MNCH services across all the 5 UHCs  

Target audience:

  1. Pregnant Women- 66,989 (PWD 937)
  2. Children (0-11 Months)- 64,584 (M- 33,123 & F- 31,461,
  3. PWD 904)
  4. Children Under 5- 372,321 (M- 187,684 & F- 184,637,
  5. PWD s212)

 

Cox's Bazar District has among the worst health, nutrition and population indicators in Bangladesh. There is a high infant mortality rate of 33 per 1,000 live births in Cox Bazar which is lower in compare to the national rate of 34 per 1,000 live births, still fall short of global targets and standards. ln addition, there is a higher prevalence of stunting among children under 5 of 34.6 per cent in Cox Bazar in compare with 28 percent at the national level.

Antenatal care coverage in Cox Bazar district is below the national average, with 60 per cent of pregnant women attending at least one antenatal care consultation in compare to 75 per cent at the national level, and only 33 per cent of pregnant women attending four antenatal care visits against 37 per cent of national average. Institutional delivery in Cox’s Bazar is 29 per cent against the 59 per cent of national average, and delivery by skilled birth attendant stands at 34 per cent in compare to 59 per cent nationally. Post-natal care for new-borns is 39 per cent in Cox’s Bazar compare to the national average of 67 per cent, and post-natal care for mothers is 37 per cent compare to 65 per cent nationally.

Complementary interventions through other collaboration:

•   UNICEF supply section is responsible for infrastructural upgradation of respective facilities

•   Apart from PHD, two partners of UNICEF are responsible for implementing some other trainings, QI initiatives, resource mobilization and data management and integration

Expected Outcomes:

All the planned interventions will contribute to enhancing the provision of -

•   CEmONC at two remote UHCs in Moheskhali and Kutubdia

•   BEmONC services at 3 UHCs in Ramu, Pekua and Chakaria

•   SCANU at the district hospital

•   NSUs, KMC & lMCl services across 5 UHCs in Moheskhali, Kutubdia, Ramu, Pekua and Chakaria

•   Quality MNCH services across all the 5 UHCs

A strengthened and resilient health system will enable the achievement of Universal Health Coverage (UHC) and address inequities, including those faced by Rohingya refugees, as well as vulnerable populations rural and hard to reach locations including PWD.

Program Output-1:

The health system is strengthened to provide access to continuous comprehensive Maternal, Neonatal, Child and Adolescence Health (MNCAH)and Nutrition services through the delivery of Essential Service Packages (ESP) for Host communities through the recruitment and placement of staffs at UHCs.

Program Output-2:

The health system is strengthened to provide access to continuous comprehensive Maternal, Neonatal, child and Adolescence Health (MNCAH) and Nutrition services through the delivery of Essential service Packages (ESP) for Host communities through technical capacity building of new and existing HCW.

Program Output-3:

The health system is strengthened to provide access to continuous comprehensive Maternal, Neonatal, Child and Adolescence Health (MNCAH) and Nutrition services through the delivery of Essential Service Packages (ESP) for Host communities by strengthening quality improvement (QI) initiatives, providing operational and coordination support

Upholding Accountability to Affected Population (AAP):

While the overarching focus and priority of Health and Gender Support Program (HGSP) is to build health systems and strengthen the delivery of high quality MNCAH&N services in host community facilities, the general expectation is that Rohingya refugees may still benefit from the strengthening of the health system in the district, especially at UHCs. The program will continue extended collaboration with key actors to ensure Accountability to Affected Populations through establishing a strong mechanism of receiving feedbacks from the service recipients and leverage existing grievance redressed mechanism (GRM). Feedbacks will be collected and tracked monthly to ensure that proper corrective actions have been taken.

Name of the project: “Model Urban Primary Health Care (PHC) Clinics”

Programme Area: PHC services in selected 6 clinics in 4 city corporations in Dhaka North, Dhaka South, Gazipur and Narayangonj as per the standard Essential Service Package (ESP) guideline

Duration: July 2021 to September 2025

Funded by: UNICEF

Consortium Lead: Partners in Health and Development (PHD)

Consortium Partners: Nari Maitree (NM) and CMED Health

Implementation area:

  1. Aalo Clinic, Karail DNCC (Ward # 19, DNCC)
  2. Aalo Clinic, Duaripara, Rupnagar, Mirpur DNCC (Ward # 06)
  3. Aalo Clinic, Shyampur, DSCC (Ward # 48)
  4. Aalo Clinic, Dhalpur, Jatrabari DSCC (Ward # 49)
  5. Aalo Clinic, Ershadnagar, Tongi, GCC (Ward # 49)
  6. Aalo Clinic Narayanganj City Corporation, (Ward # 15)

   

Target audience:

  1. Pregnant women
  2. Mother
  3. Infant
  4. Under five children
  5. Adolescent
  6. Women of reproductive age
  7. Old age population for NCDs.

 

Approximately 100,000 population in each 6 Urban  Clinics‘ catchment areas.

Purpose: To develop a model PHC service delivery system for future scaleup in 4 city corporation following Essential Service Package (ESP) guideline as and standards.

The expected results from the project: The project will achieve the below results in coordination with Mayor's office, City Corporation and Ward Health and Education Committees, and with Ministry of Health and Family Welfare (DGHS/DGFP/DGNM):

  1. Financial and Administrative management of 6 urban PHC clinics are established.

The project will assist the GOB in establishing and managing a functioning clinic, as well as establishing an effective relationship with primary healthcare in the private sector. Urban PHC clinics should be set up according to UNICEF and Bangladeshi government norms and guidelines, which include appointing general physicians and consultants, as well as hiring personnel and health workers. Patient registration, administration, account management, and telemedicine will all be put up as part of the project. The Pay-for-performance (P4P) idea will be used to build cost-effective fiscal management. The project will implement an ICT-based claim management system for claim preparation and verification.

