Project Name : Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh

Doner : AMERICARES Foundation Inc.

Sector : Health

Area : Assasuni Upazila, Satkhira District and Feni Sadar Upazila, Feni District

Time Line : Novembar-2024 through January-2025

Brief of activities :

1. Executive Summary

The “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project, implemented by Ashar Alo with funding and technical support from Americares, responded to the devastating 2024 flash floods that affected more than 5.8 million people across eleven districts. Among the hardest hit were Protavnagor Union of Ashashuni Upazila in Satkhira District and Kalidaha Union of Feni Sadar Upazila in Feni District, where thousands of families were displaced, health facilities damaged, and water sources contaminated. Vulnerable groups such as women, children, and the elderly faced heightened risks of disease outbreaks, malnutrition, and loss of education. Against this backdrop, the project sought to restore essential health services, ensure access to safe water, strengthen hygiene practices, and support maternal nutrition over a three-month period from November 2024 to January 2025.

By the close of the project on 31 January 2025, a comprehensive set of interventions had been successfully delivered. Six community clinics were restocked with essential emergency medicines, enabling the treatment of more than 5,200 patients suffering from flood-related illnesses, while referral rates to higher-level facilities fell by 40 percent. Access to safe drinking water was restored through the installation of 20 water purifiers across six clinics and 4 schools, directly benefiting an estimated 10,500 people and contributing to a 45 percent reduction in diarrheal cases within one month. To address menstrual hygiene challenges, 1,000 adolescent girls from ten schools received comprehensive hygiene kits, leading to a 30 percent improvement in school attendance during menstruation and a marked increase in confidence among beneficiaries.

Awareness building was another critical component, with eight one-day school sessions involving 800 students and generating a ripple effect as 82 percent of participants shared knowledge at home, extending the impact to more than 4,000 additional community members. In parallel, 20,000 illustrated WASH leaflets were distributed throughout Satkhira and Feni, helping to indirectly reach approximately 50,000 people with vital information on hygiene and disease prevention. Nutritional support was provided to 100 pregnant women through carefully designed food packages containing staples and supplements to improve dietary diversity and reduce anemia, ensuring healthier outcomes for both mothers and infants.

Altogether, the project directly reached 12,500 people including patients, students, adolescent girls, pregnant women, and healthcare workers while indirectly benefiting an additional 50,000 individuals across the two districts, bringing the total reach to 62,500 people. Implementation was completed on schedule and within the allocated budget of USD 25,650 (equivalent to BDT 3,026,700), with financial and operational systems maintained in full compliance with NGOAB and donor requirements. The project’s achievements were made possible through strong coordination with District Commissioners, Upazila Nirbahi Officers, Civil Surgeons, UH&FPOs, CHCPs, and school leaders, whose support ensured that interventions were aligned with government disaster response efforts and widely accepted by the community.

In sum, the project successfully restored access to essential health services, reduced the prevalence of waterborne diseases, strengthened hygiene practices, and improved maternal nutrition in flood-affected areas of Bangladesh. By combining direct service delivery with widespread awareness efforts, it not only alleviated immediate suffering but also contributed to longer-term community resilience in Satkhira and Feni.

Keywords (health, WASH, accountability, financial, and institutional).

2. Administrative Information

- Implementing NGO: Ashar Alo
- Donor: Americares
- Budget: USD 25,650 (BDT 3,026,700)
- Duration: 01 November 2024 – 31 January 2025
- Operational Areas: Kalidaha Union (Feni) & Protavnagor Union (Satkhira)
- Facilities: 6 Community Clinics and 6 schools
- Approvals: FD-2 & FD-7 (13 Nov 2024)

3. Context

Bangladesh, one of the most flood-prone countries in the world, faced an unprecedented humanitarian crisis in 2024 when flash floods devastated large parts of the southeastern and coastal regions. More than 5.8 million people across eleven districts were severely affected, with Satkhira and Feni among the worst hit. The floods displaced over 500,000 individuals, forcing them into overcrowded evacuation shelters, while more than one million people were left without access to essential services such as healthcare, clean drinking water, and sanitation. The sudden inundation destroyed homes, infrastructure, and livelihoods, creating cascading humanitarian challenges for already vulnerable populations.

The public health consequences of the floods were immediate and severe. Contaminated water sources triggered widespread outbreaks of waterborne diseases, including diarrhea, cholera, and skin infections. Health facilities were either damaged or overwhelmed, leading to critical shortages of medicines and medical equipment. In Satkhira, saline water intrusion compounded the problem, rendering vast stretches of agricultural land unproductive and making safe drinking water even scarcer. In Feni, the abrupt and intense flooding washed away stocks of medicines and destroyed vital health equipment, including blood pressure monitors, glucometers, and nebulizers in community clinics. This disruption severely constrained the ability of Community Health Care Providers (CHCPs) to respond to the mounting health needs of their communities.

The impact of the floods went beyond health services. Over 339,000 hectares of standing crops were destroyed, devastating rural livelihoods and intensifying food insecurity across affected districts. Families dependent on agriculture and daily wage labor were left without reliable income, making it increasingly difficult to purchase food or medicines. The crisis was further compounded by the closure of more than 7,000 schools, disrupting the education of approximately 1.75 million children. For adolescent girls, the situation was even more acute: the lack of access to menstrual hygiene products and safe sanitation facilities not only heightened the risk of infection but also forced many to miss school, undermining their educational continuity and well-being.

Vulnerable groups—particularly women, children, the elderly, and people living with chronic illnesses—were disproportionately affected by these cascading crises. Pregnant women faced heightened risks of malnutrition and complications during pregnancy due to the lack of access to nutritious food and antenatal care. Adolescent girls, struggling to manage their menstrual health in the absence of sanitary products and private facilities, faced both physical and psychological challenges. Elderly individuals and people with disabilities were unable to navigate overcrowded shelters or access health facilities, leaving them more exposed to illness and neglect.

In response to this complex emergency, the project “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” was designed to fill critical gaps in the immediate humanitarian response. Recognizing the urgent need for lifesaving interventions, Ashar Alo, in partnership with Americares, prioritized health, water, sanitation, hygiene (WASH), and nutritional support. The project aimed to equip six community clinics across Satkhira and Feni with emergency medicines, replace lost medical equipment, and distribute twenty water purifiers to clinics and schools. By doing so, it sought to restore the capacity of frontline health services and reduce the incidence of waterborne disease outbreaks.

Furthermore, the project emphasized preventive health measures and behavior change. To address hygiene and sanitation gaps, 1,000 adolescent girls received hygiene kits, while 800 students across eight schools participated in awareness sessions on safe water, sanitation, and menstrual hygiene management. These interventions were critical not only for immediate relief but also for fostering long-term resilience and reducing vulnerability to future disasters. The project also distributed 20,000 awareness leaflets to extend knowledge on safe practices to broader communities, reaching approximately 50,000 indirect beneficiaries.

Nutrition was another critical focus. Recognizing that malnutrition can exacerbate the vulnerabilities of pregnant women and endanger maternal and child health, the project provided food packages rich in protein, iron, and vitamins to 100 pregnant women in the targeted unions. This intervention was designed to reduce the risk of anemia, low birth weight, and other complications, while also strengthening prenatal care awareness in the affected communities.

The timing of this intervention was particularly significant. Implemented between November 2024 and January 2025, the project coincided with a period when flood-affected families were struggling to recover and local systems were overstretched. By intervening during this window, the project not only delivered urgent relief but also helped prevent secondary health crises, such as epidemics of waterborne diseases, nutritional deficiencies, and the long-term educational impacts of disrupted schooling.

In summary, the 2024 floods created an interlinked crisis of health, livelihoods, and education. Satkhira and Feni districts were emblematic of the broader devastation faced nationwide: damaged clinics, unsafe water, destroyed crops, and disrupted schools placed communities under severe stress. Women, children, and the elderly bore the brunt of this humanitarian emergency. The context clearly demonstrated the urgent need for integrated, multi-sectoral interventions combining health, WASH, nutrition, and awareness-building. Against this backdrop, the project provided a timely, targeted, and evidence-based response to restore services, protect vulnerable populations, and strengthen community resilience in the aftermath of the floods.

4. Objectives

• To provide essential emergency medical services to community clinics in flood-affected areas.
• To distribute water purifiers to ensure access to safe drinking water in community clinics and schools.
• To improve hygiene and sanitation practices among school-going children, particularly adolescent girls.
• To raise awareness on health, sanitation, and safe water practices among affected communities.
• To provide nutrition food support to pregnant women

 

5. Workplan & Chronology

The “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project was implemented over a three-month period, from November 2024 to January 2025, across Kalidaha Union of Feni Sadar Upazila in Feni District and Protavnagor Union of Ashashuni Upazila in Satkhira District. The workplan was designed to move from rapid mobilization and approvals to targeted distribution of supplies, awareness sessions, and monitoring. Below is a detailed account of each key milestone, written in chronological order.

5.1. Deployment of Project Staff

The project officially began with the deployment of staff on 05 November 2024. Ashar Alo mobilized its core implementation team, consisting of one Project Coordinator and two Program Officers, supported by twenty Health Brigade volunteers.

Project Coordinator: Oversaw overall management, liaison with stakeholders, and ensured compliance with donor and NGOAB guidelines.

Program Officers: Responsible for day-to-day operations, logistics planning, data collection, and supervision of volunteers.

Volunteers: Assisted with distribution of supplies, community outreach, and awareness activities in schools and clinics.

This deployment was critical because the floods had disrupted both government and NGO services in Satkhira and Feni. Having a dedicated team stationed in the field ensured that the project could rapidly adapt to the evolving needs of communities. The team also established field offices and coordinated closely with local government offices, including Upazila Nirbahi Officers (UNOs) and Civil Surgeons.

 

• Staff deployed on 05 Nov 2024.
• Core team: 1 Coordinator, 2 Officers, 20 volunteers.
• Base operations set up in Feni and Satkhira.
• Early liaison meetings with district and upazila authorities.

5.2. Field Assessments

Between 06 and 10 November, the project team conducted comprehensive field assessments in both districts. The assessments aimed to validate community needs, verify damage to health facilities, and prioritize interventions.

In Feni District, visits were conducted at North Gabindhapur, Chewria, and Jatrashidhe Community Clinics. The assessments revealed that floodwaters had destroyed essential medicines, damaged beds and WASH facilities, and washed away medical equipment. CHCPs reported a surge in patients suffering from diarrhea, respiratory illnesses, and skin infections.

 

In Satkhira District, assessments were conducted at North Chakala, Kurikhania, and Hizlia Community Clinics. The coastal nature of Satkhira worsened the impact of floods through saline intrusion, making drinking water unsafe. Essential medical equipment, such as blood pressure machines and glucometers, had been rendered non-functional due to water damage.

 

Simultaneously, the team met with local administrations, UNOs, and headmasters of selected schools, including United Academy Protavnagor and Gabindhapur High School. These meetings established local buy-in and secured support for hosting awareness sessions in schools once they reopened after examinations.

 

• Field assessments from 06–10 Nov 2024.
• Feni: North Gabindhapur, Chewria, Jatrashidhe CCs assessed.
• Satkhira: North Chakala, Kurikhania, Hizlia CCs assessed.
• Key findings: damaged equipment, increased disease cases, unsafe water.
• Meetings with UNOs, Civil Surgeons, school headmasters.

5.3. NGOAB Approvals

The project required formal approval from the NGO Affairs Bureau (NGOAB). From 04 to 13 November, Ashar Alo prepared and submitted FD-2 and FD-7 forms, detailing the project scope, donor funding, and implementation plan. On 13 November 2024, NGOAB officially approved the project.

This approval was crucial as it allowed the project to proceed with procurement, disbursement of donor funds, and field-level implementation. Without it, the project could not legally distribute supplies or conduct awareness activities.

 

• FD-2 and FD-7 submitted between 04–13 Nov.
• Approval received on 13 Nov 2024.
• Legal clearance for procurement and implementation granted.

5.4. Procurement Initiated

Following NGOAB approval, the procurement process was launched on 14 November 2024. The procurement team issued RFQs (Request for Quotations) to pre-qualified suppliers for emergency medicines, water purifiers, hygiene kits, nutrition packages, and IEC materials.

The procurement adhered to Ashar Alo’s robust, transparent policy, ensuring cost efficiency and accountability. Vendors were shortlisted based on quality, reliability, and delivery capacity, especially considering the urgency of reaching flood-affected areas before conditions deteriorated further.

 

• Procurement launched 14 Nov 2024.
• Items included: medicines, purifiers, hygiene kits, nutrition packages, IEC leaflets.
• Transparent vendor selection process.
• Priority given to flood-affected districts.

5.5. Nutrition Support in Satkhira

On 09 December 2024, the project began direct beneficiary interventions with the distribution of nutrition food packages to 100 pregnant women in Satkhira. The packages contained protein-rich food, vitamins, and minerals to address anemia and malnutrition.

The distribution was carried out in collaboration with the Upazila Health & Family Planning Office (UH&FPO) of Ashashuni. Pregnant women were identified through CHCP lists and antenatal care registers. Beneficiaries reported immediate relief, as many had been unable to afford nutritious food due to crop loss and rising market prices.

• 100 pregnant women received nutrition packages in Satkhira.
• Distributed in partnership with UH&FPO and CHCPs.
• Aim: reduce anemia, improve maternal and child health.

5.6. Satkhira Handovers

On 27 December 2024, Satkhira district received a major consignment of project supplies. Emergency medicines and water purifiers were handed over to three Community Clinics and the Assasuni Upazila Health Complex. School consignments, including hygiene kits and leaflets, were also staged for January distribution.

The handover was conducted in the presence of local officials, including the UNO of Satkhira, ensuring transparency. Medicines were immediately stocked in clinics, enabling treatment for over 2,000 patients within two weeks.

• 27 Dec 2024: Medicines and purifiers handed over in Satkhira.
• Recipients: 3 CCs + Assasuni UHC.
• School consignments prepared for January.
• 2,000+ patients benefited in first two weeks.

5.7. Feni Handovers

On 07–08 January 2025, similar handovers were conducted in Feni District. Three Community Clinics North Gabindhapur, Chewria, and Jatrashidhe received emergency medicines and water purifiers. Local health authorities, including the UH&FP of Feni, supervised the process.

The handover was followed by installation of purifiers in clinics and schools. Beneficiaries immediately gained access to clean drinking water, with CHCPs reporting a decline in diarrheal cases within weeks.

 

• 07–08 Jan 2025: Medicines and purifiers handed over in Feni.
• 3 CCs benefited, supervised by UH&FPO.
• Purifiers installed in clinics and schools.
• Decline in waterborne diseases observed.

5.8. Satkhira School Sessions

On 15 January 2025, after schools reopened following examinations, the project conducted four awareness sessions in Satkhira schools, including United Academy Protavnagor and Digilar Aiyght Ideal Secondary School.

Each session hosted 100 students, covering hygiene practices, safe water usage, handwashing demonstrations, and menstrual hygiene management. Hygiene kits were distributed to adolescent girls, ensuring they could attend school during menstruation. Teachers reported a visible increase in confidence among female students.

 

• 15 Jan 2025: 4 school sessions in Satkhira.
• 400 students reached; 1,000 hygiene kits distributed.
• Focus on WASH and menstrual hygiene.
• Positive feedback from teachers and students.
• Completion of 10,000 leaflet distribution.
• Broader reach to 25,000 indirect beneficiaries.

5.9. Feni Sessions and Leaflet Distribution

On 20 January 2025, four similar awareness sessions were held in Feni schools, including Gabindhapur High School and Kalidah High School. Like in Satkhira, 400 students participated, and hygiene kits were distributed to adolescent girls.

In addition, the project completed the distribution of 10,000 awareness leaflets across both districts. The leaflets used simple language and illustrations to teach communities about safe water, hygiene, and disease prevention. Teachers and volunteers assisted in distribution during school gatherings and community events.

• 20 Jan 2025: 4 awareness sessions in Feni.
• 400 students reached.
• Completion of 10,000 leaflet distribution.
• Broader reach to 25,000 indirect beneficiaries.

5.9. Project Close-out and Reporting

The project officially concluded on 31 January 2025. The close-out phase included consolidating monitoring data, compiling distribution registers, finalizing financial records, and preparing the completion report for submission to NGOAB and the donor.

 

An internal review was conducted by Ashar Alo’s Executive Director, who confirmed that all activities were delivered on time, within budget, and with full compliance to both donor and NGOAB requirements. Lessons learned were documented, emphasizing the importance of early procurement, strong community engagement, and flexible logistics.

 

• 31 Jan 2025: Project officially closed.
• Final reporting completed.
• Compliance confirmed by Ashar Alo’s Executive Director.
• Lessons learned documented for future responses.

6. Outputs

The “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project delivered a series of life-saving interventions that addressed the immediate health, water, sanitation, hygiene (WASH), and nutritional needs of flood-affected communities in Feni and Satkhira districts. Each output was carefully designed to meet identified needs, validated during field assessments, and implemented in coordination with local authorities, community health care providers (CHCPs), and school administrations. This section describes each of the outputs in detail, highlighting both quantitative achievements and qualitative impacts.

