Health Service Delivery; PHC/MNCH/RH/Nutrition/W&S; Basic Health Services / Primary health care
The objective of the evaluation was ‘to ascertain how the community-based health service initiative is contributing towards achieving the program objectives, effective delivery of primary health care services in Bangladesh; by identifying its strengths and challenges with a view of contributing to the successful implementation of the Essential Health Package. The specific issues addressed in the evaluation included:
- Documenting the history, structure, governance and policy context of the Community Based Health Service Programme with regards to the relevance of its policy goals
- Assessing the efficiency of services provided at community clinics and ascertaining how economically inputs (funds, times, etc.) have been converted into outputs
- Assessing how effective the Community-Based Service Programme was in terms of achieving the objectives formulated for the program and producing the expected effects
- Exploring the extent and nature of community engagement in the planning and operations of the community-based programme
- Documenting best practices and recommend improvements based on the findings with particular focus on better alignment with the Essential Service Package (ESP)
The evaluation was primarily based on review and analysis of secondary data (review of relevant programme documentation, past evaluations, analysis of gray literature, web search, analysis of HMIS and DHIS 2 data, Bangladesh Health Facility Survey data). It also included collection and analysis of primary data including key informant interviews (KII) at national level. Additionally, primary data was gathered in 7 upazila health complex and 16 community clinics including:
- KII with the UHC manager responsible for CCs
- KII with the referral facility (the UHC or UHFWC i/c)
- An interview with CC staff (CHCP, HA and FWA)
- Focus group discussions (FGD) with the Community Group (CG) and Community Support Group (CSG) members
- Client exit interviews of patient satisfaction
- Health facility assessment
