Verbesserung der Gesundheit von Müttern, Neugeborenen und Kindern, Bangladesch
EdM has been cooperating with BRAC since 2019 as part of the Health, Nutrition and Population Program (HNPP)!. In the years 2019-2020, several interventions in two sub-districts in Brahmanbaria district (Kasba and Sarail) aimed to improve the quality of health services: action groups from the population at the village level were trained to provide the Ministry of Health with information on the quality of care for pregnant women and to deliver their newborns. In addition, BRAC trained primary health care providers in health promotion issues, including improving the quality of health education and counseling practices for pregnant women and their families. A health promotion e-learning module for executives in the Ministry of Health has been developed and implemented to improve the quality of the public health system. These interventions were based on the strategic approach? of the World Health Organization (WHO) «Individuals, Families and Communities» (IFC).
The project played an important role in improving the perception of the community clinics by the population: most of the women did not know what services are offered in the clinics. In particular, the educational sessions were useful in promoting health care utilization in community hospitals, and a significant increase in the number of women preparing for childbirth and obstetric and neonatal emergencies was observed. In addition, the population seems to be more committed to the health of mothers and newborns by taking measures to make it easier for pregnant women to access health centers (means of transport, etc.).
Based on the encouraging results of the last phase, the 2021-2024 program is designed as a direct contribution to BRAC's HNPP. The latter contributes directly to the implementation of the National Maternal Health Strategy 2019-2030, which contains the following points: continuum of care, strengthening the health system, improving the quality of care, involving the population and cross-sectoral measures. They are also linked to the Department of Health's operational plan for maternal, newborn, child and adolescent health, including the first component on maternal health and the third component on the national newborn health program and integrated management of childhood diseases.
In addition, the National Maternal Health Action Plan 2020-2030 identifies strategies in the following areas: i) Service delivery within the continuum of maternal health care; ii) strengthening the health system to reduce inequalities; iii) Improving the quality of care and community involvement. This last strategy aims to increase the demand for care by increasing community knowledge of maternal and neonatal health rights. It is also about overcoming barriers such as poor knowledge of health risks and lack of information about available services.
The interventions of this program therefore provide for the following components:
Health education on maternal and neonatal rights and early childhood development.
According to the WHO, obstetric and emergency care measures are recommended in order to increase the use of qualified care during childbirth and obstetric and complications in infants. WHO also recommends educating women about their rights to health and access to quality, qualified health care and continuing to empower women to use these services. Based on these recommendations, pregnant women, adolescents and young mothers are informed about: maternal and newborn health issues, preparation for childbirth and complications, as well as their rights and how they can exercise them. BRAC's primary health professionals conduct health education and home visits for this purpose.
Men are also made aware of issues and rights in the area of maternal and newborn health. In addition, men and women jointly discuss how the implementation of the rights to maternal and child health can be ensured. The program will work with existing community groups that support the Department of Health's community clinics to facilitate interactions between men and women.
Enhancing the knowledge of health workers in the Department of Health and BRAC on respectful care and early childhood development
To improve the knowledge of the Department of Health's health care providers, BRAC will assist the Department in its efforts to train health workers from community clinics and family planning centers in respectful health care for mothers and children. All of the content of this e-learning course will be consistent with the WHO definition of respectful obstetrics: health care that is organized and provided to all women in a way that preserves their dignity, privacy and confidentiality, protects them from harm and abuse and enables them to make informed decisions and receive ongoing support during labor and delivery. The e-learning platform will include a user interface in Bangla. The training is expected to be approved by the Ministry of Health in 2022 and to ensure integration of the training on the Ministry's website. This would allow it to be used by all health professionals in the ministry as well as BRAC's primary health care providers.