Fistula Care Plus Project At A Glance (January, 2016 –June, 2016)

DEMOGRAPHY ( FARIDPUR DISTRICT) District 1 Upazila 9 Union 81 Village 153 Population 1858332 Household 416859 STAFFING PATTERN District Manager 1 Upazila Manager 9 Programme Organizer 33 Shasthya Kormi 62 Project Area: Fistula Care Plus project Shasthya Shebika 1470 Community Skilled birth 94 attendant The Fistula Care plus project focuses on reinforcing fistula care services in the PROJECT EVENT catchment areas of Bangladesh. The Community Based partnership between BRAC and Engender Fistula Diagnostic Event 05 Health Bangladesh increase the capacity of (CFDE) BRAC community health workers to identify, refer and support treatment facilitation and Total Suspected Cases 194 prevention of the cases of female genital fistula. Total Referral Cases 87 In addition BRAC will integrate FGF focused Referred Fistula Cases 54 information and education into its Health and Social Development Programme. Treated Fistula Cases 20 Referred Complete Goal 33 Perineal Tear Cases To disseminate the massage that female Treated Complete 18 genital fistula is treatable and support the Perineal Tear Cases clients in receiving the much needed health Total Genital Prolapse 38 care. Cases

Objectives CHECKLIST AND POSTER 1. Enhance capacity of BRAC community health workers (CHWs) in the intervention area to identify, refer, and support on treatment facilitation and prevention of cases of female genital fistula (FGF).

2. Integrate female genital fistula (FGF) focused information and education with BRAC Health and Social Development Programme.

BangladeshMIYCN HomeFortification Programme At a glance January-June 2016

MIYCN

DEMOGRAPHY

District 26

Upazila + Slum 164 + 6

Population 46.1 million

NUTRITIONAL STATUS IN PROJECT AREA

Children 59 Months Old 4 million

Underweight Children 59 1.3 million Months Old (33%)

1.7million MIYCN Home fortification Anemic Children of 6-59 months (51%) Programe: 120 Sub-District STAFFING To prevent and control anemia and other micronutrient deficiency, Bangladesh Sprinkles Program was launched in ShasthyaShebika 35,772 2010 by BRAC in collaboration with Global Alliance for Improved Nutrition (GAIN) and Renata Ltd. Later, from July ShasthyaKormi 3,600 2013, phase-II has started as Bangladesh MIYCN-Home Fortification Program. BRAC promotes Pushtikona5and Program Organizer(MIYCN) 290 make it available through its network of community health MNP DOSE AND SCHEDULE workers for children 6-59 months of age. Mothers are given demonstration onhow to follow correct procedures for Not more than one Sachets per day home-basedfood fortification with Pushtikona5. Pushtikona5 dosagewas given according to WHO protocols Average 10 Sachets per month but currently flexible regime is being followed. Compliance is monitored by BRAC health workers. Families buy Minimum 60 Sachets by 6 months Pushtikona5sachets but BRAC provides free sachets to the very poor familiesthrough BRAC’s Ultra Poor Programme. Minimum 120 Sachets by 1 year Pushtikona5is integrated into BRAC’s many different health SACHET DISTRIBUTION interventions for improving anemia situation: Rural platforms Distribution on Jan-June 2016 17.7 million . Essential Health Care (EHC) (MIYCN Program) Distribution since launch (61 . Maternal, Neonatal, and Child Health (MNCH) 101.5 million Districts) . Nutrition intervention program . Challenging the Frontiers of Poverty Reduction: Targeting the Ultra poor (CFPR-TUP) Urban platforms . Manoshi (MNCH-Urban)

Vision Bangladesh Project Pilot phase at a Glance (Jan’16– June’16)

VISION BANGLADESH PROJECT PROFILE

District 12 Population 46,904,000

PERFORMANCE FOR THE PERIOD OF January, 2016 – June, 2016

No of PSP Held 148 No of persons examined 5,149 Refraction error identified 540 Presbyopic glass sold at PSP 2319 Cataract Identified (PSP) 1,440 Cataract Operated (PSP) 473 Cataract Operated (District Coverage) 3049

