Research

Scaling with Cause

Improving Regional Efficacy of Community Clinics in Bangladesh

2024-25 Policy Brief

Illustration of a rural community scene in Bangladesh featuring a river, boats, houses, a community clinic, and people engaged in daily activities with smog stacks in the background.

Our Impact

  • To be Determined

  • October 2023 - February 2025

  • SDG 3: Health & Wellbeing

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A man giving a presentation on a case study about the Barishal Division to an audience in a conference room. The slide behind him shows a map of the Barishal region with districts and key statistics.
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Highlights

  • Two individuals standing in front of a scientific poster at a conference, smiling for the photo. The poster discusses community health care in Bangladesh and is titled 'Community Health Care in Barishal: Bangladesh's Case for Universal Health Care.' The setting appears to be a conference or academic event.

    Stanford University, California

    Poster Presentation at 22nd Community Health Symposium, Stanford University

  • Two men standing indoors, one in a pink shirt listening and the other in a maroon shirt reading from a paper.

    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 suits standing in front of a blue backdrop with the World Bank Group logo and 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

  • Flyer for the International Annual Forum on Global Health scheduled for April 19, 2024, with various speakers, moderators, and panelists from different countries, discussing achieving global health for global peace.

    Online

    Presentation of Early Insights at Global Health Panel

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    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

  • Smiling man wearing glasses, white dress shirt, green knitted vest, against a warm brown background.

    Anil Wasif

    Director, Strategy