Community Clinic in Bangladesh

Establishment of Community Clinic (CC) in 1998 was a significant sector-wide reform in the Health Sector of Bangladesh, which was revitalized in 2009 with a vision to provide primary health care service to 6000 population per CC.  The proposed number of Community Clinics is 18,000 of which 13,500 yet to be constructed and remaining 4,500 to be established in the existing Union and Upazila level health and family planning facilities.

Eminence mandate is to improve access to basic health care and treatment at household and community level though its programs and research. Eminence has very good experience in implementing community intervention for the past eight years. Realizing the health care demand in the remote areas of the country, Eminence extended its interventions to the hard to reach and most impoverished areas of Bangladesh. As of now, Eminence has covered all the 5 Upazilas of Panchgarh District and 10 Upazilas of Brahmanbaria and Thakurgaon Districts. In this course of Eminence’s action, Eminence has been able to reach 50,000 community people. Women, children and adolescents have been emphasized in all the ventures to understand their needs and translate the needs into service. The implementation team and project management unit visits the project areas time to time to ensure improved accountability and increased services.

EMINENCE intends to strengthen the following service that has been planned to be offered through Community Clinic by public sector staffs:

  • Essential service delivery packages including ANC (during pregnancy), safe delivery and PNC (within 42 days after delivery) and referring the mother to nearest health facility including MCWC in case of emergency or/and complications;
  • Vitamin A distribution among post delivery mothers (within 6 weeks after delivery) and children specially children having acute malnutrition, chronic diarrhea and measles;
  • Identification of anemia and treatment for women and adolescent girls alongside providing health service and counseling to adolescent boys and girls;
  • Child vaccination to the target group following Government EPI schedule (TB, Polio, Diphtheria, Whooping cough, Tetanus, Hepatitis–B, Haemophilus Influenzae–B and Measles) and TT vaccination among the women of child bearing age (15-49 years). Identification of AFP (sudden paralysis or numbness in hand/leg or any other part of the body) among children less than 15 years of age;
  • Provision of Vitamin-A to children aged 1- 5 years with 6 months’ interval and identification and prevention of night blindness among children;
  • Identification and treatment (as prescribed by tertiary level hospitals) of iodine deficiency disorder, anti helminthes, ARI, TB (including DOTs), Leprosy (following MDT), malaria, arsenicosis, skin diseases etc.
  • Rehydrating through oral rehydration therapy and zinc tablet (in case of children) and proper referral in case of emergency. Education with demonstration how to make oral saline;
  • Registering newly married and pregnant women , preserving EDD and contacting pregnant women at the time of EDD including blood grouping of the pregnant women;
  • Birth and death registration;
  • Community and verbal autopsy for maternal and child mortality to provide maternal and child health related nutrition information;
  • Essential service for new born;
  • Implantation of IUD among motivated women, provision of first dose of injectable contraceptives and discussion on side effects of birth control methods along with the assigned FWV working in UH&FWC. Provision of providing similar services by MA, SACMO with regular interval;
  • Giving 2nd and 3rd dose of injectable contraceptives by FWA and HA following proper procedure;
  • Strong referral system in case of emergency and/or complication;
  • Counseling and referral linkage for physical, mental, neuro, autism, blind and retarded children;
  • Identification and treatment of general diseases like injury, fever, pain, cutting, burn, bite, asthma, skin diseases, dental, eye and care of ear;
  • Raising awareness among the people coming to clinic on healthy lifestyle, hygiene and sanitation, safe drinking water, balanced diet, prevention of diseases through vaccination, providing anti helminthes, colostrums feeding and breastfeeding, preventing diarrhea, food safety, HIV/AIDS and STD, importance of family planning and various methods, harms of tobacco and tobacco products. In addition to these, raising awareness on danger signs of pregnancy, new born care, danger signs of new born and birth planning;
  • Continuous supply and distribution of temporary family planning methods like condom, pill etc;
  • Identification of dropout cases of temporary family planning users, DOTs users and pregnant women not seeking ANC and PNC care and provide services to them;
  • Home visit and providing home based services in spite of having community clinic in the proximity;
  • Planning for normal delivery by trained personnel – in case of presence of all required equipments and proper training;
  • Providing services to care givers of chronic and palliative patients and making geriatric forum and arrangement for their regular health check up and entertainment through organization of various social events;