6.1 Emergency Medicines to Six Community Clinics

The provision of emergency medicines was one of the most critical components of the project. Six Community Clinics (CCs) three in Feni Sadar Upazila (North Gabindhapur, Chewria, and Jatrashidhe) and three in Ashashuni Upazila, Satkhira (North Chakala, Kurikhania, and Hizlia)—were targeted to restore essential health services.

 

Floodwaters had damaged stocks of medicines and equipment in these facilities. CHCPs reported an immediate rise in waterborne and skin-related diseases after the flooding, including diarrhea, cholera, respiratory infections, and dermatitis. The destruction of diagnostic tools further compromised their ability to provide care.

 

Through the project, clinics were equipped with essential medicines, including oral rehydration salts (ORS), antibiotics, antihistamines, paracetamol, and dermatological treatments. The supply ensured that CHCPs could resume treating common flood-related illnesses and stabilize patients before referral to higher facilities if required.

 

By the end of the project, over 5,200 patients were treated with project-supported medicines, significantly reducing the strain on upazila health complexes and district hospitals. Reports indicated a 40% reduction in referrals from community clinics within two weeks of receiving supplies, demonstrating the critical role of this intervention.

 

 

• Six CCs (3 Feni, 3 Satkhira) received emergency medicines.
• Medicines included ORS, antibiotics, paracetamol, antihistamines, skin treatments.
• 5,200+ patients treated during project period.
• Referral rates reduced by 40%, easing burden on higher facilities.
• Direct beneficiaries: families in flood-affected catchment areas (~10,000 people).

6.2 Distribution of 20 Water Purifiers

The floods left most water sources contaminated, leading to an immediate risk of diarrheal outbreaks. In Satkhira, saline intrusion made water undrinkable, while in Feni, sudden inundation polluted tube wells and storage tanks. To address this, 20 high-capacity water purifiers were procured and installed across six clinics and four schools.

The selection of sites was guided by field assessments and consultations with Civil Surgeons, UH&FPOs, and school headmasters. Clinics prioritized purifiers to ensure safe water for patients, attendants, and healthcare staff, while schools provided access for students and teachers, many of whom had lost safe water access at home.

The installation of water purifiers had immediate effects. Within a month of distribution, community clinics reported a 45% reduction in diarrheal cases. In schools, students reported fewer absences due to stomach-related illnesses, and teachers observed improved classroom participation.

• 20 purifiers installed: 6 in CCs, 4 in schools.
• Beneficiaries: ~10,500 people (patients, attendants, healthcare staff, students).
• Diarrheal cases reduced by 45% within a month.
• Improved attendance among schoolchildren due to better health.
• Provided resilience against saline intrusion in Satkhira.

6.3 Distribution of 1,000 Hygiene Kits to Adolescent Girls

Hygiene and menstrual health management were urgent needs in the aftermath of the floods. Adolescent girls faced challenges accessing sanitary products, which led to increased absenteeism from schools, infections, and psychological stress. The project distributed 1,000 hygiene kits across 10 schools (five per district), directly addressing these gaps.

Each kit included sanitary napkins, soap, toothpaste, toothbrush, nail clippers, and hair care items such as combs or hairbands. The inclusion of sanitary napkins was particularly impactful, as most local shops were either closed or had lost stock during the floods.

Feedback from teachers indicated that the provision of hygiene kits improved attendance among adolescent girls by 30% during menstruation, as girls felt more confident and prepared. The kits also served as tools for building sustainable hygiene habits, since awareness sessions complemented the distribution with demonstrations and education.

• 1,000 hygiene kits distributed to adolescent girls.
• Target schools: 4 (2 in Satkhira, 2 in Feni).
• Contents: sanitary napkins, soap, toothpaste, toothbrush, nail clippers, comb/hairband.
• 30% improvement in school attendance during menstruation.
• Improved confidence and dignity among adolescent girls.

 

6.4 Eight Awareness Sessions for 800 Students

Awareness-building was central to ensuring sustainable impact. The project conducted one-day awareness sessions in Satkhira schools (15 Jan 2025) and four in Feni schools (20 Jan 2025). Each session had 100 student participants, making a total of 800 direct participants.

Sessions covered:

• Health risks post-floods: diarrhea, cholera, skin diseases.
• Handwashing demonstrations: correct techniques with soap and water.
• Safe water practices: boiling, purifier use, safe storage.
• Menstrual hygiene management: specifically tailored for adolescent girls.

Teachers and CHCPs co-facilitated the sessions, ensuring cultural sensitivity and credibility. Monitoring data showed that 87% of students demonstrated improved knowledge, and 82% shared learning with families, indirectly benefiting 4,000 additional people.

• 8 sessions, 800 students (400 Satkhira, 400 Feni).
• Covered WASH, menstrual hygiene, disease prevention.
• 87% students improved knowledge, 82% shared with families.
• Indirect reach: ~4,000 community members.
• Teachers reported improved health behavior among students.

6.5 Nutrition Support for 100 Pregnant Women

Pregnant women were among the most vulnerable during the floods. Many lost access to adequate food, leading to risks of anemia, low birth weight, and preterm deliveries. On 09 December 2024 in Satkhira and 07 January 2025 in Feni, 100 pregnant women received tailored nutrition packages.

The packages contained rice, lentils, oil, dried fish, iron-rich supplements, and vitamin tablets. The distribution was coordinated with UH&FPOs and CHCPs, who helped identify the most vulnerable beneficiaries using antenatal registers.

Follow-up surveys indicated improvements in dietary diversity and reduced anemia symptoms among recipients. This intervention also increased awareness about the importance of nutrition during pregnancy, with many women reporting that they shared knowledge from the sessions with peers.

• 100 pregnant women supported (Satkhira: 50, Feni: 50).
• Contents: rice, lentils, oil, dried fish, supplements.
• Delivered on 09 Dec 2024 (Satkhira) and 07 Jan 2025 (Feni).
• Reduced anemia and improved dietary diversity.
• Raised awareness of prenatal care and maternal health.

6.6 Distribution of 20,000 Awareness Leaflets

Leaflets were developed as a scalable awareness tool to extend health and hygiene education beyond direct beneficiaries. Printed in clear Bangla with visual illustrations, the 20,000 leaflets covered:

• Safe water practices (boiling, purifiers, storage).
• Handwashing steps.
• Menstrual hygiene management.
• Disease prevention post-floods.

Distribution took place between December 20, 2024, and January 20, 2025, through clinics, schools, and community gatherings. Volunteers ensured that even semi-literate and illiterate populations understood the messages by conducting verbal explanations alongside leaflet handouts.

Post-distribution surveys showed that 72% of recipients retained knowledge on disease prevention, and 85% of adolescent girls demonstrated correct sanitary pad usage and disposal practices.

• 20,000 leaflets distributed in both districts.
• Content: safe water, hygiene, disease prevention.
• Simple Bangla language with visuals.
• 72% knowledge retention reported.
• Indirect reach: ~50,000 people.

Table 1. Summary of Project Outputs

Output Area	Details of Delivery	Quantity/Units	Beneficiaries Reached	Dates Completed	Locations
Emergency Medicines	Supplied essential medicines (ORS, antibiotics, antihistamines, paracetamol, etc.) to 6 Community Clinics	6 CCs stocked	5,200+ patients treated; ~10,000 indirect	27 Dec 2024 (Satkhira); 7–8 Jan 2025 (Feni)	Satkhira: North Chakala, Kurikhania, Hizlia CCs; Feni: North Gabindhapur, Chewria, Jatrashidhe CCs
Water Purifiers	Installed purifiers in 6 clinics and 4 schools	20 units installed	~10,500 people (patients, students, staff)	27 Dec 2024 (Satkhira); 7–8 Jan 2025 (Feni)	Same as above + 14 local schools
Hygiene Kits	Distributed kits (sanitary napkins, soap, toothbrush, toothpaste, nail clippers, comb)	1,000 kits	1,000 adolescent girls	15 Jan 2025 (Satkhira); 20 Jan 2025 (Feni)	10 secondary schools (5 per district)
Awareness Sessions	Health, hygiene, and MHM sessions with demonstrations	8 sessions (100 each)	800 students direct; ~4,000 indirect	15 Jan 2025 (Satkhira); 20 Jan 2025 (Feni)	4 schools in Satkhira, 4 in Feni
Nutrition Support	Food packages (rice, lentils, oil, dried fish, iron supplements, vitamins) to vulnerable pregnant women	100 packages	100 pregnant women	9 Dec 2024 (Satkhira); 7 Jan 2025 (Feni)	2 Unions (Protavnagor, Kalidaha)
Awareness Leaflets	IEC/WASH materials on safe water, hygiene, sanitation	20,000 leaflets	~50,000 indirect beneficiaries	20 Dec 2024 – 20 Jan 2025	Distributed via schools, CCs, volunteers

 

7. Outcomes

The “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project generated significant and measurable outcomes across its key intervention areas. These outcomes reflect not only the immediate impact of distributing medicines, water purifiers, hygiene kits, nutritional packages, and awareness materials but also the longer-term effects on community resilience, public health, and social well-being. The following table provides a consolidated overview, followed by detailed analysis of each outcome area.

Table 2.  Summary of Project Outcomes

Outcome Area	Evidence of Achievement	Key Metrics / Indicators	Beneficiaries Impacted
Improved Access to Health Services	6 community clinics restocked with emergency medicines and equipment.	5,200+ patients treated; referral rates reduced by 40%.	12,000+ direct patients and clinic staff.
Reduction in Waterborne Diseases	Water purifiers installed in clinics and schools improved drinking water quality.	Diarrheal cases reduced by 45% within 1 month.	~10,500 people (students, patients, staff).
Enhanced Student Hygiene Knowledge	School awareness sessions and hygiene kit distribution improved knowledge and practices.	87% of students improved hygiene knowledge; 82% shared learning with peers.	800 direct students; ~4,000 indirect.
Improved Girls’ School Attendance	Hygiene kits and menstrual health awareness improved female students’ confidence.	30% improvement in attendance among adolescent girls during menstruation.	1,000 adolescent girls.
Strengthened Maternal Health & Nutrition	Food support packages reduced anemia and improved pregnancy outcomes.	100 pregnant women supported; improved dietary diversity reported.	100 pregnant women.
Expanded Community Awareness	Leaflets and outreach expanded beyond direct beneficiaries.	20,000 leaflets distributed; ~50,000 indirect beneficiaries reached.	Households in Satkhira & Feni districts.
Overall Reach	Combined health, WASH, nutrition, and awareness interventions improved community resilience.	12,500 direct beneficiaries; 50,000 indirect beneficiaries.	62,500 people total.

7.1 Improved Access to Health Services

Floods severely disrupted primary healthcare in Feni and Satkhira. Clinics lost stocks of medicines, while diagnostic tools were damaged. Patients presenting with diarrhea, skin infections, and respiratory conditions were either untreated or referred to distant hospitals, straining higher-level facilities.

By restocking six community clinics with essential emergency medicines, the project restored functionality. CHCPs received life-saving supplies including ORS, antibiotics, and antihistamines, enabling them to provide care immediately on-site.

 

 

Key Outcomes:

• 5,200+ patients treated during project period.
• Referral rates decreased by 40%, reducing pressure on district hospitals.
• Local clinics became reliable first-response facilities, restoring community trust.

This intervention had a multiplier effect. Families saved time and costs otherwise spent on travel to distant hospitals. Clinics also regained credibility, with patient attendance increasing, reinforcing the importance of decentralized care in disaster contexts.

7.2 Reduction in Waterborne Diseases

Safe water was one of the most pressing needs after the floods. In Satkhira, saline intrusion made groundwater unusable, while in Feni, floodwaters contaminated hand pumps and storage tanks. Without intervention, disease outbreaks such as diarrhea, cholera, and dysentery posed imminent risks.

The installation of 20 water purifiers in six community clinics and 4 schools transformed access to safe drinking water. Clinics reported immediate benefits, as patients, attendants, and healthcare workers relied on purified water. In schools, children were shielded from contaminated sources during critical hours of their day.

Key Outcomes:

• 45% reduction in diarrheal cases within a month of purifier installation.
• Approx. 10,500 beneficiaries gained access to safe drinking water.
• Reduced absenteeism among students linked to waterborne illnesses.

This outcome not only addressed immediate risks but also strengthened community resilience against future disasters by creating sustained access points for clean water.

7.3 Enhanced Student Hygiene Knowledge

Floods amplify hygiene risks, especially in overcrowded shelters and damaged schools. To prevent outbreaks, the project organized 8 awareness sessions (4 in Satkhira, 4 in Feni), each attended by 100 students.

These sessions combined lectures, demonstrations, and group activities. Students practiced proper handwashing techniques, learned how to store water safely, and engaged in discussions on menstrual hygiene. Teachers and CHCPs co-facilitated, ensuring credibility and relevance.

Key Outcomes:

• 87% of students demonstrated improved hygiene knowledge post-session.
• 82% of students shared knowledge with family members, indirectly reaching ~4,000 people.
• Teachers observed lasting behavior change, such as routine handwashing before meals.
• The student-focused approach ensured knowledge dissemination across households, making children effective ambassadors of health in their communities.

7.4 Improved Girls’ School Attendance

Menstrual hygiene management (MHM) is a persistent challenge in disaster-affected communities. Adolescent girls often miss school during menstruation due to lack of sanitary products, clean facilities, and supportive environments. The floods exacerbated these issues, as supply chains broke and private spaces were destroyed.

Through the distribution of 1,000 hygiene kits, the project empowered adolescent girls in 10 schools to maintain hygiene and dignity. Each kit contained sanitary napkins, soap, toothpaste, toothbrushes, nail clippers, and hair care items.

Key Outcomes:

• 30% improvement in attendance among adolescent girls during menstruation.
• Increased confidence and participation in school activities.
• Reduced risk of infections and related health complications.

This outcome illustrates the project’s gender-sensitive approach, recognizing and addressing the unique needs of girls in emergencies.

7.5 Strengthened Maternal Health and Nutrition

Pregnant women were among the most at risk during the floods. Many lost access to nutritious food, heightening risks of anemia, low birth weight, and preterm delivery.

The project provided 100 nutrition packages (50 in Satkhira, 50 in Feni), containing rice, lentils, oil, dried fish, iron supplements, and vitamins. Distributions were coordinated with local health facilities to ensure targeting of the most vulnerable women.

Key Outcomes:

• 100 pregnant women directly supported.
• Reported improvements in dietary diversity and reduced anemia symptoms.
• Increased awareness of prenatal care and maternal nutrition importance.

By strengthening maternal health, this intervention had intergenerational benefits, improving outcomes for both mothers and newborns.

7.6 Expanded Community Awareness

While direct interventions reached targeted groups, broader awareness was necessary to sustain behavior change across communities. To achieve this, the project developed and distributed 20,000 awareness leaflets covering safe water, sanitation, and hygiene practices.

Leaflets were designed in simple Bangla with illustrations to ensure accessibility for low-literacy populations. Volunteers and teachers provided verbal explanations during distribution, enhancing comprehension.

Key Outcomes:

• 20,000 leaflets distributed across Satkhira and Feni.
• Approx. 50,000 indirect beneficiaries reached through awareness campaigns.
• 72% of surveyed recipients retained knowledge on disease prevention and hygiene.

This broad-based awareness campaign complemented targeted interventions, ensuring community-wide impact.

 

 

7.7 Overall Reach

The project achieved a wide-reaching impact by integrating multiple sectors health, WASH, hygiene, and nutrition. By combining direct service delivery with community awareness, it ensured both immediate relief and long-term resilience.

Overall Achievements:

• 12,500 direct beneficiaries: patients, students, adolescent girls, pregnant women, and healthcare workers.
• 50,000 indirect beneficiaries: community members reached through leaflets, student knowledge-sharing, and school programs.
• 62,500 people impacted in total across Satkhira and Feni.

The project successfully mitigated post-flood health risks, restored primary health services, improved water and sanitation, empowered women and girls, and strengthened community awareness. Its outcomes demonstrate a scalable model for integrated humanitarian response in Bangladesh.

8. Monitoring, Evaluation & Learning

Monitoring, Evaluation, and Learning (MEL) formed an integral part of the “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project. Given the short three-month timeframe, MEL systems were designed to ensure accountability, transparency, and continuous learning. The MEL framework was rooted in evidence-based reporting and guided by NGOAB, AMERICARES donor requirements, and Ashar Alo’s internal monitoring policies.

The MEL system captured progress at multiple levels clinic-level service delivery, school-based awareness and attendance, community-level knowledge dissemination, and household-level nutritional outcomes. It also emphasized lessons for future programming, particularly on preparedness, resilience, and adaptive implementation.

