Evidences for planning and decision making to determine potential approaches for improving MNH services in underserved unions
USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP)
July to September 2020
List of Contributors
USAID’s MaMoni Maternal Newborn Care Strengthening Project (MaMoni MNCSP) has initiated a process to collect information from primarily selected unions in the intervention districts through physical verification. Through the process, the project generated information from the primary sources to analyze present status of underserved unions, and produced evidences for district implementation team with the objective to enabling them for using evidences in setting programmatic priorities, making appropriate decisions, and planning interventions. The following individuals have valuable contributions in the process of information collection, data recording & coding, multiple analysis and report preparation: 1. Shumona Shafinaz, Senior Technical Advisor, Program Implementation, MaMoni MNCSP, Save the Children 2. Bal Ram Bhui, Monitoring, Evaluation and Learning Advisor, MaMoni MNCSP, Save the Children 3. Md. Abdus Salam, Managing Director, Partners in Health and Development (PHD) 4. Ashish K Dutta, Director, Partners in Health and Development (PHD) 5. Jatan Bhowmick, Advisor, Local Government and Accountability, MaMoni MNCSP, Save the Children 6. Mr. Salah Uddin, Deputy Director, Program Implementation, MaMoni MNCSP, Save the Children 7. Nakul Biswas, Deputy Director, Program Implementation, MaMoni MNCSP, Save the Children 8. Bivakar Roy, Deputy Director, Program Implementation, MaMoni MNCSP, Save the Children 9. Md. Nashir Uddin Faruq, Deputy Director, Partners in Health and Development (PHD) 10. Implementing Partners staff who are involve in date collection from the field. 11. Md. Ashadur Rahman, Team Leader, MaMoni MNCSP, PHD 12. Ali Hossain, Senior Program Coordinator, MaMoni MNCSP, PHD 13. Umme Salma Mukta, MEL Coordinator, MaMoni MNCSP, PHD 14. Khondaker Rakibuzzaman, Regional Coordinator, MaMoni MNCSP, PHD 15. Md. Muarraf Hossain, Regional Coordinator, MaMoni MNCSP, PHD 16. Md. Abu Nausher Ali Sumon, Regional Coordinator, MaMoni MNCSP, PHD 17. Chapala Rozario, Senior Program Officer, MaMoni MNCSP, PHD
Page 1
Table of Contents 1. INTRODUCTION ...... 3 2. CRITERIA FOR SELECTING UNDERSERVED UNIONS...... 4 3. TIMELINE MAINTAINED ...... 4 4. OUTPUTS GENERATED ...... 5 5. APPROACH FOLLOWED IN SETTING PRIORITIES AND PLANNING INTERVENTIONS ...... 5
5.1 PRIMARY SELECTION OF UNDERSERVED UNIONS ...... 5
5.2 FINAL SELECTION OF UNDERSERVED UNIONS ...... 6
5.3 GENERATE EVIDENCES FOR PRIORITIZING, PLANNING AND DECISION MAKING ...... 6
5.4 PARTICIPATORY PLANNING THROUGH MULTI-STAKEHOLDERS’ ENGAGEMENT ...... 6 6. STRUCTURE OF INFORMATION PROFILE ...... 7 7. KEY FINDINGS...... 8
7.1 UNDERSERVED UNIONS DISTRIBUTED BY THE GEOGRAPHIC LOCATION ...... 8
7.2 UNDERSERVED UNIONS PRIORITIZED BY THE YEAR OF INTERVENTION...... 8
7.3 UNDERSERVED UNIONS CATEGORIZED BY AVAILABILITY OF FACILITY AND KEY PROVIDER ...... 9
7.4 UNDERSERVED UNIONS SEGREGATED BY DIFFERENT CHARACTERISTICS ...... 10 a) Size of total population ...... 10 b) Proportions of underserved population ...... 10 c) Access to power supply ...... 10 d) Count of FWA units ...... 11 e) Number of FWA in place ...... 11
7.5 UNDERSERVED UNIONS CLASSIFIED BY THE IMPRESSION OF KEY STAKEHOLDERS ...... 12 a) Interests of elected representatives in shouldering leadership roles ...... 12 b) Willingness of H&FP supervisors and workers in delivering MNH services ...... 12 c) Commitments of H&FP Managers in increasing coverage of MNH services ...... 12
8. SNAPSHOTS OF PROGRESSES IN THE GIVEN TIMELINE ...... 13 9. DISCUSSION AND RECOMMENDATIONS ...... 16
9.1 SET PRIORITIES FOR YEAR 4 ...... 16
9.2 PLAN INTERVENTIONS THROUGH MULTI-STAKEHOLDERS’ MEETINGS ...... 16
9.3 EMERGE INNOVATIONS FOR DEMAND CREATION ...... 17 10. CONCLUSION ...... 18 ANNEXES TO REPORT ...... 19
Page 2
1. Introduction In Bangladesh, around 28 million people are living in the underserved areas, which represent a substantial proportion of country’s total population. According to a Government Survey in 2011 showed 1144 unions of 50 districts as underserved. MaMoni MNCSP supports to MOH&FW for improving equitable utilization of quality MNH services in 10 districts to scale up proven interventions nationwide. The project aims to support alternative service delivery approaches in the underserved unions of project districts for reducing access barriers among the excluded population. As a consortium partner, PHD is responsible to perform technical roles to enable district implementation team in adopting appropriate interventions for the underserved unions for improving availability and accessibility of MNH services. The project develops physical verification report to support district implementation team with evidences in the following areas for better implementation of underserved interventions- Finalizing underserved unions based on verified information Prioritizing underserved unions to intervene in Year 3 and Year 4 Facilitating planning process through Union Parishad or UH&FWC Management Committee led multi-stakeholders’ meetings for developing appropriate action plans to achieve two prime objectives- Activating MNH service provisions in the underserved unions Increasing MNH services coverage among the underserved populations Operating an underserved dashboard to track progresses against the agreed action plans developed in multi-stakeholder’ meetings Combined with this report, MaMoni MNCSP team develops information profiles of underserved unions as a reference document for district implementation team to use in the planning process. As an integral part of this process, MaMoni MNCSP LG&A thematic team has initiated underserved dashboard for tracking progresses as a real-time monitoring tool. The project determined the unions with tea gardens as underserved because of the restricted lifestyle of garden workers with various visible and invisible barriers in assessing MNH services within and outside their territory. Some of the tea gardens have their own health facility with maternal care but many of them are bellow standard with inadequate skilled health care providers, shortage of equipment, drugs and other essentials. Jointly with Dhaka regional and Hobigonj district team, PHD MaMoni MNCSP team selected Teliapara tea garden of Sajahanpur union for piloting, conducted a study, shared key findings with all concerned, developed an agreed action plan with garden authority, and started interventions. The project decides to capture the lessons from Teliapara experiences for prospective replication in other selected tea gardens of the project areas.
Page 3
2. Criteria for selecting underserved unions Initially the project determined the term ‘hard to reach (HtR)’ considering services gaps, geographical context, distance & seasonal limitation in accessing facilities, cultural barriers, and availability of MNH services. The project already revised the concept, termed the hard to reach (HtR) as underserved (US), and revisited the selection criteria based on the difficulties with transportation, provisions of MNH services, and barriers in getting access to MNH services. MaMoni MNCSP defines a union as underserved when the nearest UH&FWC with normal delivery service is 5 km away or it requires a travel time more than 1 hour using local means of transportation to reach at the nearest UH&FWC. The project also defines a union as underserved with no provision of full-scale and limited-scale MNH services. 3. Timeline maintained The project has captured huge volumes of information through physical verification, entered them in an excel database by the name of individual union, and analyzed them for developing an evidence-based report. The team has maintained a timeline for performinng various activities during the period from November 2019 to September 2020 to produce this report as an evidance for prioritizing and intervention planning, and to make decisions for transforming the plan into visible actions.
Activities performed Time-line
Designed verification guideline and tool Nov to Dec 2019
Capacitated team for authentic data collection Jan to Feb 2020
Collected verified data by implementation team Feb to Apr 2020
Inputted verified information in database followed by Mar to May 2020 cleaning and validation
Disseminated preliminary information for priority setting May to June 2020
Prioritized unions for Year 3 interventions May to June 2020
Drafted information profiles for prioritized unions June to July 2020
Initiated planning and interventions in prioritized unions June to Sept 2020
Installed dashboard for tracking progresses Aug 2020
Completed multiple analysis and evidence-based reporting Aug to Sept 2020
Data collection tool in Bengali version is enclosed as Annex 1
Page 4
4. Outputs generated The report has pinpointed on the following statements to create a common understanding among all concerned about the outputs generated from the process-
Outputs Notes for common understanding
Selected 97 unions in 10 project Sajahanpur union of Habigonj is included in districts as underserved areas the list as location of Teliapara tea garden
Collected information of 96 unions No information is collected from Sajahanpur through physical verification union during verification
Covered 94 unions in data analysis Biddakot & Char Elahi unions are excluded and reporting due to delayed delivery of information
Prioritized 30 unions to intervene Sajahanpur union is included in the priority under Year 3 work plan list of Dhaka region
Drafted information profiles of 29 Sajahanpur union is excluded prioritized unions
5. Approach followed in setting priorities and planning interventions The Program Implementation (PI) team agreed to follow an inclusive approach for proper selection of underserved unions based on verified information, and organizing evidence- based planning process in the selected unions to initiate appropriate interventions for activating MNH services with better availability and accessibility among the underserved population. PHD as LG&A thematic lead is responsible to support district implementation team for successful implementation of the underserved approach. 5.1 Primary selection of underserved unions In consultation with MEL Team, MaMoni MNCSP designed tools for collecting secondary data from different authentic sources using both from analogue and digital datasets. The team used GoB publications, records and documents of relevant government agencies, BBS data and updated maps as major sources of secondary data, and also ensured consultation with health and family planning managers, first-line supervisors & frontline workers, LGIs representatives and NGOs representatives to validate local level information. The process covered a total of 448 unions in 10 project districts. The project sought assistance from MaMoni MEL unit for data coding, data analysis and reporting. Based on secondary data analysis, the project prepared a primary list of underserved unions considering the agreed underserved criteria. The project reviewed the available secondary information of primarily selected underserved unions, found necessity to acquire more information from the primary sources, and decided to conduct physical verification exercise through implementation team to generate required information from the primary sources.
