1. CHT Profile and NHSDP’s Scope of Building
Partnership for ESP Service Expansion
PREPARED BY:
Dr. Sanjib Ahmed
Project Manager - CHT
USAID-DFID NGO Health Service Delivery Project

2. 2 | P a g e
List of Acronyms
AIDS : Acquired Immuno Deficiency Syndrome
ANC : Anti-Natal Care
BCC : Behaviour Change Communication
BIID : Bangladesh Institute of ICT in Development
BSP : Blue-Star Provider
CC : Community Clinic
CHT : Chittagong Hill Tract
CSR : Corporate Social Responsibility
CHSW : Community Health Service Delivery Worker
EOC : Emergency Obstetric Care
ESP : Essential Service Package
FDSR : Family Development Services and Research
FFE : Fortified Food and Education
FP : Family Planning
FWA : Family Welfare Assistance
GIS : Geographical Information System
HA : Health Assistance
HDC : Hill District Council
HIV : Human Immuno Deficiency Virus
HNP : Health Nutrition and Population
HPNSDP : Health, Population and Nutrition Sector Development Program
ICDP : Integrated Community Development Project
IUD : Intra Uterine Device
KAFCO : Karnafuly Fertilizer Company
MAMA : Mobile Alliance For Maternal Development
MCWC : Mother and Child Welfare Centre
MoCHTA : Ministry of Chittagong Hill Tracts Affaires
MoHFW : Ministry of Health and Family Welfare
MOU : Memorandum of Understanding
MoWA : Ministry of Women Affaires
MSF : Medicine Sans Frontiers
NGO : Non Government Organization
NHSDP : GO Health Service Delivery Project
PNC : Post Natal Care
SH : Shurjer Hashi
SMC : Social Marketing Company
TB : Tuberculosis
THNPP : Tribal Health, Nutrition and Population Plan
TMSS : Thangamara Mohila Sobuj Songho
UN : United Nations
UNDP : United Nations Development Program
UNICEF : United Nations Children’s Fund
USG : Ultra sonogram
WFP : World Food Program

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Contents
1. Chittagong Hill Tracts (CHT) profile......................................................................................... 4
1.1. Government Administrative Frameworks within CHT....................................................... 4
1.2. Traditional System.........................................................................................................4
2. Health system in CHT............................................................................................................. 5
2.1. Health Priorities in CHT..................................................................................................5
2.2. Tribal Health, Nutrition andPopulation Plan....................................................................5
2.3. Health Interventionsin CHT............................................................................................ 6
3. Activities of FDSRin CHT........................................................................................................7
3.1. Possible collaborationswith other NGO/GO to expand delivery of ESP services................. 8
3.2. Support needed............................................................................................................. 8
3.3. Recommendations from FDSR ........................................................................................ 8
4. Our scopes of building partnership......................................................................................... 9
5. Points of mutual benefits.......................................................................................................9
6. Conclusion.......................................................................................................................... 11
References................................................................................................................................. 12

