BEES is contributing significantly for improving health condition among the community people giving maximum priority to the poorer section.

In 1984, BEES initiated its health and family planning program until 1992 with the financial support of CIDA. Since 1992, BEES continues health and family planning along with water and sanitation activities with the financial assistance of Netherlands Government under the name of Cooperative Based Health Program among the beneficiaries under BEES only. Soon it is realized that through this process only the beneficiaries under BEES are being benefited while the rest of the community people are still left out from the essential health services within the program intervention areas. Then in the same year, BEES commenced a multifaceted Community Based Health Program (CBHP) along with WatSan activities with financial assistance from Bangladesh Population and Health Consortium (BPHC), which is still continuing in two upazilas of Bogra district. The major components of the project are NMR/MMR reduction, Family Planning, Immunization, TBA Training, Vitamin ‘A’ Capsule distribution, Primary Health Care Services, WatSan, Health Education, etc. with a view to ensure maximum benefit to the rural people particularly disadvantaged women and children. The project covers a range of vast population, almost all people of the target area.

BEES adopted two stage strategies in executing its Community Based Health Program (CBHP). Firstly, it extends Mother and Child Health program to get total community coverage through conducting family planning interventions by distributing materials issued by the government involving field workers of BEES. On the other hand, it extends family planning services and health education to the beneficiaries attached to the group under BEES. The workers frequently visit to the target people- mother and child to strengthen the health services.

Objectives

To improve overall health status of the poor and help to reduce the occurrence of the common diseases that affect the poor most.

The specific outputs to attain the objectives of the program are:

§         reduction of maternal morbidity and mortality rates

§         reduction of neonatal/infant morbidity and mortality rates

§         increased distribution of vitamin ‘A’ capsule

§         increased acceptance rate of modern contraceptive

§         increased use of safe water from tubewells for all purposes

§         increased use of hygienic latrine.

Achievement

Maternal & Child Health Care Interventions

Motivation, awareness raising and dissemination of knowledge through different means and media are the most important software activities under the program to improve overall health status. Thus software supports comprise all the services, which lead to sustainable behavioral change. Keeping this in mind, awareness raising on health related issues within the community people is considered as one of the most important activities through out the reporting period.

A total of 88,759 community people were aware on health related issues against the project target of 108,936 community people, which indicates more than 81% achievement.

Among many health related issues, awareness activities were carried out on personal hygiene practice, dehydration & importance of ORS, Antenatal Care (ANC), Post Natal Care (PNC), delivery care, health & nutrition, family planning, water & sanitation, immunization, etc.

The program staff organized small and large level group meetings, made household visits and showed video film and arranged audio folk songs to raise awareness and motivate the target people. Several Behavioral Change Communication (BCC) materials like posters, leaflets, flipcharts, stickers etc. were mainly used for different promotional activities.

To achieve the objectives under Maternal Health Care program BEES is providing antenatal, postnatal and delivery care by establishing and strengthening linkage among govt. and non-govt. hospitals/clinics and operating a mentionable number of satellite and static clinics. During the reporting period, more than 15% deliveries were done safely by BEES qualified persons, while about 48% deliveries of the total were done by the BEES’s trained Traditional Birth Attendants (TBAs).

A total of 1448 pregnant mothers received at least 3 times ANC services and 788 mothers received at least one PNC service within 42 days after their deliveries against the annual targets of 1655 and 1016 mothers respectively, which signifies about 88% and 78% achievements respectively.

Again a total of 116 at risk delivery cases were referred to the govt. hospitals and clinics during the reporting session against the annual target of 174. About 96% of the pregnant mothers received TT vaccine at least twice during their pregnancy period, while 59% of the women aged 15-49 received the TT vaccine at least twice during the reporting period 2002-2003.

In regard to provide services under Child Health Care, a total of 756 children under 1 years were fully immunized against the annual target of 749 children, which indicates more that 100% achievement. Regarding distribution of vitamin ‘A’ capsules, a total of 10,359 children under 5 yrs. received vitamin ‘A’ capsules fulfilling the target of 10,359. Similarly 100% of the children under 5 years received treatment of ARI, diarrhoea and other diseases during the reporting period 2002-2003.

Status of Maternal & Child Health Care during 2002-2003

Family Planning Interventions

Family Planning is one of the most important and vital components of BEES health program. The program staff put their earnest efforts to raise awareness about the benefits of small family size and increase the percentage of users of family planning devices through motivation.

The community based MCH-FP program of BEES was registered under the Family Planning Directorate of Govt. of Bangladesh. Therefore, the program staff received family planning devices from the Upazila Family Planning Offices and distributed the materials among the fertile couples within the community in one month round. Oral Pills and Condoms were distributed to the beneficiaries against a normal service charge, while the methods IUD and Injection were provided by the Paramedics at the BEES operated static and satellite clinics and eligible couples were referred to the GO/NGO clinics for adopting the methods – Tubectomy, Vasectomy and Norplant. At the end of reporting period, more than 72% of the eligible couples adopted family planning methods. Among the adopters (i.e. 72% couples) 48% of the eligible couples adopted Oral Pill and Condom while 24% of the couples adopted IUD, Injection, Vasectomy, Tubectomy and Norplant.

Under general health care services and nutrition education to the community people, program staff carried out various types of activities during the reference period. The program staff provided preventive and curative primary health services through a total of 660 satellite clinics while about 300 satellite clinics were arranged jointly with EPI. Moreover, 1,514 EPI centers were arranged jointly with GoB. During the reporting session 2003-2003, over 4,000 patients received basic curative health services for different common diseases

Other Interventions

For awareness raising, a total of 38 Video Film shows and 31 Audio Songs were organized at community level with the participation of a huge number of community people. Moreover, several rallies, campaigns etc. on health related issues were held and National Immunization Days (NID) were also observed by BEES through organizing rallies along with miking and banner with the participation of community mothers and children. Apart from these activities, a total of 3,389 courtyard meetings were held with the participation of about 74,000 community mothers. The main objectives of the courtyard meetings were to motivate and educate the community mothers about health and nutrition.

In addition, the staff took initiatives to perform some activities for better coordination among the stakeholders and smooth implementation of the interventions. To strengthen the relationship among government and non-government stakeholders and to get their support services for smooth functioning of the program, a mentionable number of collaborative activities were organized by the program staff through out the planned period at different level.