BANGLADESHCAMBODIANEPALPHILIPPINESCommitted field force with womento-womenservicesCafeteria approach to servicesDecentralised service delivery(through s<strong>at</strong>ellite clinics <strong>and</strong> EPIoutreach centres <strong>at</strong> the grass- rootlevel)Active government–NGOcollabor<strong>at</strong>ionAdvocacy with religious <strong>and</strong> othercommunity leadersPro-active role of the mass mediaInvolvement of womenInter-sectoral collabor<strong>at</strong>ionTo overcome multi-dimensional intersectoralproblems <strong>and</strong> to meet thechallenges according to the spirit of theICPD (Cairo, 1994), the BangladeshGovernment launched the Health <strong>and</strong>Popul<strong>at</strong>ion Sector Program (HPSP) in1998, in consult<strong>at</strong>ion with developmentpartners <strong>and</strong> stakeholders to reformthe health <strong>and</strong> popul<strong>at</strong>ion sector. Thiswas done through the provision of apackage of essential health care servicesto decrease popul<strong>at</strong>ion growth. TheHPSP envisioned poverty allevi<strong>at</strong>ionwith services responsive to clients’ needsespecially those of children, women <strong>and</strong>the poor, <strong>and</strong> achieving quality of carewith adequ<strong>at</strong>e service delivery capacity<strong>and</strong> financial sustainability. Followingthis, the government adopted theBangladesh Popul<strong>at</strong>ion Policy. Itsgoals are to improve the st<strong>at</strong>us of FP<strong>and</strong> MCH including RH services,<strong>and</strong> to improve the living st<strong>and</strong>ard ofthe people of Bangladesh by strikinga desired balance between popul<strong>at</strong>ion<strong>and</strong> development in the context of theMDGs <strong>and</strong> the PRSP.Based on the different policy guidelines,protocols, str<strong>at</strong>egies <strong>and</strong> action planswere developed for implement<strong>at</strong>ionthrough the formal health system.Despite fertility transition <strong>and</strong> animpressive success of the immunis<strong>at</strong>ioncampaign, other health indic<strong>at</strong>ors arestill lagging behind. There is still theneed for more investment in the majorcomponents of RH programmes suchas safe motherhood, family planning,m<strong>at</strong>ernal nutrition, unsafe abortion,neon<strong>at</strong>al care, adolescent health care,prevention <strong>and</strong> control of RTIs / STDs,<strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong> infertility. The UrbanPrimary Health Care programme(second phase) has included menstrualregul<strong>at</strong>ion (MR) in the essential servicedelivery package. This move has beenendorsed by government, th<strong>at</strong> allprogrammes must include this service.<strong>SRH</strong> services are available through allgovernment <strong>and</strong> non-governmentalhealth facilities in Bangladesh, but<strong>HIV</strong> services are available onlythrough selected health institutionsin the country. Many NGOs havespecial programmes <strong>and</strong> facilities toprovide anten<strong>at</strong>al care <strong>and</strong> safe delivery.There are also a number of priv<strong>at</strong>ephysicians <strong>and</strong> an increasing number ofservice sites, especially in urban areas,providing the same service. There isan active social marketing company inBangladesh which sells contraceptivesthrough a network of pharmacies <strong>and</strong>shops.Bangladesh has a very well designed6
grass-roots based service deliveryinfrastructure available all over thecountry. At n<strong>at</strong>ional level there is theInstitute of Post Gradu<strong>at</strong>e Medicine<strong>and</strong> Research, the M<strong>at</strong>ernal <strong>and</strong> ChildHealth Institute (MCHTI), theInstitute of Child & Mother Health(ICMH) <strong>and</strong> 13 government medicalcollege hospitals. The services offeredare anten<strong>at</strong>al, pren<strong>at</strong>al (delivery)including comprehensive EOC services<strong>and</strong> postn<strong>at</strong>al care for mother <strong>and</strong>childcare. At district level, 57 districthospitals provide anten<strong>at</strong>al <strong>and</strong> deliverycare including comprehensive EOCservices, postn<strong>at</strong>al care, EPI <strong>and</strong> childcare services.There are 90 Mother <strong>and</strong> ChildWelfare Centres (MCWC) in thecountry situ<strong>at</strong>ed <strong>at</strong> the district, Upazila<strong>and</strong> Union level, providing anten<strong>at</strong>alcare, normal delivery services, postn<strong>at</strong>alcare, EPI, <strong>and</strong> child healthcare. Outof these 64 MCWCs also providecomprehensive EOC services. Themajor services provided in the 397Upazila health complexes throughoutthe country are anten<strong>at</strong>al care, normaldelivery, postn<strong>at</strong>al care, EPI, FP, healtheduc<strong>at</strong>ion, <strong>and</strong> child healthcare. Outof these, 40 Upazila Health Complexes(UHCs) also provide comprehensiveEOC services.There are 3,200 Constructed UnionHealth <strong>and</strong> Family Welfare Centres(UH & FWC) in the country. Theservices provided here are: anten<strong>at</strong>al(screening for “<strong>at</strong> risk” pregnancies<strong>and</strong> referrals), safe deliveries throughdomiciliary follow up, postn<strong>at</strong>al care,health educ<strong>at</strong>ion <strong>and</strong> child care. Thepresent government has plans to st<strong>at</strong>iongradu<strong>at</strong>e doctors in all UH <strong>and</strong> FWCsin phases.Every month about 30,000 “s<strong>at</strong>elliteclinics” are organised <strong>at</strong> ward <strong>and</strong>community levels all over the countryto bring service facilities to the people.These include anten<strong>at</strong>al care, familyplanning, health educ<strong>at</strong>ion <strong>and</strong> EPIservices. The