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ADB Loan To Bangladesh For Primary Health Care Services

An innovative package of primary health care services for Bangladesh’s urban poor will be provided with the aid of a US$40 million loan approved today by the Asian Development Bank.

For the first time in South Asia, an Urban Primary Health Care Project will contract the delivery of primary heath services to non-governmental organizations (NGOs) and the private sector. The pilot project will target the urban poor in the major cities of Dhaka, Chittagong, Khulna and Rajshahi, which have most of the country’s slums.

The project will provide services such as immunization, micronutrient support, family planning, prenatal care and assistance to victims of domestic violence. Approximately one quarter of deaths among women aged 15 to 44 are maternity-related, with violence accounting for a large proportion of the remainder. Bangladesh is one of the few countries where life expectancy is longer for males than females.

"Competitive tendering for the provision of primary health care services will decrease prices and improve quality," says Benjamin Loevinsohn, a senior ADB health specialist. The project will finance 15 partnership agreements with contractors in the four cities. Each contractor will be responsible for 500,000 people.

To decentralize and expand access of the poor to primary health care services, the project will construct 190 new and fully-equipped health centers, to be located near slums and used by the NGO and private sector health contractors. The project will also help local governments strengthen their ability to manage, finance and plan health services.

The project will address infectious diseases such as polio, measles, tuberculosis, and sexually-transmitted diseases. In addition, successful bidders for the partnership agreements will be required to offer a plan that deals with domestic violence, including proper referral to legal, counseling and crisis management services. As health workers are often the first point of contact for victims, they will be trained to provide immediate psychological support, detect cases of assault, and increase community awareness of the issue.

The Local Government Division, Ministry of Local Government, Rural Development and Cooperatives, will be the executing agency for the project.

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