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Independent Evaluation of Community Based Health Services in Bangladesh

Field of Expertise:
Health Service Delivery; PHC/MNCH/RH/Nutrition/W&S; Basic Health Services / Primary health care
Narrative description of project:
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)
Description of services provided:
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