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