Second Urban Primary Health Care Project

Local Government Division, Ministry of LGRD & Cooperatives

Government of the Peoples' Republic of Bangladesh

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Second Urban Primary Health Care Project (UPHCP-II)



Introduction


About 36.7 million people representing almost 26 percent of the population of Bangladesh live in urban areas, a large proportion of whom are slum dwellers. The health knowledge of the urban slum dwellers and their access to essential basic health services are low. Children living in urban slums are deprived of education and health care, and vulnerable to violence, abuse and exploitation. On the other hand, high rate of mortality and morbidity exists among slum dwelling women who remain neglected in terms of meeting their basic health needs and ensuring their rights.

The Government of Bangladesh is committed to put in place strategies to address the issues of improving the health status of the urban population. This is to be done through improved access to and utilization of efficient, effective and sustainable Primary Health Care Services. The provision of public health services in urban areas is the responsibility of Local Government Bodies as mandated by the Local Government (City Corporation) Ordinance 2008 and the Local Govt (Pourashava) Ordinance 2008.

For primary health care services delivery, the public sector works in partnership with NGOs and the local government institutions such as the City Corporations and Pouroshovas. The health service delivery mechanism in urban areas involves diverse roles of the government (MOLGRD&C and MOH&FW), NGOs and the private sector.

Urban Primary Health Care Project, a Public-Private Partnership is an innovative initiative with the goal to improve the health status of the urban population, specially the poor, particularly focusing on women and children. These population segments are usually underserved by the health care facilities due to many reasons. UPHCP is committed to provide all essential health and reproductive health services to them for improvement of their livelihood. With the aim at contributing to achieve the national goals and targets of the Millennium Development Goals (MDGs), the First Urban Primary Health Care Project (UPHCP) and Second Urban Primary Health Care Project (UPHCP-II) were initiated in 1998 and 2005 respectively which are milestones in urban health care services.

UPHCP-II commenced on 1st July 2005 following the closer of first phase. The current project covers all the 6 City Corporations of Bangladesh and 5 Municipalities (Bogra, Comilla, Madhabdi, Savar and Sirajgonj). At least 30% of service provided under the project are targeted to the poor and are provided for free to them. UPHCP-II is a pioneering new health service delivery model whereby the services provided are contracted to deliver an agreed “Essential Services Package +” (ESP+) through partnership agreements (PA) with a focus on access to the poor. UPHCP-II is executed through the Ministry of Local Government and Rural Development and Cooperatives (MoLGRDC), managed by a Project Management Unit (PMU) in the Local Govt. Division of MoLGRDC. Project Implementation Units (PIU) are established in the six City Corporations and the five selected Municipalities. The services are through Comprehensive Reproductive Health Care Centres (CRHCCs), Primary Health Care Centres (PHCCs) and PHC Outreach Centres (Satellite clinics) in 24 Partnership Areas. The Centres are managed and run by 12 partner NGOs. However, in two partnership areas in Chittagong, the centers are managed by the Health Department of Chittagong City Corporation.



Goal
To improve the health status of the urban population, especially the poor, through improved access to and utilization of efficient, effective and sustainable Primary Health Care (PHC) Services.



Objectives

To improve
1.) Access to and use of urban PHC services in the project area, with a particular focus on services provision for free to the poor;
2.) The quality of urban PHC services in the project area; and
3.) The cost-effectiveness, efficiency, and institutional and financial sustainability for the urban primary health care delivery system to meet the needs of the urban poor.

Funding: (in million US$)

Loan:
         ADB                                                      30.0
Grant:
         GOB                                                     18.0
         ADB                                                      10.0
         DFID                                                     25.0
         SIDA                                                       5.0
         UNFPA                                                   2.0
         ORBIS International                               1.0

        Total Fund: $91.0 Million


Project Components


1. Provision of Primary Health Care (PHC) through Partnership Agreements and Behavior Change Communication and Marketing (BCCM);
2. Urban Primary Health Care Infrastructure and Environmental Health;
3. Building Capacity and Policy Support for Urban Primary Health Care;
4. Project Implementation and Operationally Relevant Research.

Organizational Structure


Executing Agency
Local Government Division, MoLGRD&C.

Coordination and Management
Project Management Unit (PMU)
5 Phoenix Road, 6th Floor, Nagar Bhaban, Fulbaria, Dhaka-1000
Phone: 9550917, 9569124, 9566222, Fax: (880-2) 9569124
E-mail:info@uphcp.org; Website: www.uphcp.org

Implementing Units
Project Implementation Unit (PIU) at Health Departments of six City Corporations and five Municipalities

Project Area
City Corporations of Dhaka, Chittagong, Khulna, Rajshahi, Barisal & Sylhet, Municipalities of Bogra, Comilla, Sirajgonj, Madhobdi & Savar

Partnership Area:
Total 24 partnership areas.


In City Corporations

Barisal                         01

Chittagong                      03

Dhaka                         10

Khulna                            02

Rajshahi                      02

Sylhet                              01

In Municipalities

Bagra                          01

Comilla                           01

Madhobdi                    01

Savar                              01

Sirajgonj                      01

 


Service Providers:
12 NGOs in 22 Partnership Area and Chittagong City Corporation in 2 Partnership Areas.

Service Delivery Centers:


City Corporation/ Municipality

Comprehensive Reproductive Health Care Centre (CRHCC)

Primary Health Care Centre (PHCC)

Dhaka City Corporation

10

63

Chittagong City Corporation

03

43

Rajshahi City Corporation

02

12

Khulna City Corporation

02

15

Sylhet City Corporation

01

7

Barisal City Corporation

01

3

Bagra Municipality                      

01

5

Comilla Municipality

01

3

Madhobdi Municipality

01

3

Savar Municipality                       

01

4

Sirajgonj Municipality

01

3

Total
24
161


Services
• Reproductive Health Care
• Child Health Care
• Communicable Disease Control
• Limited Curative Care
• Management and Prevention/Control of RTIs/STIs
•VCCT for HIV/AIDS
• Management of Violence against Women
• Primary Eye Care
• TB Control & Treatment
• Behavior Change Communication
• Diagnostic Service

Population Covered
9.41 Million

Consulting Firms

• BCCP for Behavior Change Communication & Marketing (BCCM)
• DDC for Design & Supervisory Engineering Services of Construction (DSESC)
• HLSP Ltd. and Associates for Project Performance Monitoring & Evaluation (PPME) Support
• ORG and Associates for Management & Training Support (MS&T)