bees health program at a glance 01
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Background
Starting in the early 1979s, BEES was able to contribute to improve the health condition in its
working areas reducing the maternal and child mortality rate with desired success. This
impressive gain has been sustained in expanding intervention areas to the recent years, which
exemplifies the strong commitment of BEES towards healthy future for all. BEES believes thatpoor health outcomes undermine national and household productivity gravely in the existing
generation and the next. A well-
designed and essential health careservice that benefits and protects the
poor is an investment in national
productivity, social inclusiveness andstability. In the course of implementing
multi-dimensional health programs to
enhance health care services atcommunity level, BEES is still facing
enormous competing social challengesassociated with poverty, gender,
education, environmental factors and soon. Nonetheless, BEES has been
achieving impressive health outcomes
over the years for its great commitmentto sound health for sound nation. This is to say that barriers to enjoying essential health care for
poor people often become a source of increasing social unproductivity and impoverishment. To
meet the increasing need & demand in the intervention areas, BEES is responding in a range ofways to help community people expand and improve their awareness of health providing direct,
long or short term development assistance like preventive and basic curative health-care services
with component of primary health care, family planning, nutrition, food security, homesteadgardening, cooking demonstration, growth monitoring, immunization, water & sanitation, arsenic
mitigation, HIV/AIDS prevention and so on .
Target Area & Population
Presently BEES has been operating its integrated health & development activities spread over a strong
network consisting of 17 Area offices, 110 Unit Offices (branches) and one Central Office located in
Dhaka, 3,069 community nutrition centers (CNCs) covering approx. 3,400 villages under 481 unions of
84 upazilas in 31 districts of Bangladesh. The districts are- Dhaka, Gazipur, Hobigonj, Brahmanbaria,
Narshingdi, Kishorgonj, Faridpur, Madaripur, Gopalgonj, Meherpur, Magura, Chuandanga, Bogra,
Joypurhat, Noagaon, Natore, Rajshahi, Gaibandha, Rangpur, Pabna, Sirajgonj, Jamalpur, Mymensingh,
Netrokona, Sherpur, Comilla, Feni, Laxmipur, Noakhali and Chittagong.
BEES has established a sturdy association among and with more than 45 lac people, mostly
disadvantaged, deprived of all kinds of human rights, social security as well as vulnerable to HIV-
AIDS/STDs/STIs, malnutrition & ill health, who are receiving development services from BEES.
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Health Program: Its Components
BEES has been providing different types of health services at community level to its target groups
catering to them under its health & development oriented programs, projects and activities. These are:
o Health Services through Sebao National Nutrition Program (NNP)o HIV/AIDS Prevention Programo Community Based Health Programo Water & Sanitationo Nutrition Surveillance Project (NSP)o Human Resource Development through Training
Health Services through Seba
Health Services through Seba is a self-sustaining program supported
by Microfinance Program. Under this activity, comprehensive healthactivity is being implemented in 35 upazilas of 30 districts in 5divisions of Bangladesh by 35 qualified Paramedics under the direct
supervision of 2 doctors.
In the intervention areas of SEBA Health, paramedics are providing the following services:
Pregnancy weight gain monitoring and promotion by bathroom scale; and promotion(including counseling on improved caring and feeding practices).
Identifying malnourished pregnant women with BMI < 17.0; and giving counseling onimproved and demonstrative feeding to prevent malnutrition.
Delivering Ante Natal Care (ANC). Identifying pregnancy related complications and
early risk-delivery through routine close follow-up
and checking B.P., urine sugar and albumin.
Conducting normal deliveries and referring cases ofpregnancy complications and difficult delivery.
Providing Iron-Folate tablets to the pregnantwomen.
Delivering Post Natal Care (PNC). Givingawareness to lactating mothers for colostrums and breast-feeding.
Ensuring the vitamin-A for lactating mothers through coordination and collaboration withthe local UHC/USC/FWC. Monthly growth monitoring of children less than 5 years of age by Salter scale / bathroom
scale; and promotion (including counseling on improved caring and complementaryfeeding practices).
Giving EPI counseling and motivating the parents of children to attend the local EPIcenters. For immunization of the women of reproductive age and children Paramedics
doing coordination and collaboration with the government health facilities of the locality.
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Providing de-worming tablets through limited curative treatment for children below 5 yearsold and adolescent girls to prevent malnutrition.
Giving contraceptive and population control counseling to the beneficiaries, and guidingand helping them through FWC.