4. 4 | P a g e
1. Chittagong Hill Tracts (CHT) profile
ChittagongHill Tracts(CHT) isa regionwhere mostof the indigenouspeopleof Bangladesh live with
diverse culture and social environment. The Chittagong Hill
Tracts (CHT) comprises three hilly districts, Rangamati,
Khagrachari and Bandarban in the south-east region. Here the
populationdistribution is scattered and they are living in poor
socio-economic conditions. It has a total land area of about
13,294 square km (about10% of landarea inBangladesh) anda
population of about 1,587,000 (Census 2011). Around 50% of
itspopulation istribal minorities and the rest is from different
communities. The local tribes collectively known as the
Jumma, include the 11 ethnic groups of Chakma, Marma,
Tripura, Tanchangya, Chak, Pankhoa, Mro, Bawm, Lushai,
Khyang,andKhumi.Amongthe nontribal communitiesmostof
the inhabitants are Bengali. Tribes have their own languages,
social structures, cultures and economic activities. CHT is
considered as a post conflict area and clashes still persist
between the tribal and non tribal population mainly due to
land issues and ethnic conflicts. The main occupation of the
people of the CHT is agriculture where a traditional system
called Jhum cultivation is practiced. Tribal people mostly
depend on village doctors or tribal/traditional healers for health care services. This diverse health
seeking behaviour limits the use of existing modern health facilities. In the health policy of
Bangladesh Priority has given in ensuring universal accessibility and equity in healthcare, wi th
particular attention to the rural population but implementation in the CHT is hampered due to
geographical, political and ethno-lingual differences. For instance, in the plain geographical areas
one fieldworkerserves4000 people whereasinCHT this wouldnotbe possible due tothe scattered
nature of dwelling of tribal people. Often it is difficult for the community health worker (CHW) to
reach the targeted people. A tribal health plan was develop in 2004 but has never been
implementeddue tolackof reliabledataonproportionof tribal populationatunionlevel. There are
alsono ethnographicstudieson tribal population. The data we have is very old and is measured by
the division and sometimes by only the districts. It is therefore harder in the CHT to measure the
progress by health indicator.
1.1. Government Administrative Frameworks within CHT
The Government administrative system in the CHT is different from other parts of Bangladesh. At
present there are three different types of administrative systems in the CHT where as only one
general administrativesystemexistsinotherdistrictof Bangladesh.The three different systems are
a) General Administrative System (All over Bangladesh)
b) Self Rule Government or Decentralized Local Government System (only in CHT)
c) Traditional Administrative System (only in CHT)
The CHT is divided into three administrative districts. These are further subdivided into Upazila,
Union and Para (village/communities).
1.2. Traditional System
Alongside the central and decentralized Local Government systems, the CHT practices a traditional
systemof administrationformalizedunderthe CHTRegulationof 1900. Underthis system, there are

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three administrative Circles in the CHT (Mong, Chakma and Bohmong) each with their own Chief or
Raja (King).The administrative areasof the Mong,Chakma andBohmong circles broadly correspond
to the decentralized Local Government administrative areas of Khagrachari, Rangamati and
Bandarban Hill Districts. The Circle Chiefs are advisors to their relevant HDC(s) and are engaged in
otherformal governance networks. Eachcircle is subdividedintoMouzaswhere the Headmanisthe
traditional leader.EachMouza has several Paras (villages), where a Karbari is the leader. Headmen
are appointed by the Deputy Commissioner (Head of general administration) on the
recommendation from the Circle Chiefs and Karbaris are appointed by the Circle Chiefs. Headmen
and Karbarishave responsibilitiesformaintaining social law and order, revenue collection and land
registration in their communities.
2. HealthsysteminCHT
In CHT, a decentralized Local Government system is being followed, with responsibilities for the
managementof health services delegated to the Regional Council and three HDCs. The Ministry of
CHT Affairs(MoCHTA) isresponsible foroverseeingall activitiesinthe CHTand approvesthe staffing
for the Regional Council and three HDCs. The HDCs recruits 3rd and 4th class employees for the
transferred departments, and officers of the transferred departments are appointed by the
concernedMinistry.All department staff report to department heads and the departmental heads
reportto the HDC Chairman. Asper the three HDC Actsof 1900 (as amendedbythe 1997 CHT Peace
Accord), a total of 33 subjects are supposed to be transferred from the Ministries to each of the
three HDCs. Of these, 18 have already been transferred, including health. Health was transferred
from the Ministry of Health and Family Welfare (MoHFW); in the CHT the Civil Surgeon, and the
DeputyDirectorof FamilyPlanningbothreporttothe HDC Chairman.The HDCs withtheirownfunds
or fund received from the Government may formulate and implement development plans on the
subjectsanddepartmenttransferred to them. The concerned Ministries, Divisions or Departments
are required to implement through the HDCs, all national development works on the subjects
transferred to the HDCs.
2.1. Health Priorities in CHT
The CHT is the highly endemic for malaria out of the 13 malaria prone districts of Bangladesh.
Diarrheaand malnutritionisstill a big issue for the CHT due to a lack of sources for drinkable water
and food scarcity. The Health service delivered by the Government is not satisfactory and the
subsequenttake upisverylow.Mostof the healthservice provider’s post is vacant (around 50%) in
the healthservices.So most often the hospitals at a sub-district level are run by medical assistants
and nurses. Most of the patients are referred to the district hospital for better patient care where
the hospital is equipped with few logistics. The health awareness is very low in the population.
Moreoverhealthseekingbehaviorvariesindifferentethnicgroupsandthe modernhealth system is
not user friendly to some of the ethnic groups which make the traditional healers more popular.
Maternal and child mortality are still high in the CHT.
2.2. Tribal Health, Nutrition and Population Plan
The Government has made provisions for a Tribal Health, Nutrition and Population Plan (THNPP)
whichrecognizesthe specificsocial,cultural, economic and special factors to be taken into account
for HNP service delivery in tribal areas. The THNPP calls for ‘tribal sensitive’ and participatory
implementation of HNP services in tribal areas. Tribal areas are defined as those having (over) 25
percent tribal population, and include the CHT. The THNPP has not been implemented since

