Base-line Report for the Community Led Sustainable Health Project Phase II
1. Introduction
Village Education Resource Center (VERC), a Bangladeshi non-governmental organization (NGO), with the support from Simavi, a Dutch non-governmental health organization has been implementing a community led sustainable health project (CLSHP) in the three unions of Lalmohon upazila under Bhola district for three years from July 2006. In July 2009 the project was reviewed. The review report recommended for the continuation of the project with revised design, providing more emphasis on community empowerment for achieving the purpose of the project. Accordingly the second phase of the project was designed expanding to cover the entire Lalmohon upazila with the goal of institutionalizing an effective community managed sustainable health service accessible to all sections of people focusing on poor women and children in Lalmohan upazila attaining improved hygienic practices and health situation. Objectives of second phase are:
- To bring long term change in behavioral practices by raising community awareness on health and hygiene issues and hence improve the general level of health.
- To provide access to quality, affordable, sustainable health services in response to the beneficiaries’ needs.
- To ensure that all members of the community, regardless of gender, age, disability or socio-economic situation have full access to the services available and participate fully in community led initiatives.
The project aims to undertake three prong strategies. First one is massive community awareness for preventive and promotive aspects of health, so that they can control their behaviours and environment resulting minimum sickness. For this, community will be segmented into children, adolescent boys and girls and adults male and females. Each of them will be made aware on different preventive and promotive health issues using multi-channels. Second strategy is to make the community aware about the different services available to them from government and NGO sectors for needed utilization, empower community representatives to negotiate with the service providers and their controller for re-scheduling the services to best suit with communities need and play watch-dog role for the services, so that communities are guaranteed with sustainable services. The third among the strategies is to provide need based services to meet the requirements of the special groups of the community – located in difficult geographical locations, ethnic groups, marginalized communities etc.
This base-line report aims to capture a snap shot of existing health care services, both from government and non-governmental sources (excluding private-for-profit) and prevailing health outcomes. To capture prevailing knowledge, attitude and practices of the communities on selected health issues, another base-line report is scheduled to prepare.
2. Methodology
Primary data were collected from different government installations like Union Sub Center (USC), Union Health and Family Welfare Center (UHFWC), Upazila Family Planning Office, Upazila Health Complex, Maternal and Child Welfare Center and non-governmental institutions like BRAC and Swanirbhar located at Lalmohon upazila of Bhola district. In addition, secondary documents were also reviewed available at the government and non-government offices at Lalmohon upazila and also at Dhaka offices.
Limitations include poor documentation/report available particularly in government installations and also short field visit didn’t allow to visit all places intended resulting some lack of information, which are mentioned in the report and the project team is expected to collect those to complete the picture.
3. Findings
3.1 Lalmohon upazila
Population: 333, 465; Male: 173, 402, Female: 160,063
Unions: 9, Municipality: 1