Giving awareness for personal hygiene, safe water & sanitary latrine. Delivering essential drug based limited curative cares (free diagnosis, prescription,
counseling and medicine supply).
Cooking demonstration & home gardening for prevention of malnutrition pregnant women,lactating mothers, and adolescent girls and U-5 children..
Motivating the beneficiaries to participate in the National and International Health Dayslike NID, National Vitamin-A Campaign, World Health Day, etc.
In the satellite clinic following BCC are delivered among the unmarried adolescent girls (13-19
years old), pregnant women, lactating mothers and mother-in-laws:
i. Breastfeeding promotion and protection and IYCF (Infant & Young ChildrenFeeding).
ii. Bad effects of early marriage.iii. Pre-delivery preparations.iv. Risks of pre-eclampsia and eclampsia.v. Family planning.vi. Prevention of HIV/AIDS.
In the satellite and static clinics following prescription based following limited curative care aredelivered:
i. ARI, pneumonia and asthma.ii. Gastric acidity.iii. Diarrhea, typhoid and paratyphoid.iv. Worm infestation.v. Pre-eclampsia and eclampsia.vi. Skin, eye and ear diseases.
In the satellite and static clinics followingdiagnostic procedures are done:
i. Pregnancy test.ii. Detection urine sugar.iii. Detection urine protein (albumin).
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Thus, with other activities of SEBA Package, SEBA Health is being carried out to bring adevelopment in health related aspects for the family members of the beneficiaries parallel to MF
loan facilities for them. Community people can also avail the services by payment of nominal
fee.
National Nutrition ProgramWithout nutrition awareness development can bear no fruit at all. Mulling over this moot point, BEES is
enhancing its efforts to advancing development continuously through executing nutrition projects like
NNP at field level. National Nutrition Program (NNP)
is a program of Ministry of Health & Family Welfare
with the financial support of World Bank. This project
commenced on December 2003 with the vision to
reduce malnutrition, particularly among women and
children, to the extent that it ceases to be a public
health problem. Its goal is to develop and strengthen
communities capacity to assess, and analyze the
causes of their malnutrition problems and to makebetter use of family, community and external
resources to improve the nutritional status of
vulnerable groups. Food insecurity is not only the
cause of malnutrition; behavior, social attitudes, and a
lack of understanding and knowledge of nutritional
needs tend to be associated with this. Since September 1, 2006, NNP has been working under HNPSP
(Health, Nutrition & Population Sector Program). According to this new sector, specific objectives of
nutrition package have been modified from NNP to HNPSP as follows:
To reduce the prevalence of Low Birth Weight (
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Components of NNP:
A. Services Component-a. Area-Based Community Nutrition (ABCN) Services
b. National Level Nutrition Services
B. Project Support and Institutional Development
Component-a. Project Management and Development
b. Monitoring and Evaluation
c. Training and Behavior Change
Communication
Geographical Coverage: BEES has beenproviding the core ABCN services in 6 upazillas
(Tongipara, Gopalgonj Sadar, Muksudpur,
Bhanga, Sadarpur and Madaripur Sadar) under 3
districts (Gopalgonj, Faridpur and Madaripur)
through area package # 10, in 4 upazilas
(Fatikchhari, Hathazari, Anwara and Bashkhali) of Chittagong district and in 4 upazilas (Patnitala,Dhamoirhat, Porsha and Sapahar ) of Naqgan district under area package # 32 of NNP.
Target Beneficiaries:
Children less than 2 years old Pregnant women Lactating mothers Unmarried adolescent girls Newly married women
HIV/AIDS Prevention ProgramWith the objectives to strengthen
capacity and knowledge of
beneficiaries, staff and other
stakeholders like CBOs on HIV/AIDS
in project intervention areas, BEES has
been implementing HIV/AIDS
prevention programs over the years at
the community, sub national and
national level. Major strategies related
to this program are to train staff, project
personnel & other stakeholders for
instance CBO members to increase
knowledge & awareness of HIV/AIDS
and make community people involved
with AIDS prevention through
community based BCC & Advocacy
program.
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To run it as an on-going program comprehensively, BEES has set-up offices comprising satellite & static
clinics and drop-in centre in the intervention areas catering to the communities. BEES provides services
to the community people especially garment workers, slum dwellers a nd workers of hotel & tea garden,
different stakeholders including GO-NGO representatives, CBO executive members, UP Chairmen,
women members, school teachers, local elites, imams, social workers and local journalists. Under the
HIV/AIDS Prevention Program, all of them are being sensitized regularly on HIV/AIDS. Alongside,
respective project personnel always maintain liaison with other stakeholders related to HIV/AIDSprograms, and exchange information for smooth implementation. Mainly BEES in implementing the
HIV/AIDS Prevention Program through:
Direct interventions as core program on HIV/AIDS Prevention Integrated approach inbuilt with different health programs.
