Program participant under urban health program holds a health card that helps them avail subsidized health services in local clinics.
As urban centers around the world are increasingly becoming complex hubs of economic activities and opportunities; rapid migration is taking place from the rural areas. This brings new challenges in many parts of the world, and it is constantly increasing the need of basic services including health and sanitation. Urban poor are the worst sufferers. This demands innovative ways to address these challenges and calls for new partnerships. CARE Bangladesh is bringing the government, private sector entities, and communities together, connecting the dots and bringing a mix of technology and inputs to make an impact and present systemic solutions. The urban health and sanitation services have been ongoing irrespective of COVID-19 for last 19 months.
On my recent visit, here is what I learned: Early on, we realized that the health and sanitation services are suffering, not only due to lack of resources, but also due to often disjointed interactions between large numbers of diverse actors including government, private, and NGO sectors and governance is key.
Under waste management function of the project, the communities receive waste bins and domestic waste is regularly collected to dispose centrally.
To address this, since October 2018, CARE Bangladesh has been working to develop a model for addressing these issues through strengthening coordination and accountability between providers and institutions, mapping healthcare and other service gaps, and increasing community participation to achieve better outcomes, particularly for low-income people in Gazipur City Corporation (GCC), on the outskirts of Bangladesh’s capital Dhaka.
NGO coordination meeting at Gazipur City Corporation
CARE Bangladesh is working with GCC which oversees public health services for a population of 3.5 million people. We focus on improving governance in this complex system by facilitating the use of technology and other systemic processes. We use health service mapping to understand inefficiencies in primary health care and identify organizations with the capacity to fill the gaps. We embed effective reporting processes to improve GCC providers’ performance monitoring and finally, we use Community Score Cards to increase accountability.
This model helped institutions to identify service gaps and inefficient resource distribution, allowing more effective targeting of poor populations. It effectively facilitated increased monitoring of service providers, reducing reporting errors and facilitating more effective resource allocation.
Within less than three years our interventions have increased access to and accountability of healthcare services and contributed to reducing the risks of COVID-19 for the impact population.
As a result of the urban health and sanitation interventions, CARE Bangladesh has helped increase access to healthcare services and in turn, contributed to reducing the risks of COVID-19 in the Gazipur City population. We have helped service coverage expand to 300,000 low-income populations in 5 previously neglected wards. In addition, there is a 27% increase of people’s knowledge on COVID-19 issues such as proper handwashing. Lastly, during this COVID-19 period, all resources and logistics support by the development partners and other organizations are being managed and distributed in a coordinated way through the GO- NGO Coordination Forum. Gazipur City Administration is keen to expand and extend these initiatives.
Community-led drinking water system and running water supply is ensured to the communities under the project.
From CARE we would like to thank our donors and partners: UK aid from the UK government, Mott MacDonald Ltd., Marks and Spencer (M&S), Primark, and GlaxoSmithKline (GSK).
Photos: Asafuzzaman Captain/CARE Bangladesh