Vision Bangladesh Project Pilot phase is a joint venture of National Eye Care-DGHS under Ministry of Health & Primary Eye Care Services through IT Enabled Vision Centre Family Welfare (MoH&FW) of Bangladesh and BRAC to eliminate the cataract backlog from the 12 selected The project has also initiated the ‘IT Enabled Vision by 2020. The project was Centre’ initiative as a sustainable model of eye care initiated in 2011 at division as Vision Bangladesh project. The project have been planning to establish a Sylhet Division Project and performed 109,771 cataract total of 20 vision centres in the country by 2020. In surgeries. In 2013, the second phase of the project 2016, the project planned to establish 03 centres at initiatied in urban cities and performed another 106,926 Nandail, ; Dumuria, and surgeries by 2015. Khanshama, Dinajpur. The objectives of the initiative will be to provide comprehensive eye care services to Project Goal: the rural poor at affordable price. The update of the The project is aligned with Bangladesh Government’s initiative is: national goal of eliminating avoidable blindness. This project aims to improve the access to eye health  A comprehensive business plan developed service delivery for the population living in the project area by 2020.  Rental of 03 houses completed

Project Objectives:  Eye equipment and instruments set-up 1. To ensure the accessibility of the people to the  Ophthalmic Assistants (06) have been quality eye care services. recruited 2. To ensure quality eye care services to the community people  Training of OAs on Vision Centre management 3. To establish a sustainable and replicable model of at BNSB Mymensingh completed

primary eye care centre  01 month training at LAICO for the OAs is Core Interventions: under process  Prepare plan for patient screening programme (PSP) with hospital partners.  3 Medical Officer from 3 base hospital will be  Orientation of staffs on primary eye care including sent to LAICO for orientation on vision centre the primary identification of eye patients, referral and follow-up. management.  Follow-up of operated patients and refer  Partnership has been developed with Orbis on complicated cases to partner hospitals for appropriate management. the 04 vision centres (including these 03)  Maintain liaison with government and other  The centres will be functioning by October stakeholders  National Institute of Ophthalmology plays key role 2016 (August’ 2016 – Nandail, September’ in managing postoperative complicated cases. 2016 – Khanshama and October’ 2016 –  Recruit and train Ophthalmic Assistant for vision centre management Dumuria)  Establish vision centres with appropriate equipment.

BRAC HEALTH SECURITY PROGRAMME

(bHSP) At a glance (Jan’16- June’16)

Gazipur Working areas (present): Upazila 1 Branch 5

Target group: All households’ members in Manoshi catchment area of Gazipur Sadar (focus on under privileged). Human Resourse Field coordinator officer 1 Programme organizer 1

ENROLMENT & SERVICE DELIVERY (Jan’16- June’16)

No. of Policy 958 No of member 4,805

Background: Total premium collected (BDT) 1,041,800 BRAC has started a new initiative led by Total claim cost (BDT) 451,721 HNPP, a Health security programme in No. Of outpatient Service 1556 Gazipur as an integral part of national health financing strategy to achieve universal health No. Of Hospitalization service 98 coverage in Bangladesh. This is a pre-paid health scheme where same household members are covered to receive health care COMMUNITY MOBILISATION: service for one year. Initially the programme (Jan’16- June’16) is implemented in Bhogra, Noljani, Salna of  Popular theatre organised GazipurUpazila of Manoshi programme under BRAC HNPP.  Community mobilization through using different programme platform – VO meeting, Palli Somaj, Objectives:  Teacher-parents meeting, IMNCS local community meetings.  Design a national model for Healthcare

Financing to jump-start the journey towards Universal health Coverage in  Sensitizing household through shasthya shebikas & shasthya kormi Bangladesh Conducted health camp  Encourage a practice of pre-payment  and co-payment by the community  Door-to-door follow-up with operated patients by Improve access to healthcare Programme Organizer  Reduce financial constraints for seeking health care for the low-income households Key Challenges: Premium Structure: Premium is set according to household’s 1. Acceptance of the new concept in the community about the income status and can range between BDT prepaid healthcare service 900-BDT 2100 for upto 5 members of a 2. Lack of awareness regarding the annual health check-up. family. To include an additional member BDT 3. Lack of relevant evidence on the utilization of the inpatient 100 needs to be given. There is no exclusion services among the people when they are sick criteria and adverse selection and no age 4. Managing multiple implementing partners such as private limit. and public healthcare providers

