bees health program at a glance 01

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Background

Starting in the early 1979s, BEES was able to contribute to improve the health condition in its

working areas reducing the maternal and child mortality rate with desired success. This

impressive gain has been sustained in expanding intervention areas to the recent years, which

exemplifies the strong commitment of BEES towards healthy future for all. BEES believes thatpoor health outcomes undermine national and household productivity gravely in the existing

generation and the next. A well-

designed and essential health careservice that benefits and protects the

poor is an investment in national

productivity, social inclusiveness andstability. In the course of implementing

multi-dimensional health programs to

enhance health care services atcommunity level, BEES is still facing

enormous competing social challengesassociated with poverty, gender,

education, environmental factors and soon. Nonetheless, BEES has been

achieving impressive health outcomes

over the years for its great commitmentto sound health for sound nation. This is to say that barriers to enjoying essential health care for

poor people often become a source of increasing social unproductivity and impoverishment. To

meet the increasing need & demand in the intervention areas, BEES is responding in a range ofways to help community people expand and improve their awareness of health providing direct,

long or short term development assistance like preventive and basic curative health-care services

with component of primary health care, family planning, nutrition, food security, homesteadgardening, cooking demonstration, growth monitoring, immunization, water & sanitation, arsenic

mitigation, HIV/AIDS prevention and so on .

Target Area & Population

Presently BEES has been operating its integrated health & development activities spread over a strong

network consisting of 17 Area offices, 110 Unit Offices (branches) and one Central Office located in

Dhaka, 3,069 community nutrition centers (CNCs) covering approx. 3,400 villages under 481 unions of

84 upazilas in 31 districts of Bangladesh. The districts are- Dhaka, Gazipur, Hobigonj, Brahmanbaria,

Narshingdi, Kishorgonj, Faridpur, Madaripur, Gopalgonj, Meherpur, Magura, Chuandanga, Bogra,

Joypurhat, Noagaon, Natore, Rajshahi, Gaibandha, Rangpur, Pabna, Sirajgonj, Jamalpur, Mymensingh,

Netrokona, Sherpur, Comilla, Feni, Laxmipur, Noakhali and Chittagong.

BEES has established a sturdy association among and with more than 45 lac people, mostly

disadvantaged, deprived of all kinds of human rights, social security as well as vulnerable to HIV-

AIDS/STDs/STIs, malnutrition & ill health, who are receiving development services from BEES.


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Leading the Way to Wealthy Future

BEES HEALTH PROGRAM AT A GLANCE 01.doc Page 2 of 12

Health Program: Its Components

BEES has been providing different types of health services at community level to its target groups

catering to them under its health & development oriented programs, projects and activities. These are:

o Health Services through Sebao National Nutrition Program (NNP)o HIV/AIDS Prevention Programo Community Based Health Programo Water & Sanitationo Nutrition Surveillance Project (NSP)o Human Resource Development through Training

Health Services through Seba

Health Services through Seba is a self-sustaining program supported

by Microfinance Program. Under this activity, comprehensive healthactivity is being implemented in 35 upazilas of 30 districts in 5divisions of Bangladesh by 35 qualified Paramedics under the direct

supervision of 2 doctors.

In the intervention areas of SEBA Health, paramedics are providing the following services:

Pregnancy weight gain monitoring and promotion by bathroom scale; and promotion(including counseling on improved caring and feeding practices).

Identifying malnourished pregnant women with BMI < 17.0; and giving counseling onimproved and demonstrative feeding to prevent malnutrition.

Delivering Ante Natal Care (ANC). Identifying pregnancy related complications and

early risk-delivery through routine close follow-up

and checking B.P., urine sugar and albumin.

Conducting normal deliveries and referring cases ofpregnancy complications and difficult delivery.

Providing Iron-Folate tablets to the pregnantwomen.

Delivering Post Natal Care (PNC). Givingawareness to lactating mothers for colostrums and breast-feeding.

Ensuring the vitamin-A for lactating mothers through coordination and collaboration withthe local UHC/USC/FWC. Monthly growth monitoring of children less than 5 years of age by Salter scale / bathroom

scale; and promotion (including counseling on improved caring and complementaryfeeding practices).

Giving EPI counseling and motivating the parents of children to attend the local EPIcenters. For immunization of the women of reproductive age and children Paramedics

doing coordination and collaboration with the government health facilities of the locality.


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Providing de-worming tablets through limited curative treatment for children below 5 yearsold and adolescent girls to prevent malnutrition.

Giving contraceptive and population control counseling to the beneficiaries, and guidingand helping them through FWC.