  1. Quality Primary Healthcare services are provided.

The project will ensure effective delivery of Primary Healthcare as per standards in the 6 urban PHC clinics including community outreach services. The project will facilitate capacity building of service providers through training courses provided by UNICEF and GOB. Quality Primary Healthcare including essential nutrition specific services should be ensured as per the Essential Service Package for promotive, preventive and curative care for the population in the catchment area. The project will establish effective supply chain management system for Essential medicines and logistics, through the Ministry of Health and Family Welfare, i.e., the project will receive the required commodities from the MoHFW. Referral system for complicated cases and ICT based Integrated Health Management Information System (IHMIS) will be established with support from UNICEF and GOB.

  1. Service utilization rates will be increased through demand generation.

The project will ensure community participation in all steps of the project. It will introduce activities related to demand generation and promotion.

The services to be provided from the clinics are:

  1. Maternal, neonatal, child and adolescent health care pre-conception, antenatal, delivery, postnatal
  • Maternal and Newborn Care (ANC, PNC and Delivery Referral, Newborn care etc.)
  • Child Health and Immunization (IMCI, ARI, Diarrhea, GMP, EPI etc.)
  • Adolescent Health (SRH, RTI/STI, Dysmenorrhea, TT vaccine, Nutrition, counselling on mental health)

2.    Nutrition

  • Child Nutrition: assessment of nutrition status, prevention of malnutrition, management of malnutrition
  • Promote exclusive breast feeding, complementary feeding, WASH for children, GMP
  • Support to MAM children and Refer SAM children
  • Maternal Nutrition (BMI screening of malnourished pregnant, MUAC, counselling for food)

3. Non-Communicable Diseases (NCD)

  • NCD (Hypertension, Diabetes Mellitus, Arsenicosis, Chronic Obstructive Pulmonary Disease etc.) Consultation & Referral
  • Mental Health Consultation
  • Sexual and Gender- Based Violence (SGBV)

4. Management of other common conditions

  • Eye Care & Referral
  • Skin care & Referral
  • Geriatric (Elderly) care & Referral
  • Minor Infection & Disease
  • Health Education & Counselling

5. Family Planning (FP method selection counselling, provide OCP, condom, injectables and IUD)

6. Communicable Diseases (Consultation on Communicable Diseases, referral, consultation on STI/STD)

7. Laboratory Urinalysis, Hb estimation, Blood grouping and Rh typing, Blood sugar, CBC, ECG

Name of the project: “Health and Gender Support for Cox's Bazar District (HGS-CXB)”

Programme Area: Integrated sexual, reproductive health and rights (SRHR) and gender-based violence (GBV) prevention and response services and information

Duration: June 2021 to June 2023  

Funded by: World Bank

Supported By: United Nations Population Fund (UNFPA)

Implementation area of PHD: Cox’s Bazar District    

Target audience: Pregnant Women, Lactating Mothers and Caregivers, Adolescents, Under 5 Children and others.

To reinforce the integrated and equitable sexual and reproductive health information, including GBV prevention and response services and information in all aspects of mobilization and of health care facilities, host communities, DRP camps as well as information management in COX” Bazar a program is implementing which has been articulating the improving government system’s capacity. Partners in Health and Development (PHD) stepped to enhance the area of work to improve the sexual and reproductive health (SRH) of host communities through the maternal, neonatal, and reproductive health program and GBV counselling. As per the organizational context, PHD committed to sensitize and mobilize the people of the community level to search SRHR where a critical gap is identified and especially unmarried adolescents, girls in particular where SRHR insights enable young people to make more informed decisions regarding their own sexual health and rights. Information and health awareness support in maintaining the population size and to avoid unwanted pregnancies similarly, sensitize, stimulate families in the prevention of gender-based violence. Throughout the enhanced and innovative program of social mobilization in the community different strategies have been designed as per the interventions.

To aware, the community people about SRHR such as Family planning, antenatal care, postnatal care, and facility delivery, etc. community health workers will mobilize the information through household visits in those catchment areas where communication and infrastructure are in proper condition. The hard-to-reach unions and villages will be accessed through responsible and interested people of the community. Along with these, awareness sessions, workshops, and dedicated assemblies will be organized with the community leaders and people of different ages and sex to sensitize them about SRHR information and services. With a view to relating the real-life scenario on SRHR with the community people, different kinds of IPT the show, street drama, folk song, roadshow, film show, audio-visualization of educational materials on SRHR information will be developed for reaching more people. Also, slots for SRHR information on radio channels and short animated video starring a role model for TV will be utilized to disseminate the information to the common people.

To give orientation and briefings on the interventions, staff induction, Basic SRHR, and GBV training and Refresher TOT, Day long orientation/training to UP secretaries on the intervention to facilitate UP’s support to the project, keep Chairman and Parisad informed on progress and keep SRHR agenda in UP's meetings. Organize Training on Supportive Supervision for HI, AHI, FPI Support to organize UDCC meetings on a regular basis (quarterly) at the Union level will be organized to develop the knowledge and ideas of the project staff throughout the program interventions.

