Learnings From a Pilot Study to Strengthen Primary Health Care Services: The Community-Clinic-Centered Health Service Model in Barishal District, Bangladesh

Md. Eklas Uddin; Joby George; Shamim Jahan; Zubair Shams; Nazmul Haque; Henry B. Perry

doi:10.9745/GHSP-D-20-00466

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FIGURE 1
Components of the Community-Clinic-Centered Health Service Model Piloted in Bangladesh
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FIGURE 2
Social Map Showing Typical Distribution of Community Group and Community Support Group Members Before and After Reformation of Group Membership^a
^a Each dot refers to the residence location of a group member.
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FIGURE 3
Organizational Hierarchy and Relationship Between Local Government and Rural Community Health Service Delivery System, Bangladesh
Abbreviation: CSG, community support group.
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FIGURE 4
Difference in Maternal and Child Health Community Clinic Services Utilization Between the Pre-pilot Period (October 2017–September 2018) and the Community-Clinic-Centered Health Service Model Pilot Period (October 2018–September 2019), Barishal District, Bangladesh
Abbreviations: ANC, antenatal care; PNC, postnatal care.
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FIGURE 5
Difference in Antenatal Care Visits at Community Clinics (%) Between the Pre-pilot Period (October 2017–September 2018) and the Community-Clinic-Centered Health Service Model Pilot Period (October 2018–September 2019), Barishal District, Bangladesh
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FIGURE 6
Difference in Referral Cases From Community Clinics Between the Pre-pilot Period (October 2017–September 2018) and the Community-Clinic-Centered Health Service Model Pilot Period (October 2018–September 2019), Barishal District, Bangladesh

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TABLE 1.

Study Intervention and Control Areas of the Community-Clinic-Centered Health Service Model Pilot Intervention, Bangladesh

Intervention Area District	Upazila	Union Parishad	District	Control Area Upazila	Union Parishad
Barishal	Babuganj	Rahamatpur	Barishal	Agailjhara	Goila
	Bakerganj	Rangashree		Agailjhara	Rajihar
	Gaurnadi	Mahilara		Muladi	Charkalekhan
	Banaripara	Soliabagpur		Muladi	Kazirchar
	Wazirpur	Bamrail	Patuakhali	Sadar	Laukathi
	Sadar	Raypasha korapur	Patuakhali	Sadar	Borobighai

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TABLE 2.

Qualitative Data Collection of the Community-Clinic-Centered Health Service Model Pilot Intervention, Bangladesh

Type of Respondent	Respondents
Community health worker supervisors	Assistant Health Inspector	12 key informant interviews
	Expanded Program on Immunization	12 key informant interviews
	Supervisor: nongovernmental organization	12 key informant interviews
Health service managers	Upazila Health and Family Planning Officer	9 key informant interviews
Health service managers	Upazila Family Planning Officer	9 key informant interviews
Local government representative	Union parishad chairman/ Union Parishad Education, Health & Family Planning Standing Committee member	12 key informant interviews
Total		66 persons interviewed
Community representative	Community group and community support group member	12 focus group discussions (96 total focus group discussion participants)