services are complementedby approxim<strong>at</strong>ely 23,000 family welfareassistants <strong>and</strong> 15,000 health assistantsworking <strong>at</strong> grass root levels for basichealth <strong>and</strong> family planning servicedelivery.The <strong>SRH</strong> situ<strong>at</strong>ion in Bangladesh canbe easily understood from the tablebelow (table 1) which shows the currentst<strong>at</strong>istics of key RH indic<strong>at</strong>ors.1.2 <strong>HIV</strong> <strong>and</strong> <strong>AIDS</strong>Programme inBangladeshIn the Asia-Pacific region which hasthe second highest number in the worldof people living with <strong>HIV</strong>/<strong>AIDS</strong>,Bangladesh is fortun<strong>at</strong>e to be one ofthe countries where the prevalence r<strong>at</strong>eof <strong>HIV</strong> infection is low. Since the firstcase of <strong>HIV</strong> was reported in 1989,about 1,745 cases were reported as of30 th November 2009. The estim<strong>at</strong>ednumber of people living with <strong>HIV</strong> inBangladesh was about 7,500 in 2007.According to UN<strong>AIDS</strong> the number ofpeople living with <strong>HIV</strong> in the countrymay be as high as 12,000 which is withinthe range of ‘low estim<strong>at</strong>e’ by UNICEF’sSt<strong>at</strong>e of the World’s Children Report2009.Although Bangladesh is still a lowprevalence country for r<strong>at</strong>e of <strong>HIV</strong>7
- Page 2 and 3: Published by:International Council
- Page 5 and 6: Table ofContentChapter Titles Pages
- Page 7 and 8: INTRODUCTIONThe 2009 AIDS Epidemic
- Page 9 and 10: REVIEW OF LINKAGES BETWEEN SEXUAL A
- Page 11 and 12: ROUNDTABLE MEETING ON LINKAGES BETW
- Page 13 and 14: Mr Roberto M Ador, Executive Direct
- Page 15 and 16: Session 3: Health Systems Strengthe
- Page 17 and 18: Model for Public-Private Partnershi
- Page 19 and 20: CONCLUSIONSuccessful linkages betwe
- Page 21 and 22: INSTITUTIONALCAPACITY FORHIV/AIDS A
- Page 23 and 24: AbstractBackground: There are a num
- Page 25: the highest export earnings. The pr
- Page 29 and 30: However, condom use was low amongho
- Page 31 and 32: 2and Save the Children, USA, and is
- Page 33 and 34: Many important national guidelines,
- Page 35 and 36: voluntarily, among project particip
- Page 37 and 38: ut all sources have consistently sp
- Page 39 and 40: USA) and the World Bank ledconsorti
- Page 41 and 42: the Prevention of Parent to ChildTr
- Page 43 and 44: access to services for their consti
- Page 45 and 46: for planned prevention, treatment a
- Page 47 and 48: e accomplished if there is supporta
- Page 49 and 50: In addition, not all services canbe
- Page 51 and 52: daily lives and take priority overH
- Page 53 and 54: Promote the social acceptability of
- Page 55 and 56: References20 years of HIV in Bangla
- Page 57 and 58: 337
- Page 59 and 60: Annex 6: Figure 2: National AIDS Mo
- Page 61 and 62: INSTITUTIONALCAPACITY FORHIV/AIDS A
- Page 63 and 64: AbstractBackgroundThe HIV epidemic
- Page 65 and 66: NMCHCNRHPNSRSHNational Maternal Chi
- Page 67 and 68: management system, and health servi
- Page 69 and 70: universal access to HIV prevention,
- Page 71 and 72: In order to support the linked resp
- Page 73 and 74: ased violence, unplanned pregnancy/
- Page 75 and 76: The essential services package forr
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care, and VCCT and ANC;Family plann
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Strategy for RSH in Cambodia 2006 -
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Logistics management proceduresfor
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ReferencesStrategic Plan for HIV/AI
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INSTITUTIONALCAPACITY FORHIV/AIDS A
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ABSTRACTBackgroundThere are a numbe
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planning products from DHOs/DPHOs.A
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priority. A large part of the preve
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the major breakthrough in linking t
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guidelines especially those related
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Court responded to the petition byi
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34building on the technical strengt
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million from donors. As a percentag
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in hill and mountain districts. Fre
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uilding for home-based care through
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is from GFATM. It sets targetsand d
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SRH and HIV programmes are runverti
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IX. REFERENCES1. Adolescent Health
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BANGLADESHCAMBODIANEPALPHILIPPINES9
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BANGLADESHCAMBODIANEPALPHILIPPINES9
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BANGLADESHCAMBODIANEPALBackgroundTh
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BANGLADESHCAMBODIANEPALPHILIPPINESC
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BANGLADESHCAMBODIANEPALPHILIPPINESt
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BANGLADESHCAMBODIANEPALPHILIPPINES1
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BANGLADESHCAMBODIANEPALPHILIPPINEST
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BANGLADESHCAMBODIANEPALPHILIPPINESi
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BANGLADESHCAMBODIANEPALThe protocol
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BANGLADESHCAMBODIANEPALPHILIPPINESP
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BANGLADESHCAMBODIANEPALPHILIPPINES1
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