Bangladesh

For a summary of MCHIP work that has ended in Bangladesh, click here. And to visit the MaMoni Health Systems Strengthening Project website, click here.

MaMoni Health Systems Strengthening (HSS) Project

Start and end dates: September 2013 – September 2017

For more information on the MaMoni Project, click here.

MCHIP Partners Involved:

Lead Organization: Jhpiego
Partners: Save the Children, John Snow, Inc., Johns Hopkins University/Institute for International Programs

Key Partners in Country:

  • Ministry of Health and Family Welfare (MHFW)
  • International Centre for Diarrheal Disease Research, Bangladesh
  • Dnet (a Bangladeshi non-profit social enterprise)
  • Bangabandhu Sheikh Mujib Medical University
  • Six local non-government organizations: Friends in Integrated Village Development in Bangladesh, Shimantik – Bangladesh Extension Education Services, Dushtho Swasthyo Kendra, Resource Integration Center, and Partners in Health Development

Description of Work:

MaMoni HSS aims to improve the utilization of integrated maternal, newborn and child health, family planning and nutrition (MNCH/FP/N) services to increase the availability and quality of high-impact interventions. The project supports the MHFW to introduce and scale-up proven, evidence-based practices, with the ultimate aim of reducing maternal, newborn and child mortality within seven districts.

The project engages with local government and nongovernmental organizations to improve the delivery of health services. At the national level, MaMoni HSS works to build consensus around policies and standards that positively drive evidence-based interventions at all levels of care.

The project is also supporting Aponjon, the local initiative of the Mobile Alliance for Maternal Action, aimed at reaching five million pregnant women with lifesaving messages through mobile phones. The USAID-supported program, which is fully integrated into MaMoni HSS, has seen enormous success promoting messages. In September 2014, Aponjon reached the milestone of one million subscribers and currently has over 1.2 million subscribers.

Click here to learn more about the project.

Technical Scope

  • Health Systems Strengthening
  • Newborn Health
  • Maternal Health
  • Family Planning
  • Nutrition
  • Child Health
  • Community Mobilization
  • mHealth

Scale/Coverage

MaMoni HSS is using a differential approach to implementation at the district level. Districts and upazilas are categorized into two groups based on the intensity of implementation support. In total, MaMoni HSS supports the MHFW to provide services to a population of more than 12 million people in the targeted districts. In addition, the project influences and supports the scale up of several health systems improvement and service delivery initiatives at a national scale, thus benefiting the entire country.

High-intensity areas: MaMoni HSS supports high-intensity interventions in a total of 23 upazilas. These areas include all upazilas of Habiganj, Lakhsmipur and Jhalokathi districts, four upazilas of Noakhali, and two upazilas of Pirozepur district.

Health system capacity strengthening areas: In 17 sub-districts, MaMoni HSS supports implementation of selected program components. These areas also benefit from the district-level support for health system capacity strengthening.

Select Health and Demographic Data for Bangladesh
GDP per capita (USD) 957.82
Total Population 156.6 million
Maternal Health
Maternal Mortality Ratio (deaths/100,000 live births) 194
Percent of maternal deaths due to HIV
Skilled birth attendant coverage 42.1%
Antenatal care, 4+ visits 31.2%
Newborn Health
Neonatal mortality rate (deaths/1,000 live births) 28
Infant mortality rate (deaths/1,000 live births) 38
Child Health
Under-five mortality (deaths/1,000 live births) 46
Treatment for acute respiratory infection 34.2%
Oral rehydration therapy for treatment of diarrhea 84.3%
Immunizations
Diphtheria-pertussis-tetanus vaccine coverage (3 doses) 91.3%
Percent of districts with >80% DPT3 coverage N/A
DPT3 coverage equity ratio (wealthiest:poorest quintile) 1.18
Family Planning
Modern contraceptive prevalence rate 54.1%
Total fertility rate 2.7
HIV
HIV Prevalence, adult <1%
ART coverage, adult 11%
Health Systems
Density of physicians (per 1,000 population) 0.4
Density of nurses & midwives (per 1,000 population) 0.2
Total Health Expenditure per capita (USD) 32
Sources: 2013 World Bank – GDP, population; 2011 World Bank – health systems data; 2010 BMMS data – MMR; 2014 BDHS data – maternal deaths due to HIV, SBA and ANC coverage, all newborn and child health / immunization / family planning data; 2013 WHO: HIV data.

Now available based on the 2007 Demographic and Health Survey data:
Family Planning Needs during the First Two Years Postpartum in Bangladesh

Key Results to Date

  • Completed assessing all Union Health and Family Welfare Centers (UH&FWCs) across the country and developed a database of all 4,463 union level facilities. The objective of the assessment is to support the Ministry of Health and Family Welfare (MOH&FW) categorize the centers in terms of their readiness to provide 24/7 delivery care services.
  • Supporting the MOH&FW to strengthen the UH&FWCs to provide 24/7 delivery care services. In the four high intensity districts, 73 UH&FWCs are now providing 24/7 services. In the last six months, a total of 5,503 deliveries were conducted in these facilities, indicating a steady increase in utilization compared to the 7,560 in the past one year.
  • Introduced “management of infections among young infants” at union level facilities in 10 sub-districts. In the first quarter of 2016, 816 newborn cases were seen by Sub-assistant Community Medical Officers, of which 63 cases were treated for clinically severe infection and 11 cases were referred to higher level facilities.
  • Supporting the routine health information system (RHIS) initiative of the Directorate General Health Services (DGHS) and Directorate General Family Planning (DGFP) of the MOH&FW to pilot the automated Health Information System in Madhabpur and Lakhai Upazilas of Habiganj district. As the initial step, a Population Registration System (PRS) has been implemented and a total of 342,200 individuals were registered in Madhabpur under the RHIS initiative, which has been expanded to an additional sub-district.
  • Trained 28,469 service providers in 39 districts in the first quarter of 2016 in support of the national scale-up of chlorhexidine. Cumulatively, 34,904 providers from 59 districts have been trained to date. In January 2016, the 600,000 chlorhexidine procured by DGHS were transferred to Central Medical Store Depot, and by March 31, 53 districts had received chlorhexidine supply for use in the district hospital, upazila health complexes, and DGHS managed UH&FWCs.