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 Services Delivery 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. UPHCSDP 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 Services Delivery Project (UPHCSDP) and Second Urban Primary Health Care Services Delivery Project (UPHCSDP) were initiated in 1998 and 2005 respectively which are milestones in urban health care services.
UPHCSDP 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. UPHCSDP 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. UPHCSDP 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.
Urban Primary Health Care Services Delivery Project.
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