Archana Rani was worried when her 3-year-old son, Subol, developed a high fever, but she knew exactly where to take him. The Borogoan Community Clinic in Bochagani District is just a 5-minute walk from where she lives, and she trusts the community health care provider, Mr Harish Chandra Devshorma, to conduct a proper check-up and give the right advice. She also knew that if her son needed any medication, it would be provided free of charge.

“The community clinic is a blessing to us. We do not need to go to the town for essential medical care. It saves our time and money. We are economically poor as we have to work hard every day for our livelihood,” said Archana.

Local community clinics operate across Bangladesh, providing primary health care services to rural and often marginalized populations. Each clinic has a full-time community health care provider, who is assisted by 2 other community health workers who serve part-time in the clinic and part-time visiting households in the community catchment area. These community health workers provide antenatal and postnatal care, conduct diabetes and blood pressure checks, look out for signs of fever, diarrhoea and cough. They also support family planning and safe delivery, provide advice on nutrition, adolescent health and hygiene, among other services. They are regarded as the backbone of the primary health care system of Bangladesh and they have been making a major contribution to the delivery of essential health services to rural populations throughout the COVID-19 pandemic.

Community health clinics 

One of the most pioneering health efforts in Bangladesh was the introduction of a community-based health care programme in the 1970s. Since then, the programme has gone from strength to strength with a growing cadre of community health workers playing a critical role in improving the overall health and the socio-economic status of the Bangladeshi population.

Bangladesh has a pluralistic health system where both public and private sector providers play important roles. According to a study in 2021, the country has about 148,000 community health workers of which about 60,000 are supported by the Government; the rest being in BRAC and other non-government organizations. They are respected as very important assets of the health system.

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