ASSESSMENT ON
ESSENTIAL SERVICE DELIVERY
(ESD) PROGRAM IN
NGO CLINIC AND UPHCP
1
Md. Shahadat Kamal
EC Bangladesh
WHAT IS ESD PROGRAM ?
ESD is Essential Service Delivery Program
provided by some Govt. and Non Govt.
Clinics.
There are 5 Components:
• Reproductive Health Care
• Child Health Care
• Communicable Disease Control
• Limited Curative Care
• Behavior Change Communication
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OBJECTIVES OF THE STUDY
 General
Objective:
To assess the capacity and utilization of the
NGO Clinic and UPHCP for implementation
of Essential Service Delivery (ESD)
 Specific
Objectives
To investigate
- type of providers involved in the service
- experience and training of service providers to
provide ESD
- capacity to provide services
- facilities
- exit clients opinions about the service
- the opinions of community level influential’s
about the capacity of the service providers
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METHODOLOGY
 Sample
 Data
Selection (Number of sample 285)
Collection

Questionnaire Interview

Focus Group Discussion (12 FGD)

Key Informer Interview (48 KII)
 Data
Compilation
 Data
Analysis
 Reporting
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KEY FINDINGS
SERVICE EXISTED IN THE ESD PROGRAM
o
o
o
There are 46 types of services in ESD
Out of 46 services some are common, such as
Family Planning, ANC/PNC, Vaccination, MRI
are most common and Popular
4 types of services provided by the CRHCC and
PHCC under UPHCP varied but most of the
NGO clinics have same 46 of services.
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KEY FINDINGS
TYPE OF PROVIDERS IN
o
o
ESD
There are 12 types of service providers
They are Clinic Manager, Doctor, Field
Supervisor, Nurse, Counselor, Health Worker,
Accountant, Office Assistant, Lab Technician,
Pharmacist, MLSS, Night Guard and Aya
o
Highest tier is Clinic manager and the lowest is
Aya
o
Doctor is holding two positions at the same time,
Clinic Manager cum Physician
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KEY FINDINGS
EXPERIENCE AND TRAINING TO PROVIDE ESD
Mid level Staff received ESD related
training (72%)
o Top level Service providers received ESD
training (100%)
o Field level staff received (72%)
o Newly appointees are in process to receive
training
o Refresher training on ESD is irregular
o
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KEY FINDINGS
FACILITIES OF THE CLINICS
o
o
o
o
o
o
Facilities:
o Lab facility
o Client privacy
o Waiting room
 Toilet facility
o Free and low cost service
o Free Medicine
o Satellite clinic
Inadequate medicine and Lab facility
Lack of Generator for smooth electric supply
Poor client provider ratio
Inadequacy of Satellite clinic
Non-availability of Ambulance service
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KEY FINDINGS
CLIENTS AND THEIR OPINION
o
o
Clients who come in the clinic (according to monthly
income level:
o
7.5% (bellow 5000)
o
42% ( 5001- 10,000)
o
20% (10001-15000)
o
25% (15001-25000)
o
5% (more than 2500)
Clients come to the clinics because they get –
 Free and low cost treatment,
 Free medicine,
 Nearby.
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KEY FINDINGS
CLIENTS AND THEIR OPINION

o
o
o
Client’s demand for service:

Free medicine (70%)

Quick Ambulance service (70%)

Trained and skilled doctor & paramedics (75%)
Cause of client’s unhappiness: Irregular and
shortage of medicine supply
Service quality is satisfactory (70%)
Service quality is dissatisfactory (30%)
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KEY FINDINGS
OPINION OF COMMUNITY INFLUENTIAL'S ABOUT SERVICE/
PROVIDERS’ CAPACITY

Lack of modern health facilities (lab, AC)

Shortage of manpower

Low incentives for service providers

Regular supply of medicine

Staff training
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SUGGESTIONS




Satellite clinics should be increased according to the density
and demand of population
Staff’s incentives (salary, bonus, increment, PF, Gratuity,
TA/DA and other allowance) should be revised in order to
increase commitment and ensure quality of work
Staff’s capacity is very much essential for ensuring quality of
service. So refresher training should be organized regularly
in order to develop staff’s capacity. This types of refresher
training can be organized quarterly or half-yearly.
Supervision, monitoring and follow up activities should be
increased in order to ensure quality of service.
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SUGGESTIONS



Newly appointed staffs and mid level service
providers should get timely basic and refresher
training respectively
In order to increase client flow and ensure
satisfaction regular and adequate supply of medicine
should be ensured.
Some important training have been required such as
Clinic Management and Administration for clinic
manager, Application of Modern Medical Tools &
Techniques for doctor, Social Motivation &
Motivation, Planning & Implementation, Effective
Communication, Quality Service Promotion for Mid
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Level
staff
SUGGESTIONS
Modern Diagnostic services and facilities in both CRHCC
& PHCC and other clinics should be introduced
 Community involvement should be increased. Yearly or
half yearly opinion meeting, Case study dissemination
meeting and Area visit can be organized.

Continuous electricity supply should be ensured and for
this community influential's donation/contribution can be
collected for purchase of generator.
 Separate Clinic Manager (non-doctor) and doctor should
be employed in order to ensure service of quality

Thanks
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THANKS
THANKS
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