Page 5
5.2 Final selection of underserved unions The project involved the respective implementation team in physical verification for finalizing selection of underserved unions, collecting additional information of selected unions from the primary sources, and taking stakeholders’ opinions to perceive their willingness and interests in improving MNH services for the underserved populations. LG&A thematic team designed verification guidelines & tool, transferred data collection skills among the implementation team, and rolled out the process at the respective unions. During the period of February to April 2020, the implementation team gathered necessary information for reassessing primarily selected unions once again in line with the underserved criteria, and completed final selection of underserved unions in the project districts. The implementation team also decided to collect stakeholders’ opinions for improving MNH services in the selected unions. 5.3 Generate evidences for prioritizing, planning and decision making Implementation team gathered additional information of underserved unions and collected opinions from relevant key stakeholders using the agreed tool and gradually transferred union-based information to PHD national team through a prescribed format. The project conducted a rapid appraisal of the collected information based on their importance for realizing present situation of an underserved union in terms of availability and accessibility of MNH services, and for getting an indication about the willingness of relevant stakeholders in activating MNH services for the constituents. The project finalized a list of essential facts and figures related to respective unions through rapid appraisal, and decided to develop information profiles for all underserved unions. The program implementation team gave consent regarding the design and structure for drafting information profiles, and accordingly, the project developed draft information profiles as evidences and shared with district implementation team. In collaboration with the District Team, respective Regional Coordinators of PHD MaMoni MNCSP team facilitated a process for determining prioritized unions based on those evidences to intervene under 3rd year work plan. The team has shared the draft information profiles of prioritized underserved unions with respective districts to start the planning process. The LG&A thematic team has used an excel database to enter verified information in the name of individual union, and sorted information for multiple analysis to develop an evidence-based report for district implementation team with key findings and recommendations as a guiding document for planning and deciding next course of actions. 5.4 Participatory planning through multi-stakeholders’ engagement The report has provided indications on multi-stakeholders’ interest and willingness for being engaged in the planning process to start MNH services at the underserved unions and showing interests to contribute. Moreover, the report has also delivered specific directions to the implementation team on intervention planning to start MNH services, engaging multi-stakeholders to generate resources and contributions, and mobilizing community to create demands for MNH services.
Page 6
The report has conveyed key findings based on verified information to show an overall situation of MNH services in the underserved unions within the project districts to support implementation team for setting program priorities and taking appropriate decisions. The report has recommended the path-way to assist the implementation team in the planning process for determining actions for improvements. The report has generated the key findings based on the situation of the data collection period, which is between February 2020 and April 2020. 6. Structure of information profile The project has drafted the information profile in Bengali version to exhibit major information of a particular underserved union in two pages as an evidentiary document for district implementation team, so that they can share the profile of respective union with multiple stakeholders during the planning meeting and use the evidence in executing better planning and decisions making to improve MNH service provisions and coverages in the
respective union. The first page of draft profile is applicable for all underserved unions with common introduction, major objectives, selection criteria, and general setting of areas. The second page of draft profile is contents with some specific information of the respective underserved union, which includes-
Total area of a union in Sq. Km Union level health facilities in operation Total underserved areas in Sq. Km Union level service providers in place Size of total union population Distance of district headquarter Size of total population Distance of Upazila Health Complex (UHC) Total underserved villages Distance of UH&FWC & Community Clinics Types of underserved area Transport to move towards health facility Mode of transport Union map Access to electricity Opinions of key stakeholders
A sample copy of draft information profile in Bengali version is enclosed as Annex 2
Page 7
7. Key Findings 7.1 Underserved unions distributed by the geographic location 36 21 19 17 14 31 30 5 6 4 3 4 4 Feni Feni Kushtia Faridpur Habiganj Noakhali Chandpur Manikganj Madaripur Dhaka Faridpur Noakhali Lakshmipur Brahmanbaria Distribution of unions by regions Distribution of unions by districts
Figure 1 Figure 2 Figure 1 shows the distribution of Figure 2 shows that almost 73% of the underserved 97 underserved unions by 3 regions, unions are located in 4 project districts, Brahmanbaria, and 37%, 32% and 31% are from Hobigonj, Madaripur and Noakhali. Madaripur has to Dhaka, Faridpur and Noakhali region deal with highest number of unions, which is around respectively. 22% of total 97 unions.
7.2 Underserved unions prioritized by the year of intervention
14 25 10 22 20 6
Dhaka Faridpur Noakhali Dhaka Faridpur Noakhali Unions prioritized for Year 4 Unions prioritized for Year 3 Figure 3 Figure 4 Figure 3 indicates on 30 unions out of 97, Figure 4 indicates on the remaining 67 which are prioritized for Year 3, where Dhaka unions by regions targeted for Year 4, which region selected maximum of 14 unions, are distributed in three regions quite equally. followed by Noakhali region with 10 and Faridpur region with 6.
List of underserved unions by intervention year is enclosed as Annex 3
Page 8
7.3 Underserved unions categorized by availability of facility and key provider
The report defines 4 categories of underserved unions considering the availability of UH&FWC and FWV in the respective unions.
Category 1 14 underserved unions with NO UH&FWC and NO FWV
Category 2 10 underserved unions with NO UH&FWC but FWV is in place
Category 3 31 underserved unions where UH&FWC is in place but NO FWV
Category 4 39 underserved unions where both UH&FWC and FWV are in place
Figure 5 shows number of unions by 4 categories
94
39 31 14 10
US Unions NO FWC & NO FWV No FWC but FWV in FWC in place but Both FWC & FWV in place NO FWV place
Figure 5
Figure 6 to 8 shows distribution of 4 categories unions under three regions
34 29 31
18 14 11 12 10 9 4 5 3 4 2 2
US NO FWC No FWC FWC in Both US NO FWC No FWC FWC in Both US Unions NO FWC No FWC FWC in Both FWC Unions & NO but FWV place FWC & Unions & NO but FWV place but FWC & & NO but FWV place but & FWV in FWV in place but NO FWV in FWV in place NO FWV FWV in FWV in place NO FWV place FWV place place Dhaka Region Faridpur Region Noakhali Region Figure 6 Figure 7 Figure 8 Categorized unions by district with list of 4 categories of unions are enclosed as Annex 4
Page 9
7.4 Underserved unions segregated by different characteristics a) Size of total population
60 Figure 9 segregates unions in 5 clusters by the size of total population, and accordingly, showing 64% of the selected unions have an average population load between 15,000 & 35,000, 20% of unions holds high loads with more than 35,000 populations and 14 13 14% of unions holds low load with less than 15,000 5 populations. 2 5% unions are largely populated with above 55,000 55K> 35K> to 15K> to 5K> to <5K and 2% unions are under populated with less than <55K <35K <15K 5,000. Clustered 94 unions by the size of total population List of unions segregated by the size of total
Figure 9 population is enclosed as Annex 5 b) Proportions of underserved population
38 Figure 10 segregates unions in 4 clusters by the proportions of underserved population. 25 18 Broadly it indicates that proportions of underserved 13 population in 38 unions are more than 75% of total population of respective unions, and remaining unions are less than 75%. Intensity of underserved population in a union is an More than Between 50% Between 25% Less than important evidence for planning interventions and 75% to 75% to 50% 25% approximating service provisions and coverage. Clustered 94 unions by the proportions of underserved population List of unions segregated by the proportion of underserved population is enclosed as Annex 6 Figure 10 c) Access to power supply
53 Figure 11 segregates selected unions in 3 clusters by the access to electricity. It is noteworthy that 56% of unions have full access to electricity and 30% have partial access. 28 There are 13 unions where no power supply is 13 available, and this is an important aspect of planning, particularly how to create scopes for alternative power supply for facility from where underserved population is going to access MNH No access Partial access Full access services. Clustered 94 unions by the availability of power supply List of unions segregated by the level of access
Figure 11 to power supply is enclosed as Annex 7
Page 10 d) Count of FWA units
Figure 12 characterizes unions by FWA units. FWA Unit 9, 1 It is an outreach program strategy, FWA Unit 7, 5 where unions are divided into units, and concerned FWA is assigned with FWA Unit 6, 26 responsibilities of her unit to serve the targeted population. FWA Unit 5, 13 94 It is observed 1 to 2 units in 14%, 3 to Unions 5 units in 52%, and 6+ units in rest of FWA Unit 4, 17 32% union.