Table 3. Monitoring, Evaluation & Learning Framework

MEL Component	Tools/Methods Used	Key Findings / Evidence	Learning / Adaptation
Field Visits	Regular visits by Project Coordinator & Program Officers; direct observation.	Activities implemented on schedule; challenges in remote access identified.	Importance of flexible logistics (boats, alternative transport) during floods.
Clinic Registers	Patient treatment logs, medicine stock reports from CHCPs.	5,200+ patients treated; 40% reduction in referrals; decline in diarrheal cases noted.	Stock monitoring systems vital; need for pre-positioning of emergency medicines.
Surveys (post-distribution)	Surveys with patients, students, pregnant women, and community members.	87% students improved hygiene knowledge; 72% adults retained leaflet messages.	Practical demonstrations (handwashing, purifier use) more effective than leaflets alone.
Teacher Reports	Qualitative feedback on attendance and behavior changes.	30% rise in girls’ attendance; improved student hygiene behaviors.	Teachers as partners ensured cultural sensitivity and wider family outreach.
Procurement Oversight	Transparent procurement logs; warehouse inventories; handover registers.	All supplies delivered on time, despite logistical delays.	Early procurement planning is critical; consider buffer stock in disaster-prone areas.
Community Engagement	Meetings with local leaders, UNOs, Civil Surgeons, and school authorities.	Strong acceptance of interventions; support in targeting beneficiaries.	Engaging leaders boosts trust, reduces resistance, and ensures sustainability.
Feedback Loops	Informal discussions with beneficiaries during distributions and sessions.	Beneficiaries valued hygiene kits, nutrition support, and awareness sessions highly.	Two-way feedback improved adaptation and increased beneficiary satisfaction.

 

8.1 Field Visits

Regular field monitoring visits were carried out by the Project Coordinator and Program Officers in both districts. These visits included observation of clinic operations, school awareness sessions, and household-level nutrition distributions. Each visit documented activities against planned timelines, collected qualitative feedback, and identified operational challenges.

In Satkhira, visits revealed that some flood-affected areas were still waterlogged, making road access impossible. This delayed delivery to one clinic by three days. Mitigation involved engaging local government to arrange boat transport. In Feni, staff observed overcrowded clinics, leading to higher-than-expected demand for medicines. Field visits allowed timely reporting to the central office and rapid reallocation of supplies.

Key insights from field visits:

• Accessibility remained a persistent challenge in waterlogged villages.
• Local volunteers proved indispensable in reaching hard-to-reach areas.
• Stronger collaboration with UNOs and Civil Surgeons improved credibility and efficiency.

8.2 Clinic Registers

Community Health Care Providers (CHCPs) were required to maintain registers documenting patients treated, types of illnesses, and medicines dispensed. These records formed the backbone of health-related monitoring.

Analysis of clinic registers showed:

• 5,200+ patients treated over the project period.
• Common conditions included diarrhea, respiratory infections, and skin diseases.
• Referrals to higher facilities dropped by 40%, confirming improved capacity at the clinic level.
• A 45% reduction in diarrheal cases was observed after water purifiers were installed.

Registers also served as verification tools for donor reporting, ensuring accuracy in data collection.

8.3 Surveys (Post-distribution)

Post-distribution surveys were administered across target groups:

• Patients and families — satisfaction with clinic medicine supply and accessibility.
• Students — retention of hygiene knowledge and behavior changes.
• Pregnant women — use of nutrition packages and perceived health improvements.
• Community members — understanding of leaflets and hygiene practices.

Survey findings:

• 87% of students demonstrated improved hygiene knowledge after sessions.
• 72% of leaflet recipients retained knowledge on waterborne disease prevention.
• 85% of adolescent girls reported correct usage of sanitary napkins.
• Pregnant women reported reduced anemia and improved diets due to food packages.

Surveys highlighted that practical, interactive demonstrations were more effective than written IEC materials alone, particularly for low-literacy populations.

8.4 Teacher Reports

Teachers acted as key informants and evaluators for school-level interventions. After awareness sessions and hygiene kit distribution, teachers tracked changes in attendance, classroom participation, and hygiene behaviors.

Their reports confirmed:

• 30% improvement in attendance among adolescent girls during menstruation.
• Routine handwashing and use of purified water increased significantly.
• Students were motivated to share health messages at home, extending the project’s impact.

Teachers emphasized the need to include hygiene education in regular curricula, ensuring sustainability beyond emergency interventions.

8.5 Procurement Oversight

Procurement was closely monitored through transparent procedures, including supplier RFQs, warehouse tracking, and handover registers at clinics and schools. Despite nationwide demand for medicines and hygiene kits, the project ensured all items were procured and distributed within schedule.

Challenges included minor delays due to flooded roads and fluctuating market prices. However, early procurement planning and pre-approved supplier lists ensured cost savings and timely delivery.

Learning: pre-positioning buffer stocks in disaster-prone regions could further reduce delays in future emergencies.

8.6 Community Engagement

The project placed strong emphasis on involving local leaders, government officials, and community stakeholders. Meetings were held with:

• District Commissioners (DCs) and Upazila Nirbahi Officers (UNOs) for approvals.
• Civil Surgeons and UH&FPOs for health-related oversight.
• School headmasters for planning awareness sessions.

 

Engagement ensured that interventions were locally owned and culturally sensitive. Leaders helped mobilize communities, target vulnerable beneficiaries, and build trust in the interventions.

 

 

 

8.7 Feedback Loops

In addition to formal surveys, the project maintained informal feedback channels. Staff and volunteers collected beneficiary opinions during distributions and school sessions. Pregnant women appreciated the nutrition support; students expressed enthusiasm for hygiene kits; CHCPs highlighted the importance of medicines in reducing referrals.

This two-way communication improved responsiveness. For instance, in one school, additional sanitary napkins were distributed after feedback indicated shortages. In clinics, demand for specific medicines (e.g., antihistamines) was quickly relayed to procurement teams.

8.8 Learning and Adaptation

The MEL process yielded important lessons:

1. Pre-positioning of Supplies: Stocking essential medicines and hygiene kits in disaster-prone areas would reduce response times in future emergencies.
2. Community Engagement: Strong collaboration with leaders improved targeting, acceptance, and sustainability.
3. Practical Demonstrations: Interactive teaching (handwashing, purifier use) was more effective than leaflets alone.
4. Teacher Involvement: Teachers amplified impact by reinforcing health practices in classrooms and encouraging knowledge-sharing at home.
5. Flexible Logistics: Alternative transport arrangements (boats, volunteers) were critical to reach waterlogged areas.
6. Continuous Monitoring: Real-time reporting allowed rapid adaptation, ensuring interventions met evolving community needs.

9. Cross-Cutting Issues

- Gender: targeted pregnant women & adolescent girls
- Accountability: verified lists, signed handovers
- Environment: safe water storage, waste management

Cross-cutting issues were integrated into all phases of the “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project. Recognizing that emergencies disproportionately affect marginalized groups, the project mainstreamed gender equity, accountability to affected populations (AAP), and environmental sustainability. These considerations ensured that interventions were inclusive, transparent, and environmentally responsible, thereby strengthening both immediate impact and long-term resilience.

Table 4. Integration of Cross-Cutting Issues

Cross-Cutting Area	Actions Taken	Evidence / Results	Lessons Learned
Gender Equality	Prioritized vulnerable groups (pregnant women, adolescent girls); included menstrual hygiene support.	100 pregnant women supported with nutrition; 1,000 adolescent girls received hygiene kits.	Gender-sensitive targeting is critical to ensure women and girls are not left behind in emergencies.
Accountability (AAP)	Used verified beneficiary lists; maintained signed handover sheets; transparent procurement.	All distributions documented; beneficiaries validated by CHCPs, teachers, and local authorities.	Signed records and community validation increased trust and reduced duplication.
Environment	Promoted safe water storage, distribution of purifiers, hygiene practices, and safe waste disposal.	20 purifiers installed; 20,000 leaflets on water, sanitation, and waste distributed.	Linking WASH support with behavior change reduced contamination and improved resilience.

9.1 Gender Equality

Women and girls faced unique challenges during the 2024 floods. Pregnant women risked malnutrition, anemia, and poor birth outcomes due to disrupted food supplies. Adolescent girls struggled with menstrual hygiene because of damaged facilities and limited access to sanitary products.

The project directly addressed these issues by:

• Providing 100 pregnant women with nutrition packages containing iron-rich foods and supplements.
• Distributing 1,000 hygiene kits to adolescent girls, including sanitary napkins and hygiene products.
• Conducting school awareness sessions that included menstrual hygiene management (MHM), reducing stigma and absenteeism.

Impact:

• Girls’ school attendance improved by 30% during menstruation.
• Pregnant women reported improved dietary diversity and reduced anemia symptoms.
• Female students reported greater confidence and willingness to discuss menstrual hygiene.

The integration of gender-sensitive interventions not only met urgent needs but also contributed to broader goals of empowerment and resilience.

9.2 Accountability to Affected Populations (AAP)

The project ensured that assistance was transparent, inclusive, and responsive to community needs. Accountability mechanisms included:

• Preparation of verified beneficiary lists in collaboration with CHCPs, teachers, and local government.
• Use of signed handover registers for all distributions (medicines, kits, food, purifiers).
• Regular community engagement meetings with UNOs, Civil Surgeons, and headmasters to validate targeting.
• Incorporation of feedback loops, where beneficiary input shaped adaptations (e.g., additional sanitary products distributed after requests).

Impact:

• Communities trusted the process, with minimal complaints of duplication or exclusion.
• Transparent documentation ensured donor compliance and strengthened relationships with government authorities.
• Beneficiaries expressed satisfaction that their voices were heard during implementation.

9.3 Environmental Sustainability

Environmental considerations were mainstreamed to reduce secondary risks and promote resilience. Key measures included:

• Installation of 20 water purifiers, reducing reliance on unsafe water sources and encouraging sustainable safe water storage.
• Hygiene sessions emphasized handwashing, waste disposal, and water storage practices.
• Distribution of 20,000 awareness leaflets on WASH practices, highlighting environmentally responsible behaviors.
• Encouragement of safe disposal of sanitary products to prevent contamination in flood-affected areas.

Impact:

• Clinics and schools reported improved safe water handling and waste disposal practices.
• Knowledge retention surveys showed that 72% of recipients adopted sustainable hygiene practices.
• The interventions reduced the risk of contamination and secondary environmental hazards post-floods.

9.4 Lessons Learned

1. Gender: Directly targeting pregnant women and adolescent girls not only addressed urgent health and dignity needs but also improved long-term educational and maternal health outcomes.
2. Accountability: Community-verified lists and signed handovers enhanced transparency and trust, ensuring aid reached the intended recipients.
3. Environment: Linking WASH interventions with community education maximized the environmental sustainability of project outputs, reducing the likelihood of post-disaster contamination.

10. Challenges & Mitigation

- Access barriers: used alternative transport
- High demand: prioritized vulnerable groups
- MHM hesitancy: extra female-led sessions
- Tracking data: standardized tally sheets

Like all emergency interventions, the project faced operational and contextual challenges in its implementation across Satkhira and Feni districts. Flood-affected regions presented barriers to access, demand often exceeded supply, cultural hesitancy hindered adoption of new practices, and data tracking in dispersed communities required extra effort. However, the project team successfully addressed these challenges through adaptive strategies, community engagement, and innovative monitoring tools.

 

 

 

 

 

Table 5.  Key Challenges and Mitigation Strategies

Challenge	Description	Mitigation Measures	Outcomes Achieved
Access Barriers	Floodwaters and damaged roads limited transport of supplies to remote sites.	Used alternative transport such as boats; engaged local volunteers for last-mile delivery.	All 6 CCs, 14 schools, and 100 households reached on schedule despite barriers.
High Demand vs. Limited Supply	Medicines, hygiene kits, and purifiers in high demand, exceeding initial projections.	Prioritized vulnerable groups (pregnant women, adolescent girls, displaced families).	Resources reached those most at risk, minimizing inequity and duplication.
MHM Hesitancy	Cultural barriers led to reluctance in adopting menstrual hygiene practices.	Conducted additional female-led awareness sessions with teachers and health workers.	85% of adolescent girls reported correct use of sanitary pads and greater confidence.
Data Tracking	Large dispersed populations made it difficult to track beneficiaries accurately.	Standardized tally sheets; daily updates from CHCPs, teachers, and volunteers.	Reliable, verified data collected for donor and NGOAB compliance.

 

10.1 Access Barriers

Access was one of the most persistent challenges. Floodwaters rendered certain roads impassable, particularly in Satkhira, where saline intrusion worsened waterlogging. Clinics such as North Chakala and Kurikhania were cut off for several days. Without adaptation, distributions risked delays.

Mitigation:

• Supplies were transported via boats arranged in collaboration with local authorities.
• Volunteers from the Health Brigade carried smaller consignments by hand or bicycle to reach cut-off households.
• Coordination with Upazila Nirbahi Officers (UNOs) ensured safe passage and logistical support.

 

Outcome: Despite barriers, all planned deliveries medicines, hygiene kits, purifiers, and nutrition packages were completed on time. Beneficiaries highlighted their appreciation for staff persistence in reaching remote areas.

10.2 High Demand vs. Limited Supply

The floods displaced thousands and disrupted supply chains, creating a surge in demand for medicines, hygiene products, and safe water. Clinics often reported queues exceeding available stock. If not carefully managed, this could have led to frustration, inequity, or duplication.

Mitigation:

• Vulnerable groups such as pregnant women, adolescent girls, and displaced families were prioritized.
• Beneficiary lists were verified by CHCPs, teachers, and community leaders.
• Stock was rationed to ensure the widest possible coverage without leaving critical groups unsupported.

Outcome: Resources were distributed equitably, with 5,200+ patients treated, 1,000 adolescent girls receiving hygiene kits, and 100 pregnant women supported. While demand remained high, prioritization minimized inequity and ensured maximum impact.

10.3 Menstrual Hygiene Management (MHM) Hesitancy

Cultural sensitivity around menstruation posed barriers to effective adoption of menstrual hygiene management. Many adolescent girls were initially hesitant to attend mixed-gender awareness sessions or to discuss MHM openly.

Mitigation:

• Separate, female-led sessions were organized in schools. Female teachers and local women health workers facilitated discussions, creating a safe environment for girls.
• Hygiene kits were distributed privately to reduce stigma.
• Practical demonstrations were conducted on pad use and safe disposal.

 

Outcome: By the end of the project, 85% of adolescent girls reported correct use of sanitary napkins, and school attendance during menstruation improved by 30%. Teachers also noted increased confidence among girls in class participation.

10.4 Data Tracking Challenges

Monitoring and reporting across two districts and multiple intervention sites required robust systems. Initially, inconsistent reporting formats from clinics, teachers, and volunteers posed risks of data gaps or duplication.

Mitigation:

• Introduced standardized tally sheets for all distributions.
• Required daily updates from CHCPs, teachers, and field staff.
• Conducted random verification through spot-checks by Program Officers.
• Consolidated records into a central database for donor reporting.

 

Outcome: Data reliability improved, ensuring compliance with NGOAB and donor requirements. This also allowed timely analysis for instance, recognizing early reductions in diarrheal cases after water purifier installation.

10.5 Lessons from Challenges

• Flexibility is critical: Alternative transport and volunteer networks ensured last-mile delivery.
• Prioritization saves lives: Focusing on vulnerable groups allowed scarce resources to achieve maximum impact.
• Gender-sensitive delivery works: Female facilitators improved adoption of menstrual hygiene practices.
• Standardization strengthens accountability: Uniform tally sheets improved transparency and trust.

 

 

11. Financials

Financial accountability was a cornerstone of the project, ensuring that every dollar spent delivered maximum value for affected communities. The total budget of USD 25,650 (BDT 3,026,700) was allocated across human resources, administration, procurement of supplies, awareness activities, and IEC material development. The project was successfully completed within budget, with no significant overruns, and adhered to AMERICARES donor guidelines and NGOAB financial reporting standards.

Table 6.  Financial Summary

Budget Category	USD Amount	BDT Equivalent	% of Total Budget	Description of Expenditure
Human Resources	1,800	212,400	7%	Salaries/allowances for 1 Project Coordinator and 2 Program Officers for 3 months.
Administrative	850	100,300	3%	Communication, reporting, travel, audits, utilities, and general office support costs.
Supplies	20,000	2,360,000	78%	Procurement of emergency medicines, water purifiers, hygiene kits, nutrition packages.
Awareness Activities	1,600	188,800	6%	School-level awareness campaigns, student sessions, and community outreach meetings.
IEC Materials	1,400	165,200	6%	Design, printing, and distribution of 20,000 leaflets on WASH and hygiene practices.
Total	25,650	3,026,700	100%	Fully utilized within approved NGOAB and donor guidelines.

 

11.1 Human Resources

A total of USD 1,800 (BDT 212,400) was allocated for human resources. This covered the salaries and allowances of:

• 1 Project Coordinator: responsible for overall implementation, reporting, and donor compliance.
• 2 Program Officers: managed day-to-day logistics, distributions, monitoring, and awareness sessions.

Human resource investment ensured strong field presence and effective coordination with stakeholders. The cost represented only 7% of the total budget, reflecting cost-efficiency in staffing.

11.2 Administrative Costs

The administrative budget of USD 850 (BDT 100,300) supported essential operational expenses such as communication, transport, reporting, and audits. This allocation ensured smooth coordination across two districts and compliance with financial regulations. Despite logistical challenges due to flooded roads, administrative costs were kept within the approved limit, representing only 3% of the total budget.

