Taking a Pulse on Community Participation in Maternal Health through Community Clinics in Bangladesh

Int J Environ Res Public Health. 2023 Jan 27;20(3):2271. doi: 10.3390/ijerph20032271.

Abstract

Bangladesh started institutionalising community participation by setting-up community clinics (CCs) during the mid-90 s. This paper presents the genealogy of CCs, the community participation mechanism embedded within CCs, and the case of 54 CCs in Brahmanbaria, through the lens of maternal health. We undertook a desk review to understand the journey of CCs. In 2018, we assessed the accessibility, readiness and functionality of CCs, and a household survey to know recently delivered women's perceptions of CC's community groups (CGs) and community support groups (CSGs). We performed multiple logistic regression to determine the association between the functionality of these groups and women's perception regarding these groups' activities on maternal health. The integration of community participation involving CCs started to roll out through the operationalisation of the Health and Population Sector Programme 1998-2003. In 2019, 13,907 CCs were operational. However, per our CC assessment, their accessibility and readiness were moderate but there were gaps in the functionality of the CCs. The perception of women regarding these groups' functionality was significantly better when the group members met regularly. The gaps in CCs are primarily induced by the shortcomings of its community participation model. Proper understanding is needed to address this problem which has many facets and layers, including political priorities, expectations, and provisions at a local level.

Keywords: community clinics; community group; community participation; community support group; functionality; maternal health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care Facilities
  • Bangladesh / epidemiology
  • Community Participation*
  • Female
  • Heart Rate
  • Humans
  • Maternal Health*

Grants and funding

This study was funded by EdM thanks to financial support from the Swiss Agency for Development and Cooperation (SDC), the Geneva Federation for Cooperation (FGC), and its funds (grant# 01524). SDC and FGC did not have any role in the design of the study, data collection, analysis and interpretation of data, and writing of the manuscript.