Health Sector Governance Program: Resettlement Framework

| June 2015

Resettlement frameworks ensure the preparation and implementation of appropriate compensation and relocation programs if land acquisition, physical relocation, and other impacts are identified during implementation of a project.

This document dated June 2015 is provided for the ADB project 47137-003 in the Lao People's Democratic Republic.

Urban Health Project Reaches Out to Dhaka’s Poor

  • Under the ADB-supported Urban Primary Healthcare Services Delivery Project, the Government of Bangladesh is working with nongovernmental organizations in providing maternal and child care particularly to poor urban communities. Photos: ADB/Abir Abdullah.

  • The goal of the project is to provide primary health services mainly to the urban poor for free or at a low cost.  Photos: ADB/Abir Abdullah.

  • Aside from primary health care, the maternity clinic in Dhaka provides other services such as immunization and family planning.  Photos: ADB/Abir Abdullah.

Project Result / Case Study
19 December 2014
Read time: 5 mins

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A maternity clinic run under a public-private partnership provides a model for delivering primary health care to the urban poor in Bangladesh.

Sheuly Begum, 25, panicked when the arrival of her second child was delayed by about 2 weeks. Her husband immediately took her to a maternity clinic, a 15-minute drive by rickshaw in Dhaka City’s congested Pallabi area.

Within the next 24 hours, Begum gave birth to a healthy boy without any complications, thanks to the doctors at the clinic. The Al-Haj Jahurul Islam Matri Sadan (maternity center) is run by Khulna Mukti Sheba Sangstha (KMSS), a nongovernmental organization (NGO) working in partnership with the Government of Bangladesh under the ADB-supported Urban Primary Healthcare Services Delivery Project.

Saving lives

Begum’s doctor, Kamrun Nahar Dolly, said another day of delay could have been disastrous for either the baby, the mother, or both.

“The baby could have died inside the uterus. Or Begum could have suffered fistula (a hole in the birth canal),” said Dolly, who is also manager at the 10-bed clinic.

“The doctors here have saved me and my baby. I’m grateful to them,” said Begum.

She was 20 years old when she gave birth to her first son, Mohammad Kamrul, at her home in northern Netrokona district 5 years ago. “At that time there was no clinic close to my village,” said Begum.

At the maternity center, about a dozen women, some of them accompanied by their husbands, were waiting with their newborns to get post natal care and routine follow-up.

Among them was Salma Akter Runa, 22, who gave birth to her second son at this clinic 8 months ago. Before coming to this center she first went to Dhaka Medical College Hospital, the largest state-run hospital in the city.

“There at the hospital my husband and I had to move through at least six desks to get an ultrasonogram done,” said Runa. “Frustrated, we left the hospital and then came to this clinic, thanks to information given by my cousin.”

A day after Runa got admitted to the clinic, she gave birth to a girl, said Kazi Nazneen Sultana, the doctor who supervised her delivery.

Since then Runa visited the clinic every month as part of the regular health checkup of her daughter who suffered from frequent diarrhea and severe malnutrition a month after her birth.

“The baby is fine now. She is gaining weight,” said Runa.

Serving poor communities

Kazi Nurun Nabi, program director of the KMSS, said the maternity center covers an area with a population of over 200,000 people, 40% of them living in 22 slums. The clinic focuses on slum dwellers and poor garment workers who came from impoverished rural areas to the city in search of employment.

“The number of slum women coming to the health center for delivery and other health care services has risen to over 70%, almost double the number a few years ago,” said Nabi referring to a baseline survey. There have also been a number of related benefits spawned by the project.

“Five years ago only 45% of mothers exclusively breastfed their babies for the first 6 months. Now it has climbed to 70%, higher than the national average,” he said.

A key feature of the project is that 30% of services are free for people who earn less than 700 taka (about $9) a month.

Free services

Among the other services provided by the center are family planning and immunization.

A key feature of the project is that 30% of services are free for people who earn less than 700 taka (about $9) a month. At the KMSS-run center there are more than 14,000 such people who are given Red Cards so they get free services, said Md. Tauhidul Islam, project manager of the Urban Primary Healthcare Services Delivery Project.