Key prevention strategies of BEES AIDS Prevention Programs:
HIV prevention counseling and referral services: Individuals at risk for HIV are offered counselingregarding methods to eliminate or reduce their risk that they can be aware of their status and take
steps to protect their own health and that of their partners. BEES issues guidelines that are used to
develop counseling and referral services in traditional and non-traditional settings and provides social
support/assistance intended for counseling services provided at publicly static & satellite clinics.
Partner notification, including partner counseling and referral services (PCRS) with stronglinkages to prevention and treatment/care services: Sexual or needle-sharing partners of HIV-
infected persons are at-risk of being infected. Partner notification services trace out these individuals
and provide counseling and education to them about the exposure as well as services to prevent
infection or, if infected, linkages to care. BEES issues guidance on conducting PCRS and provides all
kinds of social assistance to local stakeholders like CBOs to ensure that PCRS is a high-priority and
that services are offered to all vulnerable people.
Prevention for high-risk populations:Prevention efforts for high-risk populations are
critical to reducing the spread of HIV. Efforts
ensure that those at highest risk of acquiring or
transmitting the virus are given the necessary
information & messages to protect themselves
and others. BEES supports prevention services
for persons drastically vulnerable to HIV/AIDS
and other high-risk populations susceptible to
STDs/STIs. In addition, BEES encourages all
grantees to work with the primary health care
clinics in their communities to integrate HIV
prevention services into care and treatment services.
Health education and risk reduction (HE/RR) activities: Health education is a powerful tool in theprevention of HIV. HE/RR services include individual, group, community and structural interventions
as well as prevention case management and outreach for high-risk community people. BEES alsoincludes health communication and public information programs for at-risk populations and the
general public. It supports focused health communications campaigns directly and provides technical
assistance to CBOs to offer HE/RR services focused on those most at-risk of transmitting or acquiring
HIV infection.
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Prenatal transmission prevention: When the HIV status of a pregnant woman is known, treatment ofthe woman and her infant and other preventive measures can substantially reduce the risk of HIV
transmission to the infant. BEES works with all health-care providers available at community level to
promote prenatal services through different maternal & child care activities. In addition, BEES is
involved in prenatal and postnatal care to ensure that appropriate HIV prevention counseling is
provided through regular courtyard meeting & door to door visit to reduce the risk of prenatal
transmission.
School-based HIV Prevention:Schools have an important role to play
in promoting the health and safety of
young people and helping them
establish lifelong healthy behavior
patterns. BEES school-based HIV
prevention program at community level
is to help set up school health
awareness activities that provide young
people with skills and information to
avoid or reduce behaviors that put themat risk for HIV infection and
STDs/STIs. These programs are
tailored to community norms.
Integrated CommunicationProgram for AIDS Prevention:BEES is executing Integrated
Communication Program forsupporting the AIDS Prevention
Program. Under these activities, it
has been developing messages and
materials for being used in AIDSPrevention. BEES is organizing
popular/street theatre at the
community level to make thecommunity people aware of AIDS.
It is organizing training, workshop,
orientation, seminar, colloquium,community convention, open
discussion and so on as the part of
effective developmentcommunication to strengthen the
AIDS prevention intervention atfield level.
Community-based Health Program (CBHP)
In 1979, BEES initiated its Health and Nutrition program with own support in Bogra district. Later in
1984, BEES reorganized its health and family planning services through group activities with the
financial support of CIDA. In 1992, BEES started a multifaceted Community Based Health Project with
financial assistance from Bangladesh Population & Health Consortium (BPHC-DFID) and Royal
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Netherlands Government in six upazilas of Bogra district. The goal of the project was to improve the
health status of children, women and men in BEES intervention areas. The purpose of the project was to
increase the use of and demand for cost effective ESP on Health & Population delivery solely and jointly
by NGOs and GOB amongst the poorest communities especially women and children complementing
GOBs health policy. BEES reorganized all of its
health services namely Reproductive Health & Family
planning, child health, communicable disease control,limited curative care including hygiene, safe water and
sanitation with BCC activities under this project. After
2000, the project was concentrated in Adamdighi and
Dhunot upazila of Bogra district and continued up to
2004 by BPHC-DFID support. Considering the impact
of this project, BEES is still maintaining the project
activities by the income earned from its Microfinance
program until the availability of greater donor support. During 1999-2003, BEES has implemented
another similar type of project entitledExpanded Health and Education Program (EHEP) with the
financial assistance from World University Service of Canada (WUSC-CIDA) in Brahmanbaria, Gazipur
and Narsingdi district.
