COMMUNITY HEALTH PROGRAM
“It is health that is real wealth and not pieces of gold or silver- Mahatma Gandhi”. Our health is the most important commodity that we have. Without it everything will fall apart – relationship, financial wellbeing, career, education, and so on. It is very important that one should take good care of their health. As the era of the Sustainable Development Goals (SDGs) has begun. Health is well placed in the SDGs. The health goal (SDG 3) is broad: ‘Ensure healthy lives and promote well-being for all at all ages’. The SDG declaration emphasizes that to achieve the overall health goal, ‘we must achieve universal health coverage (UHC) and access to quality health care. No one must be left behind’. This places UHC as at the centre of the SDG 3 health goal and SDG 3 as a contributor to and beneficiary of sustainable development, with linkages to all the other SDG targets. Achieving SDG 3 will depend on progress in other SDGs – e.g., poverty reduction; education; nutrition; gender equality; clean water and sanitation, sustainable energy and safer cities. Keeping this SDG goal in mind Ghashful is implementing Community Health Program (CHP) as one of the most remarkable development interventions through different approaches. With the view of expanding better health services, Ghashful has been implementing its CHP in two types of Health Program titling “Reproductive Health” and “General Health” to cover the health services to reach the beneficiaries of all ages and stages of life. CHP aims at extending good health services to the vulnerable and marginalized people and make them aware of their rights of getting proper services regarding their general and reproductive health from the respective institutions of the government for their well-being. The program provides health services through different mechanism in the operational areas surrounding all stages of human life to ensure a healthy community. Ghashful has been playing a significant role to ensure health services for the neglected children of the urban and rural working areas.
The services provided through Community Health Program (CHP) under two of the categories of the general and reproductive health care.
- Health service through fixed clinic
- Health service through satellite clinic
- Health Camp
- Family planning services and safe delivery
- Immunization
- Ensuring health service to garments workers
- Heath card service to family
- Awareness raising program
- Linkage with Government services
Reproductive Health Program
Goal and Objectives of Reproductive Health
Goal
Reduction of maternal and child mortality rate including prevalence of birth related disability.
Objective
- To extend services to the vulnerable and marginalized women, children and adolescent girls and make them aware of their rights to appropriate health provision
- To increase awareness on health-related issues including HIV/ STD/ AIDS etc.
- To decrease the growth of population rate
- To reduce reproductive health risks
Coverage Area
Hathazari and Patiya upozila, Chattogram City Corporation areas of Chattogram district and Naogaon district.
Target Beneficiaries
Vulnerable population especially women, children and adolescents
Implementation Process
Throughout the years, Ghashful is providing its health services through integrated approach in the communities and the work places. The health service intervention is being implemented basically at the local Garment Factories.
In the community level, Ghashful is providing the following health services:
Clinical Service:
Ghashful is providing two types of clinical services to its client. These are:
- Fixed Clinic
- Satellite Clinic
Fixed Clinic
The type of clinical services is being provided from a fixed clinic center. It is a regular-basis health service for the community people. Registered physicians, skilled and trained nurses and health assistants along with experienced TBAs are available in the fixed clinic from 9 am to 5 pm to serve the vulnerable community people. The center is well-equipped with health-service related instruments. Medicines are also available there. Facilities of some pathological tests are also available here. Doctors serve the medical services from 9 am to 1.30 pm at these centers. Free drugs are also provided only for very poor patients. Besides the routine works, special sessions are arranged twice a week where people can get different types of health services including maternal and general health treatments.
Satellite Clinic
The Satellite clinic has no fixed place. The roaming clinic has successfully been providing medical services from door to door at slum areas of Chittagong city and rural areas. Being very poor, the urban slum dwellers suffering from various health problems and diseases are unable to get health care services from the private clinics. Neither they have adequate health service opportunity nor are they aware about their health risks. The TBAs living at slums are primarily responsible to arrange the clinical sessions at their respective slum areas. The TBAs are generally appointed by Ghashful.
Safe Delivery Service:
Special Healthcare services for Pregnant and Lactating mother
With an aim of confirming due response to the critical health condition of mothers and the newborn babies, Ghashful is implementing the safe delivery activities in working areas. Reducing the maternal mortality rate is the prime objective of the program.
Ghashful emphasizes on appointing skilled attendants at delivery time and referral to a proper service provider for emergency care and thereby strengthening the health care systems and identifying the actions to respond to the delivery related challenges at the community level.
