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Table 4 List of initiatives taken by SHOs and their outcomes, 1994–2015, based on project documentation

From: Unlocking community capability through promotion of self-help for health: experience from Chakaria, Bangladesh

Initiatives taken by the SHOs Actions Outcome
1994–2003
 Diarrhoea Epidemic Control Pushed the local authority to control the epidemic Epidemic was controlled; permanent oral rehydration treatment depot established; SHOs gained confidence in collective action
 Campaign for Promotion of Sanitary Latrines House to house campaign to setup sanitary latrines Increase ownership of sanitary latrines; reduced incidents of related disease; market based latrine production unit established
 Campaign to promote hand washing SHO members campaigned for proper hand washing after defecation and before meals 90 % of households found using ashes or soap; diarrhoea and other related disease reduced; continued healthy practices.
 Campaign to promote practice of covering food Traders at the markets were pushed not to sell unhygienic foods and to cover food after preparation Foods were seen covered at shops; reduced selling of unsafe food items; established social responsibility
 Union Health Committee Formed a coordination body comprising representatives from all SHOs in a union Coordination of all health and development activities at union level
 Village Health Posts [24] SHOs and Union committees established 7 Village Health Posts to supplement public health services with their own resources Village Health Posts were sustained for long time (1998–2016); became a community focal point for health services and social activities.
 Family health card scheme A low cost family health card scheme initiated People were getting benefit from the scheme; 6 % of households enrolled; The scheme later was developed into micro-health insurance.
 Fund for poor people SHO members felt need to have fund to help the poor, they raise a fund through contribution from people interested to donate Poor people getting help from the fund for health and other needs
 Health facility monitoring and utilization SHOs established a system to monitor government and non-government health facilities The facilities were monitored regularly; utilization of the facilities ensured; linkage with Government of Bangladesh authorities and committees established
 Health camps Health camps were regularly organized by SHOs/Village Health Post committees for treatment Ear Nose and Throat, Circumcisions and other special camps were organized regularly
 Traditional Birth Attendants’ (TBAs) Training Training for TBAs were organized by the SHOs and supervision provided in the form of refresher training and advice from project physicians More than 50 TBAs trained by a hospital near Dhaka, the capital of Bangladesh. Fee and travel costs were provided by the project.
 Bed net program [25] With government help the bed net program was initiated Malaria incident decreased; program run by national NGOs based on SHO experience
 Training village doctors Committees felt the need to train village doctors. SHOs arranged financial assistance to train village doctors from Upazila Health Complex Village doctors were actively giving services; regular training uptakes by ICDDR,B as part of other program.
 Training of women as skilled birth attendant (SBA) [26] Community demand skilled personnel for assisting deliveries 14 were trained as community midwives; they are still giving services the community
 AIDS Awareness Campaign [27] SHO volunteers carried out the campaign Increase of knowledge reported and disseminated as per ICDDR,B records
2004–2015
 Running the village health posts in the absence external financial support SHOs kept the village health posts established earlier running by allowing the community midwives and trained village doctors to provide services from them. Village health posts continued to be the place of lowest primary healthcare for the villagers.
 Promoting and supporting the community midwives trained during the earlier phase Community midwives got a room at the village health posts to render their services regularly Pregnant women are getting benefits from the midwife services
 Promoting and supporting the trained village doctors [28] Trained village doctors were involved in services of village health posts Trained village doctors promoting telemedicine services
 Supporting and promoting a voluntary micro-health insurance programme Micro-health insurance services were running from the village health posts and the committees is in steering role People enrolling into the scheme