Existing health care services from the government
- Department of Health
- Immunization sites: 216 per month (24 sites per union per month), except the municipality, which operates their own sites
- Health Assistants: 46 (19 posts are vacant)
- Community Clinics: 19 (16 are functioning)
- Union Sub Centre: 04
- Upazila Health Complex: 01 (50 bed)
- Department of Family Planning
- Satellite Clinics: 51 in March 2010 (FWVs: 31 and SACMO: 20)
- Union Health and Family Welfare Centre: 04
- Sadar Clinic: 01
- MCWC: 01
Existing health care services from the non-governmental agencies
- Swanirbhar Bangladesh
- Static Centre: 01
- Satellite Clinics: 46
- Community Service Providers: 46
- BRAC
- Shasthaya Sebika: 230
- Shasthaya Karmi: 16
Prevailing health outcomes
- Services rendered in UHC:
- No. of Patients treated in the indoor: 359 (January 2010), 327 (February 2010)
- Bed occupancy rate in UHC: 70% (January 2010), 71% (February 2010)
- No. of Patients treated in the outdoor: 2833 (January 2010), 2735 (February 2010)
- No. of Patients treated in the emergency: 178 (January ’10), 190 (February ’10)
- Services rendered in MCWC:
- No. received ANC: 114 (January 2010), 91 (February 2010), 95 (March 2010)
- No. of Delivery: 67 (January 2010), 63 (February 2010), 68 (March 2010)
- No. received PNC: 59 (January 2010), 56 (February 2010), 60 (March 2010)
- No. of General Patients treated: 675 (Jan’10), 789 (Feb’10), 698 (March’10)
- No. of Children treated: 270 (January ’10), 288 (February ’10), 299 (March ’10)
- No. of D&C done: 5 (January 2010), 2 (February 2010), 4 (March 2010)
- No. of Patients treated in the USCs: 2524 (January 2010). 2709 (February 2010)
Performance in 2009:
January |
February |
March |
April |
May |
June |
4847 |
4338 |
3892 |
3597 |
4138 |
4279 |
July |
August |
September |
October |
November |
December |
4623 |
3890 |
2199 |
3193 |
3021 |
4045 |
- Contraceptive Acceptance Rate: 73% (December 2009)
- TB: Case Detection Rate: 76% (January 2010), 76% (February 2010)
Treatment Success Rate: 96% (January 2010), 96% (February 2010)
- Swanirbhar Bangladesh
- Services provided at Static Centre:
976 (January 2010), 908 (February 2010), 986 (March 2010)
- Services provided at Satellite Clinics:
3920 (January 2010), 3318 (February 2010), 3569 (March 2010)
- Services provided by Community Service Providers:
10,199 (January 2010), 10,604 (February 2010), 10,475 (March 2010)
3.2 Bodorpur union
Population:
Total |
Male |
Female |
0-11 months |
12-23 months |
2-4 years |
|||
46,062 |
24,051 |
22,011 |
Boys |
Girls |
Boys |
Girls |
Boys |
Girls |
719 |
661 |
710 |
646 |
3263 |
2984 |
|||
5-14 years |
15-49 years |
50+ years |
No. of House holds |
|||
Boys |
Girls |
Male |
Female |
Male |
Female |
7364 |
3738 |
3426 |
9608 |
8792 |
6013 |
5502 |
|
- Department of Family Planning
Upgraded Union Health and Family Welfare Centre: 1 at Debirchar
- Sub-Assistant Community Medical Officer – 1
- Family Welfare Visitor – 1
- Pharmacist – 1 (Vacant)
Performance:
Indicators |
January 2010 |
February 2010 |
March 2010 |
ANC-1 |
30 |
30 |
23 |
ANC -2 |
25 |
11 |
25 |
ANC-3+ |
11 |
5 |
29 |
PNC-1 |
9 |
8 |
8 |
PNC-Revisit |
9 |
10 |
9 |
Under 1 yrs. patients |
68 |
85 |
61 |
1-5 yrs. patients |
185 |
230 |
98 |
Male general patients |
151 |
145 |
176 |
Female general patients |
594 |
515 |
601 |
Total general patients |
745 |
660 |
777 |
Contraceptive Acceptance Rate (CAR) in 2009:
Jan |
Feb |
Mar |
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
Nov |
Dec |
68 |
64 |
65 |
65 |
69 |
69 |
70 |
69.49 |
70 |
71 |
70 |
69.46 |
- Department of Health
- Medical Officer – 1 (Vacant)
- Medical Assistant – 1 (? on deputation to UHC)
Ward No. 1
Existing health care services from the government
- Department of Health
- Immunization sites and schedule: Sunday/Wednesday
Site’s name |
Village |
Dates in 2010 |
||||||||
