4. Sites ofVisits
• DOTS Corner
• EPI CentreDay 1
• Western Marine ShipyardDay 2
• Fish Inspection & Quality
Control OfficeDay 3
• Clifton Garments BayezidDay 4
• SOS Children’sVillage
Day 5
5. Sites ofVisits
• Bangladesh Institute ofTropical &
Infectious DiseaseDay 6
• Faujdarhat Cadet CollegeDay 7
• Wahidpur Health and Family Welfare
CentreDay 8
• Mirsharai Upazilla Health and
Family Welfare Complex
Day 9
• Society for theWelfare of the
Intellectually DisabledDay 10
6. DAY 1
DOTS Corner & EPI Center, CMCH
Supervisor: Dr. Ajoy Deb
January 31,2016
7. DOTS stands for Directly Observed Treatment Short course
It is an organization supported by BRAC in
collaboration with the Ministry of Health,
providing services to all sector of people for
diagnosis, treatment, follow up &
management ofTB patient and distributing
Anti-TB drugs free of cost.
8. EPIstands for expanded programme on
immunization.In Bangladesh,it was formerly launched
on 7th april,in 1979.it attempts to eradicate some
vaccine preventable diseases.Financial and logistic
support of the organization is provided by both
government of Bangladesh and BRAC.
9. Purpose ofVisit
To get idea about EPI schedule.
To observe the procedure of vaccination.
To learn about preservation methods of vaccines
To collect information about DOTS program.
To observe the distribution of different types of
drugs ofTB and management system.
11. Functions
•To provide vaccination
according to EPI schedule
•To provide TT vaccine for
women of reproductive age
•Sputum examinations and
record keeping to help in
the diagnosis of TB
•To provide and ensure
drugs for the treatment of
TB
•Referral system for TB
patients
12. Strengths Limitations
•100% financial support
from the government.
•Professional health care
providers.
•Provide vaccine and
drug free of cost.
•Lack of manpower in
DOTS.
•Inadequate supply of
vaccine.
•Insufficient space in EPI
and DOTS
13. Suggestions
•Provision of trained manpower in DOTS
•Improve the supply and preservation of
vaccine
•Provision of modern equipment, a larger
working space
•Organize regular health education session
14.
15. DAY 2
Western Marine Shipyard , LTD, Chittagong
Supervisor: Dr. Priyotosh Das
February 02 , 2016
16. •Western Marine Shipyard is a
Bangladeshi shipbuilding company. It was founded in 2000 and have
since become the second largest Bangladeshi shipbuilder in terms of
number of vessel manufactured. It focuses on designing and building
vessels for private customers in addition to Bangladesh Inland transport
corporation.It is the only one international shipyard of Bangladesh. It is
our pride.
.
17. Purpose
•To see the health status of the employees
•To get idea about the organization
• To get idea about the organogram of the organization
•To observe the activities of the organization
•To find out the limitations of the organization
20. Strengths
• They are equipped with skilled manpower
• They are assisted by some international and foreign companies
• They have well electrical maintenance
Limitations
• No indoor services for severely injured workers
• They lack some medico-technical support such as x-ray and ECG
machine
• Shortage of safety instruments
21. Suggestions
• Indoor services should be provided and outdoors services
should be strengthen
• Technical support should be increased in their Primary Health
Complex
• Arrangement of sufficient safety instruments
22.
23. DAY 3
Fish Inspection and Quality Control Office
Supervisor: Dr. Zahura Khanam
February 03, 2016
24. Introduction
We all know that fish and fish products are important assets of
our country. We earn approximately 2000 crores revenues every
year from this sector. We visited ‘Fish Inspection and Quality
Control Office (FIQC)’ which deals with various aspects of fish
related export products.
25. Purpose
•To determine the organogram of this organization.
• To observe the facilities provided by them.
• To evaluate the effectivity of their program
• To Find out the limitations of the organization
27. Functions• Regulatory authority for quality control of fish and fishery
products.
• Ensure the production of safe and quality fish and fishery
products.