To develop the common understanding among stakeholders and ensure active participation and aligning activities with overall district plans and to upgrade the knowledge and Skills to minimum level different monthly, bi -monthly and quarterly meetings will be conducted. From the targeted areas some awareness groups like peer mothers, adolescent groups, etc. will be developed through providing proper information on SRHR and engaging them with program activities. Workshops on SRHR information with SACMO and other organizations will be arranged to improve the capacity of the field and facility staff of the targeted areas. Meetings with the UP standing committee, community support groups; public, private organizations, etc. will be organized to discuss SRHR information for upgrading the capacity of staff related to the projects.

The project will work to achieve 3 project objectives likely;

Objective 1: Improved access to and utilization of integrated SRHR and GBV prevention and response services in union level facilities of Cox's Bazar.

Objective 2: Improved access to and utilization of integrated SRHR and GBV prevention and response services in Displaced Rohingya Population (DRP) camps in Cox's Bazar

Objective 3: Strengthened system and capacity at the institutional and individual levels for integrated SRHR and GBV prevention and response services in Cox's Bazar

Name of the project: “USAID’s Shukhi Jibon”

Programme Area: Adolescents and youth with sexual and reproductive health information and services

Duration: May 2021 to April 2023  

Funded by: United States Agency for International Development (USAID)

Managed by: Pathfinder International (“Pathfinder”)

Implementation area of PHD: Four Upazila from Kishoreganj district (Kishoreganj Sadar, Karimganj, Hossainpur and Pakundia) of Dhaka region and Four Upazila from Moulvi Bazar district (Srimangal, Moulvibzar Sadar, Rajnagar and Kamalganj) of Sylhet Region.   

Target audience: Adolescent couple, First Time Parent (FTP), Parents/ family members of Adolescent Couple /FTPs, Adolescent (10-19), Youth (20-24) and Tea Garden Adolescent girls and mothers.

Goal: The project goal is “To increase the service seeking behaviour among the target adolescents and youths for SRH services supported by informed, empathetic and responsive healthy social environment and knowledgeable peer support”.

Bangladesh, particularly in the selected geographical areas, major information gaps exist concerning Sexual and Reproductive Health (SRH) and its knowledge, attitudes and practice among adolescents. Adolescents and Young people are predominantly vulnerable to a wide range of variables, such as peers' influence, media projection of sexuality, and access to contraceptives, informing and shaping their behaviour. Adolescents at risk are often difficult to reach as many are illiterate, school dropout and unemployed. Also, some adolescent issues are rooted in society's socio-cultural norms (tea gardens), which are not addressed properly. The most vulnerable groups are adolescent couples and First Time Parents (FTPs) as the targeted geographical areas have a high early marriage rate. Overall, the projects identified the bottleneck problems to reach adolescent with SRH messages and services using the Tanahashi Model. It determined a need to develop an informed sphere of influence that is most important to adolescents and meets their information apatite on SRH.

The project will address the problems mentioned above by creating an informed sphere of influence on SRH issues for adolescents at four levels- Peer, Family, Community and School during the major adolescent life events- Menarche, Schooling, Entry to Marriage and First Birth.

The project has 6 major objectives, likely

Objectives-1: To increase the access to accurate SRH information by target adolescent and youth and their family

Objective 2: To increase access to information on SRH at local facility level (UHFWC and CCs)

Objective 3: To enable an information friendly community environment for young and adolescents to empower them on SRH decision making

Objective 4: To improve knowledge of adolescent at school on SRH and SRHR

Objective 5 : To improve Adolescent Health and SRH knowledge at low coverage areas like Tea Garden and HTR areas

Objective 6: Partnership for modelling and scale up social media and entrepreneurship based innovative approaches for reaching adolescent with SRH message

 

 

Project name: USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP)

 

Project period: 26 April 2018 to 25 April 2023

 

Donor: USAID

 

Consortium partners: BSMMU, IHI, Jhpiego, COHSASA, icddr,b, Dnet, PHD

 

Managed by: Save the Children

 

 

Project location:

17 Districts (Brahmanbaria, Habiganj, Manikganj, Chandpur, Lakshmipur, Feni, Noakhali, Faridpur, Madaripur, Kushtia,

Cox's, Bazar, Netrakona, Sunamganj, 

Sylhet, Bandarban, Chattogram Sandwip, Mymensingh and Shariatpur)

Project overview:

Save the Children and the consortium partners work to advance learning, expand and scale up effective maternal and newborn care (MNC) interventions to substantially improve health outcomes for mothers and newborns in Bangladesh. The project supports the 4thHealth, Population and Nutrition Sector Program (HPNSP) of Bangladesh to achieve its goals of significantly reducing maternal and neonatal mortality by 2022. The project’s strategic objective of increased equitable utilization of quality maternal and newborn care services. Key outcomes will be achieved through four closely linked Intermediate Results (IRs) to advance health system responsiveness, MNC service quality and governance, access and demand for services and healthy household practices, and national capacity to deliver these services with quality at scale. In addition, the project will expand the evidence base and test new MNC innovations in selected learning sites and facilitate health systems improvements and policy changes for sustained impact at national scale.

Role of PHD:

As a technical consortium partner PHD is playing a key role to the following thematic area specific capacity building of partner NGOs and facilitate strategic directions across the several systems to bring collective expertise in policy advocacy.

  • Establish functional Social Accountability: Towards improving responsiveness of health systems to deliver patient-centered MNC Services PHD would initiate an approach to establish Social Accountability (SA) that relies on civic engagement where citizens participate directly or indirectly in demanding services from the service providers.
  • Mobilize local government and accountability: PHD would facilitate an innovative process in engaging Local Government Institutions (LGIs) in local health system and mobilize monetary and nonmonetary local resources for sustainable improvement of MNC service and household (HH) Practices.
  • Engagement and coordination of community groups: PHD would provide strategic direction and technical assistance to the Implementing Partners for improving coordination between existing community cadres and public sectors. PHD would also initiate national level advocacy to accumulate local level lessons learned.  
  • Reduction of Access barrier: Considering the geographical clusters, communication barrier, socio-economic obstacles, inaccessibility of services, seasonal limitation and the like, PHD would facilitate developing alternative service delivery strategies and approaches to reduce access barriers and establish MNC health services at the Hard to Reach (HtR) and Underserved areas.