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
Nov |
Dec |
||
South Badarpur Registered Primary School |
Badarpur |
4 |
2 |
6 |
4 |
1 |
5 |
3 |
7 |
5 |
North Badarpur Registered Primary School |
Badarpur |
7 |
5 |
9 |
7 |
4 |
1 |
6 |
3 |
8 |
Union H&FWC |
Debirchar |
11 |
9 |
13 |
11 |
8 |
13* |
10 |
14 |
12 |
Residence of Emran Khan |
Bogirchar |
13* |
12 |
16 |
14 |
11 |
15 |
13 |
14 |
12 |
Middle Badarpur Registered Primary School |
Badarpur |
18 |
16 |
20 |
18 |
16* |
19 |
17 |
26 |
19 |
Residence of Shahjol Bepari |
Debirchar |
21 |
19 |
23 |
21 |
18 |
22 |
20 |
21* |
22 |
Residence of Riazuddin Munshi |
Bogirchar |
25 |
23 |
27 |
25 |
22 |
26 |
24 |
28 |
26 |
Residence of Borondi |
Bogirchar |
28 |
26 |
30 |
27* |
25 |
29 |
27 |
24 |
29 |
* Government Holiday. Please check with Health Assistant for alternate day
- Health Assistants:
- Moulana Abu Abdullah
- Another position vacant
- Community Clinics: None
- Department of Family Planning
- Family Welfare Assistants:
- Hasina Begum
- Saiful Begum
- Satellite Clinics:
In March 2010:
SACMO
Date |
School, location and address |
Ward, Unit |
Discussion Topics |
30/03/2010 |
Bagirchar Registered Primary School |
1/Ka |
Personal Hygiene |
FWV
Date/Day |
Location |
Ward |
Concerned FWA |
10/3/2010, Wednesday |
Residence of Emran Khan/Ruzila |
1 |
Hasina Begum |
Existing health care services from the non-governmental agencies
- Swanirbhar Bangladesh
- Satellite Clinics: 2
- Community Service Providers: 2
Community Service Providers |
Village |
Location of Satellite Clinic |
Shahnaz |
Bagirchar |
Baddi Bari |
Nilufa |
Badarpur |
Residence of Kanchan Sikder |
- BRAC
- Shasthaya Sebika: 6
Shasthaya Sebika |
Village |
Lalmoti |
Debirchar |
Motibibi |
Debirchar |
Akhi |
Debirchar |
Nurjahan |
Badarpur |
Golapjan |
Badarpur |
Rahima |
Badarpur Moslem Bazar |
Ward No. 2
Existing health care services from the government
- Department of Health
- Immunization sites and schedule: Sunday/Wednesday
Site’s name |
Village |
Dates in 2010 |
||||||||
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
Nov |
Dec |
||
Residence of Mohiuddin Hawlader |
Rairabad |
4 |
2 |
6 |
4 |
1 |
5 |
3 |
7 |
5 |
Residence of Delu Pachadar |
Rairabad |
7 |
5 |
9 |
7 |
4 |
1 |
6 |
3 |
8 |
Residence of Rohom Ali Hazi |
Rairabad |
11 |
9 |
13 |
11 |
8 |
13* |
10 |
14 |
12 |
Residence of Turjon Ali Howlader |
Chartitia |
13* |
12 |
16 |
14 |
11 |
15 |
13 |
10 |
15 |
Residence of Yasin Mridha |
Chartitia |
18 |
16 |
20 |
18 |
16* |
19 |
17 |
26 |
19 |
Baddi Bari |
Chartitia |
21 |
19 |
23 |
21 |
18 |
22 |
20 |
21* |
22 |
Residence of Gofur chairman |
Chartitia |
25 |
23 |
27 |
25 |
22 |
26 |
24 |
28 |
26 |
Matabbar Bari |
Kazirabad |
28 |
26 |
30 |
27* |
25 |
29 |
27 |
24 |
29 |
* Government Holiday. Please check with Health Assistant for alternate day
- Health Assistants:
- Zulfiqar Ali
- Nurunnahar Begum
- Another post vacant
- Community Clinics: None
- Department of Family Planning
- Family Welfare Assistants:
- Nasima Begum
- Lipika Afroz
- Satellite Clinics:
In March 2010:
SACMO
Date |
School, location and address |
Ward, Unit |
Discussion Topics |
11/3/2010 |
MiddleChartitia Registered Primary School; Residence of Emran Khan |
2/Ka |
Personal Hygiene |
16/3/2010 |
Kazirabad Government Primary School |
2/Kha |
Personal Hygiene |
9/3/2010 |
South Chartitia Primary School |
2/Kha |
Personal Hygiene |
2/3/2010 |
East Chartitia Government Primary School; Jharu Hang Bari |
2/Ga |
Personal Hygiene |
18/3/2010 |
North Chartitia Primary School |
2/Ga |
Personal Hygiene |
FWV
Date/Day |
Location |
Ward |
Concerned FWA |
14/3/2010 Sunday |
Residence of Yasin Mridha, Chartitia |
2 |
Nasima Begum |
24/3/2010 Wednesday |
Matabbar Bari, Kazirabad |
2 |
Nasima Begum |
Existing health care services from the non-governmental agencies
- Swanirbhar Bangladesh
- Satellite Clinics: 3
- Community Service Providers: 3
