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Welcome to Community Based Health Care

Community Clinic (CC) is the innovation of Hon’ble Prime Minister Sheikh Hasina to extend
Primary Health Care to the doorsteps of rural people all over rural Bangladesh. Thousands of
people are getting services from the CCs & it has become an integral part of health system. It is a
unique example of Public-Private partnership as all the CCs have been constructed on
community donated land while construction, medicine, service providers, logistics & all other
inputs are from Govt. but management is both by community and Govt. through Community
Group (CG). Community owns CC & plays active role for its improvement in all regards. People
are satisfied with the services of CC as it is the one stop service outlet in respect of Health,
Family Planning & Nutrition.

It is the flagship program of present Govt. At present 13136 CCs are on board as June 2016 and
number is gradually increasing. In many cases Medical Officers & SACMOs are visiting CCs
periodically and providing services to the complicated cases. All the CCs have been provided
with Laptop & internet connection and have been reporting on line. E-health from CC to UHC
has been introduced in some places. We hope that in near future E-heath will be scaled up all
over the country. We believe that CC will be able to contribute substantially in achieving SDGs
like MDGs & health for everybody will be ensured.

At present 13136 CCs are on board & the number is increasing gradually. From 2009 – 2015,
460.88 million visits were made to CCs for services of which 9.071 million emergency &
complicated cases were referred to higher facilities for proper management. Among the service
seekers about 80% are women and children. On average 9.5-10 million visits are in CCs per
month & 38 visits per day per CC.
CC is the lowest tier health facility for quality PHC. It is one stop service outlet for Health,
Family Planning & nutrition. It is a preventive biased centre that provides mainly health
education & health promotional services. All the CCs are outreach sites for routine Immunization
& NID. It addition it provides limited curative care (treatment of minor ailments), screening of
NCD-Hypertension, Diabetes, identifying emergency & complicated cases with referral to higher
facilities. In a substantial number of CCs, normal delivery is being conducted subjected to the
availability of skilled manpower (CSBA), proactive CG, committed local health management &
where from patients can be referred within a short time or necessary support can be provided
from UHC.

 Status of important services of CC from 2009-March, 2016:

Sl # Service # of Visit/ # of Remarks

1 PHC (Health, FP & 483.20 million visits On average 39
Nutrition) visits/CC/day
2 Referred from CC 11 million emergency Most of the cases have been
& complicated referred to UHC
3 Normal Delivery (ND) 28160 Normal Delivery is going
on in 1008 CC & is
4 Supply of Medicine Medicine worth Tk. Medicine supplied by
8270.50 million EDCL & CMSD!/vizhome/CommunityClinic/CC

 Construction
 Initial target for construction of CC under RCHCIB was 2876 but there after 361 for very
hard reaching, hill, remote & isolated areas has been added to it, resulting the target 3237. At
the same time land required for construction of CC has also been increased to 8 decimals
instead of 5 decimals. Within the project period 2719 CCs have been constructed, 33 are
ongoing & 485 will remain beyond construction.
 Out of these 485 CCs, 300 CCs will be constructed out of JICA support, 10 through TIKA
support,80 through PPD & rest will be constructed under 4th sector program.

Community Clinic HRIS Database (from DGHS) >>---Hyperlink

 Repair
As the CCs were left unused for more than 7 years, repair was urgently needed prior to
making those functional in 2009. This was done by HED with block allocated fund of
MOHFW. But in most of the cases the repair was not at all up to the standard. There after
1080 CCs have been repaired under RCHCIB in phases.
 Electric line installation & Connection
There was no provision for electric supply in the CCs constructed during 1998-2001. The
CCs constructed under RCHCIB have the provision for electric line installation.

 Installation of Solar panel for electricity

In a substantial number of CCs, solar panel has been installed with the support of some
organizations/institutes under different programs e.g. Disaster management, Upazila
parishad, Hon’ble MPs, individuals. Specific information in respect of CCs’ number &
donors is being collected.

Community Mobilization (CM)

 Community Group (CG)
CG (management body of CC) has been formed for all the functional CCs with some major
changes. CG members’ number has been increased from 9-11 to 13-17 with at least one third
women members and adolescent girl/boy. The group is headed by elected UP member of that
locality instead of land donor/his or her representative. Land donor/his or her representative
is life member & senior vice president of CG. Out of president & vice presidents at least one
is female. CHCP is the member secretary in place HA/FWA.

 Community Support Group (CSG)

It is new & an addition for better community engagement under RCHCIB as there was no
such provision with CC during 1998-2001. In the catchment area of each CC, there will be 3
CSGs comprising of 13-17 members with at least one third women members. For all
functional CCs, CSGs have been formed. The CSGs help CG in CC management along with
making community aware regarding the services available at CC and common health

 Community Health Care Provider (CHCP)

Training manual for CHCPs’ basic training of 12 weeks (6 weeks theoretical + 6 weeks
hands on) & trainer’s guide have been developed though a series of meetings, workshops
with the participation of GO-NGO experts and specialists of UN Agencies. It was finalized
through a national workshop with participation of MOHFW, DGHS, DGFP, UN Agencies,
field managers & other stakeholders.

The training was cascade in type. First master trainers have been developed – there after they
conducted TOT for District & Upazila managers and then the TOT holders conducted the
basic training for the CHCPs.
10353 CHCPs have been provided Basic Training, 13114 CHCPs have provided refresher

 Community Group (CG)

Training manual for CG members & trainer’s guide have been developed though a series of
meetings, workshops with the contribution of GO-NGO experts and specialists of UN
Agencies. It was finalized in a national workshop with the participation of MOHFW, DGHS,
DGFP, UN Agencies, field managers & other stakeholders.
170799 CG members have been provided training.

 Community Support Group (CSG)

Training manual for CSG members & trainer’s guide have been developed though a series of
meetings, workshops with the participation of GO-NGO program experts. It was finalized in
a national workshop with the participation of MOHFW, DGHS, DGFP, UN Agencies &
other stakeholders.
560388 CSG members have been provided orientation.

 Statisticians’ training

All the statisticians of different levels (Division, District & Upazila) have been trained on the
reporting formats & on line reporting.
552 statisticians have been provided training on Community Clinic MIS (Management
Information System)
1st line supervisor
For the training of 1st line supervisors of both Health & Family planning, draft manual has
been developed through a series of meetings and workshop with the participation of GO-
NGO stakeholders. It has been piloted. With the findings of the pilot the draft has been
further tuned & will be finalized through a national workshop. The training will be organized
in 2016-2017.
 Local Govt. Representative
19154 Local Govt. Representatives have been provided training.

 Overseas Training
Overseas training for experience sharing & learning on PHC, has been organized for the
relevant & good performing managers of different levels (majority from the field). This was
an incentive so that others might be inspired for sincere efforts & better performance through
a healthy competition. Overseas training has been offered to 10 managers.
205 Officials of different levels have been offered overseas training.

 CSBA training for female CHCPs: 1517 female CHCPs have been trained as CSBA