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NGOs getting bigger healAcare role

Naimul Haq
The government is engaging more non-government organisations (NGOs) in healthcare service provision following donors' rebuke for poor implementation of some major health programmes involving Tk 1,172 crore in recent times.
Sources said many of the donor-supported health programmes
failed to achieve their goals due to mismanagement, political interference, corruption and delay in implementation, resulting even in withdrawal of funds in some cases.
Among the key health projects in which tire government is obliged to augment involvement of NGOs are the HIV/AIDS Programme, National Nutrition Project, National TB Programme and Community
Clinics.
Though launched back in January 2001, due to 'major design faults', the HIV/AIDS Programme still exists in paper alone and is struggling lo work out a process of its implementation. Tire programme was meant to complement and support the HIV/AIDS prevention activities of the government's three-year health programme as an integral part of it.
Noting the astounding delay, the World Bank (WB) withdrew about half of the $52-million fund it had provided for the HIV/AIDS project. Donors are also pressuring the health ministry to hand over the project's management to NGOs.
According to official sources, the ministry and the Unicef are now in the process of selecting suitable NGOs to carry out the major project components, like interventions among vulnerable groups, safe blood transfusion and communications and advocacy.
In addition, Brae will implement a separate HIV/AIDS programme involving 15 million Swedish kroner.
The Tk 640-crore National Nutrition Project, funded by the WB and other donors and scheduled to take off in July 2000, could manage to launch only recently due to bureaucratic tangles.
Disagreements between the WB and the Executive Committee of National Economic Council (Ecnec) resulted in the delay of almost two and a half years for the project design to be finalised and okayed by the Ecnec, sources said.
Then, months were spent just to select the NGOs to be assigned with the 23 area packages of tne project which aims to reduce critical and acute malnutrition, particularly among women and children.
Against this backdrop, the WB withdrew Tk 150 crore from the project funds in February last year.
Ten NGOs — Brae, TMSS, Shed, Sard, Bees, Bosd, Vard, UJMS, SGS and Heed Bangladesh -- are now implementing the project in 105
upazilas.
In case of the National TB Programme (NTP), which was launched in 1993, its failure to contain the increasing prevalence ofpulmonary tuberculosis (TB) has prompted the government to go for extensive partnership with NGOs to detect and treat TB cases.
On an average, 300,000 new TB cases are detected every year despite spending of millions of dollars provided by the World Health Organisation on an internationally recognised prescription --DOTS — to combat the second most killer disease in Bangladesh.
"We now realise it is time for partnership and such alliance has already proved effective," said a senior NTP executive.
The government is also engaging NGOs to provide healthcare under the Community Clinics (CCs) project, as over 11,000 CCs built since 2001 still remain unutilised due to political reasons.
The health ministry has already contracted out 30 such CCs each of which is meant to provide 6,000 people with basic health and family planning services.
The British overseas funding agency DFID in partnership with Bangladesh Population Health Consortium is now running six of the CCs and the USAID in cooperation with National Service Delivery Project is operating ano-ther six. The Canadian International Development Agency in association with some local NGOs is in charge of several dozens of the CCs in rural areas.
Meanwhile, the health secretary at a recent press briefing said the health ministry plans to give away some 200 more CCs to NGO partnerships.