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Bangladesh
Bangladesh
Strengthening Maternal and Newborn Care Services
AC conducting home visits in Bangladesh
In Bangladesh, ACCESS aims to increase the practice of healthy maternal and neonatal behaviors
at the household level. The overall objective of the program is to increase the practice of healthy maternal
and neonatal behaviors in a sustainable and potentially scalable manner. Specifically, ACCESS implements
behavior change for maternal and newborn health at the home level
and community mobilization at the community
level, and engages in policy and advocacy activities to strengthen maternal and newborn health care services.
ACCESS is scaling up lessons from the community-based newborn care study project Projahnmo, supported by
USAID and the Saving Newborn Lives Initiatives.
ACCESS is implementing this project in seven upazilas (sub-districts) of Sylhet district,
covering a population of 1.5 million people. ACCESS is collaborating with the International Centre for Diarrhoeal
Disease Research, Bangladesh (ICDDR, B) and two national nongovernmental organizations, Shimantik and Friends
in Village Development Bangladesh, to implement the project. Community and religious leaders, members of
women’s groups and local officials play a critical role in involving community members at the local level.
To meet the program objectives, ACCESS is conducting home visits
with trained counselors to all pregnant women in the program area, mobilizing community
support to facilitate the work of the counselors, and developing an appropriate communication
strategy to encourage and support behavior change. ACCESS is also strengthening the capacity
of the implementing nongovernmental organizations to provide services, counseling, community mobilization
and leadership. To effect change at the policy level, ACCESS is conducting advocacy
activities to build commitment, mobilize and leverage resources, and ensure ultimate sustainability
and scale-up.
The most effective means for behavior change, as lessons learned from Projahnmo study programs,
has been shown to be interpersonal communication (IPC) in or near the household, which ACCESS is scaling up in
its program area. IPC is done to involve the whole range of important decision-makers with the target group of
pregnant women. Most negotiation about specific household barriers and solutions take place at home level. Some
of this knowledge can be built through generalized communications, for widespread practice it is necessary to
identify barriers and motivators within the household, and address them through negotiation. ACCESS does not
provide direct services but depends on basic and comprehensive services for mothers and newborns that are
provided by the GoB and NGOs.
The work of the counselors is supported and
facilitated through the community mobilization
initiative. Community mobilizers work with women’s and men’s groups in the community
to encourage
and educate them on appropriate home care techniques for both mother and newborn, the need for a birth and
newborn preparedness plan for every expectant mother, and their rights as a community to adequate health care.
Community mobilizers also encourage the groups to work for change and to feel empowered to make a difference.
In Bangladesh, ACCESS-FP is working with the Johns Hopkins Bloomberg School of Public Health to
support the development and testing of birth spacing messages in two unions of Sylhet District in Bangladesh. The
study will offer an opportunity to integrate postpartum family planning activities in community-based newborn care program.
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