USAID’s MaMoni MNCSP Project:

The USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MNCSP) is designed to contribute to the Health Population Nutrition Sector Program (HPNSP 2017-22) goals for reducing maternal and neonatal deaths by increasing equitable utilization of quality maternal and newborn care services. The project is implemented by a consortium led by Save the Children and other consortium includes a team of international and national partners: The Institute for Healthcare Improvement (IHI), Jhpiego, Council for Health Services Accreditation for Southern Africa (COHSASA), icddrb, Dnet, Bangabandhu Sheikh Mujib Medical University (BSMMU), Partners in Health Development (PHD). Four local NGO partners, DASCOH Foundation, Palashipara Samaj Kallyan Samiti (PSKS), Resource Integration Centre (RIC) and Shimantik are supporting the implementation in 17 districts.

The MaMoni MNCSP project embraces the Government of Bangladesh’s (GoB) vision of “a Bangladesh where there are no preventable deaths of newborns or stillbirths, where every pregnancy is wanted, every birth celebrated, and women, babies and children survive, thrive and reach their full potential.” It will meaningfully contribute to achieving the GoB’s goals of reducing the neonatal mortality rate to less than 18/1,000 live births and the maternal mortality ratio (MMR) to less than 121/100,000 live births by 2022.

Shimantik was working at four districts namely Sylhet (5 upazilas out of 13) Hobigonj (all 8 upazilas), Sunamganj, and Brahmanbaria (9 upazilas out of 9).  April 2021, Shimantik was not working in Manikgonj district. And  added two additional districts namely Sylhet and Sunamgonj district as the working areas. Now, it covers total 9,337,707 populations from the working areas.

During this reporting period (July 2021-May 2022) followings are the key achievement highlighted relative to Maternal, Neonatal Health and Family Planning Coverage:

Among the project indicators at least one ANC, Facility delivery, PNC, ENC, PPFP are most popular & important indicator for Bangladesh where Government is expecting to achieve its target by 2022. Habiganj is still struggling to increase those indicators. To improve the situation the project monitors performances through routine HMIS.

Work Completed so far (Achievement July, 2021 to May, 2022)

  • Completed readiness in102 UH&FWC, 29 UHC and 3 DH
  •  Ensure Midwifery led care MNH services at 26 UHC.
  • Conducted 93 Special satellite clinic in underserve/Hard to reach area to serve marginalized people.
  • Ensured New born management area in 134 facilities
  • Started 61 facilities MNHQI bundles for improvement service quality
  •  Ensure QIC meeting  emergency team at 34 health facilities
  •  Formation WIT and regular meeting at SOMCH and B.Baria & Habiganj DH
  • Completed 33 Semi-Annual Performance Review Meeting at Upazila and 4 district
  • Conducted Decentralization planning meeting at 12 union and 7 Upazila
  • Service coverage follow up through 388 monthly meetings with DGFP & DGHS
  •  Conducted 75 %UH&FWC management committee meeting and documentation.
  • Initiate MNH services at 43 US/HTR areas
  •  Organized 3 District advocacy meeting with LG representatives.

USAID’s MaMoni MNCSP Project: Emergency COVID-19 Responses

As part of the COVID-19 Response Project, Shimantik started implementing on community-based pandemic response activities in six new districts (Faridpur, Gopalganj, Munshiganj, Madaripur, Laxmipur and Kushtia). The community-based intervention worked intensively with community health system and community members in order to reduce transmission of the corona virus and thus mitigate the impact on health. To manage a variety of interventions in districts and upazilas, Shimantik looks forward to hire six District Coordinators who will be responsible to engage with local health officials, plan activities and implement activities through a number of upazila-based Field Coordinators, ensure coordination of activities with relevant stakeholders, prepare budget and check expenses against the budget to ensure value for money, and produced programmatic and financial progress report as per guideline.

Initially, the period of execution of the project from September 2020 to December 2020 was assigned for four months. After that, it has been extended from January 2021 to May 2021 (five months) with the involvement of CST intervention. Further extended, from June 2021 to September 2021 (2nd time in four months) with the involvement of enhancing registration on vaccination

One month extended due to excess of the budget. So that, few new activities added here in this period with existing activity.

