Community Based Health Care ( CBHC ) Implementation period January 2017 to June 2022

General Objective To ensure healthy lives & promote well-being for all at all ages by increasing accessibility affordability & utilization of quality primary health care services within the stipulated time.

Specific Objective Community clinic (CC) to assume full responsibility of health (population and nutrition) Adequately staffing CC with proper supervision mechanism to effectively deliver the services entrusted by the ESP. Facilitating community group (CG) & community support group (CSG) for active participation in creating a health movement in the catchment area for improved health outcomes of the population through multipurpose health volunteers

CONT..... 4. Sustaining institutionalization of the community based health care efforts. 5. Streamlining and strengthening upazila health system. 6. Establishing functional referral within and beyond upazila health system . 7. Ensuring supplies for proper functioning of upazila health system.

CONT...... 8. Institutional development at different level of upazila health systems for improved performance. 9. Improved urban health through enhance utilization of facilities including floating population. 10. Improving excess & utilization of services to the tribal population.

Human resource Organogram LD PM upazilaa health system & medical waste management PM Adm & Finance PM procurement PM Infrastucture & MIS PM CM & HRD PM tribal heath & urban health DPM logistics DPM ADM Dpm procurement DPM Infrastucture DPM Finance DPM CM DPM HRD DPM tribal DPM MIS DPM Urban DPM UHS DPM WM

Background Signatory Alma-ata Declaration in 1978 Vision Heath for all by 2000 through Primary Health Care (PHC) In 1996 Bangladesh was far behind the destination Reason PHC couldn’t be made accessible to the vast rural community In 1998 GOB planned to establish 13500 Community Clinic to extend PHC at the door step of rural people (1 CC for approx. 6000 population) 1998-2001 10 723 CC were constructed & about 8000 started functioning 2001-2008 In 2001 due to policy shifting CCs were closed & remained as such till 2008 2009 GOB started revitalization of CC through RCHCIB i.e. to make both old (Constructed during 1998-2001) & new ones functional 2013 361 CC for Hill & hard to reach areas has been added to the target. Total 13861 community clinic will be establish. January 2017 ESD has been merged with CBHC.

Component of CBHC Measuring Health outcomes. Staffing & Supervision of CCs. Human Resource development & community mobilization. Referal System . Sustaining Institutionalization. Upazila Health System. Medical waste Management. Tribal Health. Urban Health.

OP Level Indicator SL. Indicator Unit of Measurement(Means of Verification Baseline (With Year and Data Source ) Middle of The Program(by June 2020) End of the Program(by June 2022) 1. Number of CC Functioning at Upazila Health Complex. Number of CCS At upazila health complex. 0 (CBHC 2016) 200 400 2. Number of CC Having population based data Number of CCs (HIS/CC Monitoring report) 0 (CBHC) 1000 5000

Cont........... 3 Functional referral system Referral system functioning in UHC(facilities records) No functional referral system exist Initiatives undertaken for establishment of referral Referral system functioning in 200 UHCS 4. Medical Waste Management operating at all levels of upazila health system. Different levels of facilities practicing medical waste management ( observance) Very limited medical waste management at upazila health complex Medical waste management initiated at all levels of facilities. Medical waste management operating at 100 UHCs 5. Institutional Mechanisms developed in 3 CHT District & respective plain land upazilas for delivering tribal health services, No. of CHT Districts & plain land upazilas ( monitoring report / admin report) 3 CHT district & 10 plain land upazilas All 3 CHT districts & all required plain land upazilas.

Estimated Cost of PIP & OP Total GOB PA(RPA) Source of PA Estimated total cost of the PIP 11548636.00 9663913 1884723.00(1167607.00) Non development cost of PIP 7200000.00 0.00 (0.00) Development cost of PIP 4348636.00 2463913.00 1884723.00 (1167607.00) Cost of OP 506597.95 358054.45 148543.50 (146533.50) Pool fund JICA,WHO,UNICEF.USAID,GAC and others OP cost as % of PIP development cost 11.65% 14.53% 7.88% (12.55%)

BCC activities Activies 2017-June 2018 June18-June19 June20-June21 1.Branding TVSpot,Documentary, Folk song Message with Calendar, Poster Mass Campain Banner News Letter, Broucheare Mass Campaign 2.Awareness Raising activities Leaflet,Banner Docu mentary Bill Board TV spot on Triva health in different language Tv Serial TV Serial 3.Advertising and Publicity TV Spot Documentary

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