NGO-Collaboration: NGO-Collaboration: lessons learned lessons learned and way forwardand way forward

Faruque AhmedFaruque Ahmed

Director, Health and Nutrition Program Director, Health and Nutrition Program BRACBRAC

Population: 132 million

Density: 894 people/sq-km

GNP per capita: US$ 345

Life expectancy: 61 years

Adult literacy rate: 41%

IMR: 66/1000 live births

TFR: 3.3

Bangladesh At a Glance

Bangladesh

BRAC ProgramsBRAC ProgramsDiverse in its operations with economic, Diverse in its operations with economic, health and education programshealth and education programs

Innovation and scaling up are two Innovation and scaling up are two distinguished featuresdistinguished features

Over 30,000 regular staff, 34,000 part time Over 30,000 regular staff, 34,000 part time teachers and 37,000 health volunteersteachers and 37,000 health volunteers

Micro-credit reached to 4.07 million poor Micro-credit reached to 4.07 million poor peoplepeople

Basic health care services to over 31 Basic health care services to over 31 million peoplemillion people

Non-formal primary education to 3.7Non-formal primary education to 3.7 millionmillion children (70% are girls)children (70% are girls)

Partnership in TB between Partnership in TB between Government and NGOsGovernment and NGOs

Over 70,000 deaths and 300,000 new TB Over 70,000 deaths and 300,000 new TB cases occur every year in Bangladeshcases occur every year in Bangladesh

DOTS strategy started in 1993 in DOTS strategy started in 1993 in collaboration with the NGOs, WHO and collaboration with the NGOs, WHO and international agenciesinternational agencies

DOTS coverage (by 1998)DOTS coverage (by 1998) BRAC 60 and other NGOs 126 sub-districtsBRAC 60 and other NGOs 126 sub-districts Government health complex 274 sub-Government health complex 274 sub-

districtsdistricts

NTP provides policy guidelines, ensure NTP provides policy guidelines, ensure supplies and NGOs implement activitiessupplies and NGOs implement activities

NTP report 2002 showed increased detection NTP report 2002 showed increased detection and cure rates in NGO collaboration areasand cure rates in NGO collaboration areas

BRAC Community Based TB Program BRAC Community Based TB Program Since 1984Since 1984

Health Volunteers Health Volunteers (Shebikas) selected from (Shebikas) selected from micro-credit group micro-credit group membersmembers

Shebika provides health Shebika provides health services to 300 householdsservices to 300 households

Shebika give education on Shebika give education on TB and identify suspectsTB and identify suspects

Mobilizing community Mobilizing community leaders and health leaders and health providersproviders

Decentralized smearing Decentralized smearing centerscenters

Financial deed Financial deed Taka 200 ($3.5) Taka 200 ($3.5) for ensuring for ensuring treatmenttreatment

Shebika provides Shebika provides DOTSDOTS

Enhancing Partnership Enhancing Partnership Between Government and Between Government and

NGOsNGOs Participatory planning meeting of all partners Participatory planning meeting of all partners

and professional association in March 2003and professional association in March 2003

key problems and priority activities identified key problems and priority activities identified and submitted a national proposal to GFATMand submitted a national proposal to GFATM

Scale up of NGO collaboration by 2003Scale up of NGO collaboration by 2003 BRAC: 283 sub-districts & part of 5 cities BRAC: 283 sub-districts & part of 5 cities Other NGOs: 177 sub-districts and part of 4 Other NGOs: 177 sub-districts and part of 4

citiescities

Government and BRAC are PRs in GFATM Government and BRAC are PRs in GFATM approved proposal ($42.4 million) for 5 yearsapproved proposal ($42.4 million) for 5 years

Achievements and Achievements and ChallengesChallenges

BRAC: case detection rate 66% and treatment BRAC: case detection rate 66% and treatment success rate 90% in 60 sub-districts where success rate 90% in 60 sub-districts where program running for 5 yearsprogram running for 5 years

National case detection rate 38% and National case detection rate 38% and treatment success rate 84%treatment success rate 84%

Increase national case detection rate to 70% Increase national case detection rate to 70% and maintain high treatment success rate and maintain high treatment success rate

Intensify DOTS services in areas where NGOs Intensify DOTS services in areas where NGOs recently expandedrecently expanded

Expansion of DOTS services to urban areas, Expansion of DOTS services to urban areas, hospitals, workplaces, and hard to reach hospitals, workplaces, and hard to reach areasareas

Lessons Learned and Lessons Learned and ConclusionsConclusions

Government and NGO commitment through Government and NGO commitment through joint planning, strategy development and joint planning, strategy development and performance reviewperformance review

International support, joint operations International support, joint operations research and sharing of findingsresearch and sharing of findings

Build and maintain mutual trust and support Build and maintain mutual trust and support among government, NGOs and donorsamong government, NGOs and donors

Human, technical and financial resources Human, technical and financial resources need to be mobilizedneed to be mobilized

Bangladesh will reach the target if not by Bangladesh will reach the target if not by 2005 then soon thereafter2005 then soon thereafter

BRAC as one of the major NGO partners of BRAC as one of the major NGO partners of NTP, commits to give full support in this NTP, commits to give full support in this endeavorendeavor