Major achievements:

  • Engaged facility management committee (FMG) and community support committee (CSC) establishing a Social Accountability mechanism in the pilot areas where client feedback on quality health services is addressed.
  • Mobilized local resources through an innovative process where LGIs and communities are engaged. Through their active participation and contribution, at the union level, the number of upgraded facilities (24/7 UH&FWC) increased up to 80% (472).
  • Director General Family Planning (DGFP) recognized the local resource mobilization model and scale up in new areas.
  • An advocacy initiative with the National Institute of Local Government (NILG) has helped in including a session: ‘Role of Union Parishad (UP) to strengthen MNC services’ in UP training manual.
  • Activated  Community Groups (CG) and Community Support Groups (CSG) through community micro-planning, facilitating front line Ministry of Health (MOH) workers such as Health Assistants (HA), Community Health Care Providers (CHCP), Family Welfare Assistants (FWA), Community Health Workers (CHW) resulting in increased registration of pregnant women (PW) and newborns and build coordination among the public, private and NGO sectors.
  • Underserved union Identified and prioritized through assessment and physical verification, and pilot MNH services initiated at the Hard to Reach and underserved areas.

Name of the project:

Essential Healthcare for the Disadvantaged in Bangladesh (EHD)

 

Implementation period:

July 2019 – Dec 2022

 

Funded by: FCDO (previously known as DFID)

 

Consortium Lead: Concern World Wide

 

Implementation site:

Districts: Bhola, Barguna and Potuakhali

 

In Year 1: Charfasion (both Urban and Rural), Barguna Sadar (Urban), Kalapara (Rural)

 

In Year 2: Patuakhali Sadar (Urban), Patharghata (Rural), Golachipa (Rural), Monpura (Rural), Bhola Sadar (Urban)

 

In Year 3: All

Brief of EHD:

“Essential Healthcare for the Disadvantaged in Bangladesh” is a new health programme funded by   FCDO (previously known as DFID). PHD is one of the partners of the Consortium led by Concern Worldwide that implement the project.

PHD is responsible to implement the project in 3 districts (Patuakhali, Bhola and Barguna) of Barisal division.

Other consortium partners include icddr,b, national international agencies experts in disability, health and family planning, who provide technical support. Telenor Health (currently Digital Health) provides telecommunication services to the project.

The programme aims to increase access to quality essential healthcare for the disadvantaged including people with disabilities in both urban and rural areas of the remote and underserved areas of Bhola, Patuakhali and Barguna districts in Barisal division.

This adaptive programme will test and support effective and sustainable models for increasing access to essential health services for 2 million disadvantaged people including estimated 138,000 people with disabilities living in the coastal areas.

The purpose of the project is to achieve sustainable improvements in health, family planning, and nutrition outcomes among disadvantaged populations including people with disabilities through reductions in morbidity and mortality and improvement in universal health coverage.

The project has two specific outcomes,

 1. Improved access to healthcare by disadvantaged populations

 2. Improved availability and quality healthcare services in the target areas that are financially sustainable;

To achieve the outcomes, EHD program has been started with five different objectives, including:

  1. Improved availability of healthcare services

  2. Improved access & affordability of healthcare services

  3. Increased quality of & accountability for essential health services

 4. Increase demand through enhanced care seeking practices and improved health practices and         behaviours

 5. Sustainable health model tested and implemented through application of adaptive programming approaches and documentation of lessons

With the core principle to deliver affordable and quality healthcare for disadvantaged people including people disability in remote and isolated locations, the project has just started its journey.

Name of the project: “USAID’s Strengthening Multisectoral Nutrition Programming through Implementation Science Activity”

 

Programme Area: Nutrition

 

Duration: July 2018 to May 2022

 

Funded by: USAID

 

Managed by: FHI360

 

Other partners are CARE Bangladesh, Social Marketing Company, Agro-Input Retailers Network and LifeChord Limited.

 

Implementation area: 70 selected unions of 22 selected Upazilas in 6 districts of Bangladesh. The districts are; Jashore,  Kushtia, Pirojpur, Jhinaidah, Chuadanga, and Barishal

 

Target audience: Direct focus on 10,000 pregnant and lactating women, and children under the age of two primarily from poor and extreme-poor

Goal: The Project Goal is “Nutrition policy making and implementation in Bangladesh is informed by high quality local evidence”.

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“USAID’s Strengthening Multisectoral Nutrition Programming through Implementation Science Activity” is a research-based project implementing through consortium approaches by 5 consortium members led by FHI360 where PHD is playing key role in field implementation. This project will contribute to the USAID Bangladesh Country Development Cooperation Strategy Development Objective, Health Status Improved. The Project is applying a mixed methods research approach to assess the effectiveness of different multisectoral nutrition intervention packages delivered through a coordinated approach by the Government of Bangladesh (GoB), NGOs, and the private sector on improving nutrition outcomes known to contribute to overall healthy nutritional status of children under two in Bangladesh.