Giving awareness for personal hygiene, safe water & sanitary latrine. Delivering essential drug based limited curative cares (free diagnosis, prescription,

counseling and medicine supply).

Cooking demonstration & home gardening for prevention of malnutrition pregnant women,lactating mothers, and adolescent girls and U-5 children..

Motivating the beneficiaries to participate in the National and International Health Dayslike NID, National Vitamin-A Campaign, World Health Day, etc.

In the satellite clinic following BCC are delivered among the unmarried adolescent girls (13-19

years old), pregnant women, lactating mothers and mother-in-laws:

i. Breastfeeding promotion and protection and IYCF (Infant & Young ChildrenFeeding).

ii. Bad effects of early marriage.iii. Pre-delivery preparations.iv. Risks of pre-eclampsia and eclampsia.v. Family planning.vi. Prevention of HIV/AIDS.

In the satellite and static clinics following prescription based following limited curative care aredelivered:

i. ARI, pneumonia and asthma.ii. Gastric acidity.iii. Diarrhea, typhoid and paratyphoid.iv. Worm infestation.v. Pre-eclampsia and eclampsia.vi. Skin, eye and ear diseases.

In the satellite and static clinics followingdiagnostic procedures are done:

i. Pregnancy test.ii. Detection urine sugar.iii. Detection urine protein (albumin).


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Thus, with other activities of SEBA Package, SEBA Health is being carried out to bring adevelopment in health related aspects for the family members of the beneficiaries parallel to MF

loan facilities for them. Community people can also avail the services by payment of nominal

fee.

National Nutrition ProgramWithout nutrition awareness development can bear no fruit at all. Mulling over this moot point, BEES is

enhancing its efforts to advancing development continuously through executing nutrition projects like

NNP at field level. National Nutrition Program (NNP)

is a program of Ministry of Health & Family Welfare

with the financial support of World Bank. This project

commenced on December 2003 with the vision to

reduce malnutrition, particularly among women and

children, to the extent that it ceases to be a public

health problem. Its goal is to develop and strengthen

communities capacity to assess, and analyze the

causes of their malnutrition problems and to makebetter use of family, community and external

resources to improve the nutritional status of

vulnerable groups. Food insecurity is not only the

cause of malnutrition; behavior, social attitudes, and a

lack of understanding and knowledge of nutritional

needs tend to be associated with this. Since September 1, 2006, NNP has been working under HNPSP

(Health, Nutrition & Population Sector Program). According to this new sector, specific objectives of

nutrition package have been modified from NNP to HNPSP as follows:

To reduce the prevalence of Low Birth Weight (


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Components of NNP:

A. Services Component-a. Area-Based Community Nutrition (ABCN) Services

b. National Level Nutrition Services

B. Project Support and Institutional Development

Component-a. Project Management and Development

b. Monitoring and Evaluation

c. Training and Behavior Change

Communication

Geographical Coverage: BEES has beenproviding the core ABCN services in 6 upazillas

(Tongipara, Gopalgonj Sadar, Muksudpur,

Bhanga, Sadarpur and Madaripur Sadar) under 3

districts (Gopalgonj, Faridpur and Madaripur)

through area package # 10, in 4 upazilas

(Fatikchhari, Hathazari, Anwara and Bashkhali) of Chittagong district and in 4 upazilas (Patnitala,Dhamoirhat, Porsha and Sapahar ) of Naqgan district under area package # 32 of NNP.

Target Beneficiaries:

Children less than 2 years old Pregnant women Lactating mothers Unmarried adolescent girls Newly married women

HIV/AIDS Prevention ProgramWith the objectives to strengthen

capacity and knowledge of

beneficiaries, staff and other

stakeholders like CBOs on HIV/AIDS

in project intervention areas, BEES has

been implementing HIV/AIDS

prevention programs over the years at

the community, sub national and

national level. Major strategies related

to this program are to train staff, project

personnel & other stakeholders for

instance CBO members to increase

knowledge & awareness of HIV/AIDS

and make community people involved

with AIDS prevention through

community based BCC & Advocacy

program.


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To run it as an on-going program comprehensively, BEES has set-up offices comprising satellite & static

clinics and drop-in centre in the intervention areas catering to the communities. BEES provides services

to the community people especially garment workers, slum dwellers a nd workers of hotel & tea garden,

different stakeholders including GO-NGO representatives, CBO executive members, UP Chairmen,

women members, school teachers, local elites, imams, social workers and local journalists. Under the

HIV/AIDS Prevention Program, all of them are being sensitized regularly on HIV/AIDS. Alongside,

respective project personnel always maintain liaison with other stakeholders related to HIV/AIDSprograms, and exchange information for smooth implementation. Mainly BEES in implementing the

HIV/AIDS Prevention Program through:

Direct interventions as core program on HIV/AIDS Prevention Integrated approach inbuilt with different health programs.

