According to the project completion report conducted by an independent consultant the project’s outcomes were achieved as targeted. The project has offered an acceptable alternative to the poor for accessing primary health care. UPHCSDP enjoys a perceived leadership position in many areas, for urban primary healthcare service delivery.Compared to Surjer Hashi (Smiling Sun) or BRAC Manoshi programs, the UPHCSDP’s services are perceived to be of value not only to the poor (who received free services) but also to the lower middle-class section of the society who paid for the services, owing to lower average costs.Some providers facilitated home deliveries and coordination was not uniform among providers in all districts.
The project aimed at improving the health of poor, women and children and hence had astrong gender focus for its operations. Providing free deliveries and antenatal as well as postnatal services free of services to the poor women and at a much more reasonable cost than the forprofit private sector to the lower middle class, the project upheld the gender theme strongly. Inviting local stakeholders into the Ward UHCCs with a stipulation of minimum 40% women representatives reinforced this further.
UPHCSDP clinics contributed to 11% of the total deliveries (institutional delivery being 62% of total births in PA in all health facilities), comparable with that in the public sector (15%) but clocking only about one-third of that of the private sector (32%). With around 3.1 million live births (UNICEF, 2015) in Bangladesh and UPHCSDP deliveries being less than 30,000 average per year30, the coverage is about 1%. Other achievements that are highlighted by the End line survey report (2018) are:
1. 42% (2 out of 5) and 54% of ever-married women in the PA received services from the CRHCC and PHCC respectively. 42% and 36% also used red card in the CRHCCs andPHCCs (in the partnership areas) respectively. Endline survey findings regarding reasonsfor selecting UPHCSDP facilities corroborated by site visits viz. proximity, quality and lowcost.2. Maternal mortality reduced due to greater involvement of a medically trained person indeliveries in both PA and NPA areas (73%).
In the first quarter of 2018 2,072,694 patients visited the health facilitie and out of them 763,787 are hard core poor. Among the total service providers 36.85% are hard corepoor which is more than the target of 30% which was planned at the beginning of the project.
