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How ADB Is Helping the Poor in Bangladesh
Health
Updated December 2006

An urban slum dweller receives primary healthcare services at a UPHCP-II clinic in Dhaka.

The Second Urban Primary Health Care Project (UPHCP - II) is providing a package of high-impact primary health care services to the urban population, particularly poor women and children in Bangladesh.

The Bangladesh Urban Primary Health Care Project (UPHCP) is pioneering in many ways. It is one of the rare large-scale projects that targets primary health care services in urban areas of developing member countries. UPHCP supports contracting services to non-government organizations (NGOs)—government financed but provided by the private sector—in geographically defined partnership areas covering from 200,000 to 300,000 people in each areas. Involving NGOs for providing healthcare through clinics run by city corporations yielded a landmark policy success in establishing GO-NGO collaboration to provide services efficiently.

After the successful completion of UPHCP-I in early 2005, the Asian Development Bank (ADB) approved UPHCP-II in May 2005 with ADF resources equivalent to $30 million in loans and $10 million in grants. UPHCP-II has cofinancing support from the Department for International Development of the United Kingdom ($25 million), the Swedish International Development Agency ($5 million), the United Nations Fund for Population Activities ($2 million), and Orbis. Participation of a wide range of development partners reflects an overwhelming endorsement of the model.

UPHCP-II design builds on the strong and tested features of UPHCP-I and further focuses on targeting the poor (at least 30% of all the services have to be accessed by poor households), HIV/AIDS, sexually transmitted infections (STIs), and reproductive track infections (RTIs). The Asian Development Fund IX HIV/AIDS and Other Communicable Diseases Grant made it possible for ADB to build sufficient incentives in UPHCP-II to undertake an effective HIV/AIDS preventive program. UPHCP-II has had a quick start. Within a year of implementation, contracts worth more than $30 million have been finalized with NGOs for the delivery beginning 1 July 2006 of out-reach services to the poor and to high-risk groups to build awareness of high-risk sexual behavior, to treat STIs and RTIs, and to counsel high-risk cases and test for HIV/AIDS.

"The project will help Bangladesh achieve the Millennium Development Goals by reducing child and maternal mortality by benefiting mostly women and children," said Hua Du, Country Director for ADB's Resident Mission in Bangladesh. "Rapidly growing urban slums without adequate primary health care may lead to epidemics of emerging or reemerging communicable diseases", she said.

The project is due for completion in December 2011.

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Urban Primary Health Care

The project focuses on improving the health of the urban poor and reducing preventable mortality and morbidity, especially among women and children in four cities of the country.

It has an innovative mechanism for increasing private sector involvement in primary health care - PHC - services. It also addresses the issue of violence against women through a component that includes public awareness campaigns against violence and health and referral services for women victims.

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