RT Journal Article SR Electronic T1 Learnings From a Pilot Study to Strengthen Primary Health Care Services: The Community-Clinic-Centered Health Service Model in Barishal District, Bangladesh JF Global Health: Science and Practice JO GLOB HEALTH SCI PRACT FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs SP S179 OP S189 DO 10.9745/GHSP-D-20-00466 VO 9 IS Supplement 1 A1 Md. Eklas Uddin A1 Joby George A1 Shamim Jahan A1 Zubair Shams A1 Nazmul Haque A1 Henry B. Perry YR 2021 UL http://www.ghspjournal.org/content/9/Supplement_1/S179.abstract AB Key FindingsThe process of creating a model to increase community health worker (CHW) harmonization and collaboration, increase community engagement, and improve quality of health services required multistakeholder platforms to develop policy, provide technical guidance, and implement interventions at the local level.Early qualitative findings of the pilot model found that there was a growing awareness of the need for the inclusion of the community as a key actor and a shared responsibility among CHWs, communities, and the local government in the process of community health system strengthening.Interventions implemented through the model increased resource mobilization for community clinic service delivery and the uptake of the primary health services at community level.Key ImplicationsFor policy makers, strengthening the delivery of community-centered primary health care services requires a comprehensive approach to engage both the community, CHWs, and local government.Background:Community clinics (CCs) staffed by community health workers (CHWs) represent an effort of the Government of Bangladesh to strengthen the grassroots provision of primary health care services and to accelerate progress in achieving universal health coverage. The Improving Community Health Workers (ICHWs) Project of Save the Children piloted a CC-centered health service (CCHS) model that strengthened community and local government engagement, harmonized the work of different CHW cadres who were working in the same catchment area of each CC, and improved the accountability of CHWs and the CC to the local community.Methods:We describe the process for developing and implementing the CCHS model in 6 unions in Barishal District where the model was piloted and provide some early qualitative and quantitative findings pertaining to the model's effectiveness. Data were collected from CCs in the 6 pilot unions and 6 other unions that served as a control. Qualitative data were collected from the intervention area during the pre-pilot (October 2017–September 2018) and pilot phase (October 2018–September 2019). Document review, key informant interviews, and focus group discussions were also conducted. Maternal and child health service utilization data were extracted from the government health information system in both the intervention and control areas.Results:Community group meetings ensured engagement with local government authorities and supported resource mobilization. There was greater coordination of work among CHWs and increased motivation of CHWs to better serve their clients. The analysis showed that the increase in maternal health consultations was substantially greater in the intervention area than in the control area, as was the number of referrals for higher-level care.Conclusion:The CCHS model as applied in this pilot project is effective in engaging local key stakeholders, increasing CHW capacity, and improving client satisfaction. The model demonstrated that a community health system can be strengthened by a comprehensive approach that engages communities and local government officials and that harmonizes the work of CHWs.