TY - JOUR
T1 - Strategies for providing healthcare services to street-dwellers in Dhaka city
T2 - Evidence from an operations research
AU - Uddin, Jasim
AU - Koehlmoos, Tracey P.
AU - Saha, Nirod C.
AU - Islam, Ziaul
AU - Khan, Iqbal A.
AU - Quaiyum, M. A.
N1 - Funding Information:
The research was supported by German International Technical Cooperation (GIZ) (Grant No. 81110469). The authors acknowledge with gratitude the support of GIZ to this research.
PY - 2012/6/13
Y1 - 2012/6/13
N2 - Background: In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers.Methods: This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another.Results: The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas.Conclusions: As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.
AB - Background: In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers.Methods: This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another.Results: The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas.Conclusions: As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.
KW - Bangladesh
KW - Health services
KW - Healthcare
KW - Satellite clinics
KW - Static clinic
KW - Street-dwellers
KW - Urban health services
UR - http://www.scopus.com/inward/record.url?scp=84862162875&partnerID=8YFLogxK
U2 - 10.1186/1478-4505-10-19
DO - 10.1186/1478-4505-10-19
M3 - Article
C2 - 22694892
AN - SCOPUS:84862162875
SN - 1478-4505
VL - 10
JO - Health Research Policy and Systems
JF - Health Research Policy and Systems
M1 - 19
ER -