Forgotten No More
Making health care available for the most marginalized groups in Bangladesh
Last month, I visited Young Power in Social Action (YPSA), a local NGO based in Chittagong city, to experience its health care program. I found YPSA provides health care to different marginalized groups including garment workers, street based sex workers and women and children of river basin areas of Chittagong rural areas too. Built on the banks of the Karnaphuli River, the city is home to Bangladesh's busiest seaport and has a population of over 5.5 million, making it the second largest city in the country.
The health care program of YPSA primarily focuses on primary health care and reproductive health for the women. It uses a peer educator approach for changing health care behavior. YPSA recruited peer educators among garment workers and female sex workers to give encourage positive health seeking behavior and educate on prevention of HIV/AIDS in their respective groups. The YPSA mobile medical team consists of weekly visits by doctors and paramedics to the drop-in center for
female sex workers, where the sex workers can also spend their day, both for rest and recreation. Further, for garment workers YPSA has contracted with factory managers to use part of lunch time for peer discussion on health issues and HIV/AIDS. The doctors and medical team also visit the factory on scheduled visits to treat workers. YPSA maintains a referral network with most of the big hospitals of the city, allowing them to refer patients to different hospitals depending on their needs.
Women at YPSA's drop-in center.
Additionally, YPSA sends it mobile medical team to remote river basin areas of Sitakundu and other remote locations where no medical facilities are available. The people of the cyclone-prone river basin areas face daily hardship for livelihood and have no social facilities like school and health clinics. Therefore, YPSA’s mobile medical team is the only health care option for women and children, who also have limited mobility.
YPSA organizes the activities with help of donors, as well as its own resources. The government of Bangladesh recognizes YPSA’s contribution and extends it supports too. However, in order to continue to provide quality care, more resources need to be mobilized for health care services for the most marginalized. Public –private partnerships and the use of ICT for health care can be explored, particularly in these areas where human resource skills for health are often lacking.