The Health Sector

Sweden´s strategy objective for the health sector is improved basic health, focusing particularly on women, children and sexual and reproductive health and rights (sub-objective 4). The sector portfolio includes interventions that address important maternal and child health problems and are focused on organisations, institutions and systems with the potential to have a significant effect on public health sector performance that are important for poverty reduction.

1. Health, Population and Nutrition Sector Development Programme, (HPNSDP), 2011 – 2016.

Sweden provides a total of 415 MSEK over 5 years to the Government of Bangladesh to implement the Health, Population and Nutrition Sector Development Programme 2011-2016 (HPNSDP). The focus is on maternal and child health and aims to increase access to better quality health services, especially for the poor in rural areas. Key areas of work are reproductive health, maternal and child health, family planning and communicable and non-communicable diseases. The programme also targets weaknesses in the public health system and works to improve components of public financial management, procurement and human resources management.

The program is embedded in a sector-wide approach (SWAp) and builds upon progress and experiences from two earlier SWAps in health (1998 – 2004, 2005 – 2011). The sector programme is supported by Sweden, the World Bank, The Netherlands, Canada, Australia, DfID, UNFPA, KfW and is administered by the WB through a Multi Donor Trust Fund (MDTF). Up to MSEK 405 is channelled by the MDTF. Up to SEK 9 500 000 has been provided to UNFPA for technical assistance to cover costs for the introduction of midwifes as a health profession in Bangladesh (read more below). 

2. Urban Primary Health Care Services Delivery Project (UPHCDSP)

This project is a continuation of two earlier phases of urban primary health care project (UPHCP). The urban population has been growing rapidly in Bangladesh, and currently represents about 33% of total population. The absolute number of poor urban house-holds is increasing. The UPHCDSP is a five year project 2012-2017. It helps ensure the delivery of a package of preventive, promotional and curative health services to the poor in eleven cities (city corporations and municipalities). The Project continues to contract out primary health care services to nongovernmental organizations (NGOs) through partnership agreements. The Project has ensured pro-poor targeting by providing at least 30% of free services to the poor. Urban primary health care is delivered through the Ministry of Local Government and Rural Development and Cooperative (LGRDC) in Bangladesh. However, the Ministry of Health and Family Welfare (MOHFW) is responsible for the monitoring and supervision of the project activities. The total project cost is estimated to be 580 MSEK. Sweden provides 145 MSEK through an agreement with ADB.

3. Sexual and Reproductive Health & Rights (SRHR) Programme

This Swedish support enables a consortium of NGOs, headed by Reproductive Health Services, Training and Education Programme (RHSTEP) to continue delivering and promote Sexual and Reproductive Health and Rights (SRHR) with a special focus on safe Menstrual Regulation (MR) and post abortion care. This support complements the ongoing support to the Health Sector Programme in Bangladesh. The Embassy has also facilitated to build the partnerships between the Swedish Association of Sexuality Education (RFSU), the icddr,b (see below) and different NGOs, based on their common interests in the area of SRHR. The volume of support by Sweden for the period 2014-2016 is approximately 45 MSEK.

4.    Core support and research support to icddr,b (2012 – 2016)

icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh) is an international research institute focusing on health and population issues located in Bangladesh. The Swedish support of MSEK 54 is divided in core and research support and is a 4 year (2012 – 2016) commitment to the national and global health research agenda. Up to MSEK 30 is provided as core funding and up to MSEK 24 is provided for research. The core funding is design to support icddr,b institutional capacity to contribute to identifying major health challenges and solutions in Bangladesh. The major outcome of icddr,b activities are identified as policies to alleviate public health challenges for women, men, girls and boys as well as evidence-based, gender responsive health care and health education. Based on the identified outcomes, the aim with the Swedish core support is to accelerate the efforts toward improving maternal and child health and thereby contributing to the impact of the health sector programme “Health, Population and Nutrition Sector Development Programme”, HPNSDP, implemented by the MoHFW (see above).

5.    Technical Assistance to Strengthen the Quality of Maternal Health Services, UNFPA (2016)

The project is implemented by the Ministry of Health and Family Welfare in an agreement with UNFPA and aims to increase the availability of midwifery services of sub-district hospitals and to increase the availability and access to quality emergency obstetric care services. The project is a direct response to the need of more qualified and higher skilled personnel providing delivery services and emergency obstetric care by establishing a new genre of midwife as stated in the health sector plan (HPNSDP).The Swedish support amounts to SEK 9 500 000 for a period of approximately one year (November 2015 – December 2016). The agreement partner is UNFPA and the project is implemented in partnership with the Ministry of Health and Family Welfare. UNFPA provides support and technical expertise in the midwifery profession, in the updating of the curriculum and in regulatory and licensing frameworks for the midwifery profession.

Project activities include: i) developing a policy and legal framework for the full development of the new professional cadre of midwifery; ii) developing midwifery institutions based on ICM standards; iii) establishing a midwifery-led maternal health care; iv) increasing awareness and demand for midwifery; v) developing a national EmONC improvement plan. These activities are expected to result in more pregnant women being attended by qualified health care professional and increased availability and utilization of quality skilled maternity care.