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Sustainable Urban Health: Evaluation of Partnership Model in Bangladesh

This study assesses the impact and sustainability of the Saidpur and Parbatipur Municipal Health Partnership model in Bangladesh, focusing on maternal and child health indicators, institutional capacities, and community health progress. Findings highlight achievements, challenges, and recommendations for future urban health initiatives.

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Sustainable Urban Health: Evaluation of Partnership Model in Bangladesh

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  1. The End of Magical Thinking: Sustainability Evaluation of the Saidpur and Parbatipur Municipal Health Partnership Model in Bangladesh Dr. Eric Sarriot – Eric.G.Sarriot@MacroInternational.com7 November 2009

  2. Why Municipal Health? • Urban poor have highest under-five mortality rate (138/1,000 LB) compared to national rate of 118 (BDHS, 2004) • 36 million urban dwellers; by 2010 over 1/3 of the population will reside in urban areas • Over 300 municipalities, and the number is growing exponentially • Policy implementation gap for urban health promotion and coordination: the poor fall between the cracks

  3. History • 1999 – CSP ‘entry phase’ • 2000 – CSP implementation in Saipur and Parbatipur (S&P) • 2004 – End of CSP • Expansion into 7 new municipalities (MHPP) • Minimum involvement in S&P as ‘Learning Centers’ (LC)_ • 2007 – First post-project assessment • 2009 – 5-Year post-project assessment

  4. Post-Intervention Assessments Methodology: October 2005 & July 2009 • 12 person team: Evidence + Participation • KPC surveys with 953 mothers with children <2 years • WHC capacity assessments (n=24) • Municipality Institutional Capacity Assessments • Additional data query; interviews; group discussions; case studies... • Each phase = 4-days field work • Synthesis with municipal stakeholders

  5. Core Elements of the Municipal Health Partnernship Model • Local government leadership • Coordination of public and private service providers • Networks of existing local resource persons • Best practices in maternal and child health • Community organizing and health promotion in each Ward • Social protection for the poorest • Facilitation with extremely limited additional financial inputs

  6. How It WorksMunicipal Health Partnership Model Municipality Cabinet, Other Departments, Health Staffs Health Platform (MEPSCC) Govt , NGO & Private Health Facilities Civil Society Social & religious leaders Ward Health Committee Private pharmacists Community organizations Youth volunteers Teachers Traditional health providers

  7. Achievements CSP phase

  8. Sustainability of Health Outcomes • child health indicators

  9. Other elements in the evaluation • WHC institutionalized, but… • Decreasing self-efficacy • Have funds • Expenditures lag • Power & Accountability • Municipal Health Department Role • Health budgets: 1-1.5% of Municipal • Gap in expenditure

  10. Conclusions on the Model • Effective? Yes! • Sustained? Partially • Still sustainable? Yes! • Sustaining community health progress? Not enough!

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