FWA Unit 3, 19 FWA units’ count in the selected union is highly related with the size of FWA Unit 2, 4 union’s population. Cross check is necessary for getting FWA Unit 1, 9 specific information of an individual union before planning, which are available in respective union profile. Figure 12 e) Number of FWA in place
Figure 13 characterizes unions by # of FWA in place. FWA 7, 1 FWA is responsible to deliver outreach FWA 6, 3 level MNC to the targeted population of their respective FWA unit. FWA 5, 6 Evidence shows that 10% unions have no FWA. 94 FWA 4, 18 Unions It is also noticed that 1 to 2 FWAs are FWA 3, 24 in place at 35% unions, 3 to 5 FWAs at 51% unions, and 6+ FWAs are FWA 2, 18 available at 4% unions. FWA 1, 15 Number of FWA in place against FWA units in a union has to be checked FWA 0, 9 before planning, and specific information is available in union profiles. Figure 13 List of the unions with 0 to 1 FWA is enclosed as Annex 8
Page 11
7.5 Underserved unions classified by the impression of key stakeholders Taking opinions from 3 categories of stakeholders is an activity of physical verification to perceive their willingness and interests in improving MNH services for the underserved populations. They are, i) Elected representatives, ii) Frontline H&FP supervisors and workers, and iii) H&FP Upazila Managers. Availability of stakeholders is a precondition of getting opinions, and team succeeded to do it in 78 to 82 underserved unions. a) Interests of elected representatives in shouldering leadership roles
High Interest 20 Figure 14 gives impression on the interest level of Modarate Interest elected representatives to lead a process for 16 13 initiating MNH services for the underserved 11 population. High interest among the elected 10 representatives creates better scope in mobilizing 8 local resources. The perception in 78 unions indicates on high interest in 44% and moderate in 56% of them. More interaction with the leaders can change the Dhaka Faridpur Noakhali situation; therefore, it is necessary to take initiative
Figure 14 for influencing their level of interests. b) Willingness of H&FP supervisors and workers in delivering MNH services High Figure 15 gives impression on the willingness Modarate 22 among HA/FWA/CHCP & HI/AHI/FPI/FWV in 19 provisioning MNH services for the underserved 15 populations. Reluctant behaviors among the 10 8 8 frontline staffs in HtR are a general feature. The perception in 82 unions indicates on high willingness in 62% and moderate in 38% of them. Their involvement with LGIs in joint collaboration Dhaka Faridpur Noakhali can improve their willingness to contribute. Figure 15 c) Commitments of H&FP Managers in increasing coverage of MNH services High Figure 16 gives impression on managers’ Modarate 17 14 commitment in 80 unions. Proactive roles from the Low 12 managers are essential for demonstrating results with visible changes. The perception indicates on 9 9 7 8 managers’ commitments as high in 31%, moderate in 54% and low in 15%. 2 2 Managers’ engagement in joint planning, collaboration and team building can enhance their Dhaka Faridpur Noakhali level of commitment in increasing coverage of MNH services among the underserved. Figure 16 Classification of union by the impressions of key stakeholders is enclosed as Annex 9
Page 12
8. Snapshots of progresses in the given timeline
During the period from November 2019 to 30 September 2020, MaMoni MNCSP team has 16 prioritized underserved unions to activate MNH 9 service delivery, connected with relevant 6 stakeholders to initiate planning process, organized multi-stakeholders’ meetings to Unions Planning MNH services NVD service develop joint work plan, and to some extent prioritized meeting provisioned started succeeded to transform the plan into action. organized
Few instances of MaMoni MNCSP initiatives and tangible changes
Stepping in prioritized unions and connecting relevant stakeholders
Charhorirampur Union Char Abdullah Union Bachamara Union Charvadrashan Upazila of Faridpur Ramgoti Upazila of Laxmipur Sadar Upazila in Manikgonj
Rema Tea garden is a private tea estate located at Gazipur Union Anderchar Union Chunarughat Upazila of Habigonj Sadar Upazila of Noakhali Experiencing alternate service delivery Introduction of alternative services in Bachamara union of Manikgonj
Union Parishad led multi-stakeholders’ meeting organized Counselling room & HR in place
New delivery room developed & equiped Normal delivery conducted Learning visits organized
Page 13
Experiencing facility readiness to initiate MNH Service delivery Completion of facility readiness interventions in Dhan shalik union of Noakhali
UH&FWC selected Multi-stakeholders meeting organized LGI contributed in renovation & readiness
Facility environment changed MP inaugurated MNH Services UH&FWC MC meeting held Continuing facility readiness intervention in Dhar mandal union of Brahmanbaria
Multi-stakeholders meeting organized Skilled midwife introduced Freeze contributed by UpZ Chairman Continuing facility readiness interventions in Kazibakai & Kadambari of Madaripur
Multi-stakeholders meeting in Kazibakai Midwife deployed in Kazibakai Multi-stakeholders meeting in Kadambari Continuing facility readiness interventions in Charhorirampur union of Faridpur
Multi-stakeholders’ consultation 1st delivery conducted Service delivered by Midwife
Page 14
Organizing satellite approach to increase MNH Service coverage Implementing crush program in Char Abdulla union of Laxmipur
Multi-stakeholders’ meeting Joint crush program One-stop service delivery
Page 15
9. Discussion and recommendations The report has drawn attention on necessity of discussion to explore opportunities for better utilization of the evidences generated through physical verification, and accordingly has given few recommendations on supplementary actions to improve effectiveness of underserved interventions. The discussion is essential to identify the techniques for the district implementation team on how to use the report findings and information profiles to make appropriate decisions for an organized stepping to Year 4 interventions particularly in three prime stages, which are as follows- Set priorities for Year 4 Plan interventions to activate MNH service provisions in underserved unions through multi-stakeholders’ meetings Emerge innovations to increase MNH service coverage in underserved unions through demand creation 9.1 Set priorities for Year 4 It may not be possible to intervene in all 30 underserved unions by the end of Year 3, and therefore, the project has to conduct an exercise among the district implementation team for reconfirming the prioritized unions to intervene under Year 4 work plan. Creative use of these findings and information can produce better results in these exercises. LG&A themetic team has to develop a matrix for each of ten districts, where overall situation of all unions are being displayed based on the parameters used in physical verification to determine key findings. District implementation team can use the matrix to finalize the list of prioritized unions of respective district for Year 4 interventions. 9.2 Plan interventions through multi-stakeholders’ meetings Multi-stakeholders’ meeting is a proven innovation to adopt supply-side planning and decision making at the periphery level to activate MNH services in the underserved unions. Generally, Union Parishads shoulder leadership roles in arranging alternative places to deliver MNH services in the unions where UH&FWCs are not available, and the report has enclosed a list of unions where alternate places may require to begin service delivering. In the unions where UH&FWCs are in place, the management committees lead the planning process for facility preparedness to improve MNH service provisions and coverage. The report has also enclosed a list of unions where need based supports are required with specific indication to those UH&FWCs where FWVs are not in place. UFPOs’ commitment to increase coverage of MNH services in respective underserved unions is an important factor for bringing positive changes. The report has enclosed segregated list of unions based on the impression of respective UFPO, and district team can use this evidence for setting priorities. Moreover, segregation of unions by the counts of FWA units and by the numbers of FWA in place is an important feature to share with concerned UFPOs before the planning process.
Page 16
The report has shared a list of unions with ZERO FWA or ONE FWA, on which, further discussion with respective UFPOs is required. Resource mobilization is a core strategy to minimize gaps and requirements for initiating MNH services for underserved populations. The project has to explore all scopes for influencing Zila Parishad, Upazila Parishad, Private Organizations, NGO projects, Corporates and Philanthropists to achieve their commitments in contributing resources. To some extent, the report has indicated on key stakeholders’ impressions on around 80% of selected unions. However, these evidences are not adequate to come into the conclusion, and implementation team has to review the situation inclusively in the context of respective district. Better mobilization of resources creates greater opportunities to initiate normal delivery service in the underserved unions and referral mechanism to support PWs for EmOC. The planning process in multi-stakeholder meetings starts with the presentation of a local service provider to describe present situation MNH service delivery in the respective union, and apparently considers the following aspects related to MNH service provisions- a) Condition of facility b) Provision of services c) Coverage of services d) Status of HR e) Supply of logistics and medicines f) Availability of medical equipment, and g) Other significant issues Most importantly, implementation team has to provide necessary support to the service providers in preparing their presentation based on evidences to ensure that all the gaps and requirements are being identified, shared and addressed in the planning process. If needed, Regional Coordinator, PHD MNCSP may provide additional inputs based on key findings of physical verification report, information profiles of respective unions and experiences from 3rd year’s interventions, so that district team can generate an inclusive action plan for each of the prioritized unions through multi-stakeholders’ engagement. From experiences, the report has suggested some initiatives to convert the plans into visible actions, and those are as follows- a) Regular follow-up with key stakeholders from distance b) Monitor progresses on certain intervals c) Maintain dashboard to track progresses d) Uphold influences on the stakeholders to assure commitments e) Support management committees in implementation of agreed action plans. 9.3 Emerge innovations for demand creation Improving access to MNH services among the targeted population is the prime objective of underserved intervention, which is correlated between availability of MNH services in underserved unions and accessibility of MNH Services among underserved population.
