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Policy Objectives are not enough to reaching the poor in urban health projects in Bangladesh. Systemic Monitoring is essential-Kamal Biswas
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Policy Objectives are not enough to reaching the poor in urban health projects in Bangladesh. Systemic Monitoring is essential-Kamal Biswas

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  • 1. Monitoring Helps Services to Reach the Poor Kamal Biswas UPHCP II, HLSP ( presenter) M Kabir, UPHCP II, HLSP A.B. Siddique, UPHCP II, PMU Sharmin Mizan, UPHCPII,PMU
  • 2. Urban Primary Health Care Project UPHCP in Bangladesh
    • Ministry of Local Govt. launched UPHCP I in 1998 in collaboration with ADB
    • Second Urban Primary Health Care Project started in 2005 with ADB, DFID, UNFPA
    • UPHCP II ends on Dec 2011
    • Area: 11 City/townships
    • Population: 10 m approximately
  • 3. Core policy
    • Public Private Partnership for service delivery
    • Reimbursable finance mechanism
    • User fees
    • 30% of each service free to poor
    • ESP plus services (CS operation, eye care)
    • Sustainability fund
    • Contracted out Management Services
  • 4. Mother and new born
  • 5. Management
    • Executing agency – Local Govt. Division of MoLGRD&C: Project Management Unit (PMU)
    • Local supervision: Project Implementation Unit of City Corporation/ municipality health department
    • Service Delivery : Partner NGOs/ Health departments
    • Monitoring Firm: PPME (HLSP)
  • 6. Objective of the study
    • Assess the situation of coverage of institutional delivery for the poor over a period of 2005 to 2009.
    • Define policy inputs helping the poverty related target.
  • 7. Methods
    • Data of the institutional deliveries in 24 maternal hospitals were taken from Health Management Information System (HMIS).
    • Descriptive analyses were undertaken to see the changes over the time.
    • HMIS data quality is assured through regular monitoring with a systematic approach.
  • 8. Findings
  • 9. Percent of poor for UPHCP Hospital delivery in Dhaka PAs 2005 2006 2007 2008 2009 DCC PA 1 0.9 1.3 4.7 13.6 20.1 DCC PA 2 0 0.3 0 12.5 26.8 DCC PA 3 0 0 0.4 21.6 39.7 DCC PA 4 0 0 0 20.2 23.5 DCC PA 5 0 0 1.9 15.4 34.4 DCC PA 6 0 0 0.7 18.8 25.1 DCC PA 7 20 15.2 28.5 39.6 34.2 DCC PA 8 0 1.7 6.4 20.6 24.8 DCC PA 9 0 0 4.6 22.1 29 DCC PA 10 0 0 3.5 11.6 29.9 Average 2.09 1.85 5.07 19.6 28.75
  • 10. Findings
  • 11. Percent of delivery for poor in UPHCP Hospitals in 14 Other cities, municipalities PAs 2005 2006 2007 2008 2009 CCCPA1 0 0 0 13.7 26.3 CCCPA2 3.1 2.7 5.7 18.5 21 CCCPA3 0 0 4.3 6.6 23.5 RCCPA1 0 0 17.3 13.9 27.4 RCCPA2 0 0 0 15.3 25.6 KCCPA1 0 0 3 17 38.5 KCCPA2 0 0 10.8 20.5 31.5 SCCPA1 0 0 1.3 23.8 23.8 BCCPA1 0 0 2.6 18.5 28.7 BogM PA 1 0 0 11.1 27.3 38 ComM PA1 0 0 5.2 42.3 31.8 MaM PA1 0 0 3.9 12 20.8 SavM PA1 0 0 19.5 21.6 20.8 SriM PA1 0 0 0 28.5 33.5 Average 0.22 0.19 6.05 19.64 27.94
  • 12. Learning
    • Pro-poor policy should be supplemented by strategies such as the entitlement card.
    • Pro-poor policy frame may not work alone. Regular monitoring with specific pro-poor indicators drives providers to reach maternal services to the poor.
    • Professional monitoring helps to improve performance and reach the poor.
  • 13. www.hlsp.org