The project has 4 major interventions, namely

  1. Social and Behavioural Change Communication (SBCC) for all the Households (HH) having Pregnant and Lactating Women (PLW)
  2. Homestead Food Production (HFP) for all poor and extreme poor PLWs in HFP study area
  3. Conditional Cash Transfer (CCT) for PLWs in extreme poor HHs
  4. Multisectoral Referral (MF) for all PLW HHs

The expected outputs of the project are:

  • Increased availability of evidence to guide multi-sectoral nutrition programming implementation
  • Improved capacity to use evidence to inform policy and programmatic decision-making Among six intervention districts

The MSNP is applying a mixed methods research approach to test and refine multisectoral nutrition approaches, interventions and service delivery mechanisms in high stunting areas of Bangladesh. PHD, as the field implementer is implementing project interventions  in various combinations of multisectoral packages under different components like- Social and behavior change communication (SBCC), Homestead food production (HFP), Conditional cash transfers (CCT), Multisectoral platforms at the subnational level, Utilization of health and other services in this project and Gender-transformative as cross-cutting interventions, which focus on strengthening multisectoral platforms at national and sub-national levels to ensure evidence is utilized for nutrition policy and programming, such as;

  • Through SBCC, project is creating opportunity of combining digital SBCC methods with manual SBCC interventions to target the 1000-day window of opportunity through BCC, Advocacy and community mobilization activities. Project is reaching each beneficiary with age specific (age of pregnancy or child) customized digital message each week and at the same time reaching physically through 1473 Mothers Group per month.
  • In HFP study area project is blending two modalities of delivery mechanism involving Community Farmers and Private retailers separately to improve year-round availability and intake of nutritious foods through providing both input and technical support.
  • Providing CCT to targeted women to make them empowered, accessible to improved nutrition care and services as well as protected from situations that could negatively impact nutrition outcomes 
  • In order to bring sustainable change outcomes, project is establishing referral linkages through strengthening union level Multisectoral Platforms (Community Clinics, Union Health & Family Welfare Centers and Union Development Coordination Committees at 70 Unions) for ensuring health and nutrition services.

 

Project Name:

Community based Interventions for Improving Sexual, Reproductive Health and Rights (SRHR) including Maternal and Neonatal Health (ImSRHR&MNH) 

 

Implementation period:

November 2018 to June 2021

 

Client: UNICEF

 

Location: Moulvibazar District of Sylhet Division

 

Duration: 30 Months 

 

Funded by: GAC, Managed and Supported by Unicef

 

Implementation area:

(Geographical Coverage): All Upazilas of Moulvibazar District in Sylhet Division 

 

Focused Population: 19,47,315

  • Pregnant women/ lactating mothers
  • < 5 Children
  • Adolescents

This intervention aims to reduce maternal, neonatal and under five child mortality and morbidity, and improve young child growth and development. The project is a cost-effective approach for district evidence-based planning and budgeting, towards improving the quality of Maternal, Neonatal and Child Health (MNCH) services and establishing a feasible model for health system strengthening including Health Management Information System (HMIS), which will inform the policy maker for national scale up to reduce neonatal mortality and morbidity in Bangladesh.

The 2-year long project is supported by Unicef Bangladesh and will utilize existing health structure of the Ministry of Health and Family Welfare (MoH&FW) for sustaining after completion. The project would introduce Maternal, Neonatal, Child and Adolescence Health (MNCAH) intervention at Moulvibazar district following the identified approaches to increase demand for MNCAH services among recipients through raising awareness of community people as well as rights holder. The project will also improve the availability, accessibility and quality of integrated SRHR including MNCAH service with the intention of empowering women and girls.

Project’s Focused Area:

Gender: The project will directly address gender equity issues focusing specifically on reproductive health services in gender and maternal health issues.

Equity: The project will take necessary measures to ensure services for the poor and vulnerable women who are inadequately served by the current system.

Aim/ Goal/Purpose:

The project aims to address equitable access of services among women, infant and young children, and improving quality of health services in health facilities.

Outcome/ Result:

  • Quality of integrated service delivery and effective coverage strengthened in national and subnational health systems to support the well-being of children under 5 years and their mothers, including those infected and affected by HIV, in emergency and non-emergency situation in rural and urban areas
  • Local Governance improved for producing functional linkages with Local Health systems to ensure equitable access to Maternal, Neonatal, Child and Adolescent Health and Nutrition (MNCAHN) services
  • Capacity of Service Providers increased for improving quality of MNCAH services
  • Appropriate knowledge, caring practices and demand for MNCAHN services increased among the Focused population
  • Community Health Systems strengthened through improved health information system, defaulter tracking of service users

Creating Access to Health for Tea Garden Communities

Moulvibazar district has the largest number of tea gardens in Bangladesh.  Historically Tea Garden Management has been responsible for health and wellbeing of Tea garden workers and the community. They have their own health facilities. However, they have less coordination with local health system and many health interventions have been failed to reach expected level of results due to low achievement in tea garden areas. Tea garden workers have their own beliefs, taboos, norms and practices. Most of which are unfortunately harmful.

Considering the previous experience, the project has undertaken special initiatives for the tea gardens and designed specific interventions for the tea garden communities. Over the years advocacy with the tea garden management has significantly contributed in this special initiative.   The project has taken special tea garden focused initiatives like involving Health and Family Planning Managers and Local Government representatives on Community Mobilization; increasing referral linkages to the Government Health Facilities, conducting regular courtyard sessions and counseling, registration of pregnant women by Community Mobilizers (CM) and reporting coordination between Midwives and the CM. PHD also organizes ‘mother assembly’ in 8 selected tea gardens.