• Implement and enforce the fish & fishery products
(Inspection and quality control) Rules 1997 and amendment
2008.
• Certify fishery products for export.
• Provide advisory service to fishery industries and
establishments related to these industries.
• Ensure safe fish and fishery for local market.
28. 1.Fund is provided by
Bangladesh government.
2.They have accredited
microbiological and chemical lab
3.They have ISO certificate.
4.Sufficient trained manpower
including 24 officers & 16 stuffs.
Strengths Limitations
1.Lack of manpower
2.No screening for local
markets
3.Space constraints
29. Suggestion
•Manpower should be increased.
•Should be updated with latest technology.
•Increasing their coverage including the
local markets.
30.
31. DAY 4
Clifton textiles and apparels Ltd, Bayezid
Supervisor: Dr.Tazkia Bashir Ullah
February 04, 2016
32. Introduction
• Under the guidance of Dr.Tazkia Bashir Ullah we
went to ISO certified Clifton textile and apparels
on February 04, 2016.It was established in 1985.
It is a leading textile among textiles of
Bangladesh
33. • To get acquainted with overall activities of the organization
• To be able to know about the garment industries of our country
• To observe which facilities are given to the worker
• To inquire about giving cash to the workers due to employment injury
according to “The Employees state Insurance Act “ which was passed in 1948
• To find out the safety facilities for the worker when any emergency arises
Purpose
35. Function
• It has a good reputation of getting new orders especially from the Europe ,
USA , Japan market
• It provides ready made garments of leading buyers like HUGO
BOSS,MARKS & SPENCER , NANITY ,FAIR etc.
• They play a huge role in earning foreign currency
• It deals with the famous companies of the world sleepwear, knit dress top,
sports bra,Underwear , thermal quality product , service and fair price
36. Strengths Limitations
1.They have ensured to bear
healthcare costs in case of accident
and gives anti-natal care for
pregnant female workers
2.They have sufficient machineries
to produce products at their highest
capacity
3.They have healthcare center for
the workers which has six doctors
and six nurses and referral system
1. Lack of automatic fire safety
system
2. Losing profit due to lack of skilled
manpower
3. Dirty hall and inefficient daycare
system
37. Suggestions
• To train and employ skilled manpower
• To improve health facilities and
daycare centre
• To improve the drawbacks in the fire
safety measures
40. • We, the students of 4th year MBBS, RFST “E” Group
set out for the visit at SOS Children’sVillage,
Chittagong from the department of community
medicine under the guidance of our beloved teacher
Dr. Zubaida Khanam. After reaching at SOS Children
Village, we met Md. Faizul Kabir (project director). He
warmly welcomed us and introduce himself.Then he
delivered an speech about this institution as well as
his role.
41. Purpose
• To get knowledge about the activities of SOS ChildrenVillage.
• To familiarize the organogram.
• To observe the service, facilities which is provided to the
orphan
and abandoned children.
• To evaluate the limitation and source of financial support.
43. Functions
• Bringing up orphan, abandoned, neglected children
(<13 years) under the care of SOS mother in family
environment
• Giving proper education or vocational training which
lead them to find out the way of getting established.
•Supporting program like Immunization, FSP (Family
strengthening program), monthly refreshing tour
take place
44. Strength Limitations
Beautiful and well
furnished building.
Dedicated SOS mother
and official staff.
Healthy and hygienic
environment.
Getting donation from
foreign sponsorship.
Shortage of manpower
and medical person.
Only 130 resident
capacity.
Deficiency in standard
grooming of children due to
absence of expert persons.
Insufficiency of monthly
budget.
45. Suggestions
• Expanding this school section up to SSC.
• Increase knowledgeable manpower.
• Sufficient monthly budget for the children.
• Increase accommodation facility for orphan and
abandoned child.
46.