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formulatedandalreadyexpiredin 2010. In the new government proposal from July 2011-June 2016
(HPNSDP), there is separate budget line for CHT health.
2.3. Health Interventions in CHT
The HDCs, through the Civil Surgeons’ offices and the offices of the Deputy Directors of Family
Planning,superviseover300 doctorsand nurses,and over 800 community health workers. They are
responsible fordeliveringhealth services across all Upazila in the CHT, and are responsible for over
235 healthfacilities,atdistrict,upazila,unionand community level. Ministry of Health has a similar
health setup in CHT like in other district of Bangladesh. Most of the health facilities in the CHT are
underusedfor many reasons. One of the most damaging effects of severely weakened and under-
resourced health systems is the difficulty they face in producing, recruiting, and retaining health
professionals,particularlyinremoteareas.Low wages,poorworkingconditions,lackof supervision,
lack of equipmentandinfrastructuremade the healthservicesmore ineffective. Communal conflict
and fear of abduction among the health staffs from outside also create loss of interest and risks to
workinginthese remote areas.Inthissituation,somanydevelopment partners and NGOs are keen
to improve the situation through different strategies focusing on different areas of interest.
For many years Medicine Sans Frontiers (MSF) provided health services in some areas in the CHT,
staffing standing clinics and deploying mobile teams, to treat malaria and other diseases. But the
majority of these clinics have now closed, following MSF withdrawal from the CHT in 2006.
UNDP modified the MSF model and in 2006 established 15 Satellite Clinics and gradually increased
themup to 75 mobile clinicsacross15 Upazilaof CHT outof a total of 25 upazila.The clinic locations
were determinedfollowingaseriesof consultations with local stakeholders and decision makers at
union, upazila and district level, with the final decision in each district resting with the HDC
Chairman. The clinics are staffed by mobile teams on a one day per week rotational basis, and
receive on average 1,000 patients a month. In addition to running Satellite Clinics, UNDP, through
the HDCs, has recruited and trained over 1000 women as Community Health Service Workers
(CHSWs).Each CHSW isresponsibleforbetween120 and 140 householdsinthe village inwhichthey
reside and the surrounding area. They provide a basic package of health services including malaria
testing and treatment of malaria, diarrhea and ARI, basic health education, referrals and maternal
services etc, and are fully supported by Satellite Clinics.
UNICEF and WFP also support community-based health initiatives in the CHT. UNICEF, through the
IntegratedCommunityDevelopmentProject(ICDP) hassupportedthe Government in establishing a
networkof Para Centersinselectedcommunities throughout the CHT. These are community-based
facilities run by Para Workers. ICDP uses the Para Centre as a base from which to offer a range of
community development activities, organized by the Para Worker. It focuses primarily on
educational activities and early childhood development, but also supports awareness raising and
promotional activities for health, water and sanitation. WFP works closely with UNICEF, providing
fortified biscuits to pre-school age children through their Food for Education program (FFE). WFP
program phased out in 2010.
UNFPA provides technical support to the Mother and Child Welfare Centers (MCWCs) in each
district, prioritizing Antenatal Care (ANC) and Postnatal Care (PNC), Safe Delivery and Emergency
ObstetricCare (EOC).Atthe communitylevel,UNFPA isprovidingSkilledBirthAttendantstraining to
Family Welfare Assistants (FWAs) and Health Assistants (HAs). With this training they are able to
provide ‘safe delivery’ at home and are able to support and provide midwifery training to Family
Welfare Visitors (FWVs).UNFPA alsosupports family planning services to distribute contraceptives
and provide counseling for long-term methods of contraception.