After that, nine and half months extended for CST intervention in different district where 10 districts are covered with two phase (1st half 5 districts & 2nd half 5districts).

Summary of Major Accomplishments (July 1, 2021 - May 31, 2022):

During this period, non-clinical support staff training was conducted at 03 Medical College Hospital, 07 Institutes, 06 General hospital and 20 districts Hospital with 30 Upazila Health facilities, where 611 cleaners, 190 drivers, 355 ward boys and 192 other support staff were trained. Total number of staff was 1348, among them 982 male and 366 female staffs have trained. The training was designed to reduce transmission of the corona virus and thus improved the support staff’s behavior as well as health systems. Title of the training was: “Training on Infection, Prevention, Control and Waste Management” and this training included Covid-19 background with spreading, hand wash cleaning procedure, PPE and other protective measurement (mask, gloves, head cap, face shield, goggles, gown and shoe cover wearing) practices, ambulance decontamination, waste management with bio hazard bag tie and how to prepared disinfectant & it’s uses.

Fig: IPC training inauguration by Civil Surgeon, Narshingdi.
Fig: Practical session on Hand wash

The Training was conducted in three ways like a PowerPoint presentation, then a video demonstration and after that practice session. Before the training start, a pre-test was taken to see the Knowledge of the participants about Covid-19 and a post-test was also taken to see the impact of the training knowledge. 

Fig: IPC training inauguration by DG of DGHS.
Fig: IPC training at Sadar Hospital, Thakurgaon.

Also, hospital authority/stakeholders help us to conduct this kind of activities to their premises for improvement of knowledges of their support staffs for combating of the covid-19 pandemic. During this year, Director General of Health Service (DGHS) inaugurated IPC training at Thakurgaon Districts Hospital. Also, he thanked USAID, Save the Children and Shimantik to organize such training.

The virtual clinical mentoring system (e-Mentoring session) was conducted 123 sessions where 1794 listeners were present. During the session, 246 mentors were participated in the HUB station and 223 mentees were presented with their case from the spoke station. This type of activity is the partnership with ECHO India by engaging senior professionals from Dhaka Medical College & Bangabandhu Sheikh Mujib Medical University(BSMMU) for ICU and case management support with the help of ICT equipment and technical support virtually.

Major Accomplishments of Community Support Team (CST) Intervention:

  • Total 129 CHW training batch was completed in all four (04) districts. During this training session, 2007 male and 2464 female were trained at CST intervention.
  • Union wise CG & CSG orientation was conducted where total 1362 Batches were completed which included 230 batches at Moulvibazar, 314 batches at Netrokona, 445 batches at Sirajganj and 373 batches at Naogaon districts. During the session, 29,830 participants were oriented. Among them, 18,815 were male and 11015 were female.
  • CHW training (3rd Phase- 1st half) – Five Districts, total 128 Batches were completed, which included 31 batches at Pabna, 17 batches at Thakurgaon, 14 batches at Panchagarh, 32 batches at Kurigram and 34 batches at Gaibandha districts, where 4360 participants were trained. Among them, 2048 were male and 2317 were female.
  • Union wise CG & CSG orientation was conducted where total 1392 Batches were completed which included 339 batches at Pabna, 204 batches at Thakurgaon, 149 batches at Panchagarh, 360 batches at Kurigram and 340 batches at Gaibandha districts. During the session, 31,775 participants were oriented. Among them, 20,859 were male and 10,916 were female.
  • CHW training (3rd Phase- 2nd half) – Five Districts, total 116 Batches were completed, which included 31 batches at Rajbari, 17 batches at Pirojpur, 14 batches at Barguna, 32 batches at Patuakhali and 34 batches at Sunamganj districts, where 4360 participants were trained. Among them, 2048 were male and 2317 were female.
  • Union wise CG & CSG orientation was conducted where total 1154 Batches were completed which included 168 batches at Rajbari, 217 batches at Pirojpur, 155 batches at Barguna, 293 batches at Patuakhali and 321 batches at Sunamganj districts. During the session, 27,186 participants were oriented. Among them, 15,566 were male and 11,620 were female.
  • Total 7000 number medical/protective items were distributed as per plan for CST/CST members at four districts.
  • Another, necessary activities that is a community awareness of Covid-19 through ‘Miking’. Around 629 Unions was covered and rest of the union will be covered during booster dose vaccination camp. During the announcing time, the leaflet also distributed to the community people. 
  • One of the most important activities that are a ‘Cow Market awareness’ thorough Mike’. Around 108 Rural Unions was covered with one round miking where population covered 1044108. Besides this, 28 municipalities cow market also covered where 376628 population was benefitted. During the announcing time, the leaflet also distributed to the community people. 
  • One batch of TOT on CST intervention for CHW training was held at Lakeshore Hotel on September, 2021. Around 39 government’s participants were participated where 35 were male and 04 were female in two districts (Naogaon and Moulvibazar). Another TOT was held at Lakeshore Hotel on October, 2021. Around 41 government’s participants were participated where 38 male and 03 were female in two districts (Netrokona and Sirajganj).
  • It has also completed activities which is ‘Puja Mondop awareness’ thorough Miking’. Around 5461 Puja Mondop was covered with one round announcing where population covered 16,220,342. Which included, 42 municipality’s area and 698 rural area during Puja time period. During the announcing time, the leaflet also distributed to the community people. 