47. DAY 6
Bangladesh Institute ofTropical and Infectious Diseases
Supervisor:Dr. Shawon Barua and Dr. Farhana
February 7,2016
48. We,the students of 4th years MBBS, RFST
E Group set out for the visit at BITID,
Chittagong from the department of
Community Medicine under the guidance
of our honorable teacher Dr. Shawon
Barua and Dr. Farhana. After reaching at
11.30 am at BITID, we met with Dr.
Narayan Chandra Director of BITID.
There was present Dr. Mamunur Rashid
Associate professor of Tropical Medicine.
49. Purpose
•To be acquainted with the services provided by these
institute.
•To learn about the administrative Organogram of the
institute.
•To observe the facilities and strengths available of the
hospital.
•To find out weakness or limitations.
•To acquire knowledge about tropical and infections
disease.
50.
51. Provided Services
• Outdoor department-
10
• Indoor department- 6
• Emergency
department
• Librarians- 5
• Scientific Officers- 10
• IT Section- Death
Review
• Laboratory- Bio-
Safety Laboratory
Investigations Done
• Virology
• Tropical Pathology
• Tropical Microbiology
• Tropical radiology
• CT Scan
• MRI
Facilities
• To provide early
diagnosis and
treatment to reduce
mortality and
morbidity rate among
the community.
• The institute creates
awareness among the
community about
various tropical and
infectious diseases
Functions
52. Strengths
• It is the only research based hospital in the country provided with bio-safety
laboratory.
• Research activities will be arrived out in collaboration with ICDDRB, Dhaka.
• Financial and administrative supports are given by government of
Bangladesh and foundation of Mauro, France
Limitations
• Limited indoor service
• Limited emergency service
• Adequate laboratory instrument and furniture are not available.
• Manpower shortage
• Structural limitation
• No ICU, CCU
53. Suggestions
•Adequate laboratory equipment should be provided
•Adequate clinical instrument should be supplied
•The services of this institute must be provided to the root
level of the community.
56. The students of RFST batch E,4th year MBBS
visited the Faujdarhat cadet
college,Faujdarhat,Chittagong on 08.02.16 with
the guidance of Dr. Narayan Chandra
Das.Faujdarhat cadet college was established in
1958.It is the first & largest cadet college in
Bangladesh.
57. Purpose
• To observe the activities of this organization .
• To get about the organogram of this
institution
• To determine the strength and facilities of this
institution.
• To get information about the health care
facilities of this institution
59. Functions
1.Educate the students on national curriculam.
2.Teach & alert the students about
discipline,honesty,integrity,bravery and patriotism.
3.Give military training to students.
4.Encourage the students to connect with different
extracurricular activities to refresh their mental health.
5.Engage the students with different types of sports for the
fitness of their physical health
61. Suggestions
1.Financial support should be
increased and govt. should
provide adequate fund.
2.More specialized doctors
should be get appointed.
3.Technical facilities &
surgical facilities should be
improved.
62.
63. DAY 8
Wahidpur Health and Family Welfare Center,
Mirsharai, Chittagong
Supervisor:Dr. Ajoy Deb
February 9,2016
1stVISIT
64. Introduction
• We, the students of 4th year MBBS, RFST “E” Group set out for the visit at
Wahidpur Health and Family Welfare Center from the department of
community medicine under the guidance Dr. Ajoy Deb. After reaching, we
met the medical officer. She warmly welcomed us and introduced herself.
Then she delivered a speech about this center as well as her role.
65. • To observe the services provided by the health center
• To learn the organogram
• To get idea about the limitations, logistics, and financial
support
67. Functions
• Health care facilities at Union level
• Minimum treatment facilities are given through outdoor
services
• Domiciliary services and family planning service through FWV
• Provision of different drugs and contraceptive tools
• Implement activities of higher authorities
68. Strengths
• All primary health care facilities available
at Union level.
• Responsibility, honesty and discipline are maintained
• Strictly monitored by Ministry of health and family
• welfare
Limitations
• Inadequate drug supply
• Suture materials and other instruments are insufficient
• There is no indoor services and ambulances
• Inadequate building maintenance and furniture
69. •Amount of supplied drugs should
be increased.
•A medical technician (pharmacy)
should be appointed.