Water and Sanitation
Since early nineties, BEES has been incorporating integrated software and hardware WatSan activities
with its programs with the assistance of NGO Forum for DWSS. Alongside its normal program BEES has
successfully performed rehabilitation activities, which mainly include building shelters, ensuring safe
water & environmental sanitation, installation of tubewells, repairing & re-sinking of damaged tubewells,
dewatering ponds and construction of sanitary latrines with the financial assistance of the World Relief
Canada. During late seventies, BEES installed more than 4,000 tubewells under the program intervention
areas in collaboration with the Bangladesh Krishi Bank. BEES provides the beneficiaries with credit
while a huge number of tubewells and latrines have been installed through these initiatives.
Furthermore, BEES has performed arsenic test for a good number of hand tubewells with its own efforts.BEES has created awareness among the people through conduction of promotional activities and using
communication materials on usage of safe water, personal hygiene practice, disposal of solid waste, and
dreadfulness of arsenic & arsenic mitigation options.
Nutrition Surveillance Project
Helen Keller International (HKI) has been operating the Nutrition Surveillance Project (NSP) since 1990
in collaboration with the Institute of Public Health Nutrition of the Ministry of Health and Family
Welfare (MOHFW) and partner NGOs. It has been an independent source of high quality data on
nutrition & health, food security, and household welfare in Bangladesh. The NSP collects information
every two months from children aged less than five years, their mothers and households throughout rural
Bangladesh, and in urban slums of six major cities.
BEES, one of the partners NGO of HKI, has been working for NSP for the last 3 years. At present, BEES
is working with National Nutrition Program (NNP) and on the other hand it is also assisting HKI in
research & development, regarding data collection for the NSP project. BEES is implementing this
project at Dhupchachia upazila, Bogra district and Sreepur upazila, Gazipur district.
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Human Resource Development through Training
BEES has been ensuring human resource development through training oriented activities that staff of
health program are able to learn new information, re-learn and reinforce existing knowledge and skills,
and most importantly have time to think and consider what
new options can help them improve their effectiveness in
performance i.e., implementation. Through such supportprogram based on demand driven approach, human resources
are developed in the way of improving knowledge, attitudes &
practices (KAP) and enhancing life-skills of the target groups.
BEES has been conducting a training cell to organize all kinds
of training activities related to the health program. This cell
having need-based plans is engaged seriously to ensure the role
of training catering to the programs and projects. To make
training programs more integrated, attractive and most of all
effective, BEES is using different timely methods like
lectures, demonstration, discussion, computer-based presentation, programmed instruction (PI), behavior-
modeling, case studies, role plays, mentoring, job instruction technique (JIT), transactional analysis,
simulation exercise, exchange visit and so forth. BEES training programs well-equipped with cognitive,behavioral and management development approach are developing skills and expertise among the staff
and beneficiaries to prevent problems from arising and providing tools to address any skill or
performance gaps within programmatic aspect.
Resource Management & Mobilization
Human Resource
BEES is always searching for better ways to produce best services and outcomes. To achieve
desired goals, BEES Health Program has been counting on skilled human resources all along.
Hiring the right people to manage and perform specific jobs, it builds up commitment and loyalty
among the staff by keeping them up to date about organizational plans and programs. Underhuman resource mobilization, it organizes such necessary activities as employee administration,
employee career development, performance management and development, series of planning,
key employee identification, moral assistance and organization development as a whole that theorganization can accomplish its work goals collectively and properly.
