Research

Scaling with Cause

Improving Regional Efficacy of Community Clinics in Bangladesh

2024-25 Policy Brief

Illustration of a rural community in Bangladesh with a river, houses, trees, and people engaging in various activities, with a community clinic sign visible.

Our Impact

  • To be Determined

  • October 2023 - February 2025

  • SDG 3: Health & Wellbeing

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A man in a gray blazer presenting a case study on the Barishal Division to an audience in a conference room. The presentation slide shows a map of the division with statistics and observations.
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A group of people attending a presentation in a conference room, seated at tables, listening to a speaker at the front with a large screen displaying a slide titled "Problem" about healthcare facilities in Bangladesh.

Highlights

  • Two individuals, a woman in maroon scrubs and a man in a suit with glasses, standing in front of a research poster presentation at a conference or academic event. The poster discusses community health care in Bangladesh.

    Stanford University, California

    Poster Presentation at 22nd Community Health Symposium, Stanford University

  • Two men engaged in a conversation indoors, with one man wearing a pink shirt and the other man holding papers, wearing a maroon shirt with small white dots.

    Patuakhali, Bangladesh

    Primary Research Survey Administration in Patuakhali, Barishal Division

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    Toronto, Canada

    Expert Interview with University Professor in Toronto, Canada

  • Three men in business attire standing in front of a blue World Bank Group backdrop with slogan, 'A world free of poverty on a livable planet.'

    World Bank, Washington DC

    World Bank Group Panel on Expanding Health Services to 1.5 Billion People Worldwide

  • Poster for the International Annual Forum on Global Health scheduled for April 19, 2024, featuring speakers, moderators, and organizers.

    Online

    Presentation of Early Insights at Global Health Panel

  • Group of young adults and children posing indoors in front of a red banner celebrating International Youth Day, with books and plants on shelves on either side.

    Gazipur, Bangladesh

    Policy Brief Program Engagement

Executive Summary

Our 2024-25 Policy Brief assesses Bangladesh’s Community Clinic Program focusing on its alignment with international standards and the challenges it faces in regional implementation.

Community Clinics in Bangladesh

Bangladesh’s PHC framework emphasizes three pillars: care at the community level, addressing socio-economic and environmental determinants of health, and empowering health decision-making. Despite its decentralized structure, featuring over 10,000 community clinics, many face challenges like inconsistent staffing, resource shortages, and limited emergency care, particularly in rural areas.

Regional Efficacy: The Case for Barishal

With 9.1 million residents, Barishal faces unique challenges due to climate vulnerability, including coastal erosion and frequent natural disasters. These environmental issues strain the healthcare system, leading to higher maternal and infant mortality rates. Clinics in the region suffer from staffing gaps, limited maternal healthcare, and challenges in data management and resource allocation.

Global Best Practices

Models from Brazil, Rwanda, and India demonstrate how integrating digital tools, community outreach, and mobile health services can improve access to care.

Recommendations

We offer four multi-faceted recommendations to improve the regional efficacy of community clinics.

  1. Eradicate Corruption: Implement real-time data reporting, audits, and merit-based hiring. Form a national health commission, restructure oversight boards, and enforce conflict-of-interest rules.

  2. Improve Training Programs: Conduct skill gap assessments (e.g., emergency care), provide hands-on instruction (including paramedics), and introduce region-specific mentorship with sufficient budgets for ongoing evaluation.

  3. Modernize Community Clinic Program: Partner with NGOs to fill capacity gaps, strengthen referral systems, co-design services with communities, adopt digital inventory tracking, expand the Essential Service Package, and leverage private-sector support.

  4. Promote Independent Research: Investigate clinical quality, health-seeking behaviors, and equity. Compare medicine distribution models, publish findings, and involve diverse stakeholders for data-driven improvements.

Through cross-sectoral action, Bangladesh can improve the efficacy of 10,000+ community clinics.

Supervisors

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Ruby Guillen, MSW, CIS

Ayesha Sania, PhD

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Joann Halpern, PhD

Authors

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Aftab Ahmed, MPP

Aaraf Ahmed, MPH

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Nicole Sandberg, MPH

Henna Hundal, MPP

Tahmid Khan, MPH

Anil Wasif, MPP

Acknowledgements

  • His Excellency Muhammad Abdul Muhith, Permanent Representative of the People’s Republic of Bangladesh to the United Nations

  • Fahmid Farhan, Permanent Mission of the People’s Republic of Bangladesh to the United Nations

  • Syed M. Ali Mustafa, International Youth Conference

  • Dr. Israt Jahan, Dhaka University

  • Dr. Muhammad Sibgat Islam, Manpura Upazila Health Complex

  • Dr. Lima Rahman, Save the Children Bangladesh

  • Yusuf Munna, Reflective Teens Trust

  • Areeba Asif, University of British Columbia

  • Farhim Zaman, BacharLorai

  • Azkka Noor, BacharLorai

  • Apanuba Puhama, BacharLorai

  • Talha Khan, BacharLorai

Research Managers

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    Aftab Ahmed

    Director, Policy Research

  • A man with short dark hair, glasses, and a beard, smiling, wearing a cream-colored shirt and a dark green cable-knit vest, standing against a warm orange background.

    Anil Wasif

    Director, Strategy