Key prevention strategies of BEES AIDS Prevention Programs:

HIV prevention counseling and referral services: Individuals at risk for HIV are offered counselingregarding methods to eliminate or reduce their risk that they can be aware of their status and take

steps to protect their own health and that of their partners. BEES issues guidelines that are used to

develop counseling and referral services in traditional and non-traditional settings and provides social

support/assistance intended for counseling services provided at publicly static & satellite clinics.

Partner notification, including partner counseling and referral services (PCRS) with stronglinkages to prevention and treatment/care services: Sexual or needle-sharing partners of HIV-

infected persons are at-risk of being infected. Partner notification services trace out these individuals

and provide counseling and education to them about the exposure as well as services to prevent

infection or, if infected, linkages to care. BEES issues guidance on conducting PCRS and provides all

kinds of social assistance to local stakeholders like CBOs to ensure that PCRS is a high-priority and

that services are offered to all vulnerable people.

Prevention for high-risk populations:Prevention efforts for high-risk populations are

critical to reducing the spread of HIV. Efforts

ensure that those at highest risk of acquiring or

transmitting the virus are given the necessary

information & messages to protect themselves

and others. BEES supports prevention services

for persons drastically vulnerable to HIV/AIDS

and other high-risk populations susceptible to

STDs/STIs. In addition, BEES encourages all

grantees to work with the primary health care

clinics in their communities to integrate HIV

prevention services into care and treatment services.

Health education and risk reduction (HE/RR) activities: Health education is a powerful tool in theprevention of HIV. HE/RR services include individual, group, community and structural interventions

as well as prevention case management and outreach for high-risk community people. BEES alsoincludes health communication and public information programs for at-risk populations and the

general public. It supports focused health communications campaigns directly and provides technical

assistance to CBOs to offer HE/RR services focused on those most at-risk of transmitting or acquiring

HIV infection.


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Prenatal transmission prevention: When the HIV status of a pregnant woman is known, treatment ofthe woman and her infant and other preventive measures can substantially reduce the risk of HIV

transmission to the infant. BEES works with all health-care providers available at community level to

promote prenatal services through different maternal & child care activities. In addition, BEES is

involved in prenatal and postnatal care to ensure that appropriate HIV prevention counseling is

provided through regular courtyard meeting & door to door visit to reduce the risk of prenatal

transmission.

School-based HIV Prevention:Schools have an important role to play

in promoting the health and safety of

young people and helping them

establish lifelong healthy behavior

patterns. BEES school-based HIV

prevention program at community level

is to help set up school health

awareness activities that provide young

people with skills and information to

avoid or reduce behaviors that put themat risk for HIV infection and

STDs/STIs. These programs are

tailored to community norms.

Integrated CommunicationProgram for AIDS Prevention:BEES is executing Integrated

Communication Program forsupporting the AIDS Prevention

Program. Under these activities, it

has been developing messages and

materials for being used in AIDSPrevention. BEES is organizing

popular/street theatre at the

community level to make thecommunity people aware of AIDS.

It is organizing training, workshop,

orientation, seminar, colloquium,community convention, open

discussion and so on as the part of

effective developmentcommunication to strengthen the

AIDS prevention intervention atfield level.

Community-based Health Program (CBHP)

In 1979, BEES initiated its Health and Nutrition program with own support in Bogra district. Later in

1984, BEES reorganized its health and family planning services through group activities with the

financial support of CIDA. In 1992, BEES started a multifaceted Community Based Health Project with

financial assistance from Bangladesh Population & Health Consortium (BPHC-DFID) and Royal


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Netherlands Government in six upazilas of Bogra district. The goal of the project was to improve the

health status of children, women and men in BEES intervention areas. The purpose of the project was to

increase the use of and demand for cost effective ESP on Health & Population delivery solely and jointly

by NGOs and GOB amongst the poorest communities especially women and children complementing

GOBs health policy. BEES reorganized all of its

health services namely Reproductive Health & Family

planning, child health, communicable disease control,limited curative care including hygiene, safe water and

sanitation with BCC activities under this project. After

2000, the project was concentrated in Adamdighi and

Dhunot upazila of Bogra district and continued up to

2004 by BPHC-DFID support. Considering the impact

of this project, BEES is still maintaining the project

activities by the income earned from its Microfinance

program until the availability of greater donor support. During 1999-2003, BEES has implemented

another similar type of project entitledExpanded Health and Education Program (EHEP) with the

financial assistance from World University Service of Canada (WUSC-CIDA) in Brahmanbaria, Gazipur

and Narsingdi district.