Family Planning Services
Healthcare services for population control
A small happy family with two children at best has been the focal point of Ghashful since its inception. In this perspective, Family Planning oriented healthcare services has been one of the top priority based development issues.
Bangladesh being a small country has numerous limitations to hold on the pressure of population magnitude as the pressure of the overpopulation on our land as well as our socio-economic condition is to be a great challenge to face on the way of achieving self-reliance. Obviously, Population control has been a key national concern for the Government of Bangladesh. But, the efforts and initiatives from the government level are not individually feasible and viable to face the challenges involved in the process of controlling the over-population problem in a very conservative country. It requires a holistic approach to combat population growth both in urban and rural areas in Bangladesh.
Ghashful, as one of the pioneer organizations in the sector, is providing basic and comprehensive delivery service among the eligible couples at working areas with the assistance of the District Family Planning Department. The organization has been playing a vital role in disseminating proper knowledge and information among community people aged 15 to 40 years for using local contraceptives and other measures to maintain a small family.
It is mention worthy that Ghashful received The President Award in 1990 for its contribution in controlling population. The organization was declared to be the best organization in Chattogram by the Ministry of Health and Family Welfare on the occasion of world population day 1998. Ghashful field workers also received awards of the best workers in the district level family planning sector.
De-worming Activity
As a notable healthcare service provider Ghashful has been distributing de-worming tablets and medication to the family member of its working areas to ensure sound health condition of the community people. Children and adults of the community are being benefited much by the de-worming activities.
Extended Program for Immunization (EPI)
With a view of decreasing health risks, Ghashful has been implementing the EPI as one of the most mandatory healthcare services for the community people. Under the program, the organization is proving supports for immunizing infants and pregnant women in the working area
Ghashful TBA group and health assistants play significant role in supporting the program of immunization. Both of these groups are responsible for educating people about the importance of immunization. The organization arranges immunization (TT, DPT & Polio) twice in a week in the fixed clinics of the organization. Besides this, Ghashful arranges regular-basis immunization program 5 times in a month. Under EPI, Ghashful effectively observes different special days for decreasing child health risks as a part of social awareness building program. Several times Ghashful has been awarded by Chattogram City Corporation for its EPI activities.
In the reporting period, Ghashful was involved with National Vaccination Day, Vitamin A+ Campaign and National De-worming Day as the supplementary force of Chattogram City Corporation.
Work Place Healthcare Intervention for Garments Employee
Since 2000, Ghashful has been implementing the work place based healthcare intervention targeting the garments employees living in Chattogram City Corporation.
Chattogram being the second largest port city of Bangladesh has been investing a lion share of the country business. The city is proud to uphold thousands of garment factories and two of the main EPZs in its boundary. In this perspective, a vast number of garments workers have been targeted for the integrated approach of Ghashful healthcare intervention.
It’s a fact that 90 % of the garment workers have come from the poor families of urban and rural areas. They are not aware about their health care. Moreover, they do
not get enough time and money to get treatment outside the workplaces. For this reason, this affects their life skills as they do not get timely information.
Considering the vulnerability, Ghashful CHP is providing the emergency healthcare services and some essential medicines to the garment workers at their work places. To grow awareness about the hazards and the ways to fight off the challenges of the incurable diseases like SRHR and HIV is one of the included initiatives of the program.
Family Health service with Health Card
With an aim of providing basic healthcare services to the community people, Ghashful has been implementing the Health Card project as a means of providing health support to the very poor people.
In 2011, Ghashful launched the ‘Health Card Project’ with the support of INAFI Bangladesh and Rock Feller Foundation. After completion of the project duration, Ghashful has been implementing the project by its own initiative in both urban and rural areas.
The fact is that poor and vulnerable people of Bangladesh get insufficient health service. The people of rural area are deprived of getting proper medical services in time. They even have no knowledge about the right place to go and the way to get the needed healthcare services. Considering the obstacles, Ghashful has been implementing the project to establish the right of the vulnerable and poor community people to get access to medical services.
The community people of the working areas including Ghashful Samity members can get this service within one-year shelter holding two types of cards. A card holder can get this medical service along with maximum five of his/her family members.
Card is renewable after the duration of validity with fixed charges for fixed time. Besides getting the general medical treatment, the card holder can also get the facilities of taking diabetic test, pregnancy test at a low price. To grow awareness among the card holders about family planning, nutrition, sanitation etc. is an added initiative of the program.