Integrated Early Childhood Development and Care Project

At a glance, Jan 2016 to Jun 2016

Target Population

1) Primary Target . Children (0-8 years) 13,093 . Parents 13,093 2) Secondary Target . Adolescent and Youth 364 . Grandparents/ Senior Citizen 52,374 . Community People 484,025 Project Coverage

District 1

Sub-district 6

Population 518,554

House hold 116,187

Health Human Resources

ECD Promoters 363 Early periods of human life, especially from conception to eight years of life is very crucial. Children develop best in this period Community Health Worker 111 with access to integrated ECD interventions - education, nutrition, Programme Organizers 41 and health services coupled with parents who are supported with Sub-district Manager 6 ECD awareness programmes. Realizing this importance, BRAC Health Nutrition and Population Programme and BRAC Education District Manager 3 Programme collaboratively initiated the Integrated Early Parenting Session (conception to 36 months) Childhood Project since December 2013. Project Goal Pregnant women counseled 16,365 The overall goal of the project is to achieve children's holistic Lactating women counseled 3,199 development by creating a joyful and child friendly learning Total Number of session held 14,151 environment so that children can lead healthy lives and attain further education. Mothers & Caregivers participated in session 77,303 Project Objectives Father Participated in session 4,538 1. To improve the knowledge, skills and awareness of parents, Total Number of child participated 77,303 care-givers, school teachers, adolescents and communities to ensure quality early childhood development Temporary Play Center 2. To create safe and child-friendly learning environments in Total Number of play center arranged 13,134 homes, communities, and schools/learning centers for Total Number of child participated 78,016 children between 0-5 years Early Learning Center 3. To improve cognitive and linguistic abilities of children for school preparedness Total number of ELC 260 4. To establish referral linkage for the children with Total number of Children 5,680 developmental delays and disabilities

HEALTH SECURITY SCHEME FOR

AARONG ARTISAN (HSS) At a glance (January 2016- June 2016)

DEMOGRAPHY

District Coverage 3 Sub-District (Upazila) 12 Population 13,025 Scale up plan in District by 2017 9

ENROLMENT & SERVICE DELIVERY (Jan’16-Jun’16)

No. Of Members Enrolment 4,009*

Total fund deposited (BDT) 6,82,000

Total claim cost (BDT) 6,73,500

No. Of Inpatient Services 258

Background: Benefit to the Artisans

The Artisan Health Security Scheme is a co- BDT 1000 as initial payment for all cases (emergency, normal contributory healthcare-access and financing delivery, surgical or medical) - scheme for the Aarong artisans jointly 1.1.1. C-Section Delivery: Additional BDT 5000 implemented by Ayesha Abed Foundation 1.1.2. Surgical Hospitalization: Additional BDT 2000 for and HNPP since February 2015. Through a investigation tests before surgery and BDT 7000 Health Protection Fund (HPF), the Artisans before the day of the surgery (minor surgery will be able to access a financial benefit excluded – list determined by HNPP). If no package to cover medical expenses. investigation tests are needed BDT 9000 will be paid. Objectives: 1.1.3. Medical Hospitalization: Additional BDT 2000 (paid in tranches of BDT 500 every 2 days)  To reduce catastrophic health expenditure among Aarong artisans through providing financial protection to them and their families in case of Challenges & Adaptation hospitalization.  The funds deposited is not sufficient to make the  Encourage a practice of pre-payment program sustainable. Thinking of increasing artisans and co-payment by the community Improve access to healthcare share of contribution to 35 taka.  Increased number of claims. Premium Structure:  Managing multiple implementing partners such as private and public healthcare providers For accessing health security Fund an artisan  Complex documentation process made have to give BDT 25 monthly and AAF will add the same amount into the pooled fund. introduction to Commcare software At present the scheme has been implemented in Manigonj, Nilphamari and Kushitia district.

