Title: Essential Healthcare for the Disadvantaged in Bangladesh (EHD)

Donor: FCDO, UKaid & Concern Worldwide

Thematic Area: Health and Health Rights

Project Duration: July 2019 to July 2021

Working Areas: Dacope & Koyra under Khulna District, Bagerhat Sadar, Morrelganj& Mongla under Bagerhat District & Satkhira Municipalicy, Shyamnagar under Satkhira District

Programme Summary:

The program is funded by UK Aid from the UK government. The program aims to increase access to quality essential healthcare for the disadvantages, including people with disabilities through innovative approaches and covering 2 million people in urban and rural areas in the unserved, remote coastal areas in the south of Bangladesh. The program duration is 3.5 years from 2019-2022. Concern Worldwide, an international NGO is leading the Consortium in partnership with KMSS, PHD, IPAS, RHSTEP, CBM, DRRA and icddr,b.

This adaptive program will test and support effective and sustainable models for increasing access to essential health services for 2 million disadvantaged people including estimated 138,000 disabled, living on the coast, for future scale-up. During this process, the program will benefit 250,000 family planning users, 100,000 pregnant women with nutrition services and help safely deliver 15,000 babies. The project duration is from 1 July 2019 to 31 December 2022. KMSS is responsible to implement the project deliverables at Bagerhat, Mongla, Morrelganj and Satkhira Municiplity and Morrelganj, Dacope, Koyra and Shyamnagar Upazillas of Khulna, Bagerhat and Satkhira districts.

The £15 million Essential Healthcare for the Disadvantaged in Bangladesh (EHD) programme of DFID Bangladesh will, over a period of four years (2019-2022), test effective and sustainable models for increasing access to essential health services for 2 million disadvantaged people including estimated 138,000 disabled, living on the coast. Building on current learning in the health sector, the programme will make use of innovations and will adapt to achieve its goal. If successful, DFID-B will consider scaling up the model/s through a subsequent phase.

The program aims to contribute to improve health outcomes of poor and disadvantaged people in remote areas by increasing access to and use of affordable and good quality essential health services. The program will apply an adaptive approach to identify models that make use of innovations to deliver a package of essential health services and are financially and operationally sustainable. The program further aims to work on women empowerment and violence against women (VAW) for disadvantage, disable& backward women by engaging them into different interventions. Apart from that, the program also closely works on disaster management in the catchment coastal areas by engaging with the local government institutions.

The programme outcomes by the end of the project, in target areas, are:

Outcome-1: Disadvantaged including disabled populations, access quality healthcare

• Uptake of essential healthcare increased by 2% annually, from baseline;

• Births assisted by medically trained providers increased by 1% annually, from baseline;

• Number of modern family planning users increased by 1% annually, from baseline;

• Uptake of essential healthcare by disabled increased by 1% annually from baseline;

Outcome-2: Sustainable model for healthcare demonstrated

• Project learning lead to adaptations year on year;

• Strengthened private providers reporting increased services;

• Aware communities contribute to increasing accountability of health providers;

• Innovative interventions enhance access and quality of care;

 

Environmental and Climate Resilience:

For the KMSS EHD project, the consortium will build on priorities articulated in the Draft Bangladesh Health-National Adaptation Plan. Training modules for public and private health providers, LGI and frontline health cadres will be developed and rolled out to improve their knowledge and skills on coping with and managing health risks posed by climate variability. Simulation exercises with reflection sessions will be conducted for practical skills building. Frontline health cadres and LGI will generate awareness among the community with particular messages on health risks, prevention and care seeking and positive coping mechanisms for disadvantaged groups. At static facilities, guidelines and SOPs will be developed with MoHFW for appropriate preparedness, response and mitigation actions pre-and-post disaster inclusive of standardizing emergency health supplies and stockpiling and reverse logistics for essential supplies and medication. This will include protection from adverse environmental consequences by supporting facility and provider readiness to effectively prevent and control disease outbreaks, respond to surges, triage critical cases, and infection prevention control. Assessments will be conducted with MoHFW on the process, availability, and provision of equipment and supplies to test, report, and address climate-related health risks (e.g. waterborne diseases and vector borne disease testing and treatment). Green hospital initiatives will be tested in selective pilot facilities and adaptations attempted and documented to reduce environmental impact. KMSS EHD project has distributed early warning system equipment to 25 union Parishad of Dacope and Morrelganj upazila as well as Satkhira and Morrelganj municipalities. Total 17 item 1657 quantity of early warning equipment’s are distributed. Among the distributed items some are, Super rechargeable mega phone, heavy duty siren, first-aid box, stretcher, life jacket, rechargeable radio, torchlight, flag and rescue kids etc.

In addition, KMSS, EHD project has plans to distribute early warning equipments for the targeted population in our working area. CPP volunteers from the intervention areas will be oriented on disaster management and how to use those early warning equipments. KMSS, EHD project will disseminate awareness raising sessions and education sessions among people from coastal areas who are in high risk of Natural Calamities. More than this we sit with the cyclone center management committee once in every 3 months to ensure proper management and use of the cyclone center. Under the EHD project advocacy meetings are conducted for Providing Health Services at the Cyclone Center during disaster and Climate Change Issue at Remote areas.EHD project also facilitated to activate / reactivate and strengthen Existing disaster Management Committee & Support to deal with climate change issues in project working areas.

 

The program is being implemented through three interlinked components.

Component 1

Component 1 would test innovative models for providing essential healthcare, including family planning, maternal-new-born health and nutrition services. It would build the capacity of existing providers, standardize their services and link them with higher-level health professionals. It would help diversify services using a social marketing approach and other innovations to increase access. The programme would raise awareness of the communities and engage them to promote health and demand quality services. The elected local government bodies and other public officials would be involved to mobilize resources and drive accountability. DFID-B’s Better Health in Bangladesh (BHB) sector programme will strongly complement EHD by strengthening national health systems, stewardship and governance.

Component 2

Component 2 will address the health needs of 138,000 disabled people by creating enabling environment, ensuring access to essential healthcare and linking them with appropriate referral centers.

Component 3

Component 3 will focus on continuous evaluation, learning and adaptation of best approaches for driving effectiveness and sustainability. Expert NGOs, selected through a competitive process, will implement components I & II, while the third component, will be implemented by a supplier under the Global Evaluation Framework Agreement. The programme’s impact would be ‘Improved outcomes in health, family planning and nutrition for targeted disadvantaged populations contributing to achieving universal health coverage. The outcomes are ‘Disadvantaged including disabled populations, access quality healthcare’ and ‘Sustainable model for healthcare demonstrated’. During the process, the programme will support 250,000 family planning users, reach 100,000 pregnant women with nutrition services and help safely deliver 15,000 babies.

Target Population

Young & Adolescent Girls, Women & Children, Hardcore Poor, Population of Reproductive age, Slum Population in Urban and Rural Area and Disable Population, etc.