11.3 Procurement of Supplies

The largest share of the budget USD 20,000 (BDT 2,360,000), approximately 78% of total project costs — was dedicated to life-saving supplies. This included:

• Emergency medicines for six Community Clinics.
• 20 water purifiers installed in clinics and schools.
• 1,000 hygiene kits for adolescent girls.
• Nutrition packages for 100 pregnant women.

Procurement followed Ashar Alo’s transparent procedures: quotations from approved suppliers, warehouse tracking, and signed handovers. This ensured accountability and minimized costs while maximizing community benefit.

11.4 Awareness Activities

An allocation of USD 1,600 (BDT 188,800) funded awareness-building activities. This included eight school sessions (reaching 800 students), teacher engagement, and logistics for meetings. These awareness initiatives contributed to 87% of students improving hygiene knowledge and had a strong indirect impact on households.

11.5 IEC Materials

To ensure sustainability, USD 1,400 (BDT 165,200) was allocated for Information, Education, and Communication (IEC) materials. A total of 20,000 leaflets were developed, printed, and distributed in simple Bangla with illustrations to promote WASH practices. Surveys showed 72% knowledge retention, confirming the value of IEC investments.

11.6 Overall Efficiency and Accountability

The project demonstrated high financial efficiency by keeping administrative and HR costs low while dedicating nearly 80% of funds directly to supplies and community-facing interventions. Financial tracking was maintained through:

• Daily expenditure logs.
• Procurement registers.
• NGOAB-compliant reporting templates.
• Donor financial reviews.

No unapproved expenses or cost overruns were reported. Minor fluctuations in market prices of medicines and hygiene items were absorbed within existing allocations.

12. Success Story

Fatema Rahman (Pseudonym), Class 8, Gabindhapur High School, Feni. She received a hygiene kit and attended awareness sessions. She gained confidence in menstrual hygiene, no longer missed school, and advocated practices among peers.

Empowering Adolescent Girls Through Hygiene Awareness

Beneficiary: Fatema Rahman, Class 8, Gabindhapur High School, Feni District

Fatema Rahman, a 15-year-old student of Grade Eight, lives in a flood-affected area of Feni. Like many adolescent girls in her community, she faced severe challenges in managing her menstrual hygiene during and after the floods. Sanitary products were unavailable, her family’s finances were strained, and the stigma surrounding menstruation made it difficult for her to discuss her needs. As a result, Fatema often missed school during her periods, leading to gaps in her education and growing anxiety about falling behind her peers.

Through the project, Fatema received a comprehensive hygiene kit containing sanitary napkins, soap, toothpaste, toothbrush, nail clippers, and hair care items. More importantly, she participated in school-based awareness sessions facilitated by female teachers and health workers. These sessions created a safe space for adolescent girls to learn about menstrual hygiene management (MHM), handwashing practices, and safe disposal methods.

Fatema’s Transformation:

• She reported feeling confident and prepared during menstruation for the first time.
• She no longer missed school, contributing to the 30% improvement in girls’ attendance observed across the project schools.
• Fatema began sharing her knowledge with friends and classmates, advocating for better hygiene practices.
•  

In her own words:

“Before, I used to feel shy and missed school during my periods. After receiving the kit and attending the sessions, I am more confident. I don’t skip classes anymore, and I tell my friends how to take care of themselves.”

Fatema’s story demonstrates the power of gender-sensitive humanitarian interventions. By combining material support with awareness and education, the project not only improved individual well-being but also empowered young girls to become health ambassadors within their communities. Her advocacy contributed to broader behavioral change among her peers, reinforcing the long-term impact of the intervention.

13. Compliance & Coordination

NGOAB approvals secured. Activities coordinated with UNOs, DCs, health officials, and school leaders. Reports submitted to donor and NGOAB. Media releases and consent forms maintained.

Compliance with regulatory requirements and strong coordination with local authorities and stakeholders were central to the success of the “Emergency Health and Humanitarian Support to Flood-Affected People in Bangladesh” project. By adhering strictly to NGOAB guidelines and AMERICARES donor requirements, the project ensured accountability, transparency, and alignment with national disaster response priorities.

Table 7.  Compliance & Coordination Overview

Area	Actions Taken	Evidence Maintained	Outcome Achieved
NGOAB Compliance	Submitted FD-2 and FD-7 forms; secured project approvals before implementation.	Approval letters (13 Nov 2024).	Full compliance ensured legal implementation and smooth fund utilization.
Government Coordination	Regular meetings with District Commissioners (DCs), UNOs, Civil Surgeons, UH&FPOs.	Meeting minutes, attendance sheets, approval notes.	Strong alignment with local administration; facilitation of transport & targeting.
Health Sector Alignment	Coordination with Civil Surgeons, CHCPs, and UH&FPOs for medicine lists and clinic targeting.	Signed handover sheets, medicine distribution registers.	Improved service delivery; avoided duplication with other health programs.
Education Sector Linkage	Collaboration with headmasters for awareness sessions and hygiene kit distributions.	School attendance registers, teacher reports.	Smooth delivery of school-based interventions and high student participation.
Donor Reporting	Regular narrative and financial reports submitted to AMERICARES and NGOAB.	Progress reports, financial statements, monitoring documents.	Transparent donor compliance; ensured accountability and trust.
Media & Consent	Collected beneficiary consent for photographs; maintained media release forms.	Americares Media Release Forms, photo records.	Ethical communication upheld; success stories documented for learning.

13.1 NGOAB Approvals

The project began only after securing mandatory NGOAB approvals. FD-2 and FD-7 forms were submitted promptly, and final approval was obtained on 13 November 2024. This compliance step ensured that all project activities were legally sanctioned, funds were used within regulations, and reporting followed government requirements.

13.2 Coordination with Local Authorities

Effective implementation was achieved through close collaboration with local government structures:

• District Commissioners (DCs) of Satkhira and Feni provided overall administrative support and legitimacy.
• Upazila Nirbahi Officers (UNOs) facilitated approvals, logistical support, and beneficiary validation.
• Civil Surgeons and UH&FPOs approved medicine lists and supervised clinical interventions.
• Community Health Care Providers (CHCPs) directly coordinated handovers and ensured service delivery in clinics.

This multi-level coordination-built community trust and aligned project activities with district-level disaster response priorities.

13.3 Collaboration with Schools

Schools were critical platforms for hygiene and awareness interventions. Collaboration with headmasters ensured that sessions were integrated into school schedules, minimizing disruption to education. Teachers acted as co-facilitators and verified beneficiary attendance. This coordination allowed smooth delivery of 1,000 hygiene kits and 8 awareness sessions, reaching 800 students directly.

13.4 Donor & NGOAB Reporting

• The project maintained full transparency by producing and submitting:
• Inception Report (November 2024).
• Progress Report (December 2024).
• Final Project Completion Report (January 2025).

Financial accountability was ensured through detailed statements, invoices, and receipts. Donor-required success stories, MEL data, and compliance records were also submitted. NGOAB reporting requirements were met in full, strengthening credibility for future projects.

13.5 Media Releases & Consent

Beneficiary dignity and ethical communication were prioritized. For all success stories and photographs, consent was obtained using the standard Americares Media Release Form. This ensured compliance with donor communication standards and respected the rights of beneficiaries, particularly adolescent girls and pregnant women.

 

13.6 Outcomes of Compliance & Coordination

• All activities were legally compliant under NGOAB regulations.
• Strong collaboration with government improved logistics, targeting, and monitoring.
• Donor confidence was strengthened through timely and transparent reporting.

Ethical standards were upheld through informed consent for communication and media use.

 

Project Name : Provide Emergency Healthcare Support to Flood-Affected People in Bangladesh

Doner : AMERICARES Foundation Inc.

Sector : Health

Area : Feni Sadar Upazila, Feni District

Time Line : 15 August - 2025 throuhh 15 October- 2025

Brief of activities :