IMPROVING MATERNAL, NEONATAL & CHILD SURVIVAL PROJECT At a glance (January – June 2016)

DEMOGRAPHY District 14 Upazila 93

Union 905

Village 15,735

Population 24,828,352 House hold 5,875,094 STAFFING PATTERN

District Manager 14

Program Organizer 516 Paramedic 5 Shasthya Kormi 1,981 Shasthya Shebika 25,536 Improving maternal, neonatal and child survival (IMNCS) project Community Skilled Birth 1,055 is a comprehensive community based health intervention focusing Attendant (CSBA) on preventive and curative care with a group of trained community MATERNAL HEALTH (14 districts) health workers under structured supervision and monitoring Contraceptive acceptance system. This comprehensive undertaking is uniquely designed to 68% rate (Modern method) address the bottlenecks of demand and supply side for ensuring continuum of care from home to hospital. About 24 million Total delivery 194,048 populations living in rural areas of 14 districts are being reached Facility delivery 83,179 (43%) with maternal, neonatal and child health services. Delivery by skilled birth 110,869 (57%) attendant C-section 48,506 (25%) Goal To reduce maternal, neonatal and child mortality and morbidity, Four or more antenatal care 149,002 (77%) particularly, among the poor and socially excluded population Postnatal care within 48 64,728 (33%) hours of delivery Objectives Three or more postnatal care 82,097 (42%) . Increased knowledge, and improved MNCH practices in communities. NEONATAL HEALTH (12 districts) . Improved provision of quality MNCH services at household Live birth 190,000 (98%) and community levels. . Increased participation, accountability and responsiveness to Low birth weight 18,635 (15%) communities’ voice in MNCH services. Initiation of breast feeding 169,126 (89%) within one hour of birth Birth asphyxia diagnosed 3,494 (02%) Community health workers (CHW), namely, Shasthya Shebika, Birth asphyxia managed by Newborn Health Worker, Shasthya Kormi and Community Skilled 1,916 (55%) Birth Attendant (CSBA) are the frontline workers catering family SS planning, pregnancy related care, newborn and under five child Neonatal sepsis referred 2,112 (97%) care at door steps. Behavior change towards healthy practices in CHILD HEALTH (12 districts) terms of reproductive health, nutrition, hygiene and sanitation is the strategy to preventive and promotive care. CHWs offer basic Exclusive breast feeding 131,829 (74%) care e.g., antenatal care, delivery care, postnatal care, newborn Fully immunized children 115,288 (99%) care and management of birth asphyxia, diarrhea, ARI and some common ailments. CSBA attends home deliveries to ensure safe Pneumonia managed by SS 77,854 (93%) maternal and neonatal outcome at birth. A well-structured referral Diarrhea managed by SS 85,933 (90%) system is in place to reduce delays in accessing health care by with ORS bridge gaps between community and facility during emergencies. In essence, a continuum of care is provided to mothers, neonates and under-five children.

Malaria Control Programme At a glance (January-June, 2016)

Malaria Control Programme Profile District 13 High Endemic Districts ( Hill Tracts) 3

Moderate Endemic ( Cox’s Bazar) 1 Low Endemic Districts 9 Upazila 71 Union 533

Pourashava 23 At Risk Population 13.25 million Total number of Malaria cases in 2015 39,719 Total number of Malaria deaths in 2015 09 P. Falciparum: P. Vivax 90:10

Information about BRAC

Working Areas 24 Upazilas Population Coverage 2.07 million Number of Laboratory 76