•Indoor services should be started
for medical emergency.
70.
71. DAY 8
2nd Visit
Ali Akber Chowdhury Community Clinic
Supervisor: Dr.Ajoy Deb
February 9,2016
72. As per schedule from 11.30am to 12.30pm, we
started our 2nd visit to Ali Akber Chowdhury
Community Clinic,there we met the community
health care provider Moriom Begum.She received us
warmly and told us about various activities of the
clinic.
73. Purpose
• To attain information about
the community clinic
• To get acquainted with the
most route level PHC
structure and its
management
• To observe the functions of
FWA and HA
• To view the grass root level
of health care facility of
Bangladesh
75. Functions
• Advice on family planning and supply of family
planning commodities
• Supply of essential drugs
• FWA gives nutritional and maternal advice
• Conduct EPI program andTT vaccination
76. Strengths
Limitations
• Community donated land
• Door to door family
planning service
• Community participation
• Application of IT
technology
• Scarcity of electricity and
water
• Insufficient drug supply
79. DAY 9
Mirsharai Upazilla Health and Family Welfare Complex
Mirsharai,Chittagong
Supervisor:Dr. Ajoy Deb
February 10,2016
80. • In the morning, we went to upazilla health
complex at Mirsharai upazilla, Chittagong with
our guide teacher Dr. Ajoy Deb. We met UH&FPO
who discussed about the indoor, outdoor
activities and services provided by the complex.
We also got information about activities,
strengths, lacking's, organogram etc. of the UHC.
81. Purpose
• To observe the facilities provided
by the health complex.
• To understand the health care
settings at union level.
• To know the interest of the people
about getting health care in
UH&FWC.
• To find out the organogram,
limitations and strength of the
institution.
83. Organogram(Cont.)
Health
Services
• Ward boy
• Night guard
• Gardener:1
• Store
keeper:1
• Cooker:1
• Ambulance
driver:1
• MLSS:4
• Technologist
(7)
a. Lab
Technologist:3
b. Dental
Technology:1
c. Radiology and
Imaging:1
d. EPI
Technologist:1
e. Pharmacist:1
• MO(2)
• Dental
Surgeon(1)
• Medical
Assistant(2)
• Nursing
staff(2)
• Resident Medical
Officer(1)
• Consultant(10)
a. Medicine:1
b. Surgery:1
c. Gynaecology:1
d. Anaesthesis:1
e. Orthopaedics:1
f. Opthalmology
g. Skin &VDRL:1
h. ENT:1
84. Functions
Indoor Services
• Indoor service
includes 2 wards-
male and female
wards combines
with pediatric
department
consisting of 31
beds. Here
treatment is given
for 24 hours.
Outdoor Services
• In OPD top5
diseases such as
PUD, diarrhoea,
leprosy,TB,Malaria
are observed.
Outdoor facilities
are given from 8 am
to 2.30 pm.
Emergency Services
• About 250 patients
come here daily.
Common diseases
encountered in
emergency are RTA,
ARI, Acute watery
diarrhoea, OPC
poisoning, full term
pregnancy with
labor pain.
85. EPI
• There are 2 EPI technicians. EPI services
are provided 6 days except Friday. Here
vaccines are preserved in cold chain
system.
Emergency Obstretic
Care
• Basic components of EOC are provided by UH&FWC.The EOC department is on the
second floor. Here facilities are provided by junior consultant, MO, Nurse, OT boy.
86. Family Planning
Services
In the health complex, family planning service
along with health service are available.The
patient does not have to pay for the services.
Family planning methods of permanent and
temporary are given at free of cost.
These are-
• Vasectomy
• Tubal Ligation
• CopperT
• Implant
• Condom
• OCP
• Injectables
87. Demand Site
Financing
This program is held under the supervision of
UH&FPO. In order to encourage mothers to
seek health services during pregnancy, they
are offered some money. Usually for normal
delivery 800 tk and for caesarian section 3000
tk is given. women whose family income is
less than 2500 hundred per month are eligible
for this service. No one gets money after 2nd
child.