Water and Sanitation

Since early nineties, BEES has been incorporating integrated software and hardware WatSan activities

with its programs with the assistance of NGO Forum for DWSS. Alongside its normal program BEES has

successfully performed rehabilitation activities, which mainly include building shelters, ensuring safe

water & environmental sanitation, installation of tubewells, repairing & re-sinking of damaged tubewells,

dewatering ponds and construction of sanitary latrines with the financial assistance of the World Relief

Canada. During late seventies, BEES installed more than 4,000 tubewells under the program intervention

areas in collaboration with the Bangladesh Krishi Bank. BEES provides the beneficiaries with credit

while a huge number of tubewells and latrines have been installed through these initiatives.

Furthermore, BEES has performed arsenic test for a good number of hand tubewells with its own efforts.BEES has created awareness among the people through conduction of promotional activities and using

communication materials on usage of safe water, personal hygiene practice, disposal of solid waste, and

dreadfulness of arsenic & arsenic mitigation options.

Nutrition Surveillance Project

Helen Keller International (HKI) has been operating the Nutrition Surveillance Project (NSP) since 1990

in collaboration with the Institute of Public Health Nutrition of the Ministry of Health and Family

Welfare (MOHFW) and partner NGOs. It has been an independent source of high quality data on

nutrition & health, food security, and household welfare in Bangladesh. The NSP collects information

every two months from children aged less than five years, their mothers and households throughout rural

Bangladesh, and in urban slums of six major cities.

BEES, one of the partners NGO of HKI, has been working for NSP for the last 3 years. At present, BEES

is working with National Nutrition Program (NNP) and on the other hand it is also assisting HKI in

research & development, regarding data collection for the NSP project. BEES is implementing this

project at Dhupchachia upazila, Bogra district and Sreepur upazila, Gazipur district.


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Human Resource Development through Training

BEES has been ensuring human resource development through training oriented activities that staff of

health program are able to learn new information, re-learn and reinforce existing knowledge and skills,

and most importantly have time to think and consider what

new options can help them improve their effectiveness in

performance i.e., implementation. Through such supportprogram based on demand driven approach, human resources

are developed in the way of improving knowledge, attitudes &

practices (KAP) and enhancing life-skills of the target groups.

BEES has been conducting a training cell to organize all kinds

of training activities related to the health program. This cell

having need-based plans is engaged seriously to ensure the role

of training catering to the programs and projects. To make

training programs more integrated, attractive and most of all

effective, BEES is using different timely methods like

lectures, demonstration, discussion, computer-based presentation, programmed instruction (PI), behavior-

modeling, case studies, role plays, mentoring, job instruction technique (JIT), transactional analysis,

simulation exercise, exchange visit and so forth. BEES training programs well-equipped with cognitive,behavioral and management development approach are developing skills and expertise among the staff

and beneficiaries to prevent problems from arising and providing tools to address any skill or

performance gaps within programmatic aspect.

Resource Management & Mobilization

Human Resource

BEES is always searching for better ways to produce best services and outcomes. To achieve

desired goals, BEES Health Program has been counting on skilled human resources all along.

Hiring the right people to manage and perform specific jobs, it builds up commitment and loyalty

among the staff by keeping them up to date about organizational plans and programs. Underhuman resource mobilization, it organizes such necessary activities as employee administration,

employee career development, performance management and development, series of planning,

key employee identification, moral assistance and organization development as a whole that theorganization can accomplish its work goals collectively and properly.

Staff of BEES Health Programs

Male

12%

Female

88%


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It has about 4,408 staff working in several project/programs. Under different health programsand activities, following human resources are engaged to carry out the programs efficiently at

field level:

Upazila Office Staff Field StaffName of Programs

UM FS Accnt OA MLSS CNO CNPTotal

NNP (National Nutrition Program), Area

Package # 106 35 6 6 6 132 1207 1398

NNP, AP # 13 4 34 4 4 4 133 1301 1484

NNP, AP # 32 4 15 4 4 4 56 561 648

Total 14 84 14 14 14 321 3069 3530

SEBA Health No. of Medical Doctors = 4, No. of Paramedics = 50 54

HIV/AIDS Prevention and Health ProgramsNo. of Medical Doctors = 5, No. of Paramedics = 15,

other field staff 5070

Grand Total 3654

Following is the Organogram of BEES Health Program:

