Promoting Sustainable Health and Nutrition Opportunities for Marginalized Urban Extreme Poor Population

As part of our commitment and ongoing efforts to ensure access to quality health services for all, we commenced an innovative 3-year program with the support of Concern Worldwide to implement a “Smart Card” based health voucher scheme starting February 2018. This program will target the extreme poor who face severe limitations in accessing health services due to financial, social and other administrative constraints. We aim to support 40,763 extreme poor people who are not covered by any other free health cards to access a free package of health, nutrition and family planning services in Feni and Chandpur municipalities. These municipalities have selected based on population size of over 150,000 with a high concentration of extreme poor living in slum and squatter settlements with poor health indicators compared to other municipalities.

Through a strong partnership mechanism, SAJIDA will lead the implementation by working with municipalities, NGOs and private health service providers in the target areas, while Concern Worldwide will be engaged in the overall delivery and management of resources for the action and provision of strategic and technical support and research. Under the program, the primary health and nutrition services will be provided to the marginalized population of the urban areas through health care card and other development related activities, including providing training in relevant institutions.

Implementing Sites Feni & Chandpur
Estimated Coverage
Households 12,000
Total Beneficiaries 40,763 (Feni 20,249 & Chandpur 20,513)
Reproductive age women (15-49 years) 11,733
Pregnant and lactating women 848
Children under five 4,076
Adolescent boys (10-19 years) 4,543
Adolescent girls  4,507
Elderly, over 60 years 2,446
People with disability 571

Extreme poor family living in a slum or squatter settlements, or pavement dwellers (inhabiting the place for at least three months) and scattered population.

Total household income of maximum BDT 7,000 per month.

People who spend more than their own monthly income for house rent, food, clothes and medical purposes.

People who can rarely afford minimum 2 or 3 meals per day.

Extreme poor households who currently do not have access to free health card from the NHSDP (Smiling Sun Clinics), UPHCSDP, Marie Stopes Bangladesh, BRAC or any other organizations in Feni and Chandpur Municipalities.

All the families living in “Gucchogram Project” of the Government.

Special attention will be provided to target women headed households, the elderly, people with disabilities and socially and professionally marginalized groups.

The project will issue the family SMART Card on the spot at distribution centers with one year validity to eligible extreme poor families which will enable them to access free services from empanelled facilities until their yearly allocated cash amount is fully utilized. The card will be renewed annually based on beneficiary reassessment criteria.

Doctor Consultation

Antenatal Care

Normal Delivery

Postnatal Care (PNC)

Neonatal Care

Reproductive Health Care

Adolescent Health Care

Family Planning

Child Health Care

Communicable Diseases

Non Communicable Diseases

Post Abortion Care

Menstrual Regulation

Violence Against Women

Maternal and Child nutrition

Disability Care

Primary Eye Health Care

Medicine

Emergency maternity care

Emergency hospital care due to causality and accidents

All family members (husband, wife and all children) of selected extreme poor families will be eligible for free health care services.

The maximum voucher value is BDT 2,800 per year per family for general health services (without maternal health care).

An additional benefit of BDT 3,400 per year per family will be provided for maternal health care (ANC, PNC, normal delivery and related investigations) when the pregnancy of the wife is confirmed.

In cases where the beneficiary is a pregnant woman and requires CEmOC (e.g. a surgical intervention like caesarean section is required to save the life of the mother and new born infant), she will be eligible for an additional BDT 6,800 (maximum) to cover the cost of emergencies/complications. This additional benefit will be added to the existing coverage of BDT 3,400 including normal delivery. It is expected that the additional BDT 6800 plus the remaining value of maternal voucher including delivery will cover the minimum cost of CEmOC (BDT 8,900) offered by empanelled facilities and government hospitals.

In case of road traffic accidents and occupational health related causalities, the beneficiaries will be eligible for an additional BDT 5,600 (maximum) financial support to access immediate emergency treatment.

The voucher scheme will cover all PHC services including Bachelor of Medicine and Bachelor of Surgery (MBBS) Doctors/Paramedics consultation fees and essential medication expenses.

A well-designed and effective SMART Card based health voucher scheme increases the poor and extreme poor people’s access to a basic package of free Primary Health Care (PHC) including access to quality medicines, nutrition and family planning (FP) services in the targeted municipalities.

Increased utilization of PHC, nutrition and FP services by poor and extreme poor people through increased knowledge on new urban health voucher scheme and availability of services.

Improved coverage and quality of existing PHC services by integrating nutrition and addressing other service gaps including reorganizing timings and increased referral linkages between health facilities through re-investment of voucher scheme funds.

Strengthened municipality leadership in coordination, financing and sustaining PHC services in targeted municipalities.