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WHO does not work directly in the CHT, but works with Government Ministries and other
stakeholdersatthe national level toimprove health management systems and good governance in
the health sector. WHO provide technical support to immunization and involved in active and
passive surveillance of communicable disease in CHT.
In addition to the work being done by the Government and UN Agencies, there are many
International andNational NGOsworkinginthe healthsectorinthe CHT,includingBangladesh Rural
Advancement Committee (BRAC), the Christian Mission Hospital, Family Planning Association of
Bangladesh(FPAB), the LeprosyMission,WorldVision,Sajeda Foundation, TMSS and also a growing
number of local NGOs. The scope of these agencies is often limited, both geographically and by
sector. BRAC is working against TB and malaria in CHT with their network of Shastha sebika and
Shastha karmi at field level.
SMC’s Blue Star Program addressingthe unmetneedof the target population by improving quality,
awareness,accessibilityandaffordabilityof prioritypublichealthservicesthroughthe private health
providers (Blue-Star Provider) throughout Bangladesh. SMC has a strong presence in CHT with
numbersof Blue-Star outlets in all CHT districts. Following services are provided through Blue Star
outlets:
a) Family Planning Counselling and Injectable contraceptive
b) IUD service (selected BSPs)
c) Maternal and Neonatal health information, services and referral (selected BSPs)
d) Referral for Long acting and Permanent Method
e) TB suspects identification and referral
The Blue Star Program is implemented by the direct guidance from “Program” department of SMC
HeadOffice aswell asits 12 AreaOffices.The Head Office doesthe total program plan and provides
TA and the SalesPromotionOfficers/Executives(SPOs/SPEs)of the AreaOfficesimplementandvisits
area wise Blue Starproviders.Tomonitor the quality of services and skill of the Blue Star Providers
(BSPs), SMC has started Quality Monitoring and Supervision (QMS) system since 2006.
Given the multiple stakeholders and resources available, better coordination among the various
agenciesworkinginthe CHTcouldsubstantiallyimprove the coverage and quality of services being
provided, maximizing limited resources and consolidating benefits for CHT communities.
3. Activities of FDSR in CHT
FDSR startedSH clinicactivitiesinOctober2010 initiallyin3districtsadormunicipalities during SSFP
period. All otherclinicsare establishedinNHSDPperiodindifferenttime. At present FDSR has been
operating 7 static and 152 satellite clinics under 3 CHT districts. The static clinics locations are:
a) Rangamati municipality
b) Kowkghali upazilla under Ranagamati distrct.
c) Khagrachari municipality
d) Dighinala upazilla under Khagrachari district.
e) Bandhorban municipality
f) Naikhangchari
g) Lama under Bandhorban district.
Khagrachari municipalityclinicisultrawithpoordelivery performance;other6staticclinics are vital.
But planto convert2 staticclinicsof Rangamati and Bandhorban district municipality in ultra clinics

8. 8 | P a g e
inFY 3. All those clinicsare providing home base delivery services except Lama. Lama and 3 district
municipality clinic are urban based and rest are (3) rural based.
In future FDSRhas plannedtoestablishnew clinicsatRamghor, Manikchari,Matirangaupailla under
Khagrachri district; Longgodu and Rangamati sador under Rangamati district and Alikadom under
Bandhorbandistrict.Itismentionedhere that FDSRproposed 3 new static clinics under Khagrachari
district in FY2 but the plan has not been executed due to budget limitation.
3.1. Possible collaborations with other NGO/GO to expand delivery of ESP
services
Mainly UNDP supported 5 NGOs are working in 12 upazillas of 3 CHT districts out of 26 upazillas.
Cord Aid supported 3 NGOs are working in 3 upazillas under Khagrachari district.
a) FDSR SH clinichas a MOU withBangladesh Police department for providing health services
at VictimSupportCenter(VSC) atRangamati under Police Reform Program (PRP) funded by
UNDP.
b) Have a MOU with Mary Stopes clinic to provide RTI / STI including delivery services in 2
districts of Khagrachari and Bandhorban under Link Up project.
c) UNDP may extend their donation to operate the SH clinics.
d) CHT council / CHT developmentBoardmay donate for water ambulance at Rangamati clinic
due to watery communication with 9 upazillas out of 10.
e) Centrally CSR activities may extend by reputable companies to lift the ethnic groups.
f) Centrally may make a MOU with the Women Affair Department for providing package
services to pregnant and lactating mothers whose are receiving FEES from respective
department.
3.2. Support needed
a) Transport (Ambulance), USG services are required for CHT clinics.
b) BCC materials must be prepared consisting photos of ethnic groups.
c) ConductinggroupmeetingwithCHTpeoplesmore BCClogisticand entertainment including
free medicine is required.
d) Staffs should be more compensated.
e) Organization may think to bear the load of cost recovery for CHT district clinics.
3.3. Recommendations from FDSR
Service providing scope is open and never ends in CHT districts. In each indicator of health and FP
are lagbehindinseriousconditionsdue toseveral reasons like- scatteredresidence,hillyandhardto
reach areas,poorawareness,cultural differences within 11 indigenous groups and disliking bangali
culture, political conflict and unrest within the ethnic groups including Bengalese, financial
insolvency due to‘Zhom’ cultivation dependence, lack of transport facilities, linguistic barrier, low
literacy rate, dependency on traditional and herbal remedies etc. So the thoughts of high cost
recovery should be avoided to operate CHT clinics. Actual cost recover of FDSR is 58% in plain land
clinicsbut CHT clinics cost recovery rate is only 11%. FDSR’s Averaging cost recovery rate is 47%. An
operational research could be launched to assess most appropriate and effective provision of service
delivery for the ethnic groups for expanding and strengthening the ESP services.