88. Strengths
• Sufficient doctors are present here.
• Specialized lab facility present here.
• Monthly wages are properly distributed here in time.
Limitations
• There is no facility of continuous water supply and electricity.
• There is lack of adequate manpower.
• Health complex is far away from different community of the upazilla.
• Many patients come with RTA but there is no trauma centre to
handle these traumatized patients.
• There is allotment of 51 beds but only facility for 31 beds is present.
89. Suggestions
1.Govt. should give more attention to utilize the facilities
present in the institute.
2.More fund should be provided for the development of the
institute.
90.
91. DAY 10
Society for the Welfare of the Intellectually Disabled(SWID)
Supervisor: Dr. Hasina Momtaj Hira
February 11,2016
92. • As per schedule from 8.30am to 1.00pm we started our
local visit to SWID School for the intellectually disabled
Chittagong branch.The principal of the school received
warmly.The school was established in 1981.The school
starts from 9am to 1.00pm.Total student of the school is
200.
93. I. Get exposed with the services provided by SWID.
II. To learn the organogram of the institution.
III.To know about the academic activities of the institute.
IV.To get idea about manpower, financial and logistic
support of this organization.
V. To observe their drawbacks.
94.
95. Function
• Helping the intellectually disabled children.
• Giving training about some extracurricular activities.
• Giving training about behavioral activities.
• To conduct the self developing activities for the disabled children
• Physiotherapy is given for the patients of cerebral palsy & sensory
therapy is given for autism.
96. Strengths
• Staff salaries are given by
Protibandhi foundation.
• Others expenses are
obtained from tution fees
& donation
Limitations
• There is not enough
space for room and field.
• Lack of adequate
teacher for guiding.
• Difficulty in raising the
fund.
• Poor guardian
compliances.
97. Recommendations
•Activaties for raising the fund should be performed.
•More trained manpower should be recruited.
•Accommodation problem should be solved.
•Wide range of media coverage is needed.
101. BACKGROUND
The study was conducted on 9th February 2016 at
Masjidia,village of Mirsarai,ctg. The aim was to
know about the disease pattern & treatment
related cost of last one year of the respondents
families
103. SPECIFIC
OBJECTIVES
• To know the socio-economic
status of the families
• To identify the health seeking
behavior of the families
104. ETHICAL
CONSIDERATION
•When we began each interview, we
introduced ourselves, stated our purpose,
and assured each person that the
information we collected from them would
remain confidential.
•We maintained the privacy for female
respondents.
105. METHODOLOGY
Type of study
Descriptive type of cross sectional study
Time of data collection
11.00 A.M. – 3.00 P.M.
Place of Study
The study was done in Masjidia village
of Mirsarai, Chittagong
Population
All the people in the locality
106. METHODOLOGY
Sample size 152
Sampling was done by Convenience Type
of Non-Probability technique
Inclusion Criteria
People present during the study time who has
given consent to participate in our study
Exclusion Criteria
People who were not present during the study
time ,those who could not respond to us & sick
person
112. 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00%
Percentage
Female Male
Gender
Of total respondents , 69.08% were females and rest 30.92% were males
Gender distribution of respondents
113. 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00%
Islam
Hinduism
92.11%
7.89%
Religion
92.11 % of the respondent belonged to ISLAMand 7.89% to HINDUISM
117. 62.5
25
11.84
0.66
0
10
20
30
40
50
60
70
1 2 3 4 & above
Number of earning members
62.5% had only one member ,25% had 2 members , 11.84% had 3 members
and 0.66% had 4 and above members earning members in their families
118. 0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
Govt. Job Private Job Business Teacher Village
doctor
Worker Farmer Abroad Job Others
OCCUPATION
Among interviewed families the occupation of the earning member of the families constitute 4.88%
Govt. Job, 19.55%Private Job, 26.66% Business, 1.33%Teacher ,0.44%Village Doctor,
8.44% Worker , 9.77% Farmer ,19.55%Abroad Job ,9.33% Others
Occupation of the earning members of the family
121. 5
3
6
8
20
42
22.73
16.67
30
25
33.33
100
1
2
3
4
5& ABOVE
TOTAL
Family Members Suffering from Diseases and Comparative
Percentage
Diseased member Percentage(%) of diseased member
1 member of family is suffering from disease constitutes 22.73%,2 members that is
16.67%,3 members constitutes 30%,4 members 25% and 5 above that is 33.33%
122. Purpose Total (TK) Percentage
A Medication purchase 1063380 48.99%
B Transport 224185 10.33%
C Special diet 14780 0.68%
D Consultation 548732 25.28%
E Referral 8200 0.38%
F Investigation 278320 12.82%
G Others (Work loss, absence
etc.)
