Community clinic lecture ppt
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Bangladesh established community clinics (CCs) starting in 1998 to extend primary health care to rural populations, with over 13,000 clinics aimed at serving around 6,000 people each. The management structure was revamped in 2009 to enhance community participation, ensuring a more significant role for women and adolescents. The initiative emphasizes community engagement in healthcare management as essential for providing accessible health services and achieving the goal of 'health for all'.
Community clinic lecture ppt
- 3. Background Bangladesh was one of the countries who signed the “Alma-Ata Declaration” in 1978 with a pledge to ensure “Health for All” (HFA) by 2000 through Primary Health Care (PHC). But in 1996 it has been observed that we were far behind the destination as per the set indicators. Unavailability & inaccessibility of PHC to the rural community of Bangladesh (about three fourths of national population) with lacking in community participation were the important reasons.
- 4. CONTD. To address those shortfalls, the then Government of Bangladesh in 1996 planned to establish Community Clinic (CC) (1 CC for about 6000 population) to extend PHC at the door steps of the villagers all over the country. Community Clinic is the brain child of Hon’ble Prime Minister Sheikh Hasina. Construction started in 1998. During 1998-2001, 10723 CCs were constructed & about 8000 started functioning. HA & FWA were service providers in addition to their domiciliary services. They had been trained on ESP (Essential Service Package) under HPSP (1st Sector Program).For management of CC activities, there was 1 Community Group (CG) for each CC having 9-11 members headed by Land Donor/his or her representative. In CG there was no distinct provision for adequate women’s representation & scope for empowerment and adolescent participation. Even, the roles & responsibilities of local govt. representatives for smooth functioning and effective management of CC was not considered with due importance.
- 5. CONTD. In 2009, Govt. planned to revitalize CCs through a project “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) as priority as it was in their election manifesto. It was a project of 5 years duration from 2009-2014. There after the span of the project has been extended for 1 year more i.e. up to 30.06.2015 in 2 phase
- 6. CONTD. Under RCHCIB, Community Group (CG) - management body of CC, has been formed for all the functional CCs with some major changes. CG members’ number has been increased from 9-11 to 13-17 with at least one third women members and adolescent girl/boy. The group is headed by elected UP member of that locality instead of land donor/his or her representative. Land donor/his or her representative is life member & senior vice president of CG. Out of president & vice presidents at least one is female. CHCP is the member secretary in place HA/FWA.
- 7. CONTD. In the catchment area of each CC, there will be 3 CSGs comprising of 13-17 members with at least one third women members. For all functional CCs, CSGs have been formed. The CSGs help CG in CC management along with making community aware regarding the services available at CC and common health messages. New category of service provider, Community Health Care Provider (CHCP) (1 for each CC) has been recruited in phases following all the necessary steps.
- 8. WHO WORKS ? Each CC is headed by a community healthcare provider (CHCP) who works 6 days a week; a health assistant (HA) and a family welfare assistant (FWA) work alternatively 3 days a week. Community Group (CG) is pivotal in the management of CC.
- 9. CONTD. After assuming the office in 1996, Prime Minister Sheikh Hasina inaugurated the first community clinic at Patgati of Tungipara in Gopalganj district on April 26 in 2000. Bangladesh has established more than 13,000 community clinics (CCs) to provide primary healthcare with a plan of each covering a population of around 6,000.
- 10. CONTD. Community participation is an essential part of promoting health as it is "a means of organizing action and motivating individuals and communities" and it helps people to shape policies and projects to meet their priorities. It is an important means of changing people's attitude and actions towards promoting a sense of responsibility in any interventions and this behavioural change is consistent with the community norms and re-affirms the role of people in managing their own health .
- 11. Based on this premise, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), in the Alma Ata Declaration in 1978, emphasized the participation of community people in primary healthcare. Since then, 150 Member States of the WHO and UN are committed to promoting people's participation in the management of healthcare facilities at the community level. It was intended to revolutionize the health systems development for achieving the aim of “health for all by the year 2000”. Moreover, universal health coverage is the major target of sustainable development goal (SDG-3). To achieve the target, cooperation, collaboration and partnership between private and public sector is needed .
- 12. FUNCTIONS Community clinic (CC) is a revolutionary initiative to provide basic health care services in the rural communities of Bangladesh. The CCs are the primary level health facilities have been established and functioning by the government along with participation of local communities.