Child Health
Even though IMCI promotes convergence of child health services through a cost effective approach, it continues to be marginalised as a component of the Child Health Programme in Bangladesh. The ARI & CDD programmes are well recognised and continue with a vertical approach under SWAP. The challenge is to take the IMCI programme to scale up after the experience in the piloting and expansion in the upazilas. More specific, the challenges are the high cost of the 11 days clinical training in-service training, sufficient capacity at training sites, only less than half of the 76 trainers are active. Other challenges are deployment of the trained manpower at the IMCI facilities, sufficient drugs at district level, inadequate supervisory mechanisms and link to the national Quality Assurance mechanism. more ...

Adolescent Health

In Bangladesh approximately 24 % of the population are adolescents. Poverty and other adolescent and development problems affect boys and girls, while early and unwanted pregnancies, gender bias, malnutrition and forced prostitutions affect mostly adolescent girls. These need to be addressed through a multi sectoral approach. Available public sector services specifically addressing adolescents are mostly reproductive health based, and several were initiated by NGOs. MOHFW is committed to take the initiative to develop an ADH strategy liaising with other Ministries and initiate district activities related to ADH. The opportunity provided by the approval of the GFATM for youth and AIDS can be utilised for providing higher visibility to ADH.

Making Pregnancy Safer
Approximately 90% of deliveries in Bangladesh are home deliveries, because it is culturally acceptable. Only around 12% are conducted by skilled birth attendants (SBA). More...

Bangladesh started the piloting of the SBA Training Programme in 6 upazillas, each 15 FWA/HA for 6 months at district training sites. Three districts/upazillas were supported by WHO, and the rest by UNFPA. The challenge is to train all FWA/HA in the pilot upazilla, because the districts can only handle 60 trainees in two years. Advocacy to district/ upazilla stakeholders and community support and advocacy for the trained SBAs is another challenge, especially for timely referral and transport to referral facilities.

To maintain the quality of competency based SBA training according to the evidence-based standard, constant monitoring is needed and regular continuing medical education for the national and district trainers should be provided.