Project Title: Empowering Women for Improved Livelihood through Skill and Entrepreneurship  Development

 

Implementation period:

2015 – On going--

 

Donor: PHD own funded

 

Location: Pangsha, Rajbari

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The overall objective of the project is empowering disadvantaged and underprivileged women and adolescent girls to enhance control over productive resources and improved livelihoods.

Deliverables of the project-

  • Women’s and adolescence skills for income generation developed
  • Engage women and adolescence in entrepreneurship
  • Decision-making by women and adolescence over productive resources and income generation improved
  • Women’s leadership and control over assets and incomes improved
  • Health, nutrition and food security for the vulnerable women, adolescent and children promoted

 

Name of the project;

Improving Community Health Workers Program Performances through Harmonization and Community Engagement to Sustain Effective Coverage at Scale in Bangladesh. Commonly, this project is known shortly as Improving Community Health Workers (ICHW) project.

 

Funded by: USAID

 

Technical Assistance by: Save the Children in Bangladesh

 

Duration: June 2016 to January 2020

https://www.phd-bd.com/admin/upload/generated_file_link/upload/uploaded_file/FILES_21_06_2020_500462042844224054_544783605212804353.jpgObjectives of the project:

  • Objective 1: Institutionalization of Community Health Workers (CHW): Efficient and effective linkages between communities, health services and local systems established inclusive of change in behavior that reduce gender barriers in systems and social norms.
  • Objective 2: Measurement to influence systems and policies: Evidence and data for decision making to promote scale, equity, and mutual accountability generated and used at all levels.
  • Objective 3: Inclusive and effective partnerships: Coordination and collaboration between government, civil society, and the private sector to influence national and local policies and plans improved.

Coverage (geographical and beneficiaries);

Six upazila of Barishal District: Babuganj, Bakerganj, Banaripara, Barishal Sadar, Gournadi and Wazirpur

Direct Beneficiary: Community Health Workers (GO & NGOs) of catchment area

Indirect Beneficiary: 13,63,465 (6,91,819 Male & 6,71,646 Female) population of catchment area

Innovations in implementation;

  • Implementation of Community Clinic (CC) Centered Health Service model
  • Reformation of Community Groups (CG) using Social Mapping
  • Application of harmonized Job Description for CHWs
  • Using of social accountability tools (Community score card) to get community feedback for better community health system
  • Report sharing meeting among community and service providers after EPI at CC

Major achievement:

  • National community health worker strategy developed and approved as part of National Health work force strategy by Ministry of Health and Family Welfare, Bangladesh (MOH&FW)
  • Approved definition of CHWs in Bangladeshi context
  • Harmonized Job Description for CHWs
  • National CHWs Profile
  • CHWs Capacity Building Plan
  • Modified Local Government Engagement Strategy

 

Name of the project:

Nutrition Awareness and Support Services (NASS)

 

Duration: 3 years

 

Funded by: World Bank

 

Managed by: Social Development Fund (SDF) of Ministry of Finance, Bangladesh

 

Implementation area: (Geographical Coverage):

175828 poor extreme poor households in 1050 villages at 15 upazilas across 5 districts

 

Target audience/ beneficiaries (if any specific):

  • Pregnant women/ lactating mother
  • < 5 children
  • adolescent girls
  • Care Givers (mother-in-laws) 

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NASS is a component of Nuton Jibon Livelihood Improvement Project (NJLIP) of Social Development Foundation (SDF) of the Bangladesh Ministry of Finance.  NASS component has been implemented by Partners in Health and Development (PHD) in Mymensing Region covering 15 upazilas of 5 districts. The project is funded by World Bank and The People’s Republic of Bangladesh.

Aim

The project aims to raise awareness, improve attitudes and practices that enhance nutritional outcomes for targeted beneficiaries and to support them in optimizing nutrition through their livelihood activities. 

Outcomes

The project is expecting 6 specific outcomes:

  1. Improved capacity of Nutrition Support Committees (NSC) to mobilize the community and deliver messages on nutrition in collaboration with Health, Family Planning and Nutrition Service Providers and Agriculture Extension Service Providers
  2. Improved child feeding and caring practices for children under 2 years of age within targeted households
  3. Improved maternal health care practices
  4. Increased households’ access to and utilization of nutrition specific services and support delivered by government, other NGOs/INGOs and private sector
  5. Improved households’ access to nutritious food through promoting homestead farming and utilizing increased family income
  6. Increased the visibility and positioning of nutrition at the community level

To achieve the outcomes, the project focuses on the following outputs:

  1. NSC members’ knowledge on key nutrition issues including health, dietary diversity and care practices improved
  2. NSC members’ skills in delivering nutrition messages through group discussion and community engagement strengthened
  3. NSC members’ capability in increasing access of primary targets to nutrition and health services and other entitlements enhanced 
  4. Community Nutrition Volunteers from unemployed youths are trained and engaged for delivering Nutrition messages at the household (HH) level
  5. Hand washing practices adopted in every targeted HHs and access to hand washing stations ensured
  6. Effective and innovative educational and communication materials/tools for communicating Nutrition developed, adapted and finally applied
  7. Nutrition Social, behavioral change communication (SBCC) customized and translated into Community Operation Manual (COM) for better inclusion
  8. Nutrients rich food production promoted under Homestead Farming through integration with Livelihood component of NJLIP
  9. One-time input (support) to every HH provisioned for distributing Seeds and Tippy Taps
  10. Nutrition SBCC package aligned with National standards and recommendations through consultation with respective government directorates
  11. Lessons and good practices documented and disseminated at National and District level

Locally Invented Low-Cost Hand Wash Station (Tippy Taps)

To encourage hygiene and hand washing behavior at house hold level, NASS has provided locally invented low-cost hand wash station for the targeted HHs.  A total of 175,828 Tippy taps have been provided and setup at household of 1,050 villages. This is to encourage community to habituate to wash hand with soap and water in critical time maintaining six steps.

