In Bangladesh, one of the greatest challenges in achieving the SDGs and advancing universal health coverage is the shortage of skilled health providers in remote areas. CARE formed a public-private partnership with the Government of Bangladesh to design and implement a sustainable solution, developing a cadre of 410 Skilled Health Entrepreneurs (SHEs) supported by communities, public health system and Local Government bodies across two remotest districts Sunamganj and Netrokona in Bangladesh. The SHEs are accredited by Bangladesh Nursing Council with six months community skilled birth attendant (CSBA) training complemented by community based integrated management of childhood illness (C-IMCI), Family Planning, nutrition, Non-Communicable Disease and entrepreneurship training.
As a result of this innovative solution, the end line evaluation, conducted by icddr’b in November, 2018, shows a significant reduction of early childhood mortality as Neonatal mortality, Infant Mortality and U-5 child mortality rate dropped to 33 from 42, 46 from 78 and 52 from 97 per 1000 live births respectively, besides delivery by skilled birth attended increased up to 37% from 13%; modern contraceptive prevalence rate (mCPR) increased by 10% percent and long acting permanent method use doubled in Sunamganj.
Even amidst the adversities of COVID-19 pandemic, the SHEs continued to serve pregnant women and children during in Sunamganj and Netrokona with 84,279 awareness sessions on hand washing, use of mask and social distancing and reached 34, 834 people over phone as of June 2020. “I know there is a risk [of contracting COVID-19] but I take personal safety measures like wearing a mask, gloves, an apron, and using sanitizer,” said Skilled Health Entrepreneur Joysna. “Risk of infection, difficulty getting transportation, and non-cooperation from my community didn’t stop me from serving the women and children in the community.’’
For the outstanding performance in significantly improving the maternal and child healthcare services in one of the most hard to reach areas in Bangladesh, the project was awarded the title of Best Performing NGO (for the year 2019-2020) by the District Administration and Family Planning Department in Sunamganj.
“Just six years back, a great portion of child birth took place at home by the unskilled traditional birth attendants. With the inclusion of 300 SHEs and their coordinated effort along with front line health workers, we have been able to establish a synergistic working platform including campaign, 24/7 deliveries at UHFWCs, regular referral for permanent methods, union level coordination and reporting which resulting in a remarkable uptake of family planning services and in recognition of their contribution to family planning sector, the award for best performing initiative of the year( 2019-2020) in Sunamganj district goes to CARE-GSK CHW Initiative by CARE Bangladesh’’, said Md. Mozammel Hossain, Deputy Director of Family Planning Department in Sunamganj, Bangladesh on the occasion on the award giving ceremony.