Creating awareness among the adolescent girls and boys about sexually transmitted diseases, HIV/AIDS, reproductive tract infection, and family planning methods is another service provided by the project. Health workers meet with a group of 15 girls every Sunday and 15 boys every Tuesday on the second floor of the center for 3 months.

“I’ve learned here about the benefits of using clean sanitary napkins,” said 13-year-old Sufia Akther from the Bhola shanty town. “I did not know that it is important to change the napkins regularly.”

“Before coming here I had no idea about HIV or AIDS,” says Saifuddin Ahmed, 16, a rickshaw driver in the northern Mirpur area. “Now I know how to keep myself protected from a deadly disease like AIDS.” He used to feel shy about talking about sexually transmitted diseases. “I thought these are the subjects that are not to be discussed publicly. Now I feel free to share the knowledge with my peers.”

The success of the project has shown the important partnership of government and NGOs in delivering of health services effectively, especially to the urban poor. The government supervises the project, while the NGOs provide the services based on the public-private partnership (PPP) model.

The project is financed by ADB and the Swedish International Development Cooperation Agency (SIDA) with technical support from the United Nations Population Fund (UNFPA). It is the third phase of ADB-supported Urban Primary Health Care Project in Bangladesh and will run through 2017; the first phase was approved in 1998 and completed in 2005. The goal of the project is to provide primary health services mainly to the urban poor for free or at a low cost.

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Latest Project Results/Case Studies

ADB Forecasts Robust Growth for Cambodia, Warns of Child Malnutrition

  • Cambodia's economy is expected to remain vigorous over the next two years, but stagnating child malnutrition rates pose a significant long-term threat to the country’s development, the ADO 2013 warns.

News Release | 09 April 2013
Read time: 3 mins

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PHNOM PEHN, CAMBODIA – Cambodia’s economy is expected to remain vigorous over the next two years as Cambodia’s main markets in Europe and United States recover, but stagnating child malnutrition rates pose a significant long-term threat to the country’s development, the Asian Development Bank (ADB) says in a new report.

“Private consumption, exports and investment, including strong and diversified foreign direct investment, will all drive economic development in 2013 and 2014” said Eric Sidgwick, ADB Country Director for Cambodia. “Economic growth is projected at 7.2% in 2013, picking up to 7.5% next year as recovery in Europe and the US takes hold.”

The Asian Development Outlook 2013 (ADO 2013), ADB’s flagship annual economic forecast, shows industry is expected to expand by 10.5% in 2013, as European demand for Cambodian products is expected to grow steadily, supported by duty-free access to the European market. Shipments of garments and footwear to the US will likely be subdued this year but should pick up after that.

The report notes that net foreign direct investment inflows surged by an estimated 75% in 2012, to $1.5 billion, funding new industries including automotive parts, electronics, and processing of agricultural products, as well as diversifying garment production into higher-value products and tourism into new areas. A surge in building approvals in 2012 will accelerate construction activity this year. The services sector is expected to grow by about 7%, with strong growth in tourism and real estate activity. Agriculture will likely grow by 4%, assuming favorable weather.

Moderate global food price increases and domestic harvests lead to expectations that inflation will average about 3.0% in 2013. In 2014, robust domestic demand is expected to result in higher inflation of 3.5%. These inflation forecasts will be at risk if bad weather pushes up food prices.

While Cambodia’s growth prospects remain positive, chronic poor health and malnutrition is stunting the growth of 40% of Cambodian children. Left unaddressed, Cambodia’s continuing high incidence of child malnutrition will negatively affect future productivity and economic growth due to the associated irreversible long-term damage to physical and cognitive development.

The report explains that functional losses experienced by children in the first 1,000 days of life, from conception to the second birthday, can never be fully recovered. ADO 2013 offers policy recommendations such as: conditional cash transfers to help change parental behavior that compromises child nutrition, improving local food production to ensure sufficient quantity, quality, and variety; promoting breastfeeding; increasing nutrition education among pregnant women; providing women and children with improved basic health services; and reducing nutrient loss through improved hygiene, sanitation, parasite control, and food processing and storage.

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Technical assistance completion reports describe for technical assistance projects the expected impact, outcome and outputs; conduct of activities; evaluation and achievement of the expected outcomes; an assessment and rating; major lessons; and recommendations and follow-up actions.

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