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. 2020 Nov 2;19(1):149.
doi: 10.1186/s12939-020-01266-5.

Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

S M A Hanifi  1 , Aazia Hossain  2 , Asiful Haidar Chowdhury  2   3 , Shahidul Hoque  2 , Mohammad Abdus Selim  2 , Shehrin Shaila Mahmood  2 , Abbas Bhuiya  4
Affiliations

Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

S M A Hanifi et al. Int J Equity Health. .

Abstract

Background: The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh.

Methods: This study was conducted from December 2017 to November 2018. Three intervention and three control CCs were selected from Chakaria, a rural sub-district of Bangladesh. CSC was introduced with the Community Groups and Community Support Groups in intervention CCs between January to October 2018. Data were collected through observation of CCs during operational hours, key informant interviews, focus group discussions, and from DHIS2. Utilisation of CC services was compared between intervention and control areas, pre and post CSC intervention.

Results: Post CSC intervention, community awareness about CC services, utilisation of clinic operational hours, and accountability of healthcare providers have increased in the intervention CCs. Utilisation of primary healthcare services including family planning services, antenatal care, postnatal care and basic health services have significantly improved in intervention CCs.

Conclusion: CSC is an effective tool to increase the service utilization provided by CCs by ensuring community awareness and participation, and service providers' accountability. Policy makers and concerned authorities may take necessary steps to integrate community scorecard in the health system by incorporating it in CCs.

Keywords: Community clinic; Community participation; Community scorecard; Service utilisation.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Intervention and control CCs and their population coverage (under Chakaria HDSS)
Fig. 2
Fig. 2
Data Sources
Fig. 3
Fig. 3
Operational hours utilised in intervention and control areas, pre and post CSC implementation. formula imagePre formula imagePost >
Fig. 4
Fig. 4
Service utilisation of intervention and control CC pre and post intervention. formula imagePre formula imagePost >
See this image and copyright information in PMC

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References

    1. Ministry of Health and Family Welfare (MOHFW) Health Bulletin 2015: Chakaria Upazila Health Complex. Management Information System (MIS), Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare (MOHFW) 2015.
    1. Directorate . General of health services, ministry of health and family welfare, government of the people’s republic of bangladesh. Dhaka: Operational plan community based health care; 2011.
    1. Ministry of Health and Family Welfare (MOHFW). Health Bulletin 2014. Management Information System (MIS), Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare (MOHFW); 2014.
    1. Directorate General of Health Services (DGHS). Ministry of Health and Family Welfare (MOHFW), Government of Bangladesh. Community Mobilization, Community Based Health Care (CBHC), Dhaka, Bangladesh.
    1. Ministry of Health and Family Welfare (MOHFW). Bangladesh National Strategy for Community Health Workers. Ministry of Health and Family Welfare (MOHFW), Government of the People's Republic of Bangladesh. Dhaka, Bangladesh. 2019.

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