Staff of BEES Health Programs
Male
12%
Female
88%
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It has about 4,408 staff working in several project/programs. Under different health programsand activities, following human resources are engaged to carry out the programs efficiently at
field level:
Upazila Office Staff Field StaffName of Programs
UM FS Accnt OA MLSS CNO CNPTotal
NNP (National Nutrition Program), Area
Package # 106 35 6 6 6 132 1207 1398
NNP, AP # 13 4 34 4 4 4 133 1301 1484
NNP, AP # 32 4 15 4 4 4 56 561 648
Total 14 84 14 14 14 321 3069 3530
SEBA Health No. of Medical Doctors = 4, No. of Paramedics = 50 54
HIV/AIDS Prevention and Health ProgramsNo. of Medical Doctors = 5, No. of Paramedics = 15,
other field staff 5070
Grand Total 3654
Following is the Organogram of BEES Health Program:
Note: DD- Deputy Director, PM- Program Manager, PR- Public Relation, REM-Research, Evaluation & Monitoring, ASF-
Agriculture & Social Forestry, UM- Upazila Manager, FS- Field Supervisor, Accnt.- Accountant, O.A- Office Assistant, MLSS-Manually Laborious Support Staff, CNO- Community Nutrition Organizer, CNP- Community Nutrition Promoter
Financial ResourceIn order to create and enhance the organizational economic wealth and capacity, BEES has been
capitalizing on creative financial planning strategies comprising well-defined wealth and risk
management implementation policy. It is very much necessary to ensure availability of adequate financial
resources for the implementation of programs at different level. Thinking over this, BEES is conducting
resource mapping, identifying opportunities to mobilize financial resources and assessing the current
Managerial Team
a. SEBA Health:
1. PM (MF)
2. A M
3. UM
4. FO
5. MLSS
b. NNP:
1. Team Leader2. Coordinator
3. Finance Officer
4. M & E Officer
c. HIV/AIDS Prevention
& other health programs:
1. Team Leader
2. Coordinator
3. Finance Officer
4. M & E Officer
ED
Coordination Team
1. DD (Admn. & PR)2. DD (Information &
Development
Communication)
3. DD (Training)4. DD (Research,
Evaluation &
Monitoring)5. Finance Controller6. DD (Microfinance)7. DD (Agriculture &
Social Forestry)
8. DD (Education)
Technical Team
1. DD (Health)2. PM (Nutrition)3. Nutrition Specialist4. Medical Officer5. Paramedics6. Community
Nutrition Workers
7. Women GroupMembers
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status of resource mobilization regularly in order to utilize all possible supply of financial resources.
Thus, BEES is ensuring continuous flow of program funding and tackling and overcoming any financial
shock and vulnerability. To produce quality outcomes consecutively and have a positive impact on the
organizational progress consistently, BEES is trying to ease its financial dependence on the donors in true
sense. In this regard, service charges collected from revolving loan fund are playing important role in
supporting BEES to be self-sufficient. Putting profound emphasis on women employment generation both
in rural and urban areas under its programs, BEES is making them economically active. Easing overheadcost and making programs and activities more cost effective, decentralization and delegation of works
among staff members are contributing to organizational sustainability as a whole.
Program Implementation approach
Conduct baseline survey Select beneficiaries and formation groups by them Procure all necessary inputs and materials through a procurement committee Provide necessary services to the beneficiaries by respective program staff in cooperation with other
units
Conduct M&E activities by respective cell personnel Make necessary correspondences with concern organizations/donors by Executive Director and
respective program head
Ensure gender friendly environment both for men and women Provide training, technology, inputs loan and other support services as required Initiate disaster management program at disaster prone area Collaboration with donors, GoB and other stakeholders Maintain networking with selected CBOs and NGOs
for effective implementation of the project activities
Build up and bolster the capacities of the CBOs atcommunity level to work as BEES partner as needed
for program/project support
Conduct mid term review for each program by BEESfinancial & accounts department
Conduct internal and external audit by extra audit firm Submit necessary reports to donors, GoB and other
concern institutions
Ensure project evaluation at the end of project inaccordance with the contract agreement.
Collaboration
Forging of alliance through collaboration activities is one significant component of BEES total
program package. The purpose of inter-agency collaboration activities is to promote, consolidateand sustain health, nutrition and HIV/AIDS prevention projects to increase health benefits and
awareness status of the people of the program intervention areas . All these functions conjure upto a system to extend effective services to the deprived and disadvantaged people. The
enthusiastic and out and out success in collaborative network has influenced BEES to be keenly
interested to boost more programs with relevant government institutions, UN bodies and nationaland external support agencies.
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Directions to the Days Ahead
BEES identifies various issues to be implemented through participatory process giving priority to
the general health care, reproductive health awareness, HIV/AIDS prevention, nutrition, water &
sanitation and development agenda which includes addressing safe motherhood, enhancing theuse of contraceptive methods, counseling and communication, RTI/STD management, training ,
sex education and related adolescent reproductive health initiatives, qualitative health and related
behavioral research, gender-based violence as well as male participation in reproductive rightsand gender equity. Each of the activities aims at bringing a new and bold approach to
overcoming persistent and intransigent obstacles to achieving a malnutrition and HIV/AIDS freeBangladesh and to checking all the factors conducive to poor health.