Shasthya Kormi involved in Malaria 788

Shasthya Shebika involved in Malaria 2231 Malaria is a major public health problem in some parts of Other Human Resources 198 Bangladesh, especially in 13 of 64 districts, of which Chittagong Hill Tracts are highly endemic and Cox’s Bazar is a moderately endemic district. Sporadic Information about SR NGOs (Sub-Recipient) incidences occur in other parts of the country. A total of Total number of SRs 20 13.25 million people in the country are now at high risk of Working Areas 47 Upazilas malaria. Population Coverage 11.18 million BRAC has been performing malaria control activities Number of Laboratory 48 since 1998, covering all sub-districts of the three hill tract Health Workers 921 districts, Rangamati, Bandarban, and Khagrachhari. In 2007, in partnership with the National Malaria Control Other Human Resources 256 Programme (NMCP) of the Ministry of the Health and Training Participants Family Welfare, BRAC successfully secured a grant from the Global Fund to fight AIDS, Tuberculosis and Malaria Training on reporting, documentation and m- (GFATM) to strengthen and expand national malaria health 25 control activities to all endemic districts. BRAC has Basic training on Malaria Management 40 included 20 sub-recipient (SR) NGOs under the GFATM grant. Basic training of laboratory technicians 20 BRAC’s main approach for malaria control is to inform Basic training of health workers 240 and educate people at the community level, promote use Performance BRAC SRs of insecticidal nets (LLINs and treated bed nets), and early diagnosis and prompt treatment of malaria. BRAC No. of blood slide examination done 72692 174414 also conducts orientation (BCC orientation, village doctor orientation) to different stakeholders of the community to No. of RDT done 108786 75535 make them aware of malarial symptoms, encourage use of LLINs, enhance referral of symptomatic cases for No. of malaria cases diagnosed 8032 1416 diagnosis by RDT or BSE, ensure treatment, and reduce No. of p.falciparum diagnosed 7210 1138 stigma. Messages regarding malaria are disseminated through house hold visits, health forums etc. No. of p. vivax diagnosed 822 278 The female community health volunteers, known as No. of malaria cases treated by community 8032 1416 Shasthya Shebikas (SS), play a pivotal role in the health service providers interventions at the community level, promoting community participation and bridging community and Social Mobilization Activities BRAC SRs government health services. Diagnostic and treatment services are delivered mainly through Shasthya No. of Peoples oriented on malaria prevention Shebikas and Shasthya Kormis (health workers). These 1528 1212 field staff also refer patients to the nearest government and control health facility and pay special attention to pregnant No. of village doctors oriented on malaria 363 513 women, children under 5 kg of weight and severe malaria cases. Number of LLIN distributed 0 41255 Medical Treatment Loan (Aroggya rin)

At a glance (January, 2016 - July, 2016) Objectives:  Assist borrowers to receive timely quality treatment from appropriate and reliable health care providers  Prevent clients borrowing at exorbitant interest rates from unauthorized moneylenders.  Reduce financial constraints for seeking health care for the low-income households  Minimize the incidents of asset depletion and adverse indebtedness on account of catastrophic health events.

Working areas (present):  21 Districts  136 Upazilas

 Target group: Current borrower of Microfinance with their families Background:

Medical Treatment Loan is a joint Service delivery initiative of BRAC Microfinance Total no of provider in (MF)and Health Nutrition Population 159 Program (HNPP). MTL started as a pilot 21 district project on 23rd October 2013, in five Total no of Patient 6965 branch offices of Rangpur district which received treatment is a launching pad to promote universal Total no of loan health coverage in Bangladesh. The 5679 purpose is to improve accessibility to disbursed reliable health care, reducing the risk of Total amount of loan 5,10,69,500 economic compromise with a goal to disbursed (BDT): yield significant health and social welfare benefits. Access to quality health services Challenges: still remains to be inadequate and  Beneficiaries have to carry the full expense of expensive for a large segment of the doctors visit population, discouraging the needy to  In the remote areas doctors are mostly access care when required. Out- of- unavailable or irregular. Pocket health expenditure in Bangladesh is one of the highest in south Asia, which  Service provision from the doctors are often results in “medical expenditure charitable so they are not bound to follow the impoverishment”. prescribing and cost estimation protocol of ours.

NCD (Non Communicable Disease) Programme at a glance (Jan16 – Jun16)

NCD Implementation Areas

District 61

Upazilla 139

City corporation 09

Human Resources

Shasthya Shebika involved 2300

Coverage

Household coverage 965,708

Performance

No. of BP screened 33,786 NCDs contribute to 60% of all deaths globally and 80% of these deaths occur in developing countries like Bangladesh. sDCN are chronic No. of hypertensive patient debilitating disease which is associated with a range of severe 14,325 complications. The burden of morbidity by NCD is enormous. referred Disabilities resulting from these non communicable diseases are very frequent that many NCD patients take ill health in their stride as a part Service received from health of “usual/normal ageing”. Countries with large population such as 11,710 Bangladesh have large number of people with NCDs. But due to center

