First Steps in Initiating an Effective Maternal