Bangladesh has made a significant progress in improving the healthcare indicators, i.e. under-five mortality and neonatal mortality rate over the past two decades. However, to attain the Sustainable Development Goals (SDGs), the country has to overcome a plethora of healthcare challenges alongside the strengthening of health systems for the overall development of the sector 1.

KEY HEALTHCARE INDICATORS2,3,4,5,6

67%

of total deaths due to NCDs.

31%

maternal deaths due to post-partum Haemorrhage.

23%

neonatal deaths due to prematurity and birth asphyxia.

221

per 100,000 Tuberculosis cases

25%

Human resources for health serves
70%
of the population

221

per 100,000 Tuberculosis cases

  • Hemorrhage and pre-eclampsia/eclampsia account for 31 % and 24 % of maternal deaths in Bangladesh respectively7.Maternal Deaths in Bangladesh occur due to Hemorrhage and 24% are due to pre-eclampsia/eclampsia7.
  • More than 50 % of pregnant women failed to undergo a mandatory four Ante-Natal Checkup (ANC) visits8
  • More than 60 % of women between the age group 15-49 years do not receive post-natal health check-up within 2 days of delivery9

Neonatal deaths in Bangladesh can be majorly attributed to10:

  • Prematurity (30%)
  • Birth asphyxia and trauma (23%)
  • Sepsis (20%)

Under 5 deaths can be attributed to11:

  • Acute Respiratory Infections (15 %)
  • Diarrhoea (6%)

Among infants, nearly 50 % are not breastfed exclusively for the first 6 months12.

Health Systems
challenges

  • Shortage of human resources in health (HRH)
  • Inadequate quality of care
  • Lack of comprehensive data collection tools for frontline workers (FLWs)
  • Limited mechanisms to ensure last mile vaccine delivery and immunization tracking
  • Limited use of technology for biomedical equipment management & maintenance
  • Lack of innovative funding mechanisms for public health programs

Source: WHO. Trends in Maternal Mortality: 2000 to 2017

Source: UNICEF data

Source: UNICEF data

Source: UNICEF data

References:

  • 1 WHO, 2017 country profile
  • 2 Bangladesh Maternal Mortality and Healthcare Survey (BMMS), 2016
  • 3 UNICEF Bangladesh report on Maternal & New-born Health Disparities, 2019
  • 4 WHO TB country profiles
  • 5 MoHFW HRD 2011, Country Case study (GHWA, 2008, https://doi.org/10.1186/1478-4505-5-1
  • 6 Bangladesh Maternal Mortality and Healthcare Survey (BMMS), 2016
  • 7 WHO data, 2015
  • 8 UNICEF Bangladesh report on Maternal & New-born Health Disparities, 2019
  • 9 UNICEF data 2016
  • 10 WHO data, 2014
  • Limited availability of trigger mechanism for identification and early referral of High-Risk Pregnancies (HRPs)

    • The prevalence of HRPs is 42% in Bangladesh.14
    • Only 47% of pregnant women are reported to have had 4 or more antenatal care visits.
  • Limited availability of skilled Human Resources for Health (HRH) in Bangladesh15

    • Limited availability of physicians (3.05 per 10,000 population) and Healthcare personnel (1.07 nurses per 10,000 population).
    • Unequal distribution of health personnel concentrated in the urban secondary and tertiary care hospitals with 70% population residing in rural parts of the country.

References:

  • 14 Abedin S and Arunachalam D. Maternal autonomy and high-risk pregnancy in Bangladesh: the mediating influences of childbearing practices and antenatal care. BMC Pregnancy Childbirth. 2020; 20: 555
  • 15 MoHFW HRD 2011, Country Case study (GHWA, 2008, https://doi.org/10.1186/1478-4505-5-1
SI No. Name of the pilot Name of the piloting solution Total no. of sites activated Number of facilities activated Total no of beneficiaries enrolled
1 Introduction of Project ECHO for capacity building of healthcare workers in the areas of case management, critical care medicine and infection prevention and control Project ECHO India 0 0 0
2 Demonstrate the effectiveness of TrueNat in prompt and accurate diagnosis of Dengue and Chikungunya cases in Bangladesh TrueNat Dengue/Chikungunya 1 0 0
3 Demonstrate the effectiveness of TrueNat in improving screening and detection of curable STIs i.e., Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) in pregnant women in Bangladesh TrueNat CT/NG and Trich 1 0 0

Pilot projects in Bangladesh

  • Name of the Pilot

    Introduction of Project ECHO for capacity building of healthcare workers in the areas of case management, critical care medicine and infection prevention and control

    Problem Statement

    Limited availability of skilled Human Resources for Health (HRH) in Bangladesh

    Our Piloting partners

    Project ECHO India (Indian healthcare solution provider), Save the Children International, Bangladesh Country Office (local implementation partner)

    Description of our pilot solution

    Project ECHO is a guided practice model to assess and identify the training needs of the healthcare workers (HCWs) in local communities (spokes) and links them with expert specialist teams at academic institutions (hub).
    It is a platform of simultaneous e-teaching and e-learning encompassing:
    a) interactive teaching and learning
    b) co-management of cases
    c) peer to peer case-based learning
    d) collaborative problem solving and monitor outcome.

  • Name of the Pilot

    Demonstrate the effectiveness of TrueNat in prompt and accurate diagnosis of Dengue and Chikungunya cases in Bangladesh

    Problem Statement

    Limited availability of standard diagnostic modalities related to serological tests, antigen detections for prompt and accurate diagnosis of Dengue and Chikungunya.

    Our Piloting partners

    Molbio Diagnostics Pvt Ltd (Indian healthcare solution provider), Surjer Hashi Network, Bangladesh (local implementation partner)

    Description of our pilot solution

    TrueNat Dengue/Chikungunya is a chip based duplex real time micro-PCR test for Dengue/Chikungunya.It is a rapid, portable, near patient, point of care system with single testing capability and sample to result in less than one hour. It offers a diagnostic solution which is relatively accurate and time saving as compared to the existing conventional diagnostic methods. It is highly sensitive and specific with capability to confirm the infection with Dengue/Chikungunya.

  • Name of the Pilot

    Demonstrate the effectiveness of TrueNat in improving screening and detection of curable STIs i.e., Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) in pregnant women in Bangladesh

    Problem Statement

    Limited availability of point of care diagnostic modalities with high sensitivity and specificity to detect asymptomatic STIs at an early stage to prevent associated morbidity and mortality in pregnant women.

    Our Piloting partners

    Molbio Diagnostics Pvt Ltd (Indian healthcare solution provider), Surjer Hashi Network, Bangladesh (local implementation partner)

    Description of our pilot solution

    TrueNat CT/NG is a chip-based Real Time PCR test for the semiquantitative detection of N.gonorrhea and C.trachomatis in female endocervical and vaginal swab specimens and Urine specimen.It aids in the diagnosis of symptomatic or asymptomatic infection with N.gonorrhea, C.trachomatis and Trichomonas vaginalis.