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Despite on-track progress toward achieving the millennium development goals, Bangladesh is suffering a huge shortage of workforce in the health sector. Kaosar Afsana, Director of Health Nutrition & Population at BRAC, Professor James P Grant of the School of Public Health at BRAC University and Jillian Evans, Immpact Associate at the University of Aberdeen, here set out the value of the role of community health workers in responding to the healthcare needs of the people in Bangladesh, and how to successfully engage with and utilize this important element of the public health workforce.
Bangladesh has many success stories in health, including its on-track progress in achieving the millennium development goals (MDGs).1,2 Yet, the country is suffering a huge shortage of workforce in the health sector, particularly doctors, nurses and midwives.3,4 the Alma Ata Declaration in 1978 reiterated the importance of primary Health Care (pHC)5 and the role of community health workers (CHWs) in responding to the healthcare needs of the people.6 in addressing this human resource gap, an innovative CHW initiative has shown promising results, including recruitment and retention of staff, health system performance and health outcomes.
Development of Chws
Collaborative working between government and non-government organizations (NGos) has enabled better utilization of human resources, particularly in the use of front-line health workers. it is estimated that out of 219,000 CHWs in Bangladesh, 56,000 are government workers and 163,000 are from NGos, of which 105,631 are employed by the largest NGo in Bangladesh, 'BrAC' (formerly known as Bangladesh rural Advancement Committee).7,8 this means a collective resource of 13.7 CHWs per 10,000 populations, much higher than...