Note: DD- Deputy Director, PM- Program Manager, PR- Public Relation, REM-Research, Evaluation & Monitoring, ASF-

Agriculture & Social Forestry, UM- Upazila Manager, FS- Field Supervisor, Accnt.- Accountant, O.A- Office Assistant, MLSS-Manually Laborious Support Staff, CNO- Community Nutrition Organizer, CNP- Community Nutrition Promoter

Financial ResourceIn order to create and enhance the organizational economic wealth and capacity, BEES has been

capitalizing on creative financial planning strategies comprising well-defined wealth and risk

management implementation policy. It is very much necessary to ensure availability of adequate financial

resources for the implementation of programs at different level. Thinking over this, BEES is conducting

resource mapping, identifying opportunities to mobilize financial resources and assessing the current

Managerial Team

a. SEBA Health:

1. PM (MF)

2. A M

3. UM

4. FO

5. MLSS

b. NNP:

1. Team Leader2. Coordinator

3. Finance Officer

4. M & E Officer

c. HIV/AIDS Prevention

& other health programs:

1. Team Leader

2. Coordinator

3. Finance Officer

4. M & E Officer

ED

Coordination Team

1. DD (Admn. & PR)2. DD (Information &

Development

Communication)

3. DD (Training)4. DD (Research,

Evaluation &

Monitoring)5. Finance Controller6. DD (Microfinance)7. DD (Agriculture &

Social Forestry)

8. DD (Education)

Technical Team

1. DD (Health)2. PM (Nutrition)3. Nutrition Specialist4. Medical Officer5. Paramedics6. Community

Nutrition Workers

7. Women GroupMembers


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status of resource mobilization regularly in order to utilize all possible supply of financial resources.

Thus, BEES is ensuring continuous flow of program funding and tackling and overcoming any financial

shock and vulnerability. To produce quality outcomes consecutively and have a positive impact on the

organizational progress consistently, BEES is trying to ease its financial dependence on the donors in true

sense. In this regard, service charges collected from revolving loan fund are playing important role in

supporting BEES to be self-sufficient. Putting profound emphasis on women employment generation both

in rural and urban areas under its programs, BEES is making them economically active. Easing overheadcost and making programs and activities more cost effective, decentralization and delegation of works

among staff members are contributing to organizational sustainability as a whole.

Program Implementation approach

Conduct baseline survey Select beneficiaries and formation groups by them Procure all necessary inputs and materials through a procurement committee Provide necessary services to the beneficiaries by respective program staff in cooperation with other

units

Conduct M&E activities by respective cell personnel Make necessary correspondences with concern organizations/donors by Executive Director and

respective program head

Ensure gender friendly environment both for men and women Provide training, technology, inputs loan and other support services as required Initiate disaster management program at disaster prone area Collaboration with donors, GoB and other stakeholders Maintain networking with selected CBOs and NGOs

for effective implementation of the project activities

Build up and bolster the capacities of the CBOs atcommunity level to work as BEES partner as needed

for program/project support

Conduct mid term review for each program by BEESfinancial & accounts department

Conduct internal and external audit by extra audit firm Submit necessary reports to donors, GoB and other

concern institutions

Ensure project evaluation at the end of project inaccordance with the contract agreement.

Collaboration

Forging of alliance through collaboration activities is one significant component of BEES total

program package. The purpose of inter-agency collaboration activities is to promote, consolidateand sustain health, nutrition and HIV/AIDS prevention projects to increase health benefits and

awareness status of the people of the program intervention areas . All these functions conjure upto a system to extend effective services to the deprived and disadvantaged people. The

enthusiastic and out and out success in collaborative network has influenced BEES to be keenly

interested to boost more programs with relevant government institutions, UN bodies and nationaland external support agencies.


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Directions to the Days Ahead

BEES identifies various issues to be implemented through participatory process giving priority to

the general health care, reproductive health awareness, HIV/AIDS prevention, nutrition, water &

sanitation and development agenda which includes addressing safe motherhood, enhancing theuse of contraceptive methods, counseling and communication, RTI/STD management, training ,

sex education and related adolescent reproductive health initiatives, qualitative health and related

behavioral research, gender-based violence as well as male participation in reproductive rightsand gender equity. Each of the activities aims at bringing a new and bold approach to

overcoming persistent and intransigent obstacles to achieving a malnutrition and HIV/AIDS freeBangladesh and to checking all the factors conducive to poor health.

bees health program at a glance 01

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