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. 2023 Jan 27;20(3):2271.
doi: 10.3390/ijerph20032271.

Taking a Pulse on Community Participation in Maternal Health through Community Clinics in Bangladesh

Goutom Banik  1 , Tapas Mazumder  2 , Abu Bakkar Siddique  3 , A F M Azim Uddin  3 , Shams El Arifeen  3 , Janet Perkins  4 , Ahmed Ehsanur Rahman  3
Affiliations

Taking a Pulse on Community Participation in Maternal Health through Community Clinics in Bangladesh

Goutom Banik et al. Int J Environ Res Public Health. .

Abstract

Bangladesh started institutionalising community participation by setting-up community clinics (CCs) during the mid-90 s. This paper presents the genealogy of CCs, the community participation mechanism embedded within CCs, and the case of 54 CCs in Brahmanbaria, through the lens of maternal health. We undertook a desk review to understand the journey of CCs. In 2018, we assessed the accessibility, readiness and functionality of CCs, and a household survey to know recently delivered women's perceptions of CC's community groups (CGs) and community support groups (CSGs). We performed multiple logistic regression to determine the association between the functionality of these groups and women's perception regarding these groups' activities on maternal health. The integration of community participation involving CCs started to roll out through the operationalisation of the Health and Population Sector Programme 1998-2003. In 2019, 13,907 CCs were operational. However, per our CC assessment, their accessibility and readiness were moderate but there were gaps in the functionality of the CCs. The perception of women regarding these groups' functionality was significantly better when the group members met regularly. The gaps in CCs are primarily induced by the shortcomings of its community participation model. Proper understanding is needed to address this problem which has many facets and layers, including political priorities, expectations, and provisions at a local level.

Keywords: community clinics; community group; community participation; community support group; functionality; maternal health.

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Conflict of interest statement

Enfants du Monde (EdM), a Swiss-based non-government organisation provided both technical and financial support to the study. As per the guidance of the Ministry of Health and Family Welfare, Bangladesh, the technical team of EdM was involved in developing the design of the household survey protocol.

Figures

Figure 1
Figure 1
Timeline of the CC journey in Bangladesh.
Figure 2
Figure 2
Accessibility status of CCs at Kasba (n = 33) and Sarail (n = 21). Data from 5/33 CCs were missing (staff absent in four CCs and one CC was destroyed).
Figure 3
Figure 3
Readiness status of CCs at Kasba (n = 33) and Sarail (n = 21).
Figure 4
Figure 4
Functionality of CGs and CSGs at Kasba (n = 33) and Sarail (n = 21).
See this image and copyright information in PMC

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