Page 17
Planning process through multi-stakeholders’ meetings activates MNH service provisions in the prioritized unions for assuring MNH services availability for underserved population. However, availability of services cannot guaranty that underserved population gets access to MNH services. Experiences revealed that both visible and invisible barriers prevent targeted populations in accessing MNH services from the facility, especially appropriate for the women. Physical verification process generated information related to supply-side barriers in delivering MNH services from the union level facilities, particularly from UH&FWCs. Demand-side barriers in accessing MNH services from UH&FWCs or other reachable facilities are not adequately identified through physical verification. Under the given situation, the report is generated few ideas for program implementation team, which are proposals to deal with demand-side barriers for improving access to MNH services among the underserved populations in the prioritized unions. a) Consult with multi-stakeholders in the planning meeting to get an indication about the geographical, socio-cultural & spiritual, economic and gender conditions and believes that prevents targeted population in accessing MNH services including normal delivery care and EmOC b) Appraise MNH service coverage of prioritized unions to get an indication about the level of accessibility to MNH services to identify low coverage unions to intervene with tested innovations for creating demands c) Adopt tested innovations for creating demands in the prioritized unions considering their scopes to- a) Organize events at periphery level, b) Share costs, b) Mobilize resources, b) Initiate collaborations, c) Deliver one-stop MNH services, d) Develop interests among multi-stakeholders, e) Generate mass awareness, and f) Ensure rapid coverage of MNH services through crush program LG&A thematic team is going to provide necessary support to implementation team for emerging tested innovations for creating demands to increase MNH service coverage in those prioritized unions where MNH services are available for the targeted underserved populations. 10. Conclusion With many limitations, the project has succeeded to accomplish a comprehensive process in all the selected underserved unions for generating evidences from the primary sources through physical verification. The report has portrayed a complete picture of the process with key findings and evidences, discussed on scope of utilizing evidences at different stages of program implementation, and recommended next actions to start the interventions in Year 4. Physical verification has created an opportunity for the project to use evidences in selecting underserved areas, setting priorities, and taking decisions for effective planning. The project has learned lessons from the process through collecting information, sorting and analyzing data, preparing report and utilizing evidences for priority setting, planning and decision making. In coordination with implementation team, LG&A thematic team needs to revisit the entire process for further modification, up- gradation and improvement before applying the underserved approach to the new districts.
Page 18
Annexes to Report
Annex 1 Data collection tool in Bengali version
Annex 2 A sample copy of draft information profile in Bengali version
Annex 3 List of underserved unions by intervention years
Annex 4 Categorized unions by district with list of 4 categories of unions
Annex 5 List of unions segregated by the size of total population
Annex 6 List of unions segregated by proportion of underserved population
Annex 7 List of unions segregated by the level of access to power supply
Annex 8 List of the unions with NO FWA and ONE FWA
Annex 9 Classification of union by the impressions of key stakeholders
Page 19
Annex 1 Data collection tool in Bengali version
†Rjv: Dc‡Rjv: BDwbqb: µg cÖkœ DËi 1 BDwbq‡bi ‡gvU AvqZb KZ? ------eM© wK:wg: 2 †mevewÂZ GjvKvi AvqZb KZ? ------eM© wK:wg: 3 BDwbq‡bi ‡gvU unit KZwU? ------wU 4* BDwbq‡bi FWA unit Gi msL¨v I bvg ------wU bvg:------5 BDwbq‡bi †mevewÂZ MÖv‡gi msL¨v I bvg ------wU bvg:------6 BDwbq‡bi †gvU †jvKmsL¨v KZ? ------Rb 7 †mevewÂZ GjvKvi †jvKmsL¨v KZ? ------Rb 8 †mevewÂZ GjvKvi cÖavb †ckv wK wK? (GKvwaK 1. PvKwi n‡Z cv‡i) 2. e¨emv 3. w`bgRyi 4. ‡R‡j 5. Ab¨vb¨ (D‡jøL Kiæb) ------9 wk vi nvi KZ? (wUK wP w`b) 1. 10-20% 2. 20-30% 3. 30-40% 4. 40-50% 5. 50%+ 10 M„n¯’vwji aib wKiƒc (GKvwaK n‡Z cv‡i)? 1. KvuPv 2. cvKv 3. Avav cvKv 4. `vjvb 5. wUb‡kW 6. Ab¨vb¨ (D‡jøL Kiæb) ------11 we`y¨r ms‡hvM Av‡Q wKbv? 1. Av‡Q (wUK wP w`b) 2. bvB 3. AvswkK 12 hvZvqv‡Zi iv¯Ívi aib wKi~c (GKvwaK n‡Z 1. KvuPv B‡Ui cv‡i)? 2. KvuPv gvwUi 3. wcP
Page 20
4. b`xc_ 5. Ab¨vb¨ (D‡jøL Kiæb) ------13 †hvM‡hv‡Mi cwienb mg~n wK wK (GKvwaK n‡Z 1. wi·v/f¨vb/ A‡Uvwi·v cv‡i)? 2. evm 3. wmGbwR 4. UgUg/bwQgb 5. Miæ- †Nvovi Mvwo 6. †bŠKv/Uªjvi 7. cv‡q nvUv c_ 8. Ab¨vb¨ (D‡jøL Kiæb) ------14 †mevewÂZ GjvKvi aiY wKiƒc (GKvwaK n‡Z 1. `yM©g /c«Z¨šÍ AÂj (`yiZ¡ Ges/A_ev mg‡qi †cÖwÿ‡Z), Øxc cv‡i)? 2. hvZvqv‡Z Amyweav- b`x fv½b, Rjve×Zv 3. †mev e¨nZ- †mev †K›`ª †bB ev eÜ 4. FZzKvjxb evav- nvIi. Pi 5. ag©xq `j 6. Avw`evwm †Mvôx 7. BÛvw « / KviLvbv- Pv evMvb, Mv‡g©›Um 8. cÖvwšÍK- RvwZMZfv‡e cÖvwšÍK, Awfevwm, Af¨šÍixYfv‡e ¯’vbPy¨Z RbmsL¨v 9. A_©‰bwZKfv‡e cÖvwšÍK 10. FWC Av‡Q wKš‘ †mev Pvjy †bB 11. Ab¨vb¨ (D‡jøL Kiæb) ------15 BDwbq‡bi gvwmK ANC msL¨v (Z_¨ msMÖ‡ni ------Rb gv‡mi c~‡e©i gv‡mi Z_¨ Avb‡Z n‡e) 16 BDwbq‡bi gvwmK PNC msL¨v (Z_¨ msMÖ‡ni ------Rb gv‡mi c~‡e©i gv‡mi Z_¨ Avb‡Z n‡e) 17 BDwbq‡bi gvwmK cÖm‡ei msL¨v (Z_¨ msMÖ‡ni gv‡mi c~‡e©i gv‡mi Z_¨ Avb‡Z n‡e) ------Rb 18 BDwbq‡bi gvwmK gvZ… g„Z¨yi msL¨v (Z_¨ msMÖ‡ni gv‡mi c~‡e©i gv‡mi Z_¨ Avb‡Z n‡e) ------Rb 19 BDwbq‡bi gvwmK wkï g„Z¨yi msL¨v (Z_¨ msMÖ‡ni gv‡mi c~‡e©i gv‡mi Z_¨ Avb‡Z n‡e) ------Rb 20 D³ BDwbq‡bi †mev‡K‡›`ªi msL¨v KZ? 1. BDwbqb ¯^v¯’¨ I cwievi cwiKíbv †K‡›`ªi msL¨v------2. KwgDwbwU wK¬wb‡Ki msL¨v ------3. Ab¨vb¨------21 eZ©gvb D³ BDwbq‡b Kg©iZ †mev cÖ`vbKvixi 1. SACMO FP------Rb msL¨v KZ? (GKvwaK n‡Z cv‡i) 2. SACMO health------Rb 3. FWV ------Rb 4. FPI------Rb 5. FWA------Rb 6. HA ------Rb 7. AHI ------Rb 8. MO------Rb 9. CHCP------Rb 10. Ab¨vb¨ (D‡jøL Kiæb) ------Rb 11. ‡Kvb †mev cÖ`vbKvix †bB 22 †mevewÂZ GjvKvq †Kvb APj (eÜ) †mev‡K›`ª 1. AeKvVv‡gvi Ae¯’v------_vK‡j Zvi eY©bv 2. hš¿cvwZ Ae¯’v------3. Jla mieiv‡ni Ae¯’v------