ECCP Procedure

According to the Government plan, one Community Health Care Provider (CHCP) will be appointed for each Community Clinic. The immediate supervisors of these clinics are the Union level supervisors, i.e. Health Inspectors (HIs), Assistant Health Inspectors (AHIs) and Family Planning Inspectors (FPIs) from the directorate of health and directorate of family planning respectively. The clinics will also be visited on a monthly basis by the union level service providers, e.g., Family Welfare Visitors (FWVs) and Medical Assistant (MAs)/Sub-Assistant Community Medical Officers (SACMOs) from the two directorates respectively.

ECCP activities at a glance

  • Assist in sstrengthening the institutional capacity of all community clinics in proposed Districts and Upzilas through full upazila approach in phases;
  • Eminence will assist RCHCIB in strengthening and management of community management groups as per approved GOB module/guideline.
  • Conduct advocacy, training, research and other supplementary programs to make this program more cost effective, participatory and pro-poor.
  • Eminence shall maintain close contact with concerned Districts and Upazila health and family planning officials for successful implementation of the planned activities;
  • Will assist in engaging local government (UP, UZ Parisad and Pouroshava) in effective and efficient management of CCs;
  • Mobilize the community groups for identifying/mapping and bringing ultra-poor to avail the health care services.

Project Areas

Implementation Plan of ECCP

Eminence is interested to work with the Government for strengthening the institutional capacity of the Community Clinics and also strengthening the community participation to support a sustainable primary health care system in around 1500 Community Clinic of 78 Upazilas of 11 proposed Districts in all 7 Divisions of Bangladesh throughout the project life. It would be implemented under the guidance of the RCHCIB, Ministry of Health & Family Welfare in 4 years (April 2011-June 2014) program in phases. The implementation plan is summarized in the following table with a detailed description:

Action-Aid Bangladesh

ActionAid started its journey in Bangladesh from 1983 and now is working since for the poor people of the country. Eminence did a Health Mapping of Bangladesh with ActionAid in the year 2006.

Alive and Thrive

Alive & Thrive (A&T) is a 5-year initiative (2009-2013) to improve infant and young child nutrition by increasing rates of exclusive breastfeeding and improving complementary feeding practices. A&T aims to reach more than 16 million children under 2 years old in Bangladesh, Ethiopia, and Viet Nam. Eminence is currently implementing an operational research “Assessing the cost effectiveness of training and supervision of frontline workers on early breastfeeding practices” with financial assistance from Alive and Thrive Small Grants program and managed by University of California Davis.  This one year operational research has started in May, 2010 in Panchagarh district, the most northern part of Bangladesh, including a total of nine unions from three selected upazilas with aiming to improve breastfeeding practices by strengthening capacity of front line workers.

Bangladesh Urban Health Network (BUHN)

Eminence serves as the secretariat of the Bangladesh Urban Health Network (BUHN). Eminence has organized roundtable meeting to advocate for the need of urban health strategy. Eminence also works closely with BUHN and International Society for Urban Health (ISUH) for arranging urban health conference and preparing urban health strategic paper

CARE Bangladesh

CARE Bangladesh amplifies the voices of the poor and the marginalized. CARE has been working in Bangladesh for 60 years. Eminence conducted a Baseline Survey of Competitive Literacy Initiative Project for CARE in the year 2007. We also did a Scoping Study of Water and Sanitation for Urban Poor (WSUP) in the same year with CARE. In 2006 a Rapid assessment of Water and Sanitation for Urban Poor was also conducted with CARE Bangladesh.

Concern Universal Bangladesh (CUB)

Concern Universal – Bangladesh is a UK based international NGO working in Bangladesh since 1993. Eminence conducted a survey with Concern Universal in the year 2008 titled “Community Perspectives on Water and Sanitation towards Disaster Risk Reduction (DRR).” Eminence has also conducted the final evaluation of the Community-based disaster risk reduction project in Barguna and Patuakhali for CUB.

