Smart Healthcare Services for Extreme-Poor Households

Category : Best Innovation in Healthcare


Innovation Title : Smart Healthcare Services for Extreme-Poor

Organization : Coraid

Bangladesh suffers from large disparities in most of the healthindicators across social, economic, and demographicparameters. Bangladesh health systems financing ischaracterized by high out-of-pocket payments (63.3%), whichis increasing. The major barriers for extreme poor householdsin accessing healthcare services includes the cost of treatmentand distance of healthcare facilities. This unfortunatecircumstance has led to people foregoing treatment, avoidingformal healthcare facilities and opting for advice from theinformal sectors which often includes retail drug shops.Sunamganj, as one of the most underserved districts in Sylhetdivision, has a very high rate of maternal mortality of 425deaths per 100,000 live births compared with the nationalaverage of 194. 89% of pregnant women have homedeliveries assisted by non-medical birth attendants.

Realizing the need, Cordaid with technical support from Sajida Foundation aims to increase and strengthen access to quality health care for extremely poor households.

The Idea
Currently, the project is working with 800 extreme poorhouseholds with a total of 3,200 beneficiaries. The projectpartnered up with two private hospitals in Sunamganj wherethe beneficiaries can avail various healthcare services rangingfrom OPD to IPD of BDT. 20,000 per year. A smart health cardhas been issued for each household, where the mainbeneficiary is the female. The insurance premium is beingcovered by an Insurance Company and quality has beenmonitored by the Municipality. Finally, a digital healthcareservice delivery mechanism has been introduced which willsupport the implementation of the national health strategy inmunicipalities.

■ Cordaid with support of Sajida Foundation identifiesbeneficiaries living in slum residents and also excludes thosewho have access to free health cards from the NHSDP,UPHCDP, Marie Stopes Bangladesh, BRAC or any otherorganizations in Sunamganj Municipalities.

■ Financial support through voucher scheme (insurancepremium).

■ Community mobilization (fieldwork to enlist beneficiariesand conduct awareness activities).

■ Digital orientation to service beneficiaries and empaneledhospitals.

■ Empanelment, Training and regular quality assessment ofhealth service providers.

■ Orient targeted households to improve health and nutritionseeking behavior and preventive practices includinginformation dissemination through community volunteers,Local TV, Newspaper etc.

■ Establish a feedback process and provide support tobeneficiaries to address any problems.

Result and Impact
■ A well-designed and effective SMART Card based healthvoucher system to support extremely poor people in themunicipality.

■ Increase utilization of Primary Health Care (PHC), qualitymedicines, investigation by urban extremely poor peoplethrough increased and availability of services.

■ Improve coverage and quality of existing PHC services byaddressing service gaps including reorganizing timings,technical support to improve services and effective referrallinkages.

■ Transfer the system/scheme to the municipality after theproject ends.Coordination.

■ Financing strategy (micro-insurance, budget allocation).Sustainability.