absence of effective community based programme, most cases could not be identified at early stage resulting large number of disabilities Hypertension Confirmed 9,440 and death. Considering this, BRAC initiated a community based NCD education and screening programme in 2011 with following goal, No. of blood glucose objectives and strategy. 18,224 Goal screened To reduce the burden of chronic NCDs by promoting healthy lifestyles No. of diabetic patient and reducing the prevalence of common risk factors through 8,314 community based health care approach. referred Objectives  To introduce life style modification education Service received from health 7,855  To provide screening services at the door steps of the clients center  To refer identified suspected cases for diagnosis and subsequent treatment Strategy Diabetes Confirmed 5,919 BRAC community health workers (Shasthya Shebikas) receive training on NCD and it's community-based approach where they learn to measure blood glucose using glucometer and measure blood pressure. They perform primary screening for Diabetes and Hypertension among people at risk and refer potential cases with positive result to partner clinics/hospitals. The referral centres confirm the diagnosis and recommend appropriate management plan. In the community, Shasthya Shebika has the responsibility to ensure compliance of the management by following patients on regular basis. Shasthya Sebikas are also involved in awareness building through community mobilization and education sessions on healthy lifestyle and risk factors for NCDs.

Nutrition Project at A Glance (January-June 2016)

NUTRITION PROJECT PROFILE DISTRICT 18 UPAZILA 114 POPULATION 27,378,036

STAFF INFORMATION

TOTAL HEALTH VOLUNTEER 18,953 SHASTHYA SHEBIKA 10,325 PUSHTI SHEBIKA 8,628 SHASTHYA KORMI (Pushti) 2,565 PO (Nutrition) 208

IYCF PERFORMANCE TOTAL CHILDREN (0-2 YEARS) 7,033,129 LIVE BIRTH 293,257 EIBF 285,880 EBF 16,80,016 TIMELY INITIATION OF CF 3,08,798 The Nutrition Project of BRAC is based on BRAC’s experience ANIMAL FOOD CONSUMPTION 8,47,967 over many years in providing nutrition intervention addressing the HAND WASHING 7,96,796 determinants of malnutrition. The program aims to reduce MATERNAL NUTRITION PERFORMANCE malnutrition among pregnant-lactating women, adolescent girls, # OF PREGNANT WOMEN and young children in order to reduce mortality and morbidity, 983,413 particularly among poor and socially excluded populations. COUNSELED ON MATERNAL INTAKE FROM 4 DIVERSIFIED Focusing Area: FOOD GROUP 7,40,601 IYCF, Maternal and Adolescent Nutrition. INTAKE OF IFA TABLET 7,89,817

# OF LACTATING MOTHER Core Interventions: COUNSELED ON MATERNAL 3,495,706 Home visits NUTRITION  Where SSs, and SKs provide mothers of children 0-24 months of age IYCF counseling, coaching, INTAKE FROM 4 DIVERSIFIED demonstrations, problem-solving, and referrals FOOD GROUP 31,32,565

 SSs and SKs provide counseling on maternal diet ADOLESCENT FORUM INFORMATION diversity for pregnant and Lactating mothers  Court yard meeting with a group of adolescent girls on # OF NUTRITION FORUM 128,882 nutrition, balance diet, anemia: causes and prevention, CONDUCTED ( By SK and PO) menstruation management and UTI. # OF ADOLESCENT GIRLS 877,642 Social mobilization COUNSELED ON NUTRITION

Social mobilization sessions on IYCF, maternal and adolescent SOCIAL MOBILIZATION INFORMATION nutrition raise awareness and seek commitments to action by # OF SOCIAL MOBILIZATION influential members of the community. This provides an overview 143 SESSION of the nutrition situation and the importance of providing optimal nutrition for the vulnerable groups like, children under two years # OF ATTENDANCE 3,161 of age, pregnant women as well as adolescent girls with the objectives and activities of Nutrition Project. Participants at this orientation include government and nongovernment officers, political and religious leaders, health officials, alternative health care providers, teachers, adolescents, and other respected members of the community.