Page 21
4. †mev cª`vbKvix------5. Ab¨vb¨ (D‡jøL Kiæb) ------23 D³ †mevewÂZ GjvKvi ‡jvKRb KvQvKvwQ †Kvb 1. †gwW‡Kj K‡jR nvmcvZvj------wK: wg: `y‡i †Kvb †mev‡K›`ª †_‡K gvZ… I beRvZK ¯^v¯’¨‡mev 2. m`i nvmcvZvj------wK: wg: `y‡i MÖnY K‡i _v‡K, Zvi `~iZ¡ D‡j L Kiæb. (GKvwaK 3. Dc‡Rjv ¯^v¯’¨‡K›`ª------wK: wg: `y‡i n‡Z cv‡i) 4. BDGBPGÛGdWwe Dwm (UH&FWC) ------wK: wg: `y‡i 5. BDGBPwm (UHC) ------wK: wg: `y‡i 6. AviwW (RD) ------wK: wg: `y‡i 7. KwgDwbwU wK¬wbK------wK: wg: `y‡i 8. e¨w³MZ wK¬wbK------wK: wg: `y‡i 9. GbwRI wK¬wbK------wK: wg: `y‡i 10. Ab¨vb¨ (D‡jøL Kiæb)------wK: wg: `y‡i 24 D‡jøwLZ †mev‡K‡›`ª hvZvqv‡Zi iv¯Ívi aib. 1. KvuPv B‡Ui (GKvwaK n‡Z cv‡i) 2. KvuPv gvwUi 3. wcP 4. b`xc_ 5. Ab¨vb¨ (D‡jøL Kiæb)------25 D‡jøwLZ †mev‡K‡›`ª hvZvqv‡Zi Rb¨ †hvM‡hv‡Mi 1. wi·v/f¨vb/ A‡Uvwi·v cwienb mg~n. (GKvwaK n‡Z cv‡i) 2. evm 3. GbwR 4. UgUg/bwQgb 5. Miæ- †Nvovi Mvwo 6. †bŠKv/Uªjvi 7. cv‡q nvUv c_ 8. Ab¨vb¨ (D‡jøL Kiæb)------26 †mevewÂZ GjvKvq †mev Pvjy Ki‡Z D³ BDwbq‡bi †Pqvig¨vb mv‡n‡ei gZvgZ 27 †mevewÂZ GjvKvq †mev Pvjy Ki‡Z mswkøó IqvW© m`m¨ / m`m¨‡`i gZvgZ 28 †mevewÂZ GjvKvq †mev Pvjy Ki‡Z D³ BDwbq‡bi †mev`vbKvix‡`i (SACMO/FWV/FPI) gZvgZ 29 †mevewÂZ GjvKvq †mev Pvjy Ki‡Z D³ Dc‡Rjvi (UH&FPO & UFPO) mv‡n‡ei gZvgZ †bvU:
1. mswk †mevewÂZ GjvKvi 4-5 wU d‡UvMÖvd mshy³ Ki‡eb 2. †mevewÂZ GjvKvi mvwe©K Ae¯’v we‡ePbv K‡i GKwU weeib w`‡eb 3. mswk GjvKvi gv I beRvZK g„Zy¨ msµvšÍ †Kvb NUbv †Km ÷vwW (bvg, eqm, cwiev‡ii A_©‰bwZK Ae¯’vmn-- ‡Kb, wKfv‡e, KLb, †Kv_vq welqK Z_¨ Avb‡Z n‡e) wnmv‡e mshy³ Kiv †h‡Z cv‡i cv`wUKv:
*Unit- GLv‡b BDwbU ej‡Z FWA unit †evSv‡bv n‡q‡Q hvi RbmsL¨v 2000 †ekx ev Kg| cwiPvjbvi myweav‡_© I eZ©gvb wi‡cvU© e¨e¯’vi Rb¨ BDwbU ej‡Z FWA unit GjvKvq RbmsL¨v‡K wb‡Z n‡e| †Kvb BDwbU‡K myweavewÂZ aiv n‡e, hw` †mLvbKvi †jvKRb AvswkKfv‡e ev m¤ú~Y©fv‡e gv I beRvZK ¯^v¯’¨‡mev †_‡K ewÂZ _v‡K| hw` †Kvb BDwbqb myweavewÂZ GjvKvi ai‡bi g‡a¨ AšÍM©Z nq, Z‡e †mLv‡bi me BDwbU myweavewÂZ GjvKvi g‡a¨ aiv n‡e| Av_©-mvgvwRK Z‡_¨i Q‡K D³ BDwb‡Ui MÖv‡gi bvg wjL‡Z n‡e|
Page 22
Annex 2 A sample copy of draft information profile in Bengali version
BDGmGAvBwW'i 'gvgwb' gvZ… I beRvZK ¯^v¯’¨‡mev Dbœqb cÖKí gvZ… I beRvZK ¯^v¯’¨‡mev ewÂZ GjvKvi Z_¨mg„× †cÖvdvBj
f‚wgKv gvZ… I beRvZK ¯^v¯’¨‡mev ewÂZ GjvKvq Kv‡Ri D‡Ïk¨mg~n wek¦Rz‡o 99% gvZ… g„Zz¨ Ges 98% beRvZK . gvZ… I wkï ¯^v¯’¨‡mev †_‡K ewÂZ A‡j †mev‡K›`ª I Zvi g„Zz¨ Dbœqbkxj †`k¸wj‡Z N‡U _v‡K| cÖme Kvh©µg wbw ZKiY msµvšÍ RwUjZvi Kvi‡Y evsjv‡`‡k eQ‡i . gvZ… I wkï ¯^v¯’¨‡mev †_‡K ewÂZ A‡j †mev`v‡bi Rb¨ 85% gvZ… g…Zy¨ N‡U, hvi g‡a¨ gvZ… I †mev‡K‡›`ª cÖ‡qvRbxq Rbej wbwðZ Kiv beRvZK ¯^v¯’¨‡mev ewÂZ GjvKv Ab¨Zg| gvZ… I wkï ¯^v¯’¨‡mev ewÂZ A‡j emevmKvix gv I wkïi gvgwb GgGbwmGmwc cÖKí Gme †mev ewÂZ . cÖ‡qvRbxq ¯^v¯’¨‡mev wbwðZ Kiv †Rjv¸wj‡Z KvR Ki‡Q (21.5 wgwjqb ¯’vbxq miKvi I RbM‡Yi AskMÖn‡Yi gva¨‡g gvZ… I wkï ¯^v¯’¨ RbmsL¨v), hvi g‡a¨ wewfbœ Pi, nvIi, Pv . wel‡q Zv‡`i mswk Zv wbw Z Kiv evMvb, †fŠMwjK I mvgvwRKfv‡e wcwQ‡q civ †mev ewÂZ A‡j cwi‡levi †ÿ‡Î evavmg~n n««vm Kiv Rb‡Mv x i‡q‡Q| . cÖK‡íi msÁv Abymv‡i myweavewÂZ Rb‡Mvôx ej‡Z †evSvq †hLv‡b gvZ… I beRvZK ¯^v¯’¨‡mev ewÂZ GjvKvi avibv AvswkKfv‡e ev m¤ú~Y©fv‡e gvZ… I beRvZK ¯^v¯’¨‡mev myweav †bB| gvZ… I beRvZK ¯^v¯’¨‡mev ewÂZ GjvKvi aib
1) `yM©g AÂj 8) BÛvw ª ev KviLvbvq
2) hvZvqv‡Z Amyweav Kg©iZ kÖwgK
3) †mev e¨nZ 9) A_©‰bwZKfv‡e
4) †gŠmygx evav wcwQ‡q civ Rb‡Mvôx 5) ag©xq msL¨v jNy 10) GdWweøDwm‡Z
6) Avw`evwm Rb‡Mvôx cÖme‡mev bvB
7) cÖvwšÍK Rb‡Mvôx 11) Ab¨vb¨
Page 23
BDwbqb: evPuvgiv Dc‡Rjv: †`ŠjZcyi †Rjv: gvwbKMÄ †mev ewÂZ GjvKvi †gŠwjK Z_¨ †mevewÂZ GjvKv †_‡K wbKU¯’ †mev‡K‡›`ªi `~iZ¡
AvqZ‡bi Z_¨ BDwbq‡bi AvqZb : 29.4 eM© wK:wg: †mevewÂZ GjvKvi : 29.4 AvqZb eM© wK:wg: †mevewÂZ GjvKv †jvKmsL¨vi Z_¨ BDwbq‡bi †gvU : 25,700 Rb †jvKmsL¨v †mevewÂZ GjvKvi : 25,700 Rb †jvKmsL¨v †mevewÂZ GjvKv †_‡K wbKU¯’ †mev‡K‡›`ª hvIqvi cwienb e¨e¯’v †mevewÂZ GjvKvi Ab¨vb¨ Z_¨ MÖvg : 27 wU GdWwe DG BDwbU : 4wU (1K, 1L, 2 (bvg) bs, 3bs IqvW©) GjvKvi aiY : `yM©g AÂj, †gŠmygx evav, hvZvqv‡Z Amyweav, †mev e¨nZ, cwienb e¨e¯’v : wi·v/f¨vb/A‡Uvwi·v, wmGbwR, UgUg/ bwmgb, †evU/ Uªjvi, †gvUi mvB‡Kj we`y¨r ms‡hvM : AvswkK
BDwbq‡bi ¯^v¯’¨ †mev‡K›`ª msµvšÍ Z_¨ †`ŠjZcyi Dc‡Rjv g¨vc BDGBPGÛGdWwe Dwm : 0 evPuvgiv KwgDwbwU wK¬wbK : 2 BDwbqb gv I wkï Kj¨vY †K›`ª : 0 AviwW/mve‡m›Uvi : 0 †emiKvwi †mev †K›`ª : 0 eÜ †mev †K›`ª : 0 Ab¨vb¨ : 0
¯^v¯’¨‡mev cÖ`vbKvixi Z_¨ ¯^v¯’¨‡mev PvjyKi‡Y mswkøó †÷K-†nvìvi‡`i gZvgZ †mK‡gv (Gdwc) : 1 BDwc †Pqvig¨vb I GdWwe Dwf/ BDGdwcI/ †mK‡gv (¯^v¯’¨) : 1 GdWwe Dwf : 1 †g¤^vi GdwcAvB BDGBPGÛGdwcI GdwcAvB : 1 †mev ewÂZ GjvKvq GdWwe DG : 1 †mev †K›`ª Pvjy Ki‡Z †mev ewÂZ AvMÖnx GjvKvq †mev †mev †K›`ª Pvjy GBPG : 4 cÖ`v‡b AvMÖnx Ki‡Z AvMÖnx ev‡RU cÖbqY I †mev †K›`ª GGBPAvB : 1 †mev †K›`ª cÖ¯‘‡Zi cÖ¯‘‡Zi Rb¨ mn‡hvwMZv Rbm‡PZbZv GgI : 0 Rb¨ mn‡hvwMZv Ki‡Z AvMÖnx e„w× Ki‡Z AvMÖnx Ki‡Z AvMÖnx wmGBPwmwc : 2 Rbm‡PZbZv e„wׇZ f‚wgKv Ab¨vb¨ : 0
Annex 3 List of underserved unions by intervention years 1. List of 30 prioritized unions planned to intervene in Year 3 SL Prioritized Unions Upazila District a) Dhaka Region - 14 Unions of 10 Upazila in 3 Districts 1 Bachamara Daulatpur Manikganj 2 Jiyanpur 3 Kakailsew Azmiriganj 4 Gazipur Chunarughat 5 Bhadeshwar Bahubal 6 Bulla Lakhai Habiganj 7 Paniunda Nabiganj 8 Muradpur Baniachong 9 Shahjahanpur (Tea Garden) Madhabpur 10 Biddyakut Nabinagar 11 Bitghar 12 Dhar Mandal B.baria 13 Chatalpar Nasirnagar 14 Bolakot b) Faridpur Region - 6 Unions of 4 Upazila in 2 Districts 1 Kadambari Rajoir 2 Kazi Bakai Kalkini Madaripur 3 Charjanajat Shibchar 4 Kanthalbari 5 Char Harirampur Charbhadrasan Faridpur 6 Gazirtek C) Noakhali Region - 10 Unions of 9 Upazila in 4 Districts 1 Char Elahi Companiganj 2 Harni Chanandi Hatiya 3 Ander char Sadar Noakhali 4 Mohammadpur Subarna Char 5 Dhanshalik Kabirhat 6 Nilkamal Haimchar Chandpur 7 Haimchar 8 Char Abdullah Ramgati Lakshmipur 9 Char Ramanimohon Sadar 10 Char Darbesh Sonagazi Feni
Page 25