Major Accomplishments of Enhance Registration on Vaccination (ERV) Intervention:

  • At 10 districts, TOT was completed for Vaccine Registration. As per the guideline, at least 3 GoB participants from each upazila received this TOT. Total 331 participants were trained, among them 272 were male and 59 were female received this training.
  • Around 504 volunteers were trained for vaccine registration. Each upazila covered by two batches. Two volunteers in each ward were selected with the help of UNO and local chairman. 
  • Total number of vaccine registration were 1, 48, 244 population which was covered only 24 unions in 8 Upazila of 4 districts. Out of them, 73,305 were male and 74,919 were female registered.
Fig: TOT on Pfizer Vaccine Implementation
Fig: TOT on Pfizer Vaccine Implementation
  • Another short-term activity, ‘Pfizer Vaccine Implementation TOT’ which was completed within 5 days (12 to 16 September) at 10 City corporation area and 11 districts. Total number of participants were 604, among them 120 male and 484 female were received TOT for Pfizer vaccine implementation.

Challenges and resolved:

  • In case of e-Mentoring session, to make this session more effective and participatory, the DGHS’ personnel were actively engaged for ensure and increase the participation of the doctors and professional bodies in the e-mentoring sessions through over phone. Observed that if the DGHS personnel do not invite and follow up the participants, e-mentoring session gets very poor number of participants.

 

  • In a crucial moment of covid-19, ‘Lock down or Shut down’ which is strongly maintained by local government in a specific area or a part of Bangladesh. Sometimes, it’s may go-slow our field activities as well as hampered project’s activity time line. In that case, we are trying to solve this situation by our field level collaboration activity.

 

  • During vaccine registration period, some times facing internet problems like slow or interupted internet which slow our registration activities. So, sometime volunteers changed the sim card and some one used updated android mobile phone set for registration.

 

  • Similarly, registration by ‘Surokkha App’ sometimes had disrupted or found log in problem. In that case, communicated with MIS department and seeking their help. So, they helped us by opening the apps for vaccine registration.

Annex A: Operational Plan Indicators, 1st July, 2021 to 31st May, 2022

Annex B: Community Support Team (CST)

Annex C: Enhance Registration on Vaccine (ERV) Intervention.

Welcome to Shimantik

Shimantik, a national non-government organization in Bangladesh, established in 1979. Shimantik is dully registered with the Social Service Department [Syl-7(221)/84, dated 16 May 1984] and NGO Affairs Bureau (Registration no.298 dated 28 May 1989), Directorate General of Health Services (DGHS), Directorate General of Family Planning (DGFP).