Saving Lives in Bangladesh

It is estimated that 25,000 children worldwide die every day from hunger or other preventable causes. Thanks to CRWRC and a $1 million grant of the United States government, the number of child deaths in parts of Bangladesh has decreased dramatically over the past five years.

In 2004, CRWRC was awarded $1,098,152 by the United States Agency for International Development (USAID) to carry out a child survival program in two rural districts of Bangladesh and four slums in the capital city of Dhaka.

Working through its existing community partners, CRWRC helped people organize themselves into community-based organizations (CBO), receive training, and address numerous factors that were contributing to childhood disease and death.

“During the five years, we saw great health outcomes,” reports CRWRC staff member Kohima Daring. “More women having safe deliveries with skilled attendants, more mothers and children vaccinated, increased prenatal medical care, improved child nutrition, and more babies being exclusively breast-fed.”

“In many of the target areas, health facilities are several kilometers away and are poorly staffed,” notes CRWRC staff member Nancy TenBroek. “By training community health volunteers and community birth attendants, we saw health statistics for mothers and children improve dramatically.”

Another part of the child survival program involved creating an emergency health fund. One of the big problems in poor communities is lack of funds for medical treatment. If people can’t afford to pay for transportation to a clinic or hospital, or if they don’t have funds to purchase medicine, they often die from easily treatable diseases.

The CRWRC program helped CBOs start an “emergency health fund” that could be accessed as interest-free loans for medical care and transportation. Members of the community each contributed a small amount to the fund each week. Teachers, professionals, and other middle-class members of the community also contributed to the fund. The fund is now accessible to anyone in the community who has a need. The CBOs work out a repayment plan that fits the circumstances of the family that has the health emergency.

“We’ve heard numerous stories of how this fund has been used,” says TenBroek. “For example, a young mother with a complicated delivery needed to get to the hospital. The birth attendant arranged for a loan from the fund and traveled on a rickshaw with the mother 12 kilometers to the nearest health facility. Mother and child are both doing well. It is exciting to hear these stories and see the community working together for better health care.”

In June 2009 a team of 15 people, led by International Health Systems consultant Dr. Frank Baer, evaluated the child survival program. The team was impressed by what they saw.

“Many people interviewed felt that [the CRWRC child survival program] has significantly reduced child and maternal deaths,” said Dr. Baer. “It is estimated that there has been a 34 percent reduction of under-5 mortality in the project area.” A 34 percent reduction in child mortality is the equivalent of saving the lives of 399 children in the target area over the five-year period.

Based on the success of this initial program, CRWRC has applied for another five-year child survival project in Bangladesh and has been recommended for another USAID award. The new project is scheduled to start in October 2009, pending final approval.