33000 1.52%
Total = 2170597
Treatment cost for illness of respondent in 2015
123. Maximum cost is occupied by Medication Purchase ,49%;then Consultation cost which is 25%,for
Investigation Purpose it is 13%,Transport Purpose it is 10%, for Special Diet purpose it is 1% total costs
Treatment cost for illness of respondent in 2015
Medication
purchase
49%
Transport
10%Special diet
1%
Consultation
25%
Investigation
13%
Others (Work loss,
absence etc.)
2%
Medication purchase
Transport
Special diet
Consultation
Investigation
Others (Work loss,
absence etc.)
124. Purpose Total (TK) Percentage
A Medication purchase 275676 63.72%
B Transport 54492 12.60%
C Special diet 1000 0.23%
D Consultation 42550 9.83%
E Referral 300 0.07%
F Investigation 52650 12.16%
G Others (Work loss, absence etc.) 6000 1.39%
Total = 432668
Treatment cost for respondent’s present illness
125. Medication purchase
64%Transport
13%
Consultation
10%
Investigation
12%
Others (Work loss,
absence etc.)
1%
Medication
purchase
Transport
Consultation
Investigation
Others (Work loss,
absence etc.)
Treatment cost for respondent’s present illness
Maximum cost is occupied by Medication Purchase ,64%;then Consultation cost which is 10%,for
Investigation Purpose it is 12%,Transport Purpose it is 13%, for other purposes it is 1% of total costs
126. Purpose Total(TK) Percentage
A Medication purchase 1727007 60.44%
B Transport 289945 10.15%
C Special diet 21365 0.76%
D Consultation 330430 11.56%
E Referral 47960 1.68%
F Investigation 253510 8.87%
G Others (Work loss, absence
etc.)
187000 6.54%
Treatment cost for illness of family members in 2015
127. Medication purchase
60%
Transport
10%
Special diet
1%
Consultation
12%
Referral
2%
Investigation
9%
Others (Work loss, absence
etc.)
6%
Medication purchase Transport Special diet Consultation Referral Investigation Others (Work loss, absence etc.)
Treatment cost for illness of family members in 2015
MaximumcostisoccupiedbyMedication Purchase,60%;thenConsultationcostwhichis 12%,forInvestigation
Purposeitis9%,TransportPurposeitis10%,forotherpurposesitis6%,forreferralpurpose 2%oftotalcosts
128. Purpose Total(TK) Percentage
A Medication purchase 879611 82.05 %
B Transport 66929.62 6.24%
C Special diet 4010 0.37%
D Consultation 43473 4.05%
E Referral 19950 1.87%
F Investigation 49480 4.62%
G Others (Work loss,
absence etc.)
8600 0.81%
Total = 1072053.62
Treatment cost for family members’ present illness
130. CONCLUSION
We came to conclude that majority of the villagers
belonged to the middle class of social strata but they
had to spend 1/3 of their yearly income just on
treatment purpose. We divided the total treatment
cost into costs involving medication, transport,
special diet, consultation, referral, investigation etc.
If awareness concerning the Govt. projects on
prevention of diseases could be raised among the
people by leaflets, fliers, posters, PVCs, short
documentaries, featured films etc. then this burden
of unnecessary treatment costs could have been
ameliorated.
