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Shahidul Hoque
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Background
Chakaria Community Health Project is being implemented in Chakaria, a south eastern sub-district of Cox‟s Bazar in Bangladesh since 1994. It is operationalised in partnership with the village based self-help organisations (SHOs) using participatory planning and implementation strategies for active engagement with the community in monitoring health related functions. The SHOs regularly meet and discuss the issues related to health service delivery and seek redressal from the public sector authorities. The organisation ICDDR,B initiated community empowerment and monitoring of the services through local health watches in 2007 |
Phase 1: Rapport building and community discussion
At the initial stage of the process, union parishad members and other local leaders in the community in each of the intervention unions were contacted. (Note: union councils - union parishads or just unions - are the smallest rural administrative and local government units in Bangladesh. Each union is made up of nine wards. Usually one village is designated as a ward). Discussion meetings were held to generate and increase knowledge of community members regarding their health status, health needs and rights, health systems and to build bridges and facilitate better communication between the different stakeholders in the community. The process involved discussions on situation analysis of health in the community, to explore solutions to existing health issues and to formulate an action plan to improve the health services. The concept and the process of monitoring health services was part of these discussions too. Lists of likely candidates for participation in the community monitoring process, indicators for monitoring the use of facilities and quality of services were discussed by the community members. |
b) Knowledge translation and developing monitoring plan
Information was collected through exit interviews outside each Urban Health and Family Welfare Centre (UH&FWC) in the intervention unions and outside the Upazilla Health Complex. Data collected included demographic and socio-economic statuses of the clients of the facilities. Data was also collected on the regularity of the health staff, the duration of the availability of services in a day. The training sessions provided training to the community monitoring team members and PRC members on different aspects of the monitoring process, particularly on the purpose of the monitoring, method of conducting interviews, formulation of the questionnaire, the importance of maintaining accuracy in the data collection process, and strategies to conduct community surveys using a simplified Lot Quality Assurance Sampling (LQAS) technique. The components of a health system were also discussed. In each union, a schedule for monitoring the facilities by the monitoring teams and a date for compilation and analysis of data was also set. |
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