Planning of Life: Root of Happy Families

In 1999, BEES started implementing a three and a half years project entitled ‘Expanded Health and Education Program (EHEP)’ in its new expanded intervention areas of Gazipur, B.Baria and Narsingdi districts with the financial assistance from World University Service of Canada (WUSC)-CIDA. The project was continued up to December 2002 covering mothers (15-49 yrs) and children (0-5 yrs) of 68,250 households within the project area.

Under the integrated support services on health and nutrition three Doctors, one Program Manager (trained in nutrition, food processing and general health), three Area Managers (trained in health, nutrition and non-formal primary education), 16 Paramedics, 2 Assistant Paramedics, 17 Health Supervisors, 195 Family Health Welfare Workers (FHWW) and 390 trained TBAs were involved with BEES in the project.

The major components of EHEP were reproductive, child & general health along with nutrition and non-formal primary education. The main objectives were to strengthen and improve general health prevention & curative services as well as to increase awareness on health & hygiene of mothers & children and; also to provide health education to women.

Objectives

The objectives of the project are to strengthen and improve reproductive, child and general health care services and to increase awareness on personal health & hygiene practices of household mothers.

Achievement

During the reporting session 2002-2003, the project EHEP continued only for the first 6 months (July-December, 2002) of the mentioned period. During this period, the project performance, particularly in case of effective functioning of the satellite clinics, participation of the children in immunization program, immunization of 15-49 aged women by TT₂, number of operating satellite clinics, usage of tubewell water for all purposes, proper sanitation practice, antenatal and postnatal care, safe delivery by BEES’s trained TBAs, etc. were quite satisfactory.

During the reference period, about 1,800 satellite clinics were held by the paramedics. About 77% pregnant mothers of the sampled households received at least two times ANC while about 75% mothers received at least one PNC within 42 days after their deliveries.

A total of 19 antenatal and postnatal mothers at high risk were referred to the govt. hospitals and clinics by the paramedics during this period. Apart from these, more than 3,000 target beneficiaries received primary health services from the satellite clinics. In the area of safe delivery, 63% deliveries of the total were facilitated by the BEES’s trained TBAs. Nearly 70% of the women aged 15-49 of the total received TT vaccine twice and 26% women of the same age group received the same vaccine 5 times while only about 4% women of 15-49 years group did not receive TT any time.

Regarding participation of the children under one year in immunization program, more than 79% children participated in Expanded Program of Immunization (EPI).

In case of usage of family planning methods, more than 57% eligible couples of the target households adopted some kind of family planning methods. Among the users nearly 17% were male while the rest of the users were female. Of them, about 18% family planning users adopted some kinds of permanent methods while more than 200 couples were referred to the govt. hospitals or clinics for adopting clinical methods.

During the reporting period, data on morbidity was also collected from the sample households. It was reported that 7.6% of the population of all age groups suffered from various types of diseases during the reporting session. Only 0.3% people in the sample households died of various diseases. On the contrary, the birth rate of the sample households, during the period was only 0.9% while the maternal mortality was found zero.

Concerning the usage of tubewell water for all purposes, about 71% of the sample households used tubewell water for all purposes. Regarding the usage of hygienic latrine by the sampled households, roughly 48% sample households of the total was found to use hygienic latrines.

Status of EHEP during July 2002-December, 2002

Nutrition Initiative Program

In traditional approach, women’s health status refers to maternal health focusing on the target women within reproductive years (15-49) and the reproductive health only. Such a narrow span of target population ignores the women under pre & post reproductive years. General health and nutrition status also influence women’s reproductive system as a whole. Fulfillment of the nutritional requirements of a woman at early age is significantly important to prepare herself for carrying and giving birth to a healthy child in future. Therefore, BEES took empathetic measures for women-folk with respect to nutrition. BEES started nutrition and growth monitoring activities along with Reproductive, Child & general health program back in 1979. Until 1992, BEES activities were confined to growth monitoring, balanced diet, poultry rearing, kitchen gardening and other promotional activities.

Later on, with a view to prevent and overcome malnutrition which manifests prevalence of low birth weight babies, formation of weaker pelvises of teenagers and birth complications of pregnant women, by nourishing their poor health, BEES had undertaken its Nutrition Initiative Program. 

The Nutrition Initiative Program initiated in 5 upazilas of 5 different districts with its own fund along with the financial assistance from WUSC-CIDA under the Expanded Nutrition Initiative Program.

Under this program, diversified activities on health and nutrition such as kitchen gardening, cooking demonstrations for balanced diet, screening of malnourished children, growth monitoring of under 2 years children, BMI measurement of 15-49 years women, supplementary feeding, poultry & livestock rearing etc. are performed. The program has been covering almost 50 thousand community people in the intervention areas through 28 Community Health and Nutrition Workers (CHNWs) and 4 Paramedics.

BEES organized several seminars, workshops and meetings in collaboration with the government departments on various issues related to health, nutrition and family planning during the reporting period for smooth functioning of the program. More than 150 rallies alongwith miking and about 50,000 courtyard meetings were organized on different relevant issues under the promotional activities to aware and motivate the target communities. 

On the other hand about 75% of the pregnant mothers of the target households received at least twice ANC, while roughly 48% of the mothers received at least once PNC within 42 days after their deliveries from BEES operating satellite clinics. Besides, the pregnant mothers at risk were identified by BMI and advised to take essential precautions before and after delivery. During the period under reference, more than 22% pregnant mothers of the total were checked by taking their weight and height to detect BMI under 18.5, who were considered to be mothers at risk.

Similarly growth monitoring were done to assess the weight of the children under 2 years against their ages to detect whether they were malnourished or not and to ascertain the degree of malnutrition. The program staff undertook various measures to reduce moderate and severe malnourished children under 2 years and were able to reduce 22% against the target of 18%. On the other hand, a total of 1,880 cooking demonstrations and 38 homestead gardening were arranged by the program staff during the review session.