8/18/2019 Poster MaMoni HSS

1/1

BackgroundReaching mothers

with critical health

services is challenging

where home delivery is

the norm. The MaMoni

Health Systems

Strengthening

Project, funded by the

United States Agency

for International

Development, trained

48 local women from

hard-to-reach areas

in a six-month course

for community skilled birth attendant (CSBA),

accredited by the Bangladesh Nursing Council,

to increase coverage of skilled birth attendants

(SBAs) in hard to reach areas. This complements

the coverage of government-supported CSBAs.

CSBA in Bangladesh:

 n Denition of CSBA: An accredited health

professional, such as midwife or nurse, who

has been educated and trained to prociency

in the skills needed to manage normal

(uncomplicated) pregnancy, childbirth and

the postnatal period and in the indication,

management and referral of complications in

women and newborns (WHO, ICM, FIGO; 2014).

 n In order to practice, CSBA must fulll the

criteria to receive registration and/or

licensure from the government-approved legal

authority.

 nLocal women in their respective communitieswere selected as pCSBAs by a team consisting

of the Ministry of Health and Family Welfare,

MaMoni and the Obstetric and Gynecology

Society of Bangladesh. Other selection criteria

were as per national guideline, including:

 n Female, age 20 to 45 years

 n Minimum Secondary School Certicate

 n Preferably married

 n Local resident

 n Willing to stay for 6 months in the district for

training

 n Acceptable to the community

 n Previous experience working for community

is an added advantage

Bringing Health Services Closer to Home:

Community Skilled Birth Attendants in theMaMoni Project, Bangladesh

by: Jebun Rahman1, Imteaz Mannan2, Marufa Aziz Khan2, and Sabbir Ahmed2

affiliation: 1Jhpiego, an affiliate of Johns Hopkins University; 2Save the Children

USAIDs MaMoni HSS Project was made posssible with the support of the American People through the U.S. Agency for International Development (USAID) in collaboration with the

Ministry of Health and Family Welfare in Bangladesh. The contents of th is particulat material are the responsibility of the authors and do no neccessarily reect the opinion of USAID or

the U.S. Government.

Conclusions n pCSBAs increased coverage of skilled care

at the community level, particularly in areas

where health facilities were inadequate

 n To maximize use of pCSBAs at the community

level, community resources are needed for

offsetting operating costs and ensuring skills

retention with supportive supervision on site

 n Proper allocation of working areas and an

incentive and recognition mechanism from the

community need special attention

Findings51% to 65% of pregnant women were identied by

pCSBAs in their working areas.

Pregnant women who received one antenatal

care visit from pCSBAs and other medically

trained providers in respective working areas

 Ajmiriganj Baniachong Nabiganj

17.6%

29%

16.9%

30%

14.4%

20%

pCSBA

Other medically trained providers

 Ajmiriganj

Baniachong 

Sadar    Bahubal

Chunarughat

Lakhai

Madhabpur 

Nabiganj

Working areas of pCSBAs

14 pCSBA

27 pCSBA

7 pCSBA

Working areas of GoB CSBA

Working areas of CSBAs, Habiganj District,

Bangladesh

 Ajmiriganj Baniachong Nabiganj

26%

48%

19%23%

16% 16%

% delivery by pCSBA in clusters

% delivery by SBA in working areas

Percentage of deliveries conducted by pCSBAs

and SBAs in respective working areas

 Ajmiriganj Baniachong Nabiganj

26%

16%

19%17% 16%

9%

Delivery by pCSBA

Delivery by CSBA

AG BC NG Total

pCSBA 14 27 7 48CSBA 13 28 21 62

Methodology

Source of data: Secondary analysis of pCSBAs’

monthly project Management Information System

forms

Area: Three sub-districts of Habiganj (Ajmiriganj,

Baniachong, Nabiganj)

Analysis period: April 2013–March 2014

(12 months)

Comparisons: Performance of pCSBAs and CSBAs

supported by the Government of Bangladesh (GoB)

ObjectiveThis analysis aimed to understand the

performance of private community skilled

birth attendant (pCSBAs) supported by

the MaMoni Project in Habiganj district

in northeastern Bangladesh.

Findings, (Continued )

Comparison of deliveries conducted by pCSBA

and GoB CSBA against projected number of

deliveries* in respective working areas