Community Service Providers |
Village |
Location of Satellite Clinic |
Taslima |
Rairabad |
Residence of Balu Howlader |
Jhorna |
Rairabad |
Residence of Habib Howlader |
Nasima |
Chartitia |
Turjan Howladar Bari School |
- BRAC
- Shasthaya Sebika: 10
Shasthaya Sebika |
Village |
Sumona |
Chartitia |
Rokeya |
Chartitia |
Anowara |
Chartitia |
Khadiza |
Chartitia |
Monowara |
Chartitia |
Minara |
Chartitia |
Fulora |
Kadirabad |
Ojufa |
Kadirabad |
Taslima |
Kadirabad |
Choleman |
Kadirabad |
Ward No. 3
Existing health care services from the government
- Department of Health
- Immunization sites and schedule: Sunday/Wednesday
Site’s name |
Village |
Dates in 2010 |
||||||||
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
Nov |
Dec |
||
Residence of Sultan Khalifa |
Rairabad |
4 |
2 |
6 |
4 |
1 |
5 |
3 |
7 |
5 |
Residence of Habi Howlader |
Rairabad |
7 |
5 |
9 |
7 |
4 |
1 |
6 |
3 |
8 |
Nazirpur Government Primary School |
Charpata |
11 |
9 |
13 |
11 |
8 |
13* |
10 |
14 |
12 |
Residence of Fazlu Chairman |
West Char Kassopia |
13* |
12 |
16 |
14 |
11 |
15 |
13 |
10 |
15 |
Sluedge Community Centre |
West Char Kassopia |
18 |
16 |
20 |
18 |
16* |
19 |
17 |
26 |
19 |
Cyclone Shelter |
Middle Char Kassopia |
21 |
19 |
23 |
21 |
18 |
22 |
20 |
21* |
22 |
Bepari Bari |
Middle Char Kassopia |
25 |
23 |
27 |
25 |
22 |
26 |
24 |
28 |
26 |
East Char Kassopia Government Primary School |
East Char Kassopia |
28 |
26 |
30 |
27* |
25 |
29 |
27 |
24 |
29 |
* Government Holiday. Please check with Health Assistant for alternate day
- Health Assistants:
- Zahangir Alam
- Rebeka Sultana
- Rabeya Akhter
- Community Clinics: None
- Department of Family Planning
- Family Welfare Assistants:
- Hosne Ara - 1
- Hosne Ara - 2
- Satellite Clinics:
In March 2010:
SACMO
Date |
School, location and address |
Ward, Unit |
Discussion Topics |
4/3/2010 |
Char Kassopia Government Primary School; Cyclone Shelter |
3/Ka |
Personal Hygiene |
25/3/2010 |
East Char Kassopia Government Primary School; Satbaria |
3/kha |
Personal Hygiene |
FWV
Date/Day |
Location |
Ward |
Concerned FWA |
2/3/2010, Tuesday |
Najirpur Sluedge Gate Beri Badh |
3 |
Hosne Ara - 1 |
7/3/2010, Sunday |
Residence of Sultan Khalifa, Rairabad |
3 |
Hosne Ara -2 |
17/3/2010, Wednesday |
Char Kassopia Cyclone Shelter |
3 |
Hosne Ara - 1 |
Existing health care services from the non-governmental agencies
- Swanirbhar Bangladesh
- Satellite Clinics: 2
- Community Service Providers: 2
Community Service Providers |
Village |
Location of Satellite Clinic |
Rahela |
Char Kassopia |
Residence of Fazlu Chairman |
Sharfunnesa |
Char Kassopia |
Sluedge Gate Community Centre |
- BRAC
- Shasthaya Sebika: 8
Shasthaya Sebika |
Village |
Saleha |
Char Kossopia |
Kohinoor |
Char Kossopia |
Maleka |
Char Kossopia |
Motibibi |
Najirpur |
Amena |
Hajirhat |
Yasmin |
Hajirhat |
Saleha |
Nobinagar |
Fuljan |
Lathial bazar |
3.3 Charvuta union
Population:
Total |
Male |
Female |
0-11 months |
12-23 months |
2-4 years |
|||
36,989 |
19,225 |
17,764 |
Boys |
Girls |
Boys |
Girls |
Boys |
Girls |
561 |
527 |
552 |
468 |
1677 |
1590 |
|||
5-14 years |
15-49 years |
50+ years |
No. of House holds |
|||
Boys |
Girls |
Male |
Female |
Male |
Female |
6,310 |
4609 |
4195 |
9047 |
7961 |
2779 |
3023 |
|
- Department of Family Planning
Upgraded Union Health and Family Welfare Centre: 1 (in North Taraganj)
- Sub-Assistant Community Medical Officer – 1
- Family Welfare Visitor – 1 (on deputation to MCWC, Lalmohon)
- Pharmacist - 1
Performance:
Indicators |
January 2010 |
February 2010 |
March 2010 |
ANC-1 |
x |
x |
x |
ANC -2 |
x |
x |
x |
ANC-3+ |
x |
x |
x |
PNC-1 |
x |
x |
x |
PNC-Revisit |
x |
x |
x |
Under 1 yrs. patients |
74 |
64 |
92 |
1-5 yrs. patients |
190 |
143 |
250 |
Male general patients |
218 |
175 |
271 |
Female general patients |
957 |
822 |
1059 |
Total general patients |
1175 |
997 |
1330 |