9. 9 | P a g e
4. Our scopes of building partnership
f) Coordination and collaboration with MoCHTA and local government authorities for using
established unused community clinics as SH clinics by the NGOs of NHSDP network
g) Up gradation and expansion of FDSR SH clinics in CHT (collecting CSR support and support
from MoWA)
h) Collaboration with UNDP, UNICEF and WFP for using their GIS map, for more community
penetration and for service expansion
i) Collaboration with MAMA to increase the client base promoting through mobile phones
j) Collaboration with SMC Blue-Star Program for establishing referral network
k) Collaboration with BIID for establishing Telemedicine facilities wherever possible in SH clinics
l) Collaboration with other NGOs working in CHT like-BRAC, TMSS, FPAB, Leprosy Mission,
World Vision, Sajeda Foundation and other local NGOs
m) Explore more co-funding opportunities as with KAFCO does.
5. Points of mutual benefits
Colourindicatingthe more benefittedpartner
Partners/
Program
Activities Modality
Benefits
NHSDP
Partner
Organization
MoCHTA/L
ocal
Governme
nt-
Underutiliz
ed/unutiliz
ed
Communit
y Clinics
(CC)
 Manageme
nt of CCs
 Service
Delivery
fromthe
CCs
 NGO/srunningSH clinicsin
CHT will take control of the
communityClinicsand will
provide ESPservicesthrough
those clinicsmaintaining
highestquality
 ControllingNGO/swill
responsible forclinic/service
promotion
 ConcernedGovernmentstaffs
(HA/FWA) will provide
necessarysupporttooperate
the clinicssuccessfully
 Service
expansion
 Acquire
leadershipin
qualityhealth
service
delivery
 Existing
infrastruct
ureswill be
used
 Communit
y will enjoy
the
ultimate
benefits
Organizati
ons willing
to provides
CSR fund
for CHT
Developme
nt
 ESP Service
expansion
 Brand
Promotion
 NGO/srunningSH clinics will
able to furtherexpansionof
the ESP Services
 NGO/srunningSH clinicswill
ensure visualizationof
supportingorganization
(brandpromotion)
 Service
expansion
(bothclinic
expansion
and service
expansion)
 increase
visualizatio
n
 Brand
promotion
UNDP  Comprehe
nsive
quality
health
service
deliveryto
 Integrationof capacity
developmenteffortsof the
service providers
 Integrationof servicesfor
providingcomprehensive
healthcare servicestothe
 Establishme
nt of new
clinics
 Expansionof
areas/servic
eswiththe
 increase
utilization
of existing
services
and
personnel

10. 10 | P a g e
Partners/
Program
Activities Modality
Benefits
NHSDP
Partner
Organization
the
communit
y
 Reduce
duplication
of services
insame
area
community.
 UNDP will allow NHSDP/NGOs
to use theirGIS map to design
appropriate interventions
 UNDP can donate fundfor
establishmentof new SH
clinics
 NHSDPNGOs will ensure
visualizationof donor
organization
helpof GIS
map
 Obtain
leadershipin
healthcare
deliveryin
CHT
 More
areas will
be
covered
 Leadershi
p inthe
communit
y
UNICEF Integrationof
services
 SH clinicwill implement
school healthprogram.
 UNICEF will referSHclinicsfor
necessaryhealthservicesof
theirbeneficiaries(education
and WATSAN)
 SH clinicswill provideservices
at a reducedprice toWFP
referredclients
 Service
expansion
 Area
expansion
 Increased
customer
base
 Integrate
d
program
approach
es
WFP Integrationof
services
 WFP couldintegrate other
nutritional servicesoffered
fromSH clinics
 WFP couldrefertheirclients
to SH clinicsforhealth
services
 SH clinicswill provideservices
at a reducedprice toWFP
referredclients
 Increased
customer
base
 Integrate
d
program
approach
es
MAMA
(Aponjon)
 Service
promotion
 Increase
clientbase
 MAMA will refertheir
mHealthrecipientstoSH
clinics
 NGO/SHwill helpMAMA for
acquiringnew mHealthclients
inCHT.
 Service
promotion
 Increase
customer
base
 Increase
mHealth
service
recipients
inCHT
BIID (e-
Clinics)
 Establishm
entof e-
Clinicsin
SH clinics
 BIID will provide support
(technical &logistics)to
establishe-ClinicsatSHclinic
premises
 BIID will developcapacityof
concerned SH staffsto
provide telemedicine services
 NGO/SHclinicswill ensure
quality telemedicine services
withinSHclinics
 New
services
 Increase
clientflow
 Increase
cost
recovery
 Obtain
leadershipI
health
service
delivery
 E-Clinic
network
increased
 Increase
cost
recovery

11. 11 | P a g e
Partners/
Program
Activities Modality
Benefits
NHSDP
Partner
Organization
SMC (Blue-
Star
program)
 Strengthen
ingreferral
linkage
 Product
promotion
 Service
promotion
 SMC Blue-StarProviderswill
refersuspectedTBcasesand
LAPMusersto nearbySH
clinics
 SH clinicswill provideservices
at a reducedprice toBlue-
Star providers’referred
clients
 SMC will promote SHclinics
throughtheirsafety-kits
 SH clinicwill sale Safety-kits
and recommenditfortheir
clientforcleanhome delivery.
 Increased
customer
base
 Promotion
of services
 Blue-Star
clientwill
get
comprehe
nsive
quality
services
 Safety-kit
sales
increased
Other
National or
local NGOs
 Service
promotion
 Service
integration
 Area
expansion
 As perthe modalityof work  Winwin
situation
 Winwin
situation
6. Conclusion
CHT is a veryvulnerable place foranydisease outbreakanddue toweakMIS the real situation is not
visible.The services provided by the government partially met the health need of the community.
Still there are huge uncoveredareas in CHT and there are overlapping/duplication of programs and
of fieldworkers. People needmore comprehensive andintegratedservices and addressing cultural
and linguistic barriers are important in this regard. That’s why the existing GoB facilities always
remainunderutilized.Onlyduringthe emergencythe people preferhospital.Becauseof povertyand
socio-demographic ineptness people like to get primary health care services nearer to their
community. Individual organization is not sufficient to design any program to address the health
needs of these hard to reach underprivileged population of the country. It also depends on
improvement of road communication system, community awareness (education & service
promotion) and expansion of existing services in the vicinity of urban and peri-urban areas.
Communitypeople donotwantto be referreddue totheirfinancial crisis.Sotheyneedmore facility
along with better service to change their mind to move towards facility. So, coordination and
collaboration of existing services offered by different Government end non Government
organization is mandatory for geographical extension and service expansion by the NGO/s and SH
clinics working in CHT

12. 12 | P a g e
References
1. HealthBulletin2009, ManagementInformationSystem, DirectorGeneral HealthService,
Mohakhali,Dhaka1212, www.dghs.gov.bd
2. BangladeshBureauOf Statistics; ParishankhanBhaban(8thfloor,Block-1),E-27/A,
Agargaon,Dhaka-1207, Phone Number:8802-9137322-3
3. MinistryOf HealthAndFamilyWelfare;Social AssessmentandTribal HealthNutritionand
PopulationPlanforthe HNPSectorProgramme (2005 to 2010);
4. WHO/SDE/HSD/99.1; The HealthOf IndigenousPeoples
5. Bestpractices& alternative integratedcommunitybasedmodel indeliveringprimaryhealth
care service forChittagonghill tractsof Bangladesh Appropriateprimaryhealthcare strategy
for ChittagongHill Tractsof Bangladesh –Studyconductedby Dr. ASMSayemin 20011
Email:drsayem007@yahoo.com