title: Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.
abstract: This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.
authors.affiliation: Centre for Health and Population Research, ICDDR,B, Mohakali, Dhaka, Bangladesh. amercer@icddrb.org
authors.forename: Alec
authors.initials: A
authors.lastname: Mercer
authors.forename: Mobarak Hossain
authors.initials: MH
authors.lastname: Khan
authors.forename: Muhammad
authors.initials: M
authors.lastname: Daulatuzzaman
authors.forename: Joanna
authors.initials: J
authors.lastname: Reid
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration; D005260:Female; D006297:Health Services Accessibility; D006305:Health Status Indicators; D006801:Humans; D008331:Management Information Systems; D009938:Organizations; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D034121:Reproductive Health Services / Q000458:organization & administration / Q000592:standards