When the simplest of solutions can be the most effective

January 13, 2015

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There is a lot of room for innovation when it comes to health. In a resource-poor country like Bangladesh, effective and low-cost preventive and basic curative interventions can save millions of lives. If they are rooted in community demand and context, they can be implemented at a great scale.

A health worker paying a door-to-door visit

A health worker paying a door-to-door visit

There is a lot of room for innovation when it comes to health. In a resource-poor country like Bangladesh, effective and low-cost preventive and basic curative interventions can save millions of lives. If they are rooted in community demand and context, they can be implemented at a great scale. For instance, BRAC’s frontline health workers address the scarcity of human resources in the health sector by providing accessible and affordable services to the majority of the population. There are currently over 100,000 health workers who are locally recruited women trained as health providers to deliver doorstep health services. Whether it was the ground-breaking use of oral rehydration solution or delivery kits, the hallmark of innovation is evident within BRAC’s interventions.

Some might argue that BRAC does not provide all its healthcare services free of cost.  But the organisation has learned from experience that services that create a culture of dependency can never be a sustainable strategy for development. The cost of basic services and medicine are usually within the reach of the poor. Nonetheless, if a client is unable to bear the cost, BRAC writes off the payment upon assessing the client’s situation in accordance to a set of criteria. On the other hand, there are some services that are completely free including ones in collaboration with the government (ie, National Tuberculosis Control Programme and National Malaria Control Programme).

A group of women attend a health forum in a village in northern Bangladesh

A group of women attend a health forum in a village in northern Bangladesh

The methods that BRAC’s health interventions use are easily accessible to communities with limited resources. At the same time, BRAC engages with and empowers communities to become allies for their own well-being. For example, BRAC has various engagement and empowerment platforms, such as health education forums, maternal, neonatal and child health committees, spouse forums, expectant mothers’ forums, women support groups, among others. Bringing positive behaviour change is an integral area that these forums address. Thus BRAC believes community-based, low-cost health interventions can reach those who need it most.

Despite being one of the poorest countries with relatively low healthcare spending, Bangladesh has made strides in healthcare in the last 43 years. Health experts say it has been made possible due to such community-based approaches to health – mainly by the large-scale operations of community health workers. The Lancet medical journal recently called Bangladesh’s success “one of the great mysteries of global health.” It is on track for achieving the sixth MDG, and has already met the fourth goal of reducing child mortality.

 

Dr Tapash Roy is the programme head and Zayed Bin Islam is the deputy manager of communications at BRAC’s health, nutrition and population programme.

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