Reaching the 'Last Mile' in Bangladesh's Urban Slums
By Zoe So - Program Manager, BRAC USA
BRAC's Manoshi project uses innovative and sustainable methods to provide maternal healthcare services, linking urban slum residents with skilled birth attendants who bring the services to the local level, working in clean and private birthing huts that dot the landscape of sprawling urban slums. This is a unique and important feature of this initiative as slum dwellers usually live in small shacks with large numbers of family members. Even more importantly, the centers provide rapid diagnosis and referrals in case of birth-related emergencies, and patients are provided quick transportation to health care facilities better equipped for complicated deliveries. Each delivery center has two birth attendants who serve about 2,000 households (about 10,000 people). Community midwives are also readily available to provide skilled service during delivery. Currently, the project is providing the maternal and child health services to around 6.1 million inhabitants of seven city corporations in Bangladesh.
Manoshi also works to enhance the knowledge of BRAC's community health workers and birth attendants, working to ensure quality health services for pregnant and lactating women, infants and children in all age groups; timely referral to quality health facilities; and strengthening and sustaining a linkage with the community, national and local government and NGOs. Over the last five years, Manoshi has developed a wide range of health cadres - slum health volunteers, health workers who visit households, urban birth attendants, community midwives, and referral advocates (program organizers) located in hospitals. The initiative has rapidly increased the access to clean delivery at birthing centers and emergency obstetric care at hospitals/clinics (from 16% at baseline to 81% after few years of intervention) and significantly contributed to reducing maternal and neonatal deaths in urban slums in Dhaka.
BRAC's Manoshi project continues to be a driving force in the organization's mission to ensure access to quality health care all the way through the "last mile".
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