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. 2025 May 5:15:04132.
doi: 10.7189/jogh.15.04132.

Improving the provision for gynaecological health care in Bangladesh using Essential Gynaecological Skills implementation package: a stakeholder-driven approach in public health facilities

Sabrina Jabeen  1 , Mehedi Hasan  1 , Santanu Acharya  2 , Md Mahiur Rahman  1 , Elizabeth Rafii-Tabar  2 , Sarah Hall  2 , Farhana Dewan  3 , Azizul Alim  4 , Sayeba Akhter  3 , Shahin Rahman Chowdhury  3 , Mustufa Mahmud  4 , Md Jahangir Alam Prodhan  5 , Salma Rouf  3 , Sameena Chowdhury  3 , S K Zinnat Ara Nasreen  3 , Fawzia Hossain  3 , Ferdousi Begum  3 , Rubaiya Matin Chandrima  1 , Md Akib Al-Zubayer  1 , Golam Sarwar  1 , Mahbuba Khan  6 , Farida Akhter  7 , Sayed Rubayet  8 , Anisuddin Ahmed  1 , Hassan Shehata  2 , Shams El Arifeen  1 , Ranee Thakar  2 , Ahmed Ehsanur Rahman  1
Affiliations

Improving the provision for gynaecological health care in Bangladesh using Essential Gynaecological Skills implementation package: a stakeholder-driven approach in public health facilities

Sabrina Jabeen et al. J Glob Health. .

Abstract

Background: Gynaecological health and its related service delivery have long been neglected in Bangladesh. In response to the high burden and improvements in the provision of gynaecological health care, the Essential Gynaecological Skills (EGS) implementation package was developed. It includes comprehensive in-service training for upskilling the non-specialised health care providers and introduces the first structured data recording system for gynaecology in the outdoor of public health facilities in Bangladesh. We outline how the stakeholder engagement process was integrated into the implementation research related to this pioneering initiative.

Methods: Based on literature review, expert consultation and prior experience, we adopted the identification, sensitisation, involvement, and engagement (ISIE) framework of stakeholder engagement and process documentation. After identifying national and local level stakeholders via a power-interest mapping exercise, we sensitised them to the gaps in gynaecological health service delivery. High-power and high-interest stakeholders were involved and engaged in developing the EGS implementation package, which was then introduced in selected public health facilities and evaluated through implementation research.

Results: Acknowledging the urgent need for gynaecological health care services, the identified and sensitised stakeholders supported the development of the EGS implementation package. This resulted in the development and implementation of the EGS implementation package under the Government of Bangladesh's leadership, highlighting government ownership. These outcomes reflected the potential for scalability and sustainability of the package. However, stakeholder engagement remains a time and resource-intensive process that requires an innovative, research-backed approach with committed implementation.

Conclusions: Our experience of using the ISIE framework showcased the potential of this framework in achieving sustainability and scalability at the national level. However, further initiatives from the government can ensure nationwide scale-up, setting an example for other lower and middle-income countries.

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

Figures

Figure 1
Figure 1
Conceptual framework adapted to guide the stakeholder engagement process to integrate EGS implementation package in routine gynaecological health care services in Bangladesh.
Figure 2
Figure 2
Power-interest mapping of national and district-level stakeholder organisations related to the EGS implementation package development and implementation in Bangladesh.
Figure 3
Figure 3
Documents developed for the EGS implementation package for improving the gynaecological services in the outdoors of public health facilities.
See this image and copyright information in PMC

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References

    1. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. 2022. Available: https://vizhub.healthdata.org/gbd-results/. Accessed: 13 December 2024.
    1. Robinson N, Stoffel C, Haider S.Global women’s health is more than maternal health: a review of gynecology care needs in low-resource settings. Obstet Gynecol Surv. 2015;70:211–22. 10.1097/OGX.0000000000000166 - DOI - PubMed
    1. Wijeratne D, Fiander A.Gynaecological disease in the developing world: a silent pandemic. The Obstetrician & Gynaecologist. 2018;20:237–44. 10.1111/tog.12515 - DOI
    1. Wijeratne D, Gibson JF, Fiander A, Rafii-Tabar E, Thakar R.The global burden of disease due to benign gynecological conditions: A call to action. Int J Gynaecol Obstet. 2024;164:1151–9. 10.1002/ijgo.15211 - DOI - PubMed
    1. Ministry of Health and Family Welfare Bangladesh. 3rd Health, Population and Nutrition Sector Development Program. Dhaka, Bangladesh: Ministry of Health and Family Welfare; 2011. Available: https://old.dghs.gov.bd/images/docs/OP/OP%20MNCAH%202011-2016%20MASTER.pdf. Accessed: 12 December 2024.