It is made by a plastic water bottle which is available everywhere in the country.  Taps are provided as symbol to remind the members of the target household to wash their hands at six critical times. Regular follow-up and counseling through home visit and conducting BCC sessions by project field staff and NSC   on personal hygiene and sanitation. Children and adolescent take it as very interesting to themself as it is a new and easy way to wash their hands.  By the continuous follow up, counseling and replacement of Tippy Taps by the household with available plastic bottles, communities are well adopted in improve hygiene and sanitation practices. Which is essentially needed during the current outbreak of COVID19 too.

 

Improving Effective Coverage of MNCAH Services to Reduce Preventable Child Deaths

Implementation period: Apr 2016- Dec 2019

Donor: KOICA

Client: UNICEF Bangladesh

Location: Tangail District

The overall objective of the project is to reduce Maternal, neonatal and under-five child mortality and morbidity as well as improvement of nutritional status to enhance Young Children’s growth and development. The project focused to key health care practices at household level improved along with timely care seeking from appropriate providers through creating an enabling environment where community, local government, NGOs/CBOs Networks and Health System are mobilized and engaged in functional collaboration for producing effective coverage of MNCH Services.

The outputs of the project are:

  • Strengthen capacity of Local Government organisations for producing functional linkages with Local Health System to ensure Community-based MNCH and Nutrition Services;
  • Capacity of Service Providers developed for improving quality of MNCH & Nutrition Service Delivery,
  • Sensitise for creating demands for accessing MNCH Services;
  • Community Health System Strengthened and integrated with HMIS
  • Lessons learned documented, consulted and transformed into wider stakeholders

 

MaMoni Health System Strengthening (MaMoni HSS)

Implementation period: Aug 2014 - Feb 2018

Donor: USAID

Client: Save The Children

Location: Jalokathi District

MaMoni HSS’ goal is to improve utilization of integrated maternal, neonatal, child health, family planning and nutrition (MNCH/FP/N) services. The project has been achieving this goal through increasing availability and quality of high-impact interventions through strengthening district-level local management and health systems. MaMoni HSS supports a set of high-impact activities to achieve four intermediate results that lead towards achieving the project objective:

  • Improve service readiness through critical gap management;
  • Strengthen health systems at district level and below;
  • Promote an enabling environment to strengthen district-level health systems; and
  • Identify and reduce barriers to accessing health services.

 

Empowering Women for improved livelihood through Skill Development

Implementation period: March 2016- Feb 2018

Donor: Australian High Commission, Dhaka

Location: Kalapara at Patuakhali district

The overall objective of the project is empowering disadvantaged and underprivileged women and adolescent girls to enhance control over productive resources and improved livelihoods.

Four deliverables of the project-

  • Women’s and adolescence skills for income generation developed
  • Decision-making by women and adolescence over productive resources and income generation improved
  • Women’s leadership and control over assets and incomes improved
  • Food security and nutrition for the vulnerable women, adolescent and children promoted

Revisit of Specific Newborn Interventions implementing under the leadership of IMCI Section, DGHS and with the support of Save the Children

Implementation period: October 2016 – March 2018

Donor: USAID

Client: Save the Children

Location: 28 Districts under Dhaka, Mymensingh, Khulna and Chittagong Division

Under the leadership of IMCI section of DGHS and technical guidance and coordination of National Newborn Cell, Revisit of Specific Newborn Interventions has been designed with the objective to cover all the 64 districts in Bangladesh in four phases, and PHD along with BSMMU has been engaged to implement Revisit Interventions in 28 districts in four phases during the period of October 2016 to February 2018.

In each district, PHD is responsible for planning and organizing following events under the Revisit of Specific Newborn Interventions-

  • Arrange Divisional advocacy and planning meeting and Dissemination meeting on Post training follow up of 7.1% CHX
  • Select three Identified Medical Officers from each district and two from each Upazilas who will act as Newborn Focal Persons
  • Organize ToT for the Identified Medical Officers
  • Organize Advocacy and Planning Meeting at the district level
  • Organize Refresher Workshops at Upazila level of Essential Newborn Care with Newborn Resuscitation (HBB) and application of Chlorhexidine organized for all SBAs, who received both the trainings at upazila level during the last scale-up interventions
  • Revisit of health facilities for quick assessment of preparedness and functionality of newborn interventions, which includes- HR and skill retention, Facility readiness, Medicine, Supply, Service utilization and Stock status of 7.1% Chlorhexidine
Moreover, PHD has been continuing the coordination role between IMCI Section and Save the Children in fund management as well as reporting, and also continuing its HR support to IMCI Section with a Senior Program Officer.

 

Urban Health System Strengthening Project (UHSSP)

Implementation period: April 2014 – March 2018

Donor: DFID

Client: Option-UK

Location: Mymensingh, Jessore and Dinajpur Municipality
UHSSP is a component of the UK Government funded Urban Health Programme jointly implemented by Options-UK, PHD and HISP-India. The planning phase of the project is under implementation from April 2015 and will be completed by Dec 2015. Thereafter, the project is expected to run from the date of signing the contract and subsequent mobilization until end of April 2018. UHSSP planned to work intensively in three Municipal Corporations,  Mymensingh, Jessore and Dinajpur to develop a model approach of HSS

 

Improving Health & Nutrition for Hard to Reach Mother & Young Children (IH&NHMYC) for reducing equity gaps

Implementation period: Apr 2014- Dec 2017

Donor: GAC

Client: UNICEF Bangladesh

Location: Three districts- Netrokona, Cox’s Bazar and Bandarban

The project focused on the reduction of maternal and under-five mortality and morbidity, and to improve child growth and development through increasing and sustaining vaccine coverage and strengthening health system with increased availability and access to quality maternal, child health and nutrition services.

