1. Background
A mid-term review of the Bangladesh Health Nutrition and Population Sector Plan (2003-2010) (HNPSP) in 2007 found that the area of neonatal health was not addressed adequately. In addition, the principal policy documents for maternal and child health – including the National Maternal Health Strategy (2001), the community-IMCI strategy (2004) and the IYCF strategy (2007) – did not include a comprehensive approach to improving newborn health. As a consequence, the MOH began a process to develop a National Neonatal Health Strategy and Guidelines (NNHS). In Bangladesh newborn program activities are implemented by two directorates of the Ministry of Health and Family Welfare – the Directorate General of Health Services (DGHS) and the Directorate General of Family Planning (DGFP). The system is centralized, with program responsibilities divided between 32 line directors at the central level. Each line director develops an annual implementation plan and budget, and is responsible for implementing activities on the ground – through districts, upazillas (sub-districts) and unions.
Health services in Bangladesh are provided by community clinics, satellite clinics and immunization clinics (community level) with each satellite clinic serving several villages; Union Health and Family Welfare Centers (union level); and by Upazilla Health Complex Hospitals (upazilla level). Low-level facilities might be staffed by a number of different cadres of health worker, including; Family Welfare Visitors (FWVs), Medical assistants (MAs), Sub-Assistant Community Medical Officers (SACMOs), and Paramedics. Upazilla level facilities are staffed by doctors and nurses. In communities, the primary government providers of health education and door-to-door visits are Family Welfare Assistants (FWAs) and Health Assistants (HAs). In addition, there are a number of NGO cadres of community health worker throughout the country. Most communities have community health committees, and regular meetings on health topics (Uthan Baithak meetings). NGO partners are expected to apply national policies and guidelines on maternal and newborn care, and timing of early PNC visits.
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