1. Executive Summary
In response to the severe July 2025 floods that impacted over 200,000 people across Feni District—including 3,837 fully waterlogged families—Ashar Alo, in partnership with Americares, swiftly implemented a focused health intervention to reduce morbidity and mortality and restore primary healthcare services in Feni Sadar Upazila. Leveraging its three decades of experience and previous partnership successes, Ashar Alo’s goal was to revitalize the local health system in the hardest-hit unions (Kalidaha, Fazilpur, and Shorshodi). Between the rapid needs assessment in early August and the formal handover on 12 September 2025, the project successfully restored service capacity at 11 Community Clinics, benefiting an estimated 60,000 people in the surrounding catchment areas. Key outputs included the procurement and distribution of 23 essential medicines and 8 categories of medical equipment (a total of 212,300 units of supplies), the installation of 11 water purifiers to ensure safe drinking water at the clinic level, and the dissemination of 10,000 illustrated hygiene leaflets covering flood risks, dengue prevention, and maternal care. All supplies were formally handed over at a centralized ceremony and delivered to Community Health Care Providers (CHCPs) with signed receipts, with Ashar Alo covering all transport and logistics. The design adhered strictly to WHO emergency guidance and Sphere standards. Continuous monitoring and qualitative feedback from CHCPs confirmed the restoration of clinic functionality, a perceived reduction in waterborne disease incidence, and improved household hygiene practices, exemplified by a successful emergency nebulization case that saved a child’s life. The intervention was executed with full financial accountability within the approved USD 20,000 budget. The largest allocation, $17,050, was dedicated to Direct Service Delivery for life-saving medicines and purifiers. The remaining funds covered Human Resources ($1,500), IEC Materials ($800), and Administrative Costs ($650). Key lessons learned emphasize the value of using pre-qualified local vendors, pre-positioning emergency stocks, and the central role of female health workers in outreach. Future recommendations include exploring mobile health units and strengthening government partnerships to build greater community resilience against future disasters.
Key Word: Flood Response, Emergency Healthcare, Community Clinics, Morbidity Reduction, Water Purification, Hygiene Promotion, Supply Distribution, Feni District, Ashar Alo, Americares.
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2. Introduction and Organizational Background
2.1. About Ashar Alo
Ashar Alo, established in 1994 and formally registered with the Government of Bangladesh in 2001, is a national non-governmental organization with over three decades of dedicated service in the fields of public health, humanitarian response, and social development. The organization possesses a proven track record of implementing high-impact projects in some of the most vulnerable and disaster-prone regions of the country. Our mission is to empower marginalized communities, including women, children, persons with disabilities, and the extreme poor, through sustainable development and emergency relief initiatives.
The organization's institutional capacity is demonstrated by its registrations with key government bodies, including the NGO Affairs Bureau (NGOAB), the Department of Social Services, the Department of Youth Development. Ashar Alo also holds a valid Business Identification Number (BIN) and Electronic Taxpayer's Identification Number (E-TIN), ensuring full compliance with national financial regulations. Our operational expertise spans community mobilization, public health education, emergency response management, research, and monitoring & evaluation.
Of particular relevance to this project is Ashar Alo's direct prior experience in implementing the "Emergency Health and Humanitarian Support to Flood-Affected" program in 2024, also funded by Americares. This previous partnership provided invaluable experience in rapid needs assessment, procurement and logistics of medical supplies, coordination with local health authorities, and effective delivery of services in a flood-affected context, forming a solid foundation for the successful execution of the 2025 intervention. 2.2. Partnership with Americares
The partnership between Ashar Alo and Americares is built on a shared commitment to providing life-saving health interventions in times of crisis. Americares, as an internationally recognized humanitarian organization with specialized expertise in emergency medicine and health programs, provides not only critical funding but also technical guidance. This project leveraged the strengths of both organizations: Americares's global expertise and swift funding mechanisms, and Ashar Alo's deep community roots, local knowledge, and established operational network within Bangladesh. This synergy was instrumental in ensuring a timely, relevant, and effective response to the flood emergency in Feni.
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3. Project Background and Justification
3.1. The July 2025 Floods: A Crisis Overview
In July 2025, southeastern Bangladesh, including Feni District, was hit by severe and prolonged monsoon rains, exacerbated by the release of upstream water from neighboring India. This led to intense riverine flooding, causing a sudden and dramatic rise in water levels. According to official data from the Ministry of Disaster Management and Relief, the floods impacted more than 200,000 people across Feni District. In the Upazilas of Fulgazi, Parashuram, and Feni Sadar, 3,837 families were completely waterlogged, with many areas remaining submerged for weeks. Critical infrastructure, including roads, bridges, and electricity and mobile networks, was severely damaged or destroyed, isolating entire communities and cutting them off from essential services. 3.2. Problem Statement and Needs Assessment
The humanitarian impact of the floods was multifaceted, creating an urgent public health emergency:
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Collapse of Primary Healthcare: Community Clinics (CCs), which are the first and often only point of contact for primary healthcare in rural Bangladesh, were themselves impacted by the floods. Many reported damage to infrastructure and, more critically, a 70% increase in patient visits. However, they were crippled by acute shortages of essential medicines, antibiotics, Oral Rehydration Salts (ORS), wound care supplies, and basic medical equipment. This gap left the population, especially the most vulnerable, without access to even the most basic medical care for common flood-related ailments.
•
Surge in Waterborne and Vector-Borne Diseases: Stagnant floodwater contaminated nearly all unprotected water sources, such as tube-wells and ponds. This led to a sharp increase in cases of acute watery diarrhea, dysentery, typhoid, and other waterborne illnesses. Furthermore, the stagnant water provided ideal breeding grounds for mosquitoes, leading to a surge in vector-borne diseases like dengue and malaria.
•
Heightened Vulnerability of At-Risk Groups: Children under five, pregnant and lactating women, the elderly, and individuals with chronic illnesses (such as hypertension and diabetes) faced disproportionately high risks. Disruption of routine healthcare services, including antenatal care and immunization, coupled with increased exposure to contaminated environments, placed these groups in grave danger.
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3.3. Evidence-Based Project Design
The design of this project was informed by globally recognized best practices and standards to ensure its effectiveness and relevance:
•
WHO Emergency Response Framework: The project adhered to the principles of the WHO framework, which prioritizes the rapid delivery of essential health services to meet the urgent needs of crisis-affected populations.
•
Bangladesh’s National Health Crisis Management Plan: The intervention was aligned with the national government's strategy for managing health crises, ensuring complementarity and support to national efforts.
•
Sphere Humanitarian Charter and Minimum Standards: The project was designed to meet the Sphere standards for health and WASH (Water, Sanitation, and Hygiene), guaranteeing that the assistance provided was safe, accessible, equitable, and of adequate quality.
•
Learning from Past Implementation: The successful model and lessons learned from the 2024 flood response project with Americares were directly incorporated, allowing for a more streamlined and targeted approach in 2025. 4. Project Framework
4.1. Project Goal and Objectives
The overarching goal of the project was to reduce morbidity and mortality among flood-affected populations in Feni Sadar Upazila by restoring access to essential healthcare and preventing the spread of communicable diseases.
The specific objectives were:
1.
To restore the capacity of 11 Community Clinics by providing essential emergency medicines and basic medical equipment.
2.
To ensure access to safe drinking water for patients and healthcare providers at the 11 targeted clinics through the installation of water purifiers.
3.
To disseminate critical health and hygiene information to at least 60,000 people to promote protective behaviors and prevent disease outbreaks.
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4.2. Target Groups and Participant Selection
The project primarily targeted an estimated 60,000 individuals residing in the catchment areas of the 11 selected Community Clinics in Kalidaha, Fazilpur, and Shorshodi Unions of Feni Sadar Upazila. This population was selected based on the severity of flooding and the assessed gap in healthcare services.
Specific attention was given to vulnerable subgroups:
•
Women and Children: Due to their specific health needs and higher susceptibility to infections.
•
Pregnant and Lactating Women: As a group requiring continuous access to healthcare and nutrition.
•
The Elderly and Chronically Ill: Who often have reduced mobility and are more vulnerable to complications from common illnesses.
•
Economically Disadvantaged Families: Who faced financial barriers to accessing private healthcare facilities.
The project design incorporated inclusive strategies to address their needs:
•
Gender Sensitivity: Engagement of female staff and Community Health Care Providers (CHCPs) to ensure comfort and access for women and adolescent girls.
•
Accessibility: Services were delivered directly through the widely distributed network of community clinics, overcoming mobility and financial barriers.
•
Culturally Appropriate Communication: Hygiene promotion materials were developed in simple Bengali with clear illustrations to overcome literacy barriers and ensure the message was understood by all. 4.3. Geographical Coverage
The project was strategically focused on Feni Sadar Upazila, one of the worst-hit sub-districts. Within it, three unions with the highest concentration of need were selected:
1.
Kalidaha Union: Serving clinics at North Gobindapur CC, Jatrashidhe CC, Cheoria CC, and Ghohadua CC.
2.
Fazilpur Union: Serving clinics at Pubali CC, Raznagor CC, North Fazilpur CC, and Aribi Hat CC.
3.
Shorshodi Union: Serving clinics at Chosna CC, Jahanpur CC, and Abu Pur CC.
This focused approach ensured that resources were concentrated where they were most needed, maximizing the project's impact.
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Table 1. List of Community Clinics Sl. No Name of District Name of Union Name of Community Clinic 1 Feni Sador Upazila (Sub-District)
Kalidaha Union North Gobindapur CC
2
Jatrashidhe CC 3 Cheoria CC
4
Ghohadua CC 5 Fazilpur Union Pubali CC
6
Raznagor CC 7 North Fazilpur CC
8
Aribi Hat CC 9 Shorshodi Union Chosna CC
10
Jahanpur CC 11 Abu Pur CC 5. Project Implementation Strategy and Activities
A phased approach was adopted to ensure a systematic and efficient implementation process. 5.1. Pre-Implementation Phase: Mobilization and Coordination (Late July - Mid-August 2025)
•
Rapid Needs Assessment: Ashar Alo's team conducted a rapid assessment in the first week of August to verify the initial data and identify the specific clinics and supply gaps.
•
Staff Mobilization: A dedicated project team was formed, comprising one Project Coordinator and two Project Officers, who were responsible for day-to-day management, coordination, and monitoring.
•
Stakeholder Engagement and NGOAB Compliance: Immediate coordination meetings were held with the Upazila Health and Family Planning Officer (UH&FPO), the Upazila Nirbahi Officer (UNO), and the management committees of the selected Community Clinics. The mandatory FD-2 and FD-7 forms were submitted to the NGO Affairs Bureau, securing approval for the project inception and fund release.
•
Detailed Planning: A detailed implementation plan, budget, and monitoring framework were finalized.
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5.2. Core Implementation Activities (Mid-August - Early October 2025)
5.2.1. Procurement and Supply Chain Management
All procurement activities were carried out in full alignment with the established procurement policies of both Ashar Alo and Americares, ensuring that every step of the process upheld the principles of quality, cost-effectiveness, accountability, and transparency.
To meet the immediate health needs of flood-affected communities, a comprehensive list of essential medicines such as Fexofenadine, Montelukast, Omeprazole, Aceclofenac, Albendazole, ORS, and Zinc syrup was prepared through close consultation with qualified medical professionals. This collaborative approach ensured that the selected pharmaceuticals directly addressed the most prevalent flood-related illnesses, including respiratory infections, gastrointestinal problems, allergies, and dehydration.
Additionally, critical medical equipment and supplies including BP machines, glucometers, and nebulizers were procured to support effective diagnosis and treatment at the field level. The procurement team carefully verified product specifications, supplier reliability, and overall durability to ensure that these medical devices could withstand repeated use in challenging conditions.
Furthermore, 11 high-quality water purifiers were sourced from a reputable and vetted supplier. The selection process prioritized reliability, ease of operation, and suitability for emergency response settings, ensuring that safe drinking water could be provided promptly to vulnerable households during and after the flood emergency.
Overall, the procurement and supply chain process was systematic, evidence-based, and responsive to the specific needs identified during the emergency, enabling timely and effective service delivery to affected communities. 5.2.2. Delivery of Emergency Medicines and Medical Supplies
Ashar Alo successfully completed the distribution of all medicines, medical equipment, water purifiers, and IEC materials for the 11 Community Clinics under Feni Sadar Upazila on 12 October 2025. Instead of conducting distribution at the individual clinics, all supplies were formally handed over through a centralized program organized at Dr. Sazzad Auditorium in the Feni Sadar Upazila Health Complex.
During the ceremony, the Ashar Alo Authority officially handed over the complete consignment of items to the Civil Surgeon of Feni, the UNO of Feni Sadar Upazila, the UH&FPO of Feni Sadar, and the Country Representative of Americares. Following the formal handover, these government officials and the Americares representative jointly distributed the medicines, medical equipment, water purifiers, and leaflets to the 11 Community Health Care Providers (CHCPs) from the respective Community Clinics.
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Each CHCP received a standardized package comprising 23 essential medicines, 8 categories of medical equipment, water purifiers, and all relevant IEC materials, in accordance with the approved distribution plan. All handovers were duly documented through signed receipts from the CHCPs.
Ashar Alo also assumed full responsibility for transporting all distributed items from the event venue to each Community Clinic. The organization independently covered all transportation, logistical, and handling expenses, ensuring that every clinic received its allocated supplies promptly and without interruption. 5.2.3. Health and Hygiene Promotion Campaign
To strengthen the impact of the medical and material support, Ashar Alo implemented a comprehensive Information, Education, and Communication (IEC) campaign aimed at improving community awareness on key health and hygiene issues, particularly in the context of flood-affected areas. A total of 10,000 leaflets were designed, printed, and widely distributed among community members.
The leaflets were developed using simple language and visually engaging illustrations, focusing on the following key themes:
•
General Health Awareness: Basic information on maintaining personal hygiene, preventing common communicable diseases, and ensuring family well-being during and after floods.
•
Proper Handwashing Practices: Definition and importance of hand hygiene; step-by-step instructions for effective handwashing with soap; key moments for handwashing (after using the toilet, before eating, before preparing food, after handling waste, etc.).
•
Flood-Related Health Risks: Explanation of how floods contaminate water sources and increase disease transmission; guidance on preventing waterborne and vector-borne diseases; steps to keep food and drinking water safe.
•
Dengue Prevention and Symptom Recognition: Description of dengue, its common symptoms (fever, headache, joint pain, rash), and warning signs requiring immediate medical care; instructions on preventing mosquito breeding (removing stagnant water, covering containers, using mosquito nets and repellents).
•
Care for Pregnant Women: Special precautions for pregnant women during floods, including safe drinking water practices, nutrition advice, hygiene measures, danger signs during pregnancy, and the importance of timely antenatal and postnatal care.
•
Safe Water Practices: Methods for ensuring safe drinking water, such as boiling, using water purifying tablets, and properly storing purified water.
•
Sanitation Guidance: Safe disposal of child feces, maintaining clean latrines, and ensuring proper waste management to prevent disease outbreaks.
Each message provided clear definitions, symptom checklists, preventive methods, and recommended actions to promote overall health and safety.
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The distribution of the leaflets took place through community clinics, local gatherings, and with the support of community volunteers, ensuring that the information reached a broad audience, including vulnerable households. The IEC campaign significantly contributed to increasing community awareness and promoting healthier practices during the post-flood period. 5.3. Monitoring and Evaluation Framework
Continuous monitoring was integral to the project. The Project Officers conducted regular field visits to the clinics to:
•
Track the utilization of supplied medicines.
•
Monitor the functionality of the water purifiers.
•
Observe the dissemination of hygiene messages.
•
Collect feedback from CHCPs and community members.
This real-time monitoring allowed for minor adjustments in implementation, such as redistributing certain medicines between clinics based on patient load. The primary quantitative indicator was the number of direct participants (60,000), defined as individuals residing in the catchment area who benefited from improved clinic services, safe water, or hygiene information. 6. Project Outcomes and Achievements
6.1. Quantitative Results and Outputs
Table 2. Results and Outputs of the Project. Output Indicator Planned Target Actual Achievement Verification Number of Direct Beneficiaries 60,000 ~60,000 Based on catchment population of 11 CCs
Community Clinics Supported
11
11
Distribution reports, signed receipts Types of Medicines Distributed 23 23 Procurement and distribution lists
Units of Medicines & Supplies Distributed
212,300
212,300
Stock registers of CCs Water Purifiers Installed 11 11 Installation reports, photos
Hygiene Awareness Leaflets Distributed
10,000
10,000
Distribution records
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6.2. Qualitative Impact and Outcomes
The project's success extends beyond mere numerical outputs to tangible, positive changes in the community's health landscape:
•
Restored Primary Healthcare Services: The provision of medicines and equipment revitalized the 11 community clinics, enabling them to function effectively again. CHCPs reported that they could now treat the vast majority of common cases on-site, reducing the need for patient referrals to overburdened Upazila Health Complexes. For example, CHCP Ziaur Rahman Rasel from North Gobindapur CC stated, "The timely supply of medicines, especially antibiotics and ORS, allowed us to manage the surge in diarrhea and skin disease cases effectively. We felt empowered to serve our community in its time of greatest need."
•
Reduction in Disease Incidence: While a formal comparative study was beyond the project's scope, qualitative reports from CHCPs indicated a noticeable decline in new cases of waterborne diseases, particularly acute watery diarrhea, in the weeks following the distribution of water purifiers and hygiene leaflets. The availability of medicines also meant that cases were treated early, preventing complications.
•
Improved Health Knowledge and Practices: The hygiene leaflets served as a constant reminder and reference for good hygiene practices. Feedback from community members indicated that the illustrated messages were particularly effective. A community elder from Fazilpur Union noted, "The pictures on the leaflet showed us exactly how to wash hands properly. Even my grandchildren understand it. We are now more careful about drinking water."
•
Strengthened Local Health System: The project did not create a parallel system but instead bolstered the existing government-led community clinic network. This capacity-building approach ensures that the benefits of the project will endure beyond the project period. 6.3. Beneficiary Testimonials and Success Stories
Success Story:
North Gobindapur Community Clinic, Kalidaha Union, Feni Sadar Upazila
Late one night at around 10:00 PM, Community Clinic Health Care Provider (CHCP) Ziaur Rahman Rasel of the North Gobindapur Community Clinic received an urgent phone call from the parents of a one-year-old child who was experiencing severe shortness of breath. The parents were terrified and unsure where to seek immediate help, as flooding and poor road conditions made it difficult to reach the Upazila Health Complex (UHC) at night.
Because the CHCP lives close to the clinic, he immediately went to the facility and collected the nebulizer machine and Salbutamol respiratory solution supplied through this project. He then rushed to the child’s home and administered emergency nebulization on the spot.
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Within minutes, the child’s breathing eased, and the condition stabilized, bringing visible relief to the anxious parents. The CHCP advised them to visit the UHC the following morning for further examination and treatment.
The next day, the family took the child to the UHC, where doctors diagnosed pneumonia. The child was admitted and received seven days of treatment, after which he made a full recovery.
The parents expressed deep gratitude, explaining that without the timely nebulization provided that night, their child’s condition could have deteriorated rapidly:
“If the nebulizer was not available that night, we could have faced a much worse situation. This support saved our child.” 7. Operational and Implementation Challenges
The implementation was not without its hurdles, though all were successfully mitigated:
Using Community Clinics Ensured Fast and Effective Service Delivery: Delivering a one-time handover of emergency medicines and equipment through existing community clinics proved highly effective. These public clinics already had established patient networks and trusted healthcare staff, enabling immediate use of the supplies and faster restoration of essential services without creating temporary or parallel systems.
Local Procurement Reduced Delays During the Flood Emergency: Procuring medicines and equipment from district-level vendors significantly shortened delivery time. This approach avoided transport disruptions caused by flooding and ensured clinics received the full package of supplies promptly after the one-time distribution.
Simple, Visual IEC Materials Improved Community Hygiene Practices: The use of straightforward, illustrated hygiene leaflets helped households easily understand safe water, sanitation, and vector control practices. This was especially effective in low-literacy communities and proved valuable as a complementary strategy to the one-time supply distribution.
Close Local Coordination Supported Quick Adaptation: Strong communication with CHCPs, union parishad members, and local authorities allowed the project team to quickly address any immediate needs following the distribution. Their involvement ensured the supplies were properly utilized and that messaging reached the most affected households.
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8. Lessons Learned
The experience and outcomes of this project provide valuable guidance for strengthening future emergency health responses in flood-prone areas:
Establishing a Pre-Qualified Local Vendor Roster: The project demonstrated the importance of maintaining an updated list of reliable district-level suppliers who can deliver medicines and essential items quickly during emergencies. This will streamline future procurement processes and minimize delays during disaster response.
Pre-Positioning Essential Supplies in High-Risk Areas: Pre-stocking emergency medicine kits, basic medical equipment, and hygiene IEC materials in vulnerable unions ahead of the monsoon season will significantly improve readiness. Early pre-positioning can ensure faster service restoration and reduce gaps in healthcare access during sudden flooding events.
Strengthening the Role of Female Health Workers in Outreach: Women health workers played a critical role in engaging households and promoting hygiene behaviors. Keeping them at the center of community outreach efforts will support sustained behavior change, improve trust, and ensure that women, children, and elderly individuals continue to receive inclusive and culturally appropriate health information. 9. Financial Management and Accountability
The project was implemented with strict financial discipline and transparency. The total budget of USD 20,000 was utilized as follows, in full alignment with the submitted budget narrative:
•
Human Resources (USD 1,500): For the salaries of one Project Coordinator and two Project Officers for two months.
•
Administrative Costs (USD 650): Covering internal audit fees, communication costs, and local travel for monitoring.
•
Direct Service Delivery (USD 17,050): The bulk of the budget was allocated to the procurement of emergency medicines, medical equipment, and 11 water purifiers.
•
Printing and Distribution (USD 800): For the design, printing, and distribution of 10,000 hygiene awareness leaflets.
All expenditures were supported by appropriate invoices, receipts, and vouchers. A detailed financial report with all supporting documentation has been prepared and is available for audit. The project was completed on budget, with no significant unforeseen expenditures.
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10. Conclusion and Recommendations
10.1. Conclusion
The project "Provide Emergency Healthcare Support to Flood-Affected People in Bangladesh" successfully met its objectives, delivering critical and timely assistance to 60,000 vulnerable people in Feni. Through a well-executed strategy of supplying medicines, purifying water, and promoting hygiene, the project alleviated immediate suffering, curbed the spread of disease, and supported the recovery of the local primary healthcare system. The partnership between Ashar Alo and Americares once again proved to be a vital mechanism for delivering effective humanitarian aid in Bangladesh. 10.2. Recommendations for Future Interventions
1.
Build on Local Partnerships: Continue to deepen collaboration with the Ministry of Health and Family Welfare to ensure alignment with national health priorities and protocols.
2.
Consider Mobile Health Services: For future responses in areas where static clinics are destroyed or inaccessible, supplementing support with mobile medical units could be highly effective.
3.
Expand WASH Focus: While water purification was addressed, future projects could include the distribution of hygiene kits (soap, water purification tablets, buckets) to individual households, especially those with pregnant women and young children.
4.
Strengthen M&E: Incorporate simple pre- and post-intervention knowledge, practice, and coverage (KPC) surveys to more robustly measure the project's impact on health-seeking behavior and disease prevalence.
Ashar Alo extends its deepest gratitude to Americares for its steadfast support and trust. We look forward to the potential for continued collaboration to build the resilience of vulnerable communities in Bangladesh against future disasters.

Project Name : MITIGATING THE IMPACT OF COVID-19 THROUGH COMMUNITY-LED PREVENTION PROGRAM (Bangladesh)

Doner : AMERICARES Foundation Inc.

Sector : Health

Area : Satkhira, Khulna, Barisal, Joshore, Narail

Time Line : August 2021- January 2022

Brief of activities :

1. OUTLINE OF THE PROJECT               

1.1 Background of the Project (as of project design on July 2021)

The COVID-19 pandemic in Bangladesh is a part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) causes by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was confirmed to have spread to Bangladesh on 8^th March 2020. Since then, the pandemic has spread day by day over the whole nation and the number of affected people has been increasing. Bangladesh is the second most affected country in South Asia, after India.

 

The situation as of July 2021 depicted, COVID-19 infections were increasing in Bangladesh, with 6,625 new infections reported on average each day. Bangladesh reported its largest number of new COVID 19 infections since the start of the pandemic last year. Health authorities of the country recorded the highest number of new Covid-19 cases since the beginning of the pandemic for the second time in three days. The test positivity rate was the second-highest since the beginning. Only on 30 June 2021, a total of 8800 new cases were identified -that’s 95% of the peak. 28 infections per 100K people reported last seven days. There have been 913,258 infections and 14,503 coronavirus-related deaths reported in the country since the pandemic began. The situation has exaggerated when new variants of coronavirus evolved - made the second wave on COVID-19 infections[1].

 

Hospitals in Bangladesh are under pressure, 57 districts are at high risk of increased infections. The rising number of infections has been putting hospitals across the country under extreme pressure. Hospital beds are becoming occupied at an alarming rate.  Lockdowns imposed in border districts had made some improvement, but the infection rates are still very high.  Army and BGB had been deployed alongside the law enforcement agencies to impose the lockdown. Bangladesh had gone into a strict Covid-19 lockdown on 01 July 2021, with the army and police ordered to stop people from leaving their homes except for emergencies or to buy essentials. The government said the country of 168 million people was seeing an "alarming and dangerous" rise in cases, blamed largely on the highly infectious Delta variant. The authorities warned that the capital Dhaka and port city Chittagong may be next to face the wave of Covid-19 that has been wreaking havoc in the border districts.

 

More than two-thirds of new virus cases in Dhaka are of the Delta variant, according to a study by the independent Dhaka-based International Centre for Diarrheal Disease Research. The first phase ground to a halt when India stopped exporting the AstraZeneca vaccine earlier this year to focus on its own needs. Bangladesh has administered at least 10,101,143 doses of COVID vaccines so far. Assuming every person needs 2 doses, that’s enough to have vaccinated about 3.1% of the country’s population. During the last week's report, Bangladesh averaged about 1,825 doses administered each day. At that rate, it would take a further 17,869 days to administer enough doses for another 10% of the population

 

Geographically, Bangladesh consists of eight administrative divisions. Khulna, the southern-western part of Bangladesh is one of them. The COVID-19 situation in Khulna is worsening day by day with new cases. With the fresh fatalities, the total death toll from Covid-19 reached 1,109 in the division. Besides, 1,245 people were found infected with the deadly virus during the 24 hours, taking the total tally to 57,520 in 10 districts of the Khulna division. It may become the next hotspot of infection if health measures are not properly enforced.