Reading Glasses for Improved Livelihoods (RGIL)

At a Glance (Jan’16 to June’16)

Plan to be Expansion PANCHAGARH THAKURGAON LALM ONI RHAT RGIL PROFILE NI LPHAMARI DINAJPUR KURIGRA M Present coverage RANGPUR District 61 GAIBANDHA JOYPURHAT JAMA LPUR SHERPU R NE TRAKONA SYLHET NA OGAON SUNAMGANJ City Corporation 11 BOGRA NA WAB GANJ MYMENSINGH SI RAJGANJ KISHOREGANJ M AULVIBAZAR NATORE TA NGAI L HABIGANJ Upazila 456 PA BNA GAZIPUR BRAHAMANBARI A KUSHTIA MANI KGANJ NARSINGDI Target Population MEHERPUR RAJBARI 16.1 CHUADANGA JHENAIDAH FARI DPUR MUNSHIGANJ MAGURA SHARIA TPUR COMI LLA MADARI PUR CHANDPUR KHAGRACHHARI JESS ORE NARAIL GOPALGANJ FENI RANGA MATI LAKSHMI PUR RGIL TRAINING INFORMATION NOAKHALI BAGERHAT KHULNA SATKHIRA JHALOKATI CHITTAGONG PATUAKHALI PIROJPUR BHOLA SS (Shasthya Shebika) 30,887 BA RGUNA BANDARBAN District Manager 74 COX'S BAZAR Upazila Manager 464

Program Organizer 2,311

Nurse / Paramedic 132

Shasthya Kormi 2,788

This project aims to combat Presbyopia - a chronic eye problem, PERFORMANCE (Jan’16 to which results difficulty in near vision and reduces productivity of June’16) adults over the age of 35 years. In Bangladesh about 20% people suffer from presbyopia (Bourne SS involved with Eye screening 14,025 et al.2004 a) and are deprived of contributing to household activities and in the national economy as well, so it has become a Total # of persons screened 552,416 major public health problem.

Strategy: Identified as Presbyopia 347,305 The project has been implemented in partnership between BRAC (63%) Identified as Other Eye 118,852 and VisionSpring(formerly Scojo Foundation).VisionSpring is a not- for-profit organization in the USA. problems (22%) The mission of VisionSpring- “to reduce poverty and generate Persons received service 86,016 opportunity in the developing world through the sale of affordable against refer (72%) eyeglasses” is consistent with the mission of BRAC “---- to bring Identified as No Eye Problem 86,259 about positive changes in the quality of life of people who are (16%) poor.” Total Glasses sold 111,681 The activities on Reading Glasses have been incorporated in the normal work schedule of the Shasthya Sebika (SS). Before a) Single Vision 53,038 (47%) conducting vision screening in the community the SS mobilizes people who suffer from eye problems. She uses the forums - like b) Bi-focal 58,601 (52%) village organization (VO) meeting, group health education c) Sunglasses & Eye Protector 410 (1%) meeting etc. For a broader coverage of the program camps are held.

After testing vision the SS offers reading glasses of proper magnification to the presbyopic clients at affordable cost. Patients with other eye complaints are referred to district eye hospitals. SK, PO support the SS in screening and referral. Upazila Manager and other supervisors provide periodic supervision and follow-up. Initially this project will receive a loan from BRAC of one million USD.

Sustainable Clubfoot Care in Bangladesh (SCCB) At a glance (Jan’16- June’16)

 Dhaka  Chittagong Working areas (present): In 17 public medical colleges in 14 districts (  Rangpur Target group:  Dinajpur All households’ members in Manoshi and EHC Pabna catchments area of upazillas of 17 districts.  Bogra Kishorganj Tangail  Faridpur Human Resource:  Barisal Project Manager 1 Technical Manager 1  Goplaganj Regional coordinator 6  Noakhali Programme organizer 11   Cox Bazar

Background: COMMUNITY MOBILISATION: ENROLMENT & SERVICE DELIVERY (Jan’16- June’16) (Jan’16- June’16) In Bangladesh an estimated 5,000 children a year are born with clubfoot No. of Patient enrolled 478 deformity. Access to standard of care treatment Foot under Treatment 724 using the appropriate method (Ponseti Method) is Age under 3 months at first visit 324 limited in Bangladesh. Ponseti clubfoot treatment Tenotomy performed 171(43%) (serial casting, Achilles tenotomy – minor % of male and female patient (69& 31) outpatient surgery under local anesthesia – and serial bracing) has high efficacy in correcting the No. of drop out 6(1.3%) deformity. Project Period: April 2014 - June 2017 COMMUNITY MOBILISATION: (Jan’16- June’16) Objectives:  Refreshers training conducted for SSs and Sks