2. List of remaining 67 unions planned to intervene in Year 4 SL Remaining Unions Upazila District a) Dhaka Region - 22 Unions of 9 Upazila in 3 Districts 1 Char Katari Daulatpur 2 Baghutia Manikganj 3 Teota Shivalaya 4 Badarpur Azmiriganj 5 Paikpara Chunarughat 6 Ranigaon 7 Lakhai Lakhai 8 2no Chowmuhoni Madhabpur Habiganj 9 8no Bulla 10 Kagapasha 11 Pailarkandi Baniachong 12 Mandari 13 Makrampur 14 Kaitola 15 Barail 16 Birgaon 17 Krishnanagar Nabinagar 18 Nutghar B.baria 19 Ratanpur 20 Kaitola-south 21 Shibpur 22 Goalnagar Nasirnagar b) Faridpur Region - 25 Unions of 7 Upazila in 3 Districts 1 Mahendradi-Haridasdee 2 Amgram 3 Bajitpur Rajoir 4 Hossainpur 5 Ishibpur 6 Paikpara 7 Chardolatkhan 8 Ramjanpur 9 Enayetnagar Kalkini Madaripur 10 Laxmipur 11 Kayaria 12 Shikar Mangal 13 Bhadrasan 14 Boheratala 15 Bandarkhola Shibchar 16 Sannyasir Char 17 Siruail 18 Char Jhaukanda Charbhadrasan Faridpur 19 Kamarkhali Madhukhali 20 Fulbaria 21 Korsha 22 Ambaria Mirpur 23 Malidah Kushtia 24 Baroipara 25 Charsadipur Kumarkhali
Page 26
C) Noakhali Region - 20 Unions of 10 Upazila in 4 Districts 1 Char Jubilee 2 Char Clerk 3 Char Bata Subarna Char 4 Char Wapda 5 Purbo Charbata 6 Char Jabbar 7 Musapur Companiganj 8 Char Matua Noakhali 9 Dharmopur Sadar 10 Purbo Char Matua 11 Nalchira 12 Sukh Char Hatiya 13 Nijhumdip 14 Dhanshiri Kabirhat 15 Char Bhairabi Haimchar 16 Gazipur Chandpur 17 Char Chandira Sonagazi 18 Chithalia Porshuram Feni 19 Ghopal Chhagalniya 20 Char Bangshi Dakshin Raipur Lakshmipur
Page 27
Annex 4 Categorized unions by district with a list of 4 categories of unions 1. Categorized unions by district 5 3 13 2 7 5 0 0 1 0
US Unions NO FWC No FWC FWC in Both FWC US Unions NO FWC No FWC FWC in Both FWC & NO but FWV place but & FWV in & NO but FWV place but & FWV in FWV in place NO FWV place FWV in place NO FWV place Manikgonj District Brahmanbaria District 16 4 3 10 5 1 0 0 1 0 US Unions NO FWC No FWC FWC in Both FWC US Unions NO FWC No FWC FWC in Both FWC & NO but FWV place but & FWV in & NO but FWV place but & FWV in FWV in place NO FWV place FWV in place NO FWV place Faridpur District Habiganj District
21 6 10 8 4 2 1 1 0 1
US Unions NO FWC No FWC FWC in Both FWC US Unions NO FWC No FWC FWC in Both FWC & NO but FWV place but & FWV in & NO but FWV place but & FWV in FWV in place NO FWV place FWV in place NO FWV place Madaripur District Kustia District
18 4 4
4 4 5 5 0 0 0
US Unions NO FWC No FWC FWC in Both FWC US Unions NO FWC No FWC FWC in Both FWC & NO but FWV place but & FWV in & NO but FWV place but & FWV in FWV in place NO FWV place FWV in place NO FWV place Chandpur District Noakhali District 4 4 3 2 1 0 0 0 0 0
US Unions NO FWC No FWC FWC in Both FWC US Unions NO FWC No FWC FWC in Both FWC & NO but FWV place but & FWV in & NO but FWV place but & FWV in FWV in place NO FWV place FWV in place NO FWV place Lakshmipur District Feni District
Page 28
2. List of unions by 4 categories-
a) Underserved unions in Dhaka region by category Category 1 Category 2 Category 3 Category 4 2no Kaitola Bachamara Muradpur Barail Gazipur Chowmuhoni Makrampur Char Katari Kakailsew Birgaon Bhadeshwar 8no Bulla Dhar Mandal Krishnanagar Bulla Kagapasha Nutghar Paniunda Pailarkandi Ratanpur Bitghar Mandari Goalnagar Chatalpar Ranigaon Badarpur Bolakot Kaitola-south Paikpara Jiyanpur Shibpur Lakhai Baghutia Teota 2 Unions 2 Unions 12 Unions 18 Unions b) Underserved unions in Faridpur region by category Category 1 Category 2 Category 3 Category 4 Charjanajat Gazirtek KaziBakai Korsha Kadambari Kayaria Mahendradi Kanthalbari Ambaria Paikpara Baroipara Shikar Mangal Haridasdee Char Fulbaria Malidah Bhadrasan Kamarkhali Ishibpur Harirampur Sannyasir Char Jhaukanda Charsadipur Chardolatkhan Boheratala Char Amgram Ramjanpur Bandarkhola Siruail Bajitpur Enayetnagar Hossainpur Laxmipur 3 Unions 4 Unions 14 Unions 10 Unions c) Underserved unions in Noakhali region by category Category 1 Category 2 Category 3 Category 4 Harni Char Jubilee Ander char Char Jabbar Char darbesh Chithalia Chanandi Char Nilkamal Char Matua Mohammadpur Nijhumdip Ghopal Ramanimohon Haimchar Dharmopur Dhanshalik Char Clerk Musapur Char Char Bangshi Purbo Char Matua Purbo charbata Abdullah Dakshin Nalchira Char bata Char Chandira Sukh Char Char Wapda Dhanshiri Char Bhairabi Gazipur 9 Unions 4 Unions 5 Unions 11 Unions 14 Unions 10 Unions 31 Unions 39 Unions
Page 29
Annex 5 List of unions segregated by the size of total population 5 Unions (55,000 +) Faridpur Region (22) Noakhali Region (5) Faridpur Charbhadrasan Gazirtek Noakhali Hatiya Harni Chanandi Faridpur Madhukhali Kamarkhali Noakhali Hatiya Nijhumdip Madaripur Shibchar Charjanajat Noakhali Subarna Char Char Clerk Madaripur Shibchar Kanthalbari Noakhali Subarna Char Char Wapda Madaripur Shibchar Boheratala Feni Sonagazi Char Chandira Madaripur Rajoir Amgram 14 Unions (35,000 - 54,999) Madaripur Rajoir Bajitpur Dhaka Region (5) Madaripur Rajoir Ishibpur Madaripur Rajoir Kadambari B.baria Nasirnagar Chatalpar Madaripur Rajoir Paikpara Habiganj Bahubal Bhadeshwar Madaripur Kalkini Enayetnagar Habiganj Chunarughat Gazipur Madaripur Kalkini Kayaria Habiganj Chunarughat Ranigaon Madaripur Kalkini Laxmipur Habiganj Nabiganj Paniunda Madaripur Kalkini Ramjanpur Noakhali Region (9) Madaripur Shibchar Sannyasir Char Noakhali Hatiya Nalchira Madaripur Shibchar Siruail Noakhali Sadar Dharmopur Kushtia Mirpur Ambaria Noakhali Sadar Anderchar Kushtia Mirpur Baroipara Noakhali Kabirhat Dhanshiri Kushtia Mirpur Fulbaria Noakhali Subarna Char Char Jubaly Kushtia Mirpur Korsha Noakhali Subarna Char Char Jabbar Kushtia Mirpur Malidah Noakhali Subarna Char Purbo charbata Kushtia Kumarkhali Charsadipur Noakhali Subarna Char Mohammadpur Feni Sonagazi Char darbesh Noakhali Region (11) Noakhali Hatiya Sukh Char 60 Unions (15,000 - 34,999) Noakhali Sadar Char Matua Dhaka Region (27) PurboChar Noakhali Sadar Manikganj Daulatpur Bachamara Matua Manikganj Daulatpur Baghutia Noakhali Kabirhat Dhanshalik Manikganj Daulatpur Jiyanpur Noakhali Subarna Char Char bata Manikganj Shivalaya Teota Noakhali Companiganj Musapur B.baria Nabinagar Kaitola Char Bangshi Lakshmipur Raipur B.baria Nabinagar Barail Dakshin B.baria Nabinagar Birgaon Char Lakshmipur Sadar B.baria Nabinagar Bitghar Ramanimohon B.baria Nabinagar Nutghar Chandpur Haimchar Nilkamal B.baria Nabinagar Ratanpur Feni Porshuram Chithalia B.baria Nabinagar Krishnanagar Feni Chhagalniya Ghopal B.baria Nabinagar Shibpur 13 Unions (5,000 - 14,999) B.baria Nasirnagar Goalnagar Dhaka Region (2) B.baria Nasirnagar Dhar Mandal Manikganj Daulatpur Char Katari B.baria Nasirnagar Bolakot B.baria Nabinagar Kaitola-south Habiganj Baniachong Makrampur Habiganj Baniachong Kagapasha Faridpur Region (8) Char Habiganj Baniachong Muradpur Faridpur Charbhadrasan Harirampur Habiganj Baniachong Mandari Madaripur Shibchar Bandarkhola
