Strengthen partnership to Improve Nutritional Support Service in India, Cambodia and Bangladesh Project

The project has been implemented for the period of January to December 2022 to improve knowledge and skills of existing health team members on health and nutrition along with capacity building of participating organizations. Due to the global coronavirus pandemic, implemented activities virtually using project supported digital platforms. The project was funded by Norwegian Agency for Exchange Cooperation (Norec) and implemented by ASPADA Paribesh Unnayan Foundation as coordinating partner and Pahal Jan Sahyog Vikas Sansthan, India and Krousar Yoeung Association (KrY), Cambodia as partners.

Enhancing Resources and Increasing Capacities of Poor Households towards Elimination of their Poverty (ENRICH) Project

Enhancing Resources and Increasing Capacities of Poor Households towards Elimination of their Poverty (ENRICH) is a comprehensive household development project where health and nutrition are a major component. Under the ENRICH project, the organization is operating 5 PHCCs (Primary Healthcare Center) in the Hobirbari union of Bhaluka Upazila of Mymensingh districts that emphasize maternal and neonatal care including limited curative service. However, the project tried to improve health seeking behavior of poor community results and has been implementing health consciousness building activities. The project ensures primary health care service at door steps through its medically trained health visitors. Besides, ASPADA has been performing outreach activities to promote the good health of the pastoral community. The door-to-door health care service emphasizes on maternal, neonatal and geriatric care, health awareness building, personal and household level hygiene and sanitation promotion activities make the exemplary initiative of ASPADA. ASPADA has been implementing this project since 2014 with a 50% grant from PKSF and 50% is its own contribution.

Health Cooperative Project

The health cooperative project has been implementing as a sequence of the “Capacity Building of Organizations through Exchange of Primary Healthcare Approach” project the Bhaluka Upazila of Mymensingh district since 2016 with the financial support of FK Norway’s and technical support of SAHAJ Community Hospital, Nepal aims to enhance primary health care facilities for poor segment of population in the doorstep. The project exchanged the working approach of primary health care to boost up both organizational competencies. The ASPADA has adopted the “Cooperative based primary health care approach” which is practiced by SAHAJ community hospital Nepal, likewise, SAHAJ adopted the “door to door primary health care model” which is practiced by ASPADA. In 2019, the FK Norway funded project phased out and partnership also ended, although since then, ASPADA has been nursing the cooperative with its own fund which is now “Health Cooperative Project of ASPADA”.

Preventive Health Care

The organization believes “Prevention is better than Cure”, therefore arranges preventive health care service for the poor target community. Health seeking behavior of a society drives by the socio-economic condition and customs which is still poor in Bangladesh from which the poor population have been suffering. At the primary stage of any disease, very few people meet appropriate medical professionals but when it becomes complex then willing to meet a doctor when it requires specialized medical care. Therefore, aiming to improve health seeking behavior of the target community ASPADA implemented scores of preventive health care activities through donor funds and its own funds.

Curative Health Care

As a least developed country, Bangladesh has limited capacity to provide curative health care service to its mass population, as a result service is overall inadequate compared to population. On the other hand, Mymensingh division is a poverty prone area where we are implementing most of the project. Though the government extended curative health care service up to ward level through community clinics, although
the service is not generous as a result mass population have no set trust on their service. Similarly, behaviour and care of service providers to the poor is not satisfactory, as a result mass population are not willing to go to government facilities. Alternatively, curative health care service in the private facility is highly expensive, that can’t be affordable for the poor.

Safe motherhood promotion and advocacy

Though Bangladesh has significant achievement in maternal health outcomes, the rural part has been struggling with safe motherhood and institutional safe delivery. As a result, the organization keeps the issue in multiple health care projects. Its objectives are to improve clinical standards in maternal health. Local health service providers including midwives, village doctors were all involved in training and monitoring while messages about reproductive health were delivered at school and other public areas. Such has been the success of the project that is now replicated by other agencies and in other communities, while we are incorporating the monitoring tools into our other program.

Nutritional counselling

In Bangladesh today, malnutrition amongst mothers and children is still a major public health issue; we are helping to change this situation through our maternal and child nutrition program in the Mymensingh division. It focuses on the management of preventive and curative health services for inter-generational moderate malnutrition at 5 weekly community-based outpatient clinics. Children and lactating women identified as malnourished receive beneficial basic training on how to deal with the problem. Besides, paid and trained health volunteers provide nutritional advisory especially to women, children, and geriatric people. Furthermore, we promote agro production-based nutrition service especially kitchen gardens with local varieties which entails the nutritious food available every day without extra cost. Also, added nutritional counselling service in its core health programme.

Water and Sanitation

We are supporting water, sanitation, and hygiene activities in schools and communities to improve health by reducing water and sanitation risks. With over 95% of members now using sanitary latrines and most having arsenic-free tubewell, there has been a noticeable drop in diarrheal diseases. Besides, the projects promote WASH at the household level, school, and community settings through health volunteers.

Reproductive Health

The organization has been providing reproductive health services through static and satellite clinics of ENRICH project and health cooperative project with a network of health professionals, volunteers, and trained midwives. We are involved in various projects and studies in this field to ensure young children have the best possible start in life.

Under those primary healthcare projects, ASPADA has provided reproductive health care to the target community. The organization-initiated peer group discussion on menstrual hygiene, safe sexual intercourse, and their rights, and around 1000 adolescents have participated in the reproductive health events.

Geriatric Care

The elderly care project has been implemented with the support of PKSF aim to ensure good health (physical and mental) of the geriatric population living in the target area and increase social cohesion. 198 elderly peoples (age 60 years above) are currently being engaged directly with the project. The project activities comprise of group discussion on any stress or issues, regular health check-up in the satellite clinic, assistive aids distribution (stick, hearing aid, googles, high commode, etc.), facilitate recreational space, food, and nutritional advisory, planning for local development, arrange periodic events to cheer up them, elderly allowance distribution, awareness raining on the contemporary issue, and advocacy for their rights and entitlements, etc. The project has been nursing 9 groups at the ward level and one group at the union level and they sit together once a month. Besides, the project provides an elderly allowance to the 100 selected poor people Tk. 500 per month. Finally, in each area there are recreational facilities for elderly people where they can enjoy like club.