 To build capacity and integrate Ponseti  Follow up and all households of enrolled patient clubfoot treatment within the Bangladesh  Conducting parent support group meeting in every PTC healthcare system Orientation of doctors, medical students and nurses during  To strengthen capacities of Bangladesh’s  medical, paramedical, and nursing schools in launching ceremony of PTCs Ponseti clubfoot management,  Orientation and meeting on world Clubfoot day 3 June, 2016  To perform evaluations designed to assure quality of Ponseti method treatment at NITOR Key activities:  Orientation session during BOSCON, 2016 conference  Capacity building: train the trainers, staff and community health workers;  Strengthening capacity of government institutions and NGOs to treat and train Key Challenges: healthcare workforce;  Continuous treatment adherence as it takes about 4 years  Developing national guidelines and modules for treatment completion on Ponseti method treatment;  Providing same level of quality care from all PTCs  Community mobilization and awareness building;  Managing multiple implementing partners such as private  Ensuing continuum of Ponseti clubfoot care; and public healthcare providers  Performing evaluation and quality assurance  Inclusion of clubfoot care in GOB Op and its Sustainability

TB CONTROL PROGRAMME

At a glance (January-June, 2016)

Map of Bangladesh indicating PROFILE districts supported by NGOs District 42 (excluding metropolitan city areas) Upazila 297 City Corporation 7 Population( million) 92.9 Rural-88.2; Urban- 4.7 HUMAN RESOURCES Shasthya Shebika involved in 63810 DOTS

Number of DOTS provider 15274 Programme Organizer (Lab) 513 Programme Organizer 829

207 Upazila Manager

District Manager 59 SETUPS AND PLACES COVERED Peripheral laboratories 416 DOTS corner at hospitals 38 Prisons covered 41 Port hospital covered 2 EPZ covered 3

In Bangladesh, tuberculosis (TB) is a major public health Work places covered 776 SOCIALproblem MOBILIZATION and a leading ATTENDED cause of adult FOR mortality. THE MONTH The OF WHO ranks APRIL- JUNE 2 th TRAINING and SOCIAL MOBILIZATION Bangladesh the 7 among 22 high burden TB countries. Every PARTICIPANTS year around 81,000 people die of TB in Bangladesh. BRAC is PO Refresher TB 284 the first NGO to sign a MoU with the Government of Training of lab technicians 98 Bangladesh in 1994 to expand the Directly Observed Treatment Orientation of interns &private Short-course (DOTS) services nationwide. Along with the 2837 practitioners government, BRAC is the principal recipient of Global Fund to Village doctors 1244 Fight AIDs, Tuberculosis and Malaria (GFATM) to strengthen 12 health system and expand DOTS across Bangladesh. BRAC Basic training on lab PO

and 28 NGOs are implementing TB interventions in partnership Lab PO refresher training 50 with the government. PERFORMANCE

43112 New smear positive cases Goal To reduce morbidity, mortality and transmission of TB until it is 15649 New smear negative cases no longer a public health problem. 12332 New extra pulmonary cases Objectives To achieve and sustain at least 70% case detection and 85% Relapse cases 2943 treatment success among smear-positive TB cases under 74036 DOTS. Total case notification

Symptomatic tested for MDR TB 7006 BRAC’s approach for TB diagnosis and treatment focuses on MDR TB patients diagnosed 213 community level education and engagement. BRAC conducts

orientation with different stakeholders of the community to Child TB diagnosed 1386 engage them in efforts to identify patients, ensure treatment Treatment success rate of adherence, and reduce stigma. The stakeholders include: cured new smear positive cases 94 TB patients, local opinion and religious leaders, girls’ guides and scouts, other NGO workers, village doctors, pharmacists Treatment success rate of 93 and private practitioners. all cases Treatment success rate of The Shasthya Shebika (SS), the first frontline community health MDR TB cases 75 worker, plays a pivotal role of connecting individuals with TB control services during household visits and health forums. INFORMATION SR (SUB RECIPIENT) They disseminate TB messages, identify presumptive, refer Total number of SRs 28 them for sputum examination to Upazila Health Complex (Government sub-district health complex) or BRAC laboratory Population coverage( million) 57 services, ensure daily intake of medicine for identified TB Human resources 865 patients through DOT and refer for proper management of the side effects during TB treatment.