Page 30
Habiganj Baniachong Pailarkandi Mahendradi Madaripur Rajoir 2no Haridasdee Habiganj Madhabpur Chowmuhoni Madaripur Rajoir Hossainpur Habiganj Madhabpur 8no Bulla Madaripur Kalkini Chardolatkhan Habiganj Azmiriganj Badarpur Madaripur Kalkini Kazi Bakai Habiganj Azmiriganj Kakailsew Madaripur Kalkini Shikar Mangal Habiganj Lakhai Bulla Madaripur Shibchar Bhadrasan Habiganj Lakhai Lakhai Noakhali Region (13) Habiganj Chunarughat Paikpara Lakshmipur Ramgati Char Abdullah Chandpur Haimchar Char Bhairabi Chandpur Haimchar Haimchar 2 Unions (Less than 5,000) Faridpur Region (1) Faridpur Charbhadrasan Char Jhaukanda Noakhali Region (1) Chandpur Haimchar Gazipur
Page 31
Annex 6 List of unions segregated by the proportion of underserved population 38 Unions (More than 75%) 18 Unions (Between 25% to 50%) Dhaka Region (13) Dhaka Region (9) Manikganj Daulatpur Bachamara Manikganj Daulatpur Baghutia Manikganj Daulatpur Char Katari Manikganj Daulatpur Jiyanpur B.baria Nabinagar Kaitola Manikganj Shivalaya Teota B.baria Nabinagar Barail B.baria Nabinagar Kaitola-south B.baria Nabinagar Birgaon B.baria Nasirnagar Chatalpar B.baria Nabinagar Nutghar Habiganj Madhabpur 8 no Bulla B.baria Nabinagar Krishnanagar Habiganj Azmiriganj Kakailsew B.baria Nasirnagar Goalnagar Habiganj Lakhai Lakhai B.baria Nasirnagar Dhar Mandal Habiganj Chunarughat Paikpara B.baria Nasirnagar Bolakot Faridpur Region (5) Habiganj Baniachong Makrampur Faridpur Madhukhali Kamarkhali Habiganj Baniachong Muradpur Madaripur Shibchar Sannyasir Char Habiganj Baniachong Mandari Madaripur Shibchar Siruail Faridpur Region (11) Kushtia Mirpur Fulbaria Char Kushtia Mirpur Korsha Faridpur Charbhadrasan Harirampur Noakhali Region (4) Faridpur Charbhadrasan Gazirtek Noakhali Subarna Char Char Jabbar Faridpur Charbhadrasan Char Jhaukanda Noakhali Subarna Char Mohammadpur Mahendradi Madaripur Rajoir Feni Sonagazi Char Chandira Haridasdee Feni Sonagazi Char darbesh Madaripur Rajoir Amgram 25 Unions (Less than 25%) Madaripur Rajoir Bajitpur Dhaka Region (6) Madaripur Rajoir Kadambari 2no Madaripur Rajoir Hossainpur Habiganj Madhabpur Chowmuhoni Madaripur Rajoir Paikpara Habiganj Azmiriganj Badarpur Kushtia Mirpur Baroipara Habiganj Bahubal Bhadeshwar Kushtia Kumarkhali Charsadipur Habiganj Chunarughat Gazipur Noakhali Region (14) Habiganj Chunarughat Ranigaon Noakhali Hatiya Harni Chanandi Habiganj Nabiganj Paniunda Noakhali Hatiya Nalchira Faridpur Region (9) Noakhali Hatiya Sukh Char Madaripur Kalkini Chardolatkhan Noakhali Hatiya Nijhumdip Madaripur Kalkini Enayetnagar Noakhali Sadar Char Matua Madaripur Kalkini Kazi Bakai Noakhali Sadar Dharmopur Madaripur Kalkini Kayaria Purbo Char Madaripur Kalkini Laxmipur Noakhali Sadar Matua Madaripur Kalkini Shikar Mangal Noakhali Sadar Ander char Madaripur Kalkini Ramjanpur Noakhali Kabirhat Dhanshiri Kushtia Mirpur Ambaria Noakhali Kabir Hat Dhanshalik Kushtia Mirpur Malidah Chandpur Haimchar Char Bhairabi Noakhali Region (10) Chandpur Haimchar Gazipur Noakhali Subarna Char Char Jubilee Chandpur Haimchar Haimchar Noakhali Subarna Char Char Clerk Chandpur Haimchar Nilkamal Noakhali Subarna Char Char bata 13 Unions (Between 50% to 75%) Noakhali Subarna Char Char Wapda Dhaka Region (6) Noakhali Subarna Char Purbo charbata B.baria Nabinagar Bitghar Noakhali Companiganj Musapur
Page 32
B.baria Nabinagar Ratanpur Char Bangshi Lakshmipur Raipur B.baria Nabinagar Shibpur Dakshin Habiganj Baniachong Kagapasha Char Lakshmipur Sadar Habiganj Baniachong Pailarkandi Ramanimohon Habiganj Lakhai Bulla Feni Porshuram Chithalia Feni Chhagalniya Ghopal Faridpur Region (6) Madaripur Shibchar Charjanajat Madaripur Shibchar Kanthalbari Madaripur Shibchar Boheratala Madaripur Shibchar Bandarkhola Madaripur Rajoir Ishibpur Madaripur Shibchar Bhadrasan Noakhali Region (1) Lakshmipur Ramgati Char Abdullah
Page 33
Annex 7 List of unions segregated by the level of access to power supply No Access Full Access Faridpur Dhaka Faridpur Charbhadrasan Char Harirampur Manikganj Daulatpur Jiyanpur Faridpur Charbhadrasan Gazirtek Manikganj Shivalaya Teota Faridpur Charbhadrasan Char Jhaukanda B.baria Nabinagar Kaitola B.baria Nabinagar Barail Noakhali B.baria Nabinagar Birgaon Noakhali Hatiya Harni Chanandi B.baria Nabinagar Bitghar Noakhali Hatiya Nalchira B.baria Nabinagar Kaitola-south Noakhali Hatiya Sukh Char B.baria Nabinagar Nutghar Noakhali Hatiya Nijhumdip B.baria Nabinagar Ratanpur Lakshmipur Ramgati Char Abdullah B.baria Nabinagar Krishnanagar Lakshmipur Sadar Char Ramanimohon B.baria Nabinagar Shibpur B.baria Nasirnagar Goalnagar Chandpur Haimchar Char Bhairabi B.baria Nasirnagar Chatalpar Chandpur Haimchar Gazipur B.baria Nasirnagar Dhar Mandal Chandpur Haimchar Haimchar B.baria Nasirnagar Bolakot Chandpur Haimchar Nilkamal Habiganj Baniachong Makrampur Partial Access Habiganj Baniachong Kagapasha Habiganj Baniachong Mandari Dhaka Habiganj Madhabpur 2no Chowmuhoni Manikganj Daulatpur Bachamara Habiganj Madhabpur 8no Bulla Manikganj Daulatpur Char Katari Habiganj Azmiriganj Badarpur Manikganj Daulatpur Baghutia Habiganj Azmiriganj Kakailsew Habiganj Baniachong Muradpur Habiganj Lakhai Bulla Habiganj Baniachong Pailarkandi Habiganj Lakhai Lakhai Habiganj Bahubal Bhadeshwar Habiganj Chunarughat Ranigaon Habiganj Chunarughat Gazipur Habiganj Nabiganj Paniunda Habiganj Chunarughat