Improving Service Accessibility for Least Advantaged Clients
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Transcript of Improving Service Accessibility for Least Advantaged Clients
Improving Service Accessibility for Least Advantaged Clients
NGO Service Delivery ProgramHouse NE (N), Road 88, Gulshan-2, Dhaka-1212
NGO Service Delivery Program (NSDP) Slide # 2
Overview of NSDP
35 NGOs35 NGOs61 districts
85 municipalities 6 city corporations
317 Clinics 8,302 Satellite Spots6,330 Depotholders 1.7 million customer served/
monthBasic Service PackageBasic Service PackageComprehensive FP & RH Services Child Health services TB in urban areasANC and maternal healthLimited Curative CareBCC activities
NGO Service Delivery Program (NSDP) Slide # 3
Study Objectives
• To identify least advantaged clients (poorest of the poor)
• To isolate and understand barriers they face in accessing
services
• To design ways to overcome barriers
• To improve communication between the poor and NGO
service providers
NGO Service Delivery Program (NSDP) Slide # 4
Methodology
• Participatory Rural/Urban Appraisal applied with women – Social Mapping– Wealth Ranking– Venn Diagram
• Meeting with Stakeholders
• Study Coverage: – 8 NGOs – 24 Static Clinics – 826 Satellite Clinics spots
NGO Service Delivery Program (NSDP) Slide # 5
PRA Sessions and Participants
• 390 stakeholder meetings and 694 PRA meetings conducted
• 24,533 community members participated in PRA meetings
• 6,556 stakeholders attended meetings expressing their commitment for serving poorest of the poor.
NGO Service Delivery Program (NSDP) Slide # 6
Who are poorest of the poor
Poor community members identified context specific indicators in PRA session:
Rural• Day laborers• Depend on food collected
door to door• Cannot eat twice in a day• No education• Little income above
expenditure
Urban• No land• Begging• Suffers from untreated
diseases • Works as house maid• No work no food
NGO Service Delivery Program (NSDP) Slide # 7
• Services:– Limited range of services– inadequate number of
satellite clinics and – limited hours
• Information: Not informed about availability and types of services
• Poverty: – High service charge and
price of medicine– No free treatment
• Quality of service: – Diseases not cured – Incorrect treatment
• Providers’ behavior: – Poor are neglected
– Not allowed to speak
• Proximity: – Distance of clinic
– Clinic staff don't visit remote areas
Barriers
NGO Service Delivery Program (NSDP) Slide # 8
Participatory appraisal (Urban and Rural)
• Sharing of information/findings
• Joint planning for reducing
barriers
• Partnership between providers
and community
Joint Planning Session
NGO Service Delivery Program (NSDP) Slide # 9
Strengthening Community Based Forums
• Satellite clinic support group & static clinic advisory
teams consist of community members and service
providers
• Very poor people are now involved in planning
• Assigned tasks and follow up
• 90,000 members are involved in these forums
• SCSG/SCAT actively involved in planning & organizing
satellite clinics.
NGO Service Delivery Program (NSDP) Slide # 10
Addressing financial barriers
• Exemption policy for the very poor– Health benefit card
– Pricing policy for able to pay customers
• NSDP piloted incentive scheme in four NGOs
• Fund diversification strategies adapted– Involving business for serving extremely poor people
– 83 clinics of 13 NGOs generated Tk. 3,55,632 as community fund & using RDF profit for serving poor
– Pharmaceutical companies are started to provide free medicine.
NGO Service Delivery Program (NSDP) Slide # 11
Percentage of Clients Who Are Poor
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Months
Percentage
NGO Service Delivery Program (NSDP) Slide # 12
Some Changes
• All concerned are highly sensitized and oriented to meet needs of the poor
• NSDP incorporated the needs and expectations of the community in the work plan
• Providers’ satisfaction enhanced because they are involved in planning process
• Interpersonal communication strengthened
• Service utilization increased by the poor
• Pro-poor BCC strategy adapted.
NGO Service Delivery Program (NSDP) Slide # 13
Conclusion
• NGOs learned the application of participatory
techniques to integrate into their management.
• SCSG/SCAT to be more active in promoting linkages
with community groups and play advocacy role
• NGOs need to focus on providers attitude towards poor
in making service poor friendly
• Continuous community feedback and consultation may
help developing new strategic direction.
Thank You