Concern Worldwide Bangladesh

Concern Worldwide works with the poorest people in the poorest countries of the world to enable them to transform their lives. In Bangladesh, Eminence has worked with Concern Worldwide to conduct an End line Evaluation on Knowledge Practice and Coverage of Urban Nutrition and Household Food Security Program in the year 2007

GMMB

GMMB is a full-service, strategic communications agency with more than 170 seasoned communications professionals. With offices in Seattle, Washington, D.C., and Los Angeles, GMMB is uniquely positioned to conduct communications outreach throughout USA and around the world. Over the last 20 years, GMMB has earned a reputation for creating highly effective communications campaigns and providing top-level public relations counsel and support to nonprofit organizations, foundations, major associations, corporations, and federal and state governments. Eminence has recently collaborated with GMMB to connecting media of Bangladesh with Child Nutrition.

ICF Macro and Measure DHS

ICF Macro, an ICF International company, is dedicated to improving lives worldwide through service to the public sector. For the US Agency for International Development (USAID) MEASURE DHS project, ICF Macro has conducted more than 200 national surveys in 75 countries over the past two decades. Since 1984, the Measure DHS (Demographic and Health Surveys) project has provided technical assistance to more than 240 surveys in over 85 countries, advancing global understanding of health and population trends in developing countries. ICF Macro and Measure DHS support Eminence with the project titled Improving the Health, Nutrition and Population Indicators of Bangladesh through workshop with grassroots level key stakeholders in a low performing based on BDHS findings.

International Diabetes Federation

The International Diabetes Federation (IDF) has been leading the global diabetes community since 1950. IDF’s mission is to promote diabetes care, prevention and a cure worldwide. The Federation is engaged in action to tackle diabetes from the local to the global level ― from programs at community level to worldwide awareness and advocacy initiatives. Eminence got the opportunity to work for IDF in the year 2009. As part of their BCC activities, IDF developed several BCC materials for global distribution. Eminence supported IDF in developing the contents of the materials and translating them in Bangla.

International Epidemiological Association

The Ninth South-East Asia Regional Scientific Meeting of the International Epidemiological Association was held in Dhaka, Bangladesh from 9-12 March 2008. Eminence served as the local organizer of the conference.

Marico International Business Group

Marico is a leading Indian Group in Consumer Products & Services in the Global Beauty and Wellness space. Eminence, as part of its Influential Marketing, has conducted local and national seminars, sensitization workshops, and dissemination workshops to promote products of Marico Bangladesh.

Marie Stopes Clinic Society

Marie Stopes has been working in Bangladesh from 1988 to improve the sexual and reproductive health (SRH) and well being of women and men and adolescents. It is now one of the pioneers in developing and providing quality SRH programs especially for the poor and vulnerable.  Eminence’s relation with Maries STopes dates back to 2006 when the former conducted an evaluation survey of Block Grant Project. During the same year two baseline surveys were conducted by Eminence for Marie Stopes – one for the MSB-Plan Urban Health Project and another for the European Commission Co-financing Project on Sexual and Reproductive Health. The end of project evaluation of the same project was also conducted by Eminence in the year 2010. Other works with Marie Stopes include Qualitative Assessment of Client Satisfaction on Sexual and Reproductive Health Services (2008) and Exit Interview Data Validation Survey (2010).

Micronutrient Initiative (MI)

With significant support from the Government of Canada through the Canadian International Development Agency (CIDA), MI offering its knowledge and technology to the food industry to add nutrients, such as iron and folic acid, to food cost-effectively without affecting its quality or taste, helping to improve the quality of life for women and their families.  MI is implementing projects in Bangladesh that focus on the vulnerable groups of the population, particularly children and women. Eminence has a long working relationship with MI. Major assignments undertaken for MI are: Follow-up Study of Iron & Folate Supplementation for Adolescent Girls to reduce Anemia program, End line evaluation of Iron & Folate Supplementation for Adolescent Girls to reduce Anemia program and Monitoring and evaluation of Iron & Folate Supplementation for Adolescent Girls to reduce Anemia program.

