Ensuring Sustainable Urban Primary Health Care Services in Bangladesh: A Policy Advocacy Approach of Concern Worldwide

  News   Dec 2, 2024   1307  Add to Reading List
Ensuring Sustainable Urban Primary Health Care Services in Bangladesh: A Policy Advocacy Approach of Concern Worldwide

Concern Worldwide (CWW) has extensive experience in urban health and nutrition programming in Bangladesh, focusing on marginalized populations in Dhaka and Chattogram. Urban primary health care (PHC) is crucial for slum dwellers, pavement dwellers, and low-income communities, including women, children, adolescents, and the elderly. Although health service provision is a constitutional responsibility, urban PHC delivery is managed by the Local Government Division (LGD) under the Ministry of Local Government, Rural Development, and Cooperatives (LGRD&C). The Urban Primary Health Care Project (UPHCP), initiated in 1998, has significantly improved urban PHC services but is set to conclude in 2025, raising concerns about sustaining these services.

Joint Advocacy Initiatives:

To ensure sustainable urban PHC delivery, Concern Worldwide, in collaboration with the Coalition for Urban Poor (CUP) and other stakeholders, has undertaken the following initiatives:

  • Contributed to the Urban Nutrition Strategy and operational guidelines led by the Bangladesh National Nutrition Council (BNNC).
  • Conducted a SMART survey on urban nutrition with ACF and WFP in Dhaka.
  • Piloted community-managed malnutrition programs in Dhaka City Corporation slums.
  • Supported BNNC in developing its Annual Activity Plan 2024.
  • Advocated for urban PHC sustainability in parliament, drawing attention to high-level policymakers.
  • Prepared a policy brief highlighting challenges, gaps, and recommendations for sustainable PHC services.

Policy Recommendations:

  1. Policymaker Sensitization: Increase awareness of urban health care needs to enhance urban service delivery mechanisms.
  2. Establishing an Urban Health Care Cell: Create an Urban Primary Health Care Cell within LGD, with the long-term goal of transforming it into an Urban Health Care Directorate.
  3. Leveraging Public-Private Partnerships: Continue the existing model of PHC operations, with the Urban PHC Cell managing key functions such as proposals, poverty surveys, and service delivery.
  4. Performance-Oriented Contracts: Develop contracts with clear performance indicators to ensure accountability and effectiveness in PHC service delivery.

Sustaining urban PHC services requires joint advocacy efforts to hold policymakers accountable and address both demand and supply-side challenges. Strengthened urban health systems can reduce out-of-pocket expenses, meet SDG 3 targets, and support Bangladesh’s commitment to universal health coverage.