Community Health Program (CHP)
Facts and Figure in the year JULY 2019-2020
| Sl. No | Service | Male | Female | Child | Total | Boy | Girl | Total |
| 1 | General Health Services | – | 15737 | 497 | 18936 | 232 | 265 | 497 |
| 2 | Family Planning Services | 5785 | 3132 | – | 8917 | – | – | – |
| 3 | EPI | – | 267 | 924 | 1191 | 458 | 466 | 924 |
| 4 | Safe Delivery | – | – | 189 | 189 | 106 | 83 | 189 |
| 5 | Pathological-P.T. | – | 88 | – | 88 | – | – | – |
| 6 | Pathological Test- CBG | 88 | 349 | 15 | 452 | 6 | 9 | 15 |
| 7 | Health Card | 50 | 419 | 16 | 485 | 6 | 10 | 16 |
| 8 | Garments Health service | 2633 | 13795 | 10 | 16438 | 3 | 7 | 10 |
Performance Highlights 2019-2020
World Population Day- “Family Planning is a Human Right.”
11 July, 2019 a colourful rally, discussion meeting and prize giving ceremony was organized by the District Family Planning Office, Chittagong in collaboration with all the local Non-Government Organizations. The theme of World Population Day 2019 is fulfilling the commitments made at the 1994 International Conference on Population and Development (ICPD) in Cairo. In the 25 years since ICPD. On the day of the occasion a colourful rally started from the Chittagong Circuit House and ended at the Bangladesh Shilpokola Academy, Chittagong. At the end of the rally a discussion meeting was held at the auditorium of Shilpokola Academy and it was chaired by the Additional District Commissioner Kamal Hossain. Additional Divisional Commissioner (Development) Nurul Alam Nizami attended the meeting as the Chief Guest. Among the special guests there were Deputy Director of Health Dr. Abdus Salam, Deputy Civil Surgeon Dr. Tayeeb Ali. Deputy Director of District Family Planning Office, Chittagong Dr. U Khe Wheen gave the welcome speech. Speakers at the meeting said that a planned family can play an important role in meeting the basic nee as well as building a happy and a prosperous country. A planned family is the key to development. In the socio-economic context of Bangladesh, there is no other alternative to a planned family. At the end of the meeting, certificates and crest were given to various organizations and individuals for their special contribution in family planning at District and Divisional level. The employees of Ghashful’s Community Health Program took active participation in the event.
Seminar on Dengue Prevention
A seminar on dengue prevention was organized by the Ghashful’s Community Health Program at the fixed clinic of Ghashful situated in Madarbari area on the 13th of August. The meeting was presided over by the Asst. Director of Ghashful Microfinance and Financial Inclusion Department and the focal person of Community Health Program Mohd. Tajul Islam. Taimul Alam – manager, Microfinance and Financial Inclusion, Nazmul Hasan Patwari- Deputy Manager, Medical officer of Ghashful Dr. Fatema Islam attended the seminar as special guests. Guests mentioned in their speeches that we need to be aware of dengue prevention. In order to prevent dengue we need to keep the surroundings of our house clean, use mosquito nets at night and to seek immediate medical attention in case of any kind of fever. The In Charge of Ghashful Community Health Program Mohd. Atiqul Islam and branch employees and many beneficiaries of Ghashful were also present at the seminar.
World Breastfeeding Week
This year’s World Breastfeeding Week slogan is “Empower Parents, Enable Breastfeeding”. The slogan was chosen to be inclusive of all types of parents in today’s world. Focusing on supporting both parents to be empowered is vital in order to realise their breastfeeding goals.World Breastfeeding Week is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of babies around the world. It is recommended exclusively to start breastfeeding within one hour after birth until a baby is 6 months old. Nutritious complementary foods should then be added while continuing to breastfeed for up to 2 years or beyond. It and help parents nurture and bond with their children in early life, when it matters most. This includes enacting paid maternity leave for a minimum of 18 weeks, and paid paternity leave to encourage shared responsibility of caring for their children on an equal basis. Mothers also need access to a parent friendly workplace to protect and support their ability to continue breastfeeding upon return to work by having access to breastfeeding breaks; a safe, private, and hygienic space for expressing and storing breastmilk; and affordable childcare.Breastfeeding promotes better health for mothers and children alike. Increasing breastfeeding to near-universal levels could save more than 800 000 lives every year, the majority being children under 6 months. Breastfeeding decreases the risk of mothers developing breast cancer, ovarian cancer, type 2 diabetes, and heart disease. It is estimated that increased breastfeeding could avert 20 000 maternal deaths each year due to breast cancer.