The project consisted of five major outputs as follows:

  • Default tracking and management system established at the community level for effective coverage of MNCHN services
  • Community support system developed and linked up with local health system for optimum uptake of MNCHN services
  • Community Health Information System (HIS) under Community Clinic is developed for tracking un-served and left-out patients/families to bring them in health care system.
  • Capacity of the GoB service providers and field workers is improved for increased uptake of essential MNCHN services.
  • Effective referral system established for maternal, child survival and nutritional services among Community Clinics, Family Welfare Centres, Upazila Health Complexes and District Hospitals

 

Chars Livelihoods Programme (CLP) of DFID

Implementation period: July 2012 – March 2016

Donor: Jointly UKaid and Australina Aid (through DFID & DFAT)

Implemented through: Maxwell Stamp Plc.

Location: Kurigram, Gaibandha, Jampalpur, Lalmonhirat, Nilpharmari, Rangpur, Pabna and Tangail

PHD has been engaged as the Specialist Service Provider (SSP) for inclusion of Primary Health Care - Family Planning (PHC-FP) Component in Chars Livelihood Project (CLP). In particular to provide technical assistance to the implementing partners (IPs) in designing health project; planning, managing, monitoring and supervising project activities; organizing project staffs’ training; orientating religious leaders, newlywed couples, community birth attendants and rural medical practitioners; ensuring clinical governance and quality assurance; utilizing funds;  and maintaining linkages with relevant government agencies/departments, NGOs, UN stakeholders in order to obtain their support and cooperation.

PHD engaged a seven members’ technical team based in Bogra to provide Specialist Services to CLP and IPs working in 08 northern districts in Bangladesh (Kurigram, Gaibandha, Jampalpur, Lalmonhirat, Nilpharmari, Rangpur, Pabna and Tangail)

 

Joint UN Maternal and Neonatal Health Initiatives (MNHI)Implementation period: July 2009 – Dec 2016

Donor: EU/DFID

Client: UNICEF Bangladesh

Location: Moulvibazar, Bagerhat and Patuakhali Districts

PHD implemented a comprehensive project on “Community Support System (ComSS) Interventions for maternal, neonatal and child care services through community development intervention” under the GOB-UN joint MNH Initiatives for “Accelerating Progress towards Maternal and Neonatal Mortality and Morbidity Reduction”.

The project aimed to ‘capacitate’ communities to uphold statutory health rights, particularly for women and children through creating demands for maternal, neonatal, child care and nutritional services in reducing maternal and neonatal mortality and morbidity. It produced good practices at community and household level, and also created conducive environment for the poorest in accessing their statutory entitlement.

The project developed ComSS in participation with the Community Clinics Management Group (CG) and Community Support Groups (CSGs) representing Community Leaders, Professional Groups, Youths and Adolescents, Women Activists, Mothers, Poor and Vulnerable Population and Elected representative of Union Parishad.

 

Maternal Neonatal and Child Survival (MNCS) in Bandarban 

Implementation period: December 2012 - Aug 2008

Donor: Australian Aid

Client: UNICEF Bangladesh

Location: Bandarban District

The purpose of MNCS project was to improve health and nutrition care practices at the family level, to promote care-seeking behavior among the community, and to ensure neonatal and child health and nutrition services for the poor families.

PHD learned lots of good lessons through its interventions with the Indigenous Community, particularly in identifying taboos and traditional values, in designing and implementing BCC interventions to promote appropriate health and nutrition practices.

For smooth implementation of the MNCS, a total of 94 staff and 420 volunteers as Health Promoters were provided with different types of training and orientation to develop their skills in various aspects of C-IMCI, ENC, PNC, Planning, PRA, Nutrition, supervision and monitoring, surveillance registrar, etc. Under the intervention, trained community health promoters visit households to register pregnant women, newborn and under 5 children and provide antenatal information, neonatal kits and counseling on nutrition, essential newborn care and danger signs for newborn and mothers. The trained health promoters also accomplished postnatal visit to ensure essential neonatal care, assisted the mothers to do birth registration, provided five counseling visit immediate after identification of a woman as pregnant and referred sick and malnourished children of < 5 aged to the health facilities as needed.

 

Improving Health & Nutrition for Hard to Reach Mother & Young Children (IH&NHMYC) for reducing equity gaps

Implementation period: Apr 2014- Dec 2017

Donor: GAC

Client: UNICEF Bangladesh

Location: Three districts- Netrokona, Cox’s Bazar and Bandarban

The project focused on the reduction of maternal and under-five mortality and morbidity, and to improve child growth and development through increasing and sustaining vaccine coverage and strengthening health system with increased availability and access to quality maternal, child health and nutrition services.

The project consisted of five major outputs as follows:

  • Default tracking and management system established at the community level for effective coverage of MNCHN services
  • Community support system developed and linked up with local health system for optimum uptake of MNCHN services
  • Community Health Information System (HIS) under Community Clinic is developed for tracking un-served and left-out patients/families to bring them in health care system.
  • Capacity of the GoB service providers and field workers is improved for increased uptake of essential MNCHN services.
  • Effective referral system established for maternal, child survival and nutritional services among Community Clinics, Family Welfare Centres, Upazila Health Complexes and District Hospitals