NNP

National Nutrition Programme (NNP) of Ministry of Health and Family Welfare is the largest nutrition initiative to reduce malnutrition in the country. Eminence, with support from NNP and Bangladesh Breastfeeding Foundation (BBF) conducted a research on Determinant of Exclusive Breast Feeding in Bangladesh in the year 2006.

Non Communicable Diseases Forum (NCD-F)

Non Communicable Diseases Forum (NCD-F) was established on 16th November, 2009 with the objective to create a platform for civil society organization (CSO) members, key stakeholders, NCD prevention and control workers, activists, media and mass communication workers. Eminence has been working closely with NCD-F since its inception and has organized a number of press briefings, dissemination seminars and Scientific Seminar for NCD-F.

Plan Bangladesh

Plan is one of the oldest and largest children’s development organizations in the world. They work in 48 developing countries across Africa, Asia and the Americas to promote child rights and lift millions of children out of poverty. Plan’s work in Bangladesh focuses on 4 key areas: child protection and participation, community learning, community managed health and economic security. Eminence, in 2005, conducted a Baseline Survey of Integrated Nutrition Project (INP) for Plan Bangladesh. Later in 2006, the midterm survey of the same project was also conducted by Eminence. In 2008, an assessment of Post Disaster Food Security and Nutritional Status of Children Aged under Five was conducted by Eminence.

Save the Children (Norway)

Save the Children Norway is a child rights based advocacy and development assistance organization. In 2004, Eminence assessed the Health Seeking Behavior and Psycho-social Aspect of Disable Children in Bangladesh for Save the Children Norway.

Save the Children UK

Save the Children UK is an internationally active NGO helping children in need around the world. Eminence is conducting an Anthropometric Survey among Women and Children (under 5 years of age) in Khulna and Bagerhat district of Bangladesh. Previous assignments include: Rapid Nutritional Assessment of Rat Infested Chittagong Hill Tracks Areas (2008), Round Table Discussion on Poverty and Working Children – Child Rights Perspective (2009) and ‘Get on Track’ to Save Children’s Lives – Evidence Based Campaign Activity in all over the country to achieve Millennium Development Goal (MDG)–4.

Save the Children USA

Save the Children USA is the leading independent organization creating lasting change in the lives of children in need in the United States and around the world. With Save the Children USA, Eminence conducted a Governance Assessment of the GFATM (the Global Fund) Partners in the year 2009. Eminence has also developed Essential Handbook for the Health Staff of Save the Children (USA), Handbook of Occupational Health, Training Manual on Adolescent Health and Training Manual for Communication Skill Development.

Social Marketing Company

Social Marketing Company (SMC) in Bangladesh was initiated to challenge the rapid population growth by marketing contraceptive products widely accessible at a price affordable to the general population and bring about behavioral change through extensive mass promotion. During their 37 years of operation, SMC is now regarded as a significant contributor to the reproductive and child health services in Bangladesh by complementing the public sector distribution with private sector social marketing model. In 2010, we conducted the Evaluation Study of the Blue Star program with around 2000 sample size across 7 divisions of the country.

WaterAid Bangladesh

WaterAid is a leading independent organization which enables the world's poorest people to gain access to safe water, sanitation and hygiene education. WaterAid has been working in Bangladesh since 1986 and has a total of 21 partners covering 19 rural districts, three City Corporations and one Municipality in urban areas. In 2006, an Evaluation of Arsenic Mitigation Program for VARC was conducted by Eminence. Later in 2007, Eminence did an assessment of Response of Local government Institutions (LGIs)/Public Service Delivery Institutions (PSDIs) in Response to the Community Demand Creation for WaterAid Bangaldesh.

World Health Organization

World Health Organization (WHO) is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. Eminence has been working closely with WHO-country office for Bangladesh. Eminence have so far conducted a need assessment study of Voluntary Counseling and Testing (VCT) Services of HIV/AIDS in Bangladesh and has developed Work Place Based Non-Communicable Diseases Prevention Programme in Garments Factories of Bangladesh: A Model Document, Flip Chart for Work Place Based Non-Communicable Diseases Prevention Programme in Garments Factories of Bangladesh and Training Manual for the Health Educators and Health Assistants for Work Place Based Non-Communicable Diseases Prevention Programme in Garments Factories of Bangladesh.

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