On August 5th 2019 Ghashful Community Health Program organized a seminar to celebrate the “World Breastfeeding Week” at their fixed clinic center situated in West Madarbi, Chattogram. The meeting was presided over by Mohd. Tajul Islam Khan – Asst. Deputy Director of Ghashful Microfinance and financial Inclusion and Focal person of CHP program. Dr. Fatema Islam attended the meeting as the special guest. Dr. Fatema mentioned in her speech that breast milk acts like an antidote to boost the immune system for a newborn. She requested all the mothers and the new mothers to breast feed their infant and newborns and call for encouragement and awareness among the family members. Also present at this time were the beneficiaries of Ghasful, including the in-charge of the Ghasful Community Health Program Mohd. Atiqul Islam and the branch level officials.
World AIDS Day
“Communities make the difference” Keeping the theme in mind “World AIDS Day” was celebrated by the Civil Surgeon Office in collaboration with all the local NGOs on 1st December 2019. On the day of the occasion a colourful rally started Anderkillah General Hospital and ended at Anderkillah General Hospital after going around different important roads of the city. The rally was inaugurated by the Additional District Commissioner Mohd. Kamal Hossain. After the rally a discussion meeting was held at the Civil Surgeon Office and Civil Surgeon of Chittagong District Dr. Sheik Fazle Rabbi presided over the meeting. The Community Health Program officers of Ghashful participated in the program along with many other Govt. and Non-Govt. organizations.
World Tuberculosis Day
“It’s time to pledge for building Tuberculosis-Free Bangladesh.” Keeping this theme in mind “World Tuberculosis Day” was celebrated by the Chittagong Divisional Health office, Civil Surgeon Office and few of their affiliates on 24 March, 2020. Because of COVID-19 exceptional events were organized on this day instead of colourful rally, seminar and meetings. Around 9 am in the morning that day more than two hundred hand sanitizer and mask were distributed among the doctors and patients of Heart Disease Clinic and Anderkilla General Hospital adjacent to the Civil Surgeon’s office in Chattogram city. Divisional Director of Health Dr. Hasan Shehreyar Kabir, District Civil Surgeon Sheikh Fazle Rabbi, Superintendent of Chattogram General Hospital Dr. Asheem Kuman Nath, many others were present during the occasion. Employees of Ghashful Community Health Program participated actively in the program.
National Vitamin “A” Plus Campaign
As part of the Vitamin “A” plus campaign announced by the government of Bangladesh, Ghashful organized a campaign at East Madarbari Shebok Colony along with three other places under the supervision of Chattogram City Corporation on 11 January, 2020. On the day of the campaign from 9 AM to 4 PM the staffs of Ghashful Community Health Program gave feed Vitamin “A” Plus Capsules to children aged six months to sixty-nine months. The locations where the campaign took place were the fixed clinic at West Madarbari area, Agrabad Bepari Para, Choto pool and East Madar bari Shebok Colony. During the campaign 850 children between the age of six months to eleven months were given blue capsules and 1200 children between the age of 12 to 59 months were given the red capsules. In total vitamin “A” plus capsules were feed to 2250 children.
Ghashful Vision Center and Eye Care –
Government of Bangladesh, being a signatory to the vision 2020 , a glosbal campaign for elemination of avoidable blindness be the year 2020. Formulated a nation-eye care plan under the leadership of the Bangladesh National Council for the blind , an apex body under the Ministry of Health and Family Welfare. Development of this plan involved stakeholders across the country including National and International NGOs working in the country for control of blindness.
Approximately 80 percent of Bangladeshis living in rural areas are deprived of getting eye-care services. Most of the eye-care centers and facilities are urban area based. In this perspective, eliminating blindness is one of the major challenges for Bangladesh government. As a part of the country’s mission to combat blindness, Ghashful initiated Vision Eye-care Center with the support of ORBIS International and collaboration of Islamia Eye Institute and Hospital. Through the activities of the Vision Centre, Ghashful has made standard eye treatment facilities available to the poor and vulnerable people of the remote areas.
