Since 1987, TAI along with MSH has been assisting Ministry of Health & Family Welfare to improve the performance of the Bangladesh Family Planning Program at the community level. USAID supported this highly successful project over the ten-year period.
Over 20 years ago, with one of the highest maternal mortality rates and population densities in the world, the Government of Bangladesh declared fertility reduction the nation’s “number one priority.” The government recognized the need to increase community involvement in family planning initiatives and to develop well-managed, sustainable programs with high-quality services at the local level. Through the FPMD project, TAI and MSH worked with the Ministry of Health (MOH) from 1987-1998 to improve the national family planning program at the grassroots level.
Through the Local Initiatives Program (LIP), worked to strengthen the management skills of thana (sub-district) family planning staff, public administrators, and local leaders. The mainstay of the program was the introduction of female volunteers from the local communities to provide family planning outreach. Through the LIP, has increased community awareness about family planning. More importantly, it has involved the community in developing action plans and mobilizing human and financial resources, contributing to the significant advances Bangladesh has made in its national family planning program despite continued poor economic development.
The LIP has shown that it is possible to effectively and economically deliver modern contraceptives to hard-to-reach populations. It provides a strong example of how public and private organizations can work together to meet local needs by conducting training programs, developing and using tools, and following up with local leaders. The success of the LIP has led to its use as a model for similar programs in other countries, such as India. With strong political support and community participation, Bangladesh will continue to make great strides in meeting the needs of its families.
Lesson 1: Developing management skills at the community level helps to improve service delivery
Lesson 2: The program achieves more by involving communities in program planning, implementation, and resource mobilization
Lesson 3: Large numbers of volunteers can be used efficiently to minimize program costs, increase accessibility of services, and institutionalize community participation
Lesson 4: The efforts made to institutionalize management skills, techniques, and tools at the community level should not exceed the community’s ability to absorb these new skills.
The LIP has succeeding in increasing access to health services through three major initiatives:
“Project accomplishments to date are highly commendable and a model for the integration of “top down” management interventions at the government level, with “bottom up” community supported development and MCH/FP activities…”
Bill Trajfords et. al. Evaluation of the FPMD