Paikpara Faridpur Madaripur Rajoir Mahendradi Haridasdee Faridpur Madaripur Rajoir Amgram Faridpur Madhukhali Kamarkhali Madaripur Rajoir Bajitpur Madaripur Shibchar Charjanajat Madaripur Rajoir Ishibpur Madaripur Shibchar Kanthalbari Madaripur Rajoir Kadambari Madaripur Shibchar Boheratala Madaripur Rajoir Hossainpur Madaripur Shibchar Bandarkhola Madaripur Rajoir Paikpara Madaripur Shibchar Sannyasir Char Madaripur Kalkini Chardolatkhan Madaripur Shibchar Siruail Madaripur Kalkini Enayetnagar Madaripur Shibchar Bhadrasan Madaripur Kalkini KaziBakai Noakhali Madaripur Kalkini Kayaria Noakhali Noakhali Sadar Char Matua Madaripur Kalkini Laxmipur Noakhali Noakhali Sadar Dharmopur Madaripur Kalkini Shikar Mangal Noakhali Noakhali Sadar PurboChar Matua Madaripur Kalkini Ramjanpur Noakhali Noakhali Sadar Ander char Kushtia Mirpur Ambaria Noakhali Kabir Hat Dhanshalik Kushtia Mirpur Baroipara Noakhali Subarna Char Char Jubilee Kushtia Mirpur Fulbaria Noakhali Subarna Char Char Clerk Kushtia Mirpur Korsha Noakhali Subarna Char Char bata Kushtia Mirpur Malidah Noakhali Subarna Char Char Jabbar Kushtia Kumarkhali Charsadipur Noakhali Subarna Char Purbo charbata Noakhali Noakhali Subarna Char Mohammadpur Noakhali Kabir Hat Dhanshiri Feni Porshuram Chithalia Noakhali Subarna Char Char Wapda Noakhali Companiganj Musapur Lakshmipur Raipur Char Bangshi Dakshin Feni Sonagazi Char Chandira Feni Sonagazi Char Darbesh Feni Chhagalniya Ghopal
Page 34
Annex 8 List of the unions with NO FWA and ONE FWA a) Unions with no FWA SL Region District Upazila Underserved Unions 1 Shibchar Charjanajat Madaripur 2 Faridpur Rajoir Mahendradi Haridasdee 3 Kushtia Kumarkhali Charsadipur 4 Harni Chanandi 5 Noakhali Hatiya Nalchira 6 Nijhumdip Noakhali 7 Ramgati Char Abdullah Lakshmipur 8 Sadar Char Ramanimohon 9 Chandpur Haimchar Gazipur b) Unions with one FWA SL Region District Upazila Underserved Unions 1 Manikganj Daulatpur Bachamara 2 B.baria Nasirnagar Goalnagar Dhaka 3 Baniachong Pailarkandi Habiganj 4 Madhabpur 8no Bulla 5 Faridpur Charbhadrasan Char Jhaukanda 6 Kanthalbari 7 Bhadrasan Shibchar 8 Boheratala Faridpur Madaripur 9 Bandarkhola 10 Kayaria Kalkini 11 Laxmipur 12 Kushtia Mirpur Fulbaria 13 Sadar Anderchar 14 Noakhali Noakhali Kabirhat Dhanshiri 15 Subarna Char Char Wapda
Page 35
Annex 9 Classification of unions by the impressions of key stakeholders a) Unions classified by the level of interests among UP representatives Dhaka Faridpur Noakhali High Modarate High Modarate High Modarate Char Char PurboChar Harni Bachamara Char Katari Harirampur Jhaukanda Matua Chanandi Baghutia Teota Gazirtek Boheratala Ander char Nalchira Char Jiyanpur Goalnagar Kamarkhali Bandarkhola Sukh Char Ramanimohon Mahendradi Krishnanagar Makrampur Charjanajat Char Bhairabi Nijhumdip Haridasdee Chatalpar Kagapasha Kanthalbari Kadambari Gazipur Char Matua Dhar Mandal Muradpur Amgram Paikpara Haimchar Dharmopur Bolakot Mandari Bajitpur Kayaria Nilkamal Dhanshiri 2no Sannyasir Pailarkandi Ishibpur Ghopal Dhanshalik Chowmuhoni Char 8no Bulla Bulla Hossainpur Siruail Char Jubilee Bhadeshwar Lakhai Chardolatkhan Bhadrasan Char Clerk Gazipur Enayetnagar Charsadipur Char bata Paikpara Kazi Bakai Char Jabbar Ranigaon Laxmipur Char Wapda Shikar Mangal Purbo charbata Ramjanpur Mohammadpur Malidah Char Abdullah Char Bangshi
Dakshin Chithalia Char Chandira Char darbesh 10 13 16 11 8 20 b) Unions classified by the willingness of H&FP supervisors and workers Dhaka Faridpur Noakhali High Modarate High Modarate High Modarate Char Bachamara Baghutia Kamarkhali Harni Chanandi Char Matua Harirampur Char Char Katari Teota Gazirtek Nalchira Dharmopur Jhaukanda Jiyanpur Shibpur Charjanajat Boheratala Sukh Char Dhanshalik Mahendradi Char Krishnanagar Makrampur Kanthalbari Nijhumdip Haridasdee Abdullah Chatalpar Kagapasha Bandarkhola Kadambari Purbo Char Matua Chithalia Char Dhar Mandal Muradpur Amgram Kayaria Ander char Chandira
Page 36
Sannyasir Char Bolakot Mandari Bajitpur Char Jubilee Char darbesh 2no Pailarkandi Ishibpur Malidah Char Clerk Ghopal Chowmuhoni 8no Bulla Bhadeshwar Hossainpur Char Bata Paniunda Bulla Paikpara Char Jabbar Lakhai Chardolatkhan Char Wapda Gazipur Enayetnagar Purbo Charbata Paikpara Kazi Bakai Mohammadpur Char Bangshi Ranigaon Laxmipur Dakshin Char Goalnagar Shikar Mangal Ramanimohon Ramjanpur Char Bhairabi Siruail Gazipur Bhadrasan Haimchar Ambaria Nilkamal Fulbaria Korsha Charsadipur 10 15 22 8 19 8 c) Unions classified by the commitments of H&FP Managers Dhaka Faridpur Noakhali High Moderate Low High Moderate Low High Moderate Low Char Mahendradi PurboChar Char Bachamara Baghutia Kagapasha Kamarkhali Harni Chanandi Harirampur Haridasdee Matua Chandira Char Katari Teota Pailarkandi Charjanajat Gazirtek Chardolatkhan Anderchar Nalchira Char darbesh Bandarkhol Char Jiyanpur Krishnanagar Enayetnagar Char Abdullah Sukh Char a Jhaukanda Char Bangshi Goalnagar Shibpur Amgram Kanthalbari Kazi Bakai Nijhumdip Dakshin Char Makrampur Chatalpar Bajitpur Boheratala Laxmipur Char Matua Ramanimohon Mandari Dhar Mandal Ishibpur Kadambari Shikar Mangal Char Bhairabi Dharmopur Bulla Bolakot Hossainpur Paikpara Ramjanpur Gazipur Dhanshiri Lakhai Muradpur Kayaria Korsha Haimchar Dhanshalik 2no Paniunda Sannyasir Char Nilkamal Char Jubilee Chowmuhoni 8no Bulla Siruail Char Clerk Bhadeshwar Bhadrasan Char bata Gazipur Charsadipur Char Jabbar Paikpara Char Wapda Ranigaon Purbo charbata Mohammadpur Chithalia Ghopal 9 14 2 7 12 8 9 17 2
Page 37
d) List of excluded unions where key stakeholders’ impressions not taken UP Representatives (16) H&FP Frontline Staff (12) H&FP Managers (14) Dhaka Faridpur Noakhali Dhaka Faridpur Noakhali Dhaka Faridpur Noakhali Shibpur Ambaria Musapur Badarpur Baroipara Dhanshiri Kakailsew Ambaria Musapur Badarpur Baroipara Kakailsew Musapur Kaitola Baroipara Kakailsew Fulbaria Kaitola Barail Fulbaria Paniunda Korsha Barail Birgaon Malidah Kaitola Birgaon Bitghar Barail Bitghar Kaitola-south Birgaon Kaitola-south Nutghar Bitghar Nutghar Ratanpur Kaitola-south Ratanpur Badarpur Nutghar Ratanpur 11 4 1 9 1 2 9 4 1
Page 38