Urban Primary Healthcare Service Delivery Project (UPHCSDP), Uttara
DAM has valuable experience in working with multiple donors for implementation of different projects focusing on health, nutrition, sanitation, gender equality, preventing HIV/AIDS, adolescent health, sexual and reproductive health rights etc. DAM also contributes in providing services through the tertiary level health facilities for the treatment of cancer, communicable/non-communicable diseases and other general health issues. Hence, DAM has gained the thorough insight about the scopes of the projects.
The project aims to improve the access, equity, quality, utilization and institutional sustainability of Urban Primary Healthcare (PHC) services in all the city corporations and selected municipalities, particularly for the poor and women & children.
The project focuses on the primary healthcare services for the urban poor, specially targeting the women & children, based on the national expanded Essential Service Delivery (ESD+) packages. It delivers the services through one Comprehensive Reproductive Healthcare Center (CRHCC), Six Primary Healthcare Centers (PHCC) and satellite services. The services are being provided from centers equipped with surgical amenities, diagnostic laboratories, wards and other clinical facilities.
Target beneficiaries of the project are the poor, underprivileged and highly vulnerable population. It delivers the healthcare services free of cost for at least 30% of the local people. DAM has conducted a household baseline survey under the partnership agreement with the Ministry of Local Government, Rural Development and Co-operatives (MoLGRD&C) to identify the poor households, based upon social and economic indicators. The list gets updated every year. However, the access to the PHCCs and CRHCC is open for everybody, from every level of the society.
Name of Donors
The project is funded by the Asian Development Bank (ADB), Swedish International Development Corporation Agency (SIDA) through the Local Government Division (LGD) of the MoLGRD&C.
Health Sector of Dhaka Ahsania Mission has been implementing the project in Uttara of Dhaka city through the Dhaka North City Corporation. It has started delivering its services from 31 December 2012.
Total of 133 staffs has been working on different aspects of the project. There are 14 physicians including full time Gynecology & Obstetrics specialist and pediatricians, four nurses, 21 paramedics, seven family welfare volunteers and seven laboratory technicians dedicated to provide services under the UPHCSDP – Uttara.
The project is delivering the following services:
- Maternal Healthcare: UPHCSD Project has been providing maternal healthcare services through static and satellite points. The project conducts antenatal checkups, safe deliveries, MRs, TT vaccination and post natal care.
- Neonatal & Child Healthcare: All the PHCCs and CRHCC deliver neonatal and child healthcare; including counseling of the mothers on neonate and child physical – psychological development, as well as on the improvement of treatment seeking behavior.
- RTI/STI Management: The satellite clinics, PHCCs and CRHCC ensure the proper identification of RTI/STIs and the management, which includes counseling sessions alongside the medical treatments for the ailment.
- Adolescent Healthcare: All PHCCs, CRHCC and satellite clinics provide adolescent health services. There is a provision of ‘Exclusive Afternoon Hours’ for adolescents once a week in CRHCC & PHCCs.
- Population and Family Planning Services: Contraceptives are provided to the clients with the support from Directorate of Family Planning. CRHCC, PHCCs and satellite points provide the temporary methods of contraception, and the permanent methods are only being provided from the CRHCC.
- Nutritional Services: UPHCSDP-Uttara has been providing nutritional services to the poor women & children through the CRHCC, PHCCs and satellite centers. Nutritional counseling, Micro Nutritional Powder for supplements and other food supplementations are provided to mothers and children; based on the BMI for adults & adolescent, and on the growth monitoring chart of under five children. Vitamin A supplementation for the children and lactating mothers were provided, mothers are also provided with Folic Acid. De-worming week was observed under the project activities.
- Limited Curative Care: Provision of the basic first aids for common injuries; such as cut, burn, fracture etc, and treatment of medical emergencies; such as management and referral of high fever, pain, drowning, poisoning, asphyxia etc, are the vital components of quality curative care from PHCC and CRHCC.
- Behavior Change Communication (BCC): The project has organized a number of trainings, workshops, awareness raising sessions and school/college programs to discuss about health and nutrition issues with the clients and community peoples. BCC materials were developed and distributed through the CRHCC, PHCCs and satellite centers.
- Diagnosis Services and Emergency Transportation Service: As part of the support services, the project has pathological laboratory in each PHCC and CRHCC to conduct definite diagnostic tests like blood, urine, stool etc.
- Violence against Women (VAW): Violence against women is another important component of the project. Counseling and referral supports are being provided to the victim clients. Each and every incidence of VAW is handled delicately at both the PHCCs and CRHCC.
- Immunization Program: DAM conducts immunization sessions when the entire population from the catchment area, are mobilized to have their children fully immunized.
- Friday Clinic and Evening Clinic: DAM organizes the Friday Clinic every month in the slum area. DAM also organizes the Evening Clinic everyday at the PHCCs for the benefit of the working women. General treatment and family planning services are being provided through these clinics.
- VIA Screening and Treatment: UPHCSDP – Uttara has been conducting VIA (Visualize Inspection with 5% acetic acid) screening for detection and staging of cervical cancer through the CRHCC and PHCCs. This screening has been being conducted regularly at the CRHCC level on a certain date (24th of every month) at the PHCCs.
- Community Participation: DAM UPHCSDP – Uttara formed the Users Forum, and WUHCC committee with the participation of community people & ward counselors. Quarterly basis meetings are being conducted to review the performances and to provide necessary feedback for improvement. Users Forum Committee members are actively involved in selecting the satellite clinic spots, beneficiary selection, organizing satellite support group meetings, service promotion as well as solving the local level problem and raising awareness through their activities in the community.
- Infection Prevention and Clinical Waste Management: UPHCSDP follows a systemic process to control infection which are
- a. Hand washing (normal hand wash and surgical hand scrub)
- b. Gloves wearing
- c. Decontamination
- d. Cleaning
- e. High level disinfection
- f. Sterilization
- g. Waste disposal: In every center we have color coded waste containers.
- DAM, UPHCSDP, DNCC, PA-5 Received Family Planning Award: DAM received certificate that recognizes its outstanding contributions in family planning activities (clinical methods) during the 2015-2016 period under the Tajgaon Thana, Dhaka.
- Free Treatment through Medical Camp: DAM has been organizing free medical camps for the poor and disadvantaged people in the working area. These medical camps provide support in eye care, general health, diabetes, cardiac and child healthcare services.
- School/College-based Adolescents Health Programs: Adolescents are at the risk of early and unwanted pregnancy. They are not aware of the contraceptive measures. Also teenage pregnancy results in increased morbidity and mortality. To create awareness in prevention of such complications, UPHCSDP organizes school based programs in different institutions in the working area. The project staff discuss with the youths about their personal hygiene, advantage of immunization/TT vaccination, adolescent health, gender issues, early marriages & its demerits, RTI/STI and HIV/AIDS, physical and mental changes during puberty etc. Counselors create awareness on sexuality, safe sex, menstruation, special nutrition, hygiene, TT vaccination, reducing early marriage, pregnancy, high risk behavior, psychological issues, gender issues among the groups of adolescent girls and boys.
- Free Service for the Red Card Holders: This project has been providing full free services in all the components among at least 30% of the beneficiaries. A total of 73,016 households exist in the working area of UPHCSDP, Uttara, Dhaka. The project serves 35,000 households, excluding the households living in the high rise buildings. Out of those, 16,956 are red card holders. The red card holders and their family members receive free medical services.