 

Hospitals struggled particularly in areas bordering India where the strain was first detected. Some rural towns recorded infection rates of 70%. A total of 7,082 infected patients had undergone treatment at different designated hospitals. Amid the worsening Covid-19 situation in Khulna, the division in 24 hours till Thursday morning registered its highest-ever fatalities with 39 new deaths. Meanwhile, the district had undergone a strict Covid-19 lockdown with the rest of Bangladesh, with the army and police ordered to stop people from leaving their homes except for emergencies.

 

Under the above backdrop, AMERICARES funded ASHAR ALO, a local NGO for community-based awareness against COVID-19, vaccine hesitancy, and emergency medical oxygen supply at the community level. Ashar Alo intended to implement a community-based COVID 19 prevention program in 10 locations in the coastal region of the Khulna division, Bangladesh. The need-based project idea was conceived in consultation with the government health authorities, local NGO partners and health workers, and community people. The authorities of the health facilities and managers are encouraged to impart treatment of COVID 19 patients at home unless it is in critical condition. They also encouraged community organizations and volunteers to extend support to those patients and families with counseling, precautions, and advice on where to go if an emergency arises. The health managers of the project locations asked to support more with face masks, gloves, and disinfectants- as they still need for these items are high at the health facility level. The health managers also suggested intensity the community awareness on COVID 19 prevention and support with oxygen at the community level.

 

1.2 Objectives of the Project

The objectives of the projects are

• Reducing mortality and morbidity associated with COVID-19 infections through augmenting emergency medical support
• To enhance the capacity of the health workers with supporting personal protective equipment (PPE) and medical supplies
• To lessen the impact of COVID-19 critical patients through supporting oxygen.
• Prevention of COVID-19 through community awareness and support 
• Coordination and liaison with local government health centers and other social

 

1.3. Project Period:

The Project was commenced on 1^st   August 2021 with six (6) months from 1^st   August 2021 to 31 January 2022.

The project was completed within the time and budget.

1.4 Target and Expected Outputs of the Project

Title of the Project: The title of the project is " Project Title: Mitigating the impact of COVID-19 through community-led prevention program in Bangladesh”

 

Expected Goals which will be attained after the Project Completion

(1) Reducing mortality and morbidity associated with COVID-19 infections through augmenting emergency medical support.  

(2) To lessen the impact of COVID-19 critical patients through supporting oxygen.

 

Outputs

(1) To enhance the capacity of the health workers with supporting personal protective equipment (PPE) and medical supplies;

(2) Prevention of COVID-19 through community awareness and

 (3) Distribution of Personal protective equipment and medical supplies to the health centers that provide COVID-19 treatment

 

Project sites are Khulna and Barisal Division in Bangladesh.

Geographically, Bangladesh consists of eight administrative divisions. Khulna, the southern-western part of Bangladesh is one of them. Barisal is the southern-central part of Bangladesh.

 

Beneficiaries

Beneficiaries of the project are health service providers in different hospitals and communities of Bangladesh.

• Health service providers
• Critical COVID-19 patients
• Community people

 

SL	Name of district		Name of sub-districts/hotspots
1	Satkhira	1	Kaliganj
		2	Debhata
		3	Shyam Nagar
		4	Ashasuni
2	Khulna	5	Digholia
3	Barisal	6	Wazirpur
4	Joshore	7	Sadar
		8	Bagherpara
5	Narail	9	Sadar
		10	Lohagara

 

1.8 Plan and Actual Operation

The project was implemented at the community level by a group of trained community workers and volunteers. To implement, 10 work-stations were established and 10 community workers deployed. The community workers distributed PPE to prevent COVID 19 (supplied by Americares) to the concerned health facilities, mobilize the community, create awareness through volunteers (COVID19 Brigade), and supply oxygen cylinders to the critical patients suffering from COVID19 (as referred by the doctors). The oxygen support was supplied and ensured from the community-based COVID19 hub.
 

Described below the plan and actual operation of this project

SL	Description of operation plan	Planned	Actual	Remarks
1	Establishes Community help center	10	10
2	Printing leaflet on Covid19 prevention and Oxygen use	10000 copies	10000 copies
3	Banner/signpost for Community Help center	10 centers	10 centers
4	T shirt and Cap for 300 Covid-19 Brigade	350 PCS	350 PCS
5	Number of community awareness meetings at the community level on Covid19 prevention (10 centers x 8 meetings percenter = 80 meetings)	80 meetings	80 meetings
6	Number of participants attended the community awareness meeting (80 meetings x 20 participants =1600 participants)	1600 participants	2000 participants
7	Publicity through miking (2 months) (10 centers x 8 times = 80 times)	80 meetings	80 meetings
8	Orientation of volunteers/Covid-19 Brigade (10 centers x 1 training x 30 volunteers = 300 volunteers)	300 volunteers	300 volunteers
9	Deploy field workers, accountant, and program coordinator	12 persons	12 persons
10	Help for vaccine registration
11	Free oxygen refilling	500 times	500 times
12	Payable oxygen refilling
13	Distributions of PPE	10 Centers	10 Centers

 

2. SUMMARY OF MANUALS AND ACTION PLAN

2.1 Summary of Design Manual for Volunteers training

The summary of the manuals was

• About COVID-19
• The present situation of COVID-19
• Symptoms of COVID-19
• How to mitigate the wave of COVID-19
• Encouragement of taking about COVID-19 vaccine
• How to take oxygen properly
• When taking oxygen for COVID-19 patient  

2.2 Summary of leaflet

• About COVID-19
• Symptoms of COVID-19
• How to prevent COVID-19
• When taking treatment of COVID-19 patient

3. PROJECT ACTIVITIES

3.1 Receive and distribute the PPE and Oxygen cylinder from suppliers

At first, Ashar Alo received the PPE and Oxygen from XY Trade International then they distributed the items in medical college, district hospital, Upazila health complex, community clinic, union welfare center, social organization, and Ashar Alo established community help centers.

After the distribution of PPE, the program officer of Ashar Alo was monitored for using PPE in different levels of health facilities. Following the total number of PPE items were included:

SL	PPE items	Unit
1	Oxygen Cylinder (20 liters) with trolley and flowmeter and mask	70
2	Spare nasal cannula and mask	500
3	Pulse Oximeter	70
4	Forehead scan, infrared with LCD display with Battery	70
5	Powder Free/Latex Free Hand gloves	25,000
6	3PLY Protective Surgical mask	400,000
7	Liquid Soap (Lifebuoy 250 ml container) Hand wash	1,000
8	Antiseptic Disinfectant Lysol (975 ml)	1,000
9	Hand sanitizer 250 ml Hexisol Hand Rub (bottle) at least 60% ethanol or isopropyl alcohol	1,000
10	PPE for field workers and community volunteers (Face shield)	350

 

3.2 Deployed the stuff for the COVID-19 emergency response program

Ashar Alo was deployed 1 Fieldworker for each center for 6 months (01 Aug 2021 to 31 Jan 2022. An agreement will be signed in between the employer and employees. The salary/remuneration of the Program Officer was Tk. 12,500 per month. Ashar Alo was sent salary to field worker account each month. Each Program Officer was also received Tk. 3,300 per month for communication (phone, net, travel to the field, etc.).

 

The Program Officer conducted risk communication campaigns, establishing contact-tracking and reporting systems, training and managing volunteers, raising awareness related to COVID-19 vaccines to increase uptake, and addressing vaccine hesitancy. The Program Officer has oriented the attendants (and also provide a leaflet diagramming how to inhale oxygen) on how to inhale the oxygen. The Program Officer was be working as a “Corona fighter” and if required will visit the patient's house at the community to orient. The Program Officer was helping online registration for the vaccine receiver and establishing support systems for at-risk persons.

 

The Program Officer was selected, mobilize and organize 300 COVID -19 brigade (volunteers) from their community, organize orientation for them. The Program Officer was organized community meetings, arrange public announcements on prevention of COVID 19, monitoring and reporting

Ashar Alo was deployed as the 10-program officer for 10 community help centers and 1 accounts officer and 1 project coordinator at the beginning of the project by maintaining organizational recruitment system, and then Ashar Alo was arranged a short-term training for the staff to enhance their ability and working capacity.

3.3 Establish 10 community help centers

At the beginning of the projects established the 10-community help centers on a rental basis at an appropriate location in 4 Districts at 10 Upazila in Bangladesh. This office was considered as a center, from where a program officer operates the activities and supplies the Oxygen cylinder.

3.4 Distribute PPE and medical supplies to the 10 Community Help Centers

Ashar Alo was distributed PPE at 10 Community Help Center in 10 Upazilla for the use of volunteers, program officers, attendants, or relatives of COVID-19 patients when receiving oxygen cylinder and community people in 10 community help centers which were used in the whole project period. Here we give a hierarchy that presented 10 Community Help Centers.

 

SL	ITEMS	Quantity per Upazilla	Number of Upazilla	Total Quantity
1	Oxygen Cylinder (20 liters) with trolley and flowmeter and mask	7	10	70
2	Spare Nasal-canola and mask	50	10	500
3	Pulse Oximeter	7	10	70
4	Forehead scan, infrared thermometer	7	10	70
5	Powder Free/Latex Free Hand gloves	500	10	25,000
6	3PLY Protective Surgical mask	5,000	10	400,000
7	Liquid Soap (Lifebouy 250 ml container)	12	10	1,000
8	Antiseptic Disinfectant Lysol (975 ml)	12	10	1,000
9	Hand sanitizer 250 ml Hexisol Hand Rub (bottle) at least 60% ethanol or isopropyl alcohol	10	10	1,000
10	PPE for field workers and community volunteers	35	10	350

               

 

3.5 Select and mobilize and organize 300 COVID-19 brigades (volunteers)

Program officer of Ashar Alo selected primarily 40 volunteers in their working area, covering all unions than in special consideration of their working experience, the mentality of voluntary service and finally select 30 volunteers, 50% selected volunteers were female. They are willing to agree to fulfill the following responsibilities with Ashar Alo

• Work with Ashar Alo as volunteers to the prevention of COVID-19
• Take part in the training arranged by Ashar Alo
• Coordinate and arrange a union level awareness meeting
• Motivate people on COVID-19 awareness and supply oxygen cylinder
• Communicate with COVID-19 patients with the message on where to go for treatment
• Take part in miking and public announcement
• Ashar Alo provides a T-shirt/Polo shirt, cap, necessary PPE, and face masks
• Ashar Alo also provide a certificate after completion of the project
• The volunteer works for six months starting from August 2021.

 

3.6 Organize 10 orientation training on COVID-19 prevention with volunteers

Ashar Alo was Organized the 10-orientation training on COVID-19 prevention with volunteers on August 2021 in 10 Upazila.  

• The venue of the orientation program was the Upazila Health Complex conference room.
• Duration of the orientation program 10.00 am to 4.00 pm including lunch and prayer break.
• The main guest of the orientation program was District Commissioner/Upazila Nirbahi Officer/Upazila Health and Family Planning Officer
• This program also invited local public health experts, social workers, political leaders, religious leaders, civil society, and also local communities.
• In this orientation program engage local government doctors as a resource person on COVID 19, and particularly on how to use oxygen cylinder
• The training topics are awareness on prevention of COVID 19, how to supply oxygen cylinder to critical patients, use of Oxygen cylinder at home/community, roles of volunteers at the community, registration for vaccination, how to organize awareness meetings at the community,

 

3.7 Organized 80 community awareness meetings on COVID-19 prevention and availability of Oxygen cylinder

After the end of the orientation program, Ashar Alo organized the 80-community awareness meeting at the union level at the union Parishad hall room or campus of the union Parishad with engaging volunteers’ group.  

The total budget for each meeting is Tk 5,000. You will receive a total amount of TK 40,000 for organizing 8 meetings. The budget is for refreshments and the miscellaneous cost of the meeting.  The program coordinator was kept the record for reporting. 

 

Tasks:

• Organized community awareness meeting at the community level with at least 20 participants or more than
• A guest speaker was invited to discuss this topic in this meeting.
• The meeting topics were: awareness on prevention of COVID-19, availability of oxygen cylinder to critical patients, use of Oxygen cylinder at home/community, roles of community leaders at the

community, registration for vaccination, how to create awareness among the community.   

3.10 Arrange 80 public announcements on COVID-19 prevention and availability of Oxygen cylinder

The program officer and volunteers of Ashar Alo was arranged a public announcement (miking) on

• Prevention of COVID 19
• Availability of oxygen cylinder for critical COVID 19 patients
• Vaccine hesitancy
• Availability of and assistance for vaccine registration

 

3.11 Printing 10,000 leaflets on COVID-19 prevention and availability of Oxygen cylinder
 

Ashar Alo has printed 10000 leaflets on COVID-19 prevention and availability of oxygen cylinders. The program officer of Ashar Alo was distributed among the community people as per need and preferably in the community meeting. The main messages of the leaflet were

§  About COVID-19

§  Symptoms of COVID-19

§  How to prevent COVID-19

§  How to aware general people about COVID-19

§  How to remove vaccine hesitancy of COVID-19

§  How to help with COVID-19 vaccine registration

 

8.12 Printing and distribution of 350 T-shirts and caps with message and sign of COVID-19 Brigades

 

Ashar Alo has printed 350 T-shirts for the COVID-19 volunteers and distributed them among the volunteers before the volunteer’s orientation program. In this T-shirt, the logo of AMERICARES and Ashar Aol was added.

 

4. KNOWLEDGE TRANSFER

4.1 Volunteers Orientation

Ashar Alo has arranged 10 volunteer orientations from August to September 2021 at 10 Upazilla. This program was held in UH&FPO and UNP conference room with including doctor, nurse, UNO, technician, public health expert, and volunteers. The main context of these meetings

§  About COVID-19

§  Symptoms of COVID-19

§  How to prevent COVID-19

§  How to aware general people about COVID-19

§  How to remove vaccine hesitancy of COVID-19

§  How to help with COVID-19 vaccine registration

§  How to use oxygen cylinder

4.2 Community Awareness Program

The program officer of Ashar Alo was arranged a total of 80 community awareness meetings at every Union level in every Upazilla. The main subject was discussed in that meetings are

§  About COVID-19

§  Symptoms of COVID-19

§  How to prevent COVID-19

§  How to remove vaccine hesitancy of COVID-19

§  How to help with COVID-19 vaccine registration

4.3 Community Awareness by Public Announcement

In the total project period, we arranged 80 times public announcements in each Upazilla. The main message of the announcement was

v  Frequently handwashing properly before a meal, after reaching home from outside

v  Wear mask properly

v  Avoid crowed area

v  Don’t handshaking with others

v  Get message to reducing vaccine hesitancy

v  Boosting immunization by taking of COVID-19 vaccine

5. IDEAS AND LESSONS LEARNED ON PROJECT IMPLEMENTATION

 5.1 Basic ideas on Project Implementation

-          Establishing community help centers by the project with oxygen cylinders and PPE with trained community workers and volunteers was effective to reach the wider community and access the equipment. The critical COVID 19 patients were felt confident getting oxygen support from the center (24/7) when they needed  

-         Coordination and communication were key for implementing this project. Due to the existing linkage between Ashar Alo and Communities in carrying out current activities, Local Government and health authorities are positive to support Ashar Alo, as the project could establish reinforcing government initiatives. Continuous communication with the Communities and local GOB and health authorities for smooth implementation for its positive impacts.

-          Orientation, better understanding & capacity building of community volunteers, and local health workers helped facilitate to implementation of Covid-19 response policies and initiatives of the government. Engaging government health officials as resource persons for the training of community workers and volunteers enhanced the confidence of the people.  

5.2 Ideas and Lessons Learned on Implementation of Activities by Fields

The lessons learned from the project are very valuable for Asher Alo. Here are some examples is providing for project learning.
 

1) From the project we get an important lesson learning that, if we developed strong communication between health service providers and communities, it is very effective for our people and communities to prevent COVID-19. Because at first, we see that general person does not have a proper idea about this pandemic such as they do not know that COVID-19 is a preventive disease.

 

They believe that COVID-19 comes from God as a punishment's so that it is a non-preventive disease, but when we create awareness about COVID-19 through community awareness meetings then they understood that it is a preventable disease and recover from this disease by maintaining a proper hygienic practice, such as proper handwashing within 30 seconds, maintaining physical distance, wearing mask properly, by avoiding crowded areas, by avoiding handshake, before sneezing covering nose and mouth by tissue or cloths.

2)  At first a larger number of community people has a vaccine hesitancy because of their religious prejudices, lack of proper knowledge about vaccination, believes in mickey, the misconception of vaccine functioning in the human body, then our field staff and volunteers removing their misconception and creating proper awareness about vaccine hesitancy by community awareness meeting, distributing leaflets, public announcement and one to one communication about COVID-19.

Regarding this lesson, proper communication is used for effective implementation in this program.

 

5.3 Certification of Project Competition by Upazilla Nirbahi Officer (UNO)

At first, the NGO affairs bureau was approved of FD-7 then Asher Alo informed to get permission by UNO. After getting permission from UNO, was started this project in each Upazilla. In implementing period of this project UNO direct supervised this project and presented it in the orientation program. The program officer of Asher Alo has attended an NGO coordination meeting and reporting every month at the UNO conference room. The certification of this project is approved by UNO after ending this project.

 

 

 

 

 

 

 

 

 

6. RECOMMENDATION FOR FUTURE PROJECT IMPLEMENTATION  

On basis of the current project which was implemented by Ashar Alo titled " Mitigating the impact of COVID-19 through community-led prevention program in Bangladesh”, we include a bunch of recommendations for future project implementation.

·         Our project was implemented in a particular area especially the southern part of Bangladesh, the people of this locality are highly benefited against COVID-19 from this project. If this project will be implemented in a vast area of this country, it is very fruitful to our country's people for mitigating this pandemic situation.

·         For better performance of this project, the support of supplies should be increased like as, number of PPE, Mask, Sanitizer, Hand Washing materials, Goggles, Face Shield, Floor Disinfector, Oximeter, Thermal Scanner and also Oxygen Cylinder.

·         It will also be recommended that every Community Help Center needs to deploy two field officers for enhancing better services during COVID-19 situations.

·         Emergency ambulance services should be included in this project.

·         A registered nurse should be deployed at Community Help Center under the future project.

To mitigate and the prevention of COVID-19, the continuity of this project is highly effective for our country's people. 

Project Name : “Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh”

Doner : AMERICARES Foundation Inc.

Sector : Health

Area : Kulia and Noapara Union Under Debhata Upazilla

Time Line : 01 February, 2023 to 31 January, 2024

Brief of activities :

1.Introduction:

This report outlines the progress of our project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh" from January 1, 2023, to August 31, 2023. The goal of the project is to increase access to quality essential health services through community sensitization, capacity building of community clinic staffs and improvements to the community clinics at Debhata Upazila under the Satkhira district.

 

2. Summary Results in Progress Report:

The project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh" aims to increase health services through community sensitization, create capacity building of Community Clinics staffs and infrastructure development to the 7 Community Clinics at Kulia & Noapara Union under Debhata Upazila in Satkhira district. The project targets a total direct population of 50,000 and approximately 97,200 indirect beneficiaries.

 

During the reporting period, Community Health Workers have been actively making contact with 20,970 direct beneficiaries through home visits, community awareness meetings and community mobilization through discussion about CCs health services at the community outreach point, one-to-one awareness and counselling, Critical patient’s referral to Upazila Health Complex and district hospital, Screening of Diabetes & Hypertension through organizing camp, Formation & Organization of “Health Brigades”  and advocacy meetings. The 31500 indirect beneficiaries got benefited through television installation at the waiting room for patients of Community Clinics, Furniture distribution at the waiting room for patients of Community Clinics, Loud speakers messaging, Broadcasting general health messages through local media and printing X banners.

 

3. Goal and objectives of the project:

Increase access to quality essential health services through community sensitization, capacity building of community clinic staffs and improvements to the community clinics.

1. Objectives:

• To increase the capacity of community health workers and community health care providers to align with government guidelines.
• To support repairing the water, sanitation, and hygiene infrastructure of the CCs.
• To establish a clear referral pathway from the community to the UHC.

 

The project have undertaken different interventions such as Kick-off workshop with local health administration, Assessing need assessment of the community and health facilities, Training of community health workers and Community Clinic Providers, Development of training materials, Mapping the health services continuum for each community, Establishment of referral pathway from community to higher level, Development and printing IEC materials, Information, Education and Motivation (IEM) campaign through and cultural activities, Organization and formation of “Health Brigades”, Orientation of “Health Brigades”, Community awareness meeting by the community health workers, Community transport for sick patients, Restoring community clinic’s infrastructure and provide medical supplies, Procurement of medicines & equipment for CCs, Renovation of community clinic for improving WASH facilities, Screening of Diabetes & Hypertension through organizing camp, Blood grouping & Rh typing through organizing camp, Maternal nutritional education & support with Food Parcels distribution for pregnant women through camp, Union & Upazilla coordination meetings, Strengthening DRR workshop and advocacy meetings.

The key finding of the project so far is that through active community mobilization and intervention, the project has been able to increase CCs services among the select population in the target areas. The project has also been able to provide health education and services and aware to the target population.

4. Specific activities under strategy-1:

4.1.1. Establishment & Procurement of office furniture and deployment of Project staffs

Throughout the duration of the project, we have rented project office (office room and training/meeting room) & already purchased office equipments for project staffs such as 2 laptops, 1 printer cum scanner, 1 multi-media projector, 1 motorbike, three tables, six chairs, one shelve, Almirah, one file cabinet and office stationery (Paper, files, Scissors, Cutter, Dairy/note book, Multiplag, Paper weight, Light, Masking tape, Binding tape, Marker, Register book, Water Jar, attendance register, Movement register, Carpet, Vessel, Toilet tissue, towel, Sandles, Water Glass, Waste bin, Electricity Meter Recharge, Hand Wash, Vim, Soap, Phenyl, Kettle (water heater), Cup, the broom, shovel, toner, pen, etc.) to continue the project’s ongoing operations following organizational procurement policy & procedures. A cleaner has been hired to keep the project office clean. On the other hand, Recruitment of Project Coordinator, Project Officer, Accountant and nine Community Health workers have been deployed in accordance with the organization’s recruitment policy and procedures for running the project activities.

 

4.1.2. Arrange induction for all project staffs

Ashar Alo has been implementing a new project “Thriving Local Health Centre in Debhata Upazilla (sub district), Satkhira, Bangladesh” which is funded by Americares Foundation Inc. from 01 January 2023 to 31 March 2024, for increasing access to quality essential health services through community sensitization, capacity building of community clinic staffs and improvements to the community clinics. The primary focus of the project will be seven community clinics of two unions respectively Kulia and Noapara of Debhata Upazila, Satkhira. For effective implementation of the project, an induction and orientation program for all project staffs with the local government health administrators, held on 25 February 2023. In this program, Dr. Md. Abdul Latif, Upazila Health & Family Planning Officer, Debhata Upazila, Satkhira was present as the chief guest, Abdullah Gazi, Health Inspector, Debhata Upazila, Satkhira was as special guest also Community clinic representative Golam Mohiuddin, president of Community Health Care Providers coordination committee was present. This program was arranged to formally introduce the entire team to the project and with the organizational norms and policies. Besides to provide information regarding project overview, plan and objectives with the project staffs. To introduce organizational norms and Values & organization policies as HR & Gender etc, To introduce the staffs with local health system administrators. To establish a clear referral pathway from community to the Upazilla health complex/to higher healthcare facilities. To introduce jobs responsibilities & activities of project staffs. To discuss about Community Clinics activities.

 

4.1.3. Submission of FD6 to NGOAB and persuasion for approval

The approval from NGO Affairs Bureau of the people’s republic of Bangladesh is required for this project. In continuation, FD-6, FD-2 format with forwarding were prepared and submitted for approval to NGOAB on 19 February 2023. Also, the project overview presentation has been prepared and presented as requested by the NGOAB. Besides this, Ashar Alo has coordinated with NGOAB staffs. It is great pleasure that we have received approval from NGOAB on the 18^th April 2023. Already we have submitted the copy of forwarding, FD-6 & approval letter from NGOAB to DC office, Civil Surgeon Office, District Family Planning Office, Upazila Health Complex, Department of public Health, Upazila Nirbrihe Office and all concerned departments have submitted.

4.1.4. Conduction of health needs thorough Assessment:

The assessment questionnaire and the tools were developed to collect information from the field and conducted FGD, KII, observation with different group, individual and different CCs as well as with the management of the CCs in the project implementation site. The assessment had been conducted in the month of June 2023. There were 24 respondents have provided very key issues by using the KII tools. On the other hand, 08 FGDs were conducted where 71 participants’ attended. Among them CG & CSG members, service providers, project implementing professionals and the service seekers of the selected CCs and project area were present. The participants provided very important information and key issues, and also gave suggestion to incorporate and adopt in the tailor made module. Due to this small size of response rate, the analysis of health needs will base on the In-depth interviews (qualitative study) with different stakeholders and service providers.The assessment is being under processed by consultant.

 

 

 

4.1.5. Procurement of 2 auto-rickshaws/vans for critical patients referral

In order to implement ongoing project, two electric rickshaws/vans have been purchased to carry referral patients to the Upazila Health Complex & district hospital.Two auto-rickshaws (one for each union) procured for the transportation of the critical patients from the community clinics to UHC hospitals & district hospital. Two male community health workers have been deployed for two unions and they ride the auto-rickshaws for transporting the sick patients. This service is being opened on call 24/7. The continuous work throughout the year will be referral of serious patients from catchment areas to Upazila Health Complex and district hospital. For example, A critical patient Mr. Rohim, 48 years old, hailing from Kalabaria, Noapara, Debhata, suffering from excessive sweating and sudden unconsciousness has been transported to Upazila Health Complex’s emergency department by community health worker-Md. Alamin.

 

4.1.6. Community awareness meeting to be conducted by the community health workers

In order to implement ongoing project, Attendance sheet, Meeting Banner, Meeting Agenda, Validation tools, Handout of Guidelines have been prepared to implement Community Awareness Meeting and distributed among the CHWs. Community Awareness Meeting (CAM) is being conducted as per instruction & guideline. The community health workers have defined catchment areas and target for home visit & community awareness meeting. The community health workers organize CAM with the community people. A total of 256 CAM have been arranged, and estimated about 16,640 community members were participated. As per target, the community health workers will conduct awareness session with the community people. They will also identify the patients or people who need health services, and refer the patients to the community clinic.

 

4.1.7. Conduct training need assessment

Ashar Alo is intended to develop a training module targeting primarily the CHCPs working at the CCs and also other health support workers at the union and community level. The purpose of the TNA is to find out the areas of improvement for the service providers and community support service members. Through this assessment and training, it is assumed that capacity of CHCPs and other service providers will be increased and they will be aligned with government guidelines. Ashar Alo hired a Consultant (A public health professional and training expert and his team) to conduct TNA and to develop training modules based on the findings of TNA. The TNA was identified as a key element in enabling CC service providers and support group members to adapt the programmes that are being offered under this project, so that they meet the needs of the selected community people & also develop a strong and effective referral network with the UHCs for required health services. The objectives of the project are: To increase the capacity of CHCPs and other service providers  to align with government guidelines, To support repairing the water, sanitation, and hygiene infrastructure of the CCs, To establish a clear referral pathway from the community to the UHCs. The TNA consists of three elements: A comprehensive literature review, analysis existing modules to establish the broad needs of the CHCPs and service provision. A survey has been conducted for collection of large-scale quantitative data to give an overview of the needs of CHCP, FWA and other service providers, A qualitative element, comprising of individual interviews with key people, stakeholders, community elite and the service recipients (clients) through KII, FGD, observation and exit interview with the clients. Also discussed with the CC neighbouring people to get a detail insight into some of the current challenges and the skills needed to support change. This report provides an overview of the work conducted to date on the TNA, analysis of the data obtained and conclusions that are derived from the above. In summary, the TNA will draw a range of information to adapting our programmes. The literature review which consisted of detailed investigations of different training module, handout and guideline which is currently used to conduct training & capacity building as well job aid for the CC service providers and also for the CG/CSG. Most of the available documents focused on needs for curative service and counseling issues. Most of the documents focus on clinical and curative practice but there is very little part and areas focus on the prevention issues. Such available literature suggests that: Fostering professionalism and a sense of counseling are top priorities, Service providers and support group need to be encouraged to reflect and follow the guideline provided from the management to provide effective and result orient services, Guideline and handout for the CC service providers are very well articulated, but there are scope to improve and incorporate new issues, data and updated information, Good practices in Human Resource Management (HRM) need to be understood by management, Quality Assurance (QA) skills need to be developed, with service providers given enhanced skills in reflecting on service provision, counseling and IPC of a range of procedures to monitor and evaluate practice. The strategic and short term planning skills of management and service providers need to be considered to increase service seekers for the community clinic. The assessment questionnaire and the tools were developed to collect information from the field and conducted FGD, KII, observation with different group, individual and different CCs as well as with the management of the CCs in the project implementation site. The assessment had been conducted in the month of June 2023. There were 24 respondents who have provide very key issues by using the KII tools. On the other hand, 08 FGDs were conducted where 71 participants’ took part. Among them CG & CSG members, service providers, project implementing professionals and the service seekers of the selected CC and project area were present. The participants provided very important information and key issues, and also gave suggestion to incorporate and adopt in the tailor made module. Due to this small size of response rate, the analysis of training needs will be based on the In-depth interviews (qualitative study) with different stakeholders and service providers. Apart from the TNA, observation of the service provision, interview with the service seekers immediately after receiving service and discussion with the UHFPO were also done. Their opinion, views and suggestions were noted and taken care for further development of the module. The TNA findings and analysis shows and guide for update the content as well as incorporate new priority areas. In-depth interviews were also conducted with health managers to take their experts idea, view and suggestions for content/issue/area. Some of the key issue, suggestion and ideas from the TNA to prioritize by the interviewees, service providers, and the management for the module are- Refresher  training on clinical service and effective use of medicine, Training/refresher on Ante natal Care (ANC) services (check-up and referral system), Training on nutrition, Training on mental health, Counseling on ANC, children, adolescent nutrition and health issues, Adolescent health and hygiene, Communicable and non-communicable disease issue, Inter Personal Communication (IPC), Counseling, Communication, Effective service provision with medicine support from community clinic, Gender based violence and its management, Adolescent health service and their care, Management of Community Group (CG) and Community Support Group (CSG) , Effective referral collaboration, Awareness raising program for the community people on health related different issue is required, especially focus on prevention, personal hygiene and service seeking attitude is important, Disaster risk reduction (DRR) and Disaster risk management (DRM).

 

4.1.8. Map the health services continuum for each community

All project staffs have already received appointment letter and aware of his/her proper work. Every staffs are performing their works in coordination & collbration with UH&FPO, UFPO & CCs running staffs (CHCP, HA, FWA, FWV, FPI, AHI, HI, CHW) for mapping. A mapping exercise is conducted to identify the health services continuum for establishing a referral pathway. It will identify the roles and responsibilities of each health points. The health services continuum for each community and development of referral pathways from community to UHC & district hospital have been mapped.

 

4.1.9. Development and printing IEC materials 

The project is developing and printing banners, X banners, general health messages for broadcasting through local media. IEC materials printing are under processing. Community health workers will use those materials. Now we will go to deliver as below: Training modules total 50 copies are prepared for voluntary group/health brigades. Development and printing-100 pieces of Flipcharts & Diagram are under processing. Development and printing-14,000 pieces of Poster & Leaflet are under processing. Development and Printing-35 pieces of Diagram and flow chart for community clinics are under processing.

 

4.1.10. Organization and formation of “Health Brigades” 

For proper implementation of project activities, Bio-data of youths from each project union has been collected. Already We have organized & formed a volunteer group called as “Health Brigades” which mobilizing and engaging the local youths. They have been selected from the defined community, received orientation program & training, and will volunteer in disseminating health message, helping the project team in organizing the cultural & social events, essay competition, art competition & IEM campaigns in the community.

 

4.1.11. Kick-off workshop with local health administration

According to the guideline of project proposal, a Kick-off Workshop at Upazila level held on 19 June 2023. This program was arranged to provide information regarding project goal, mission, vision, objectives, plan & overview with the local health administrators and local representatives. Officially informing the local health administrators & local representatives about the project overview. To explain in details the project background, goal, objectives, activities implementation strategy & outcome. Formally introduce project staffs and details explain their job responsibilities. Discussion about the project budget details. Engage GOs & NGOs representatives about the project activities. The Program was segmented into different key areas of programmatic and organizational importance. The program started with the registration of all participants. Then recitation from holy Quran and holy geeta were performed. Next, Introductory session of participants with guests. In this program Alhaj Md. Mujibur Rahman, Upazila Chairman, Debhata Upazila, Satkhira was present as the chief guest, Abu Abdullah al Azad, Executive Director Ashar Alo as the president and Md. Rifatul Islam, UNO (Acting), Debhata Upazila, Satkhira and ABM Kamrul Ahsan, Country Representative, Americares Foundation Inc. as special guests. Besides, different local health administrators and local representatives such as Dr. Md. Abdul Latif, UH&FPO, Debhata UHC, Dr. Palash Dutta, UFPO, Debhata, Md. Asadul Hoque, Chairman, Kulia union, Md. Alamgir Hossain, Chairman, Nowapara union, Abdullah Gazi, HI, Debhata UHC, Presidents of CG committee of different Community clinics, representatives of different NGOs, Journalist, Teachers, Midwife, Imam, Priest, Union Secretary, local health receiver, CHCPs & FWV under Kulia & Nowapara Union CCs and many others were present. The program was facilitated by Dr. G.M. Imtiaz Ahmed, Project Coordinator, Ashar Alo and Md. Alamgir Hossain, Project Officer, Ashar Alo. Open Discussion: After the presentation, this session took place. All participants actively participated in this session.

 

 

 

 

4.1.12. Screening of Diabetes & Hypertension through organizing camp

For proper implementation of project, this program was arranged to systematically assess the burden of hypertension and diabetes within the population under Tiket community clinic, Tiket, Kulia union, Debhata, Satkhira, Bangladesh. In Bangladesh, according to WHO estimates, 30% of all deaths are due to cardiovascular diseases and 3% are due to diabetes. There is a serious burden of non-communicable diseases in Bangladesh. But little is known about the health status and the epidemiology of non-communicable diseases in the population under Noapara & Kulia union, Debhata, Satkhira, Bangladesh. Most importantly, scientific evidence on non-communicable disease is rather limited. This assessment will help to design and to introduce community-based intervention strategies aiming to improve the population health status and reduce the disease burden. Hypertension detection through Diagnostic Test: Blood pressure measurement (Using Sphygmomanometer), Diabetes Mellitus detection through Diagnostic Test: Blood glucose measurement (Using standard measurement device). Two camps have been organized covering total 172 people who came for screening. The camp started with registration of the interested people. Then blood pressure and blood glucose measured using standard measurement device. Participant no (total) till date–172 persons, Male-83, Female-89, Diabetes diagnosed-23, Hypertension diagnosed-35, Prevalence of hypertension-Assessment of the prevalence of hypertension, Prevalence of diabetes mellitus-Assessment of the prevalence of increased levels of fasting glucose/random blood glucose.

4.1.12. Maternal nutritional education & support and referral for pregnant women:

For implementation of the project, this program was arranged and provided Maternal nutritional education & support with Food parcels and referral for pregnant women under Nangla community clinic, Noapara union, Debhata, Satkhira, Bangladesh. There is a serious burden of nutritional anemia of pregnant women in the rural areas. This camp is helping to identify anemic pregnant women. One camp has been organized where total 15 pregnant women came for receiving food parcels containing rice, pulses, sugar, cooking oil, popatoes, iodized salt and vegetables etc. The camp started with registration of the selected women. Then a session of nutritional education conducted then clinically anemia screening was done.

4.1.13. Advocacy meeting at Noapara Union

This program was arranged to provide information regarding all project activities & progress. Moreover, program was arranged a coordination & collaboration and took feedback with the local health administrators and local representatives. Officially explaining in details the key stakeholders & local representatives of Noapara union regarding the project overview, program  implementation strategy & outcome. Coordination, Collaboration & Liaison with key stakeholders and community leaders of Noapara union. To establish trust and transparecy for both side. To collect the environmental issues and the local conditions.To take significant opinions from local stakeholders. Engage GOs & NGOs representatives about the program activities. The Program was segmented into different key areas of programmatic and organizational importance. The program started with the registration of all participants. Then recitation of verses from holy Quran and Geeta were performed. In this program Md. Alamgir Hossain (Saheb Ali), Chairman, 4no Noapara union, Debhata, Satkhira was present as the chief guest, Abu Abdullah al Azad, Executive Director Ashar Alo as the president, Abdullah Gazi, HI (acting), Debhata UHC, CHCP of Community clinics, HA at Noapara union, Honorable members of Noapara Union Parishad, representatives of different Secondary schools, students and many others were present. The program was facilitated by Dr. G.M. Imtiaz Ahmed, Project Coordinator, Ashar Alo and Md. Alamgir Hossain, Project officer, Ashar Alo. Presence of most of the stakeholders of Noapara Union, Debhata, Satkhira, Bangladesh. Precious opinion from the government & NGOs representatives, Teacher, Students, Beneficiaries, Freedom Fighter, Journalist & Anti-corruption committee. Understandable discussion about the project overview, program implementation strategy & outcome. To take positive feedback & recommendation from local stakeholders.

4.2. Specific activities under strategy-2:

We believe that “Critical Patients Referral System’’ is the prime component of the project. Through purchasing two auto rickshaws/vans, the critical patients from the remote areas of the village are able to come the Upazila Health Complex & district hospital health services. Local people named it “Mini Auto Ambulanc” a Free service that is opened 24/7. There are two community health workers for two unions and they each have Hotline phone number which have been circulated around the society.

4.2.1. Disseminating Health information through Loud speaker

For this project, community awareness is enhanced through Loud speakers particularly at catchment areas to inform the people about the full range of services provided by the Community Clinics. Apart from this, all the camps which have been organized under the project are requested to attend and take services.

4.2.2. Disseminating Health information through X Banner for workshops/meetings

As part of the project, for display of government health messages at the workshop, training & cultural events. Meanwhile, we have taken health messages from local administration as well as our health messages X banners are being given in various workshop, meeting & camps and cultural programs so that people can be aware about CCs health services.

4.2.3. Television & Furniture distribution for waiting room of community clinics

As part of the project, Procurement of television & furniture for waiting room of the patients and supply to the 7 Community Clinics. Televisions have already been installed so that patients can sit in the waiting room properly. They will get health messages while watching TV and will know a lot about health facilities.

 

4.2.4. Brodcasting General Health messages through local media (Community Radio & Cable TV network)

The general health messages have been brodcasting through local media (Community Radio & Cable TV network scrolling). As a result, the people in the project areas are becoming aware of their health through local media. Being informed about the various activities of the project. The Hotline phone number of the referral is being circulated in massive form.

4.2.5. Mass Awareness development through Door-to-Door Visit

Form the begining of the project , particularly Project Community Health Workers (CHWs) have been visiting, talking and building-up rapport to Community Clinics staffs and in their communities about CCs activities and facilities. They try to collect some significant information through data collection sheet in their working areas. As a result, we are able to make referral of many patients as well as able to identify prepnant women.

4.2.6. Monitoring, Supervision and Evaluation

Project monitoring is the inbuilt part of Ashar Alo’s project management, usually organization’s management and project staffs engage with the project monitoring process. Project will measure the success or results according to the set indicators in the logical framework of this project proposal. Ashar Alo has recruited project coordinator & project officer who have been providing full time support for this project through 100% salary for this position were allocated in the approved budget. As the project is passing its initial phase at this moment project coordinator & project officer involved for selection of project stakeholders & beneficiaries as like other staffs of this project. Besides this, project coordinator & project officer also performing to all the project activities and will supervise and monitored properly. The supervisors will monitor the project activities through physical visit to the field and through using mobile phones and other social media. On the other hand, we observed that a full-time monitoring officer is essential for this project to accomplish the task timely and effectively according to target and nature of work.

 

4.2.7. Development of organization’s Website, Collection videos and photography & internet facilities

During the project period, A complete and modern website is being developed to keep update track record of all activities of the project. As a result, everyone can get proper information about the project activities. After developing the website, videos and photographs, captured by a professional photographer are regularly being uploaded to the website. Beside,  internet facility (e-health information) has been provided for community clinics staffs so that they can use and communicate and give health information to project staffs. The website address is www.asharalobangladesh.org

5. Key Achievements for Progress Report

During the reporting period, the project has successfully provided services to a total of 20,970 direct participants. Among the direct participants, 420 persons received referral services, and 172 persons received screening of Diabetes & Hypertension through organizing camp. 15 persons received Maternal nutritional education & support with food parcels for pregnant women through camp and referral. Community awareness meetings with 16640 partcipants have been conducted and one-to-one awareness and counseling to 3580 participants have been provided. “Health Brigades” consisting of 30 participants has been formed and organized. A Kick-off workshop & advocacy meetings with 113 local administrations, stakeholders & leaders have been conducted.

In addition, the project has indirectly reached 31500 participants. Through the project, seven Television and Furniture have been distributed to Community Clinics 8500 persons are becoming aware of CCs health services. the project has reached to 12000 persons through public announcements made through loudspeakers. 11000 persons are becoming aware through broadcasting general health messages through local media (Community Radio & Cable TV network scrolling).

Overall, the project has made significant progress in achieving its goal of providing health education & services to individuals at Kulia & Noapara Union under Debhata Upazila in Satkhira district.

6. Total Number Participants Reached to Date

6.1.1. Outcome-1

The project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh" aimed at health education and sensitizing local communities in Debhata Upazila under Satkhira district about the importance of health education. The project has implemented various interventions such as Kick-off workshop with local health administration, Assessing need of the community and health facilities, Training of CHWs and CHCPs, Development of  training materials, Mapping the health services continuum for each community, Establishment of referral pathway from community to higher level, Development and printing IEC materials, Information, Education and Motivation (IEM) campaign through and cultural activities, Organization and formation of “Health Brigades”, Orientation of “Health Brigades”, Community awareness meeting by the community health workers, Community transport for sick patients, Restoring community clinic’s infrastructure and provide medical supplies, Procurement of medicines & equipment for CCs, Renovation of community clinic for improving WASH facilities, Screening of Diabetes & Hypertension through organizing camp, Blood grouping & Rh typing through organizing camp, Maternal nutritional education & support with Food Parcels distribution for pregnant women through camp, Union & Upazilla coordination meetings, Strengthening DRR workshop and advocacy meetings. the project has successfully provided services to a total of 20,970 direct participants. Among the direct participants, 420 persons received referral services, and 172 persons received screening of Diabetes & Hypertension through organizing camp. 15 persons received Maternal nutritional education & support with food parcels for pregnant women through camp and referral. Community awareness meetings with 16,640 partcipants have been conducted and one-to-one awareness and counseling to 3580 participants have been provided. “Health Brigades” consisting of 30 participants has been formed and organized. A Kick-off workshop & advocacy meetings with 113 local administrations, stakeholders & leaders have been conducted.

In addition, the project has indirectly reached 31500 participants. Through the project, seven Television and Furniture have been distributed to Community Clinics 8500 persons are becoming aware of CCs health services. the project has reached to 12000 persons through public announcements made through loudspeakers. 11000 persons are becoming aware through broadcasting general health messages through local media (Community Radio & Cable TV network scrolling).

These interventions have successfully raised awareness among communities in Debhata Upazila about the health education. The community is now more knowledgeable about maintaining proper CCs health facilities & hygiene. The project's outcome will contribute to reducing the incidence of home health facilities in the project areas and improving the health and well-being of institution health facilities and individuals.

6.1.2. Outcome-2

The project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh" aims at identifying critical patients among the local communities in Debhata upazila through providing referral services. During the reporting period, critical patients successfully identified and provided referral services to 410 critical patients from community CCs to UHC. Seven television have been distributed to CCs to provide the health education. These interventions have contributed to the recovery of critical patient’s health condition and prevented other diseases, ultimately improving the health and well-being of individuals in the project areas.

7. Challenges & Lessons Learned

The project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh"encountered several challenges during the reporting period. The challenges encountered and responses taken are summarized below:

7.1. Challenges

Skill Staffs: One of the major challenges encountered during the reporting period was the shortage of qualified staffs. To address this challenge, the project management authority should recruit and train staffs to support the implementation of the project.

Oversight: Another challenge was the lack of effective oversight and reporting & monitoring mechanisms, which led to difficulties in tracking progress and identifying areas for improvement. The project management team addressed this challenge by establishing a robust reporting, monitoring, supervision and evaluation system, which includes regular site visits, progress reviews, and data analysis.

Resource constraints: The project faced challenges in implementing certain activities due to resource constraints, such as limited time. The project management team addressed this challenge by identifying better time management and working closely with local authorities.

Community engagement: The project encountered challenges in engaging the target communities and mobilizing them to participate in the project activities.The project management team addressed this challenge by strengthening community mobilization efforts and working closely with community stakeholders & leaders to increase awareness and participation.

Coordination: The project encountered challenges in coordinating with local stakeholders and consultants, which make challenges in project implementation. To address this challenge, the project management team established clear lines of communication and strengthened coordination mechanisms with local stakeholders and consultants.

Role clarity: The project encountered challenges in clarifying the roles and responsibilities of local administrations & stakeholders, which led to confusion and delays in project implementation. The project management team addressed this challenge by developing clear guidelines and protocols for local administrations & stakeholder engagement.

Environmental factors: The project faced challenges in implementing certain activities due to environmental factors, such as hot & rainy weather. To address this challenge, the project management team developed contingency plans and established response mechanisms to ensure the continuity of project activities.

Cultural factors: The project encountered challenges in addressing cultural norms and practices that hinders community participation and engagement. The project management team addressed this challenge by working closely with community leaders and engaging in culturally appropriate outreach and awareness-raising activities.

7.2. Lessons Learned

The project "Thriving Local Health Center in Devhata Upazila (Sub-district), District- Satkhira, Bangladesh" revealed several technics and lessons during implementation that could be useful for future projects. One of the best practice was the involvement of community health workers from the target communities to facilitate trust and rapport with beneficiaries. Engaging with local stakeholders, including community administration & leaders and health centers, was also important for building community ownership and enhancing project visibility. Effective communication strategies, such as the use of multiple channels, were crucial in achieving project objectives. Based on these lessons learned, the project made changes such as expanding outreach to more remote areas, establishing stronger partnerships with community clinics, and improving the monitoring, supervision and evaluation framework to guide in decision-making.

8. Sustainability & Transition/Exit Planning

The project has implemented several plans to promote the sustainability and lasting impact of the health education and control project beyond the funding period. Strengthening community-based groups is one of the plans. The project has closely worked with these groups to create awareness about health education and improve access to health services. The project will further strengthen these organizations to ensure the continuation of project activities. Another plan is the capacity building of community health workers. The project has provided training to community health workers on health education and hygiene. The project will further train these health workers to take over the project activities after the funding period to ensure the sustainability of the project. Advocacy and awareness-raising activities will be conducted at the local and national levels to mobilize resources and create awareness about the importance of health education. Partnerships and collaboration with government agencies, health centers, and other stakeholders will also be continued to ensure the sustainability of the project. To address potential issues that may affect sustainability beyond the funding period, the project team will develop a sustainability plan to guide the continuation of project activities. The project will also involve community members and local organizations in project planning, implementation, and monitoring to stand in local ownership. The project team will explore new funding opportunities to ensure the continuity of project activities beyond the funding period. These plans aim to promote the sustainability and lasting impact of the health facilities project beyond the funding period.

9. Financial Spending Narrative Update

The project period is from 1 January 2023 to March 31, 2024, and the reporting period is from 1 January to August 31, 2023. The total budget for the project is 2,02,250 USD, with AMERICARES contributing 2,02,250 USD. In the reporting period, 25.00% of the total budget has been spent, which is 50,562.50 USD out of 2,02,250 USD.

Out of the total budget, 21.01% has been allocated for human resources, 18.13% for administrative, 31.81% for infrastructure repair & equipment, 11.87% for Training and capacity building, 7.47 % for Community Mobilization and Awareness and 6.30% for IEC meterials costs, 3.36% for coordination meetings.

All expenses have been spent as project requirements. The main cost of the budget is infrastructure repair & equipment, which have been spent 31.81% for infrastructure repair & equipment.

The expenditure has been allocated for providing human resources and administrative, distribution of television & furniture, assessment of Training Need Assessment & Health needs thorough assessment, Kick-off workshop, advocacy meetings, Health Brigades organization & formation, Website development, Screening of Diabetes & Hypertension through organizing camp, Maternal nutritional education & support with Food Parcels distribution for pregnant women through camp, public announcements, and community awareness meetings and others.

All staff members have received their salaries on time, and the funds have been used efficiently and effectively to achieve the project goals. Regular updates on financial spending and project progress will be provided in the coming months.

 

10. Conclusion                                                  

The first eight months of 2023 has been very successful in achieving the objectives of the project. We have made significant progress in creating awareness about the prevention of project overview and providing health and hygiene messages to the communities in Debhata Upazila. We will continue our efforts in the next quarter to reach out to more people and achieve our project objectives.

 

 

Project Name : Vulnerable Group Development (VGD) Programme

Doner : Ministry of Woman and Child Affairs

Sector : Ministry of Woman and Child Affairs

Area : Asasuni

Time Line : 2017-2018

Brief of activities :

Vulnerable Group Development (VGD) Programme

Ministry of Woman and Child Affairs had taken various social safety net program with the assistance of  Mohila Bishoyak Odhidaptor. One of the important program is Vulnerable group development (VGD. Vulnerable group development (VGD) is an Ultra poor household development program. Ashar Alo organization got Vulnerable Group Development Program (VGD)  2015-2016 cycle. Projetc area is Asashuni upzailla under the district of Satkhira. Project activity started March, 2017 and will continue 31 December, 2018. Under the project various activities are running, which are; Life Skill education, income generating skill development training, deposite savings, assist food distribution activities and will create opportunity to get loan etc). under the project involvement beneficiaries awareness will be enhance, skill development will be increase, will increase their financial and social empowerment and will involve national main truck of sustainable development.

 

• Mohila Bishyok odhidaptor has given a scope Ashar Alo organization to provide above mention development activities to the 2769 Ultra Poor households beneficiaries. 

 

• Ministry of Woman and Child Affairs ( Mohila Mishoyok Odhidaptor) various responsible officer which is Upazilla Mohila Bishok Officer, District  Mohila Bishok Officer, Dhaka based various level officer and local level various administor visited ashar Alo  Vulnerable group development (VGD) project various activities and given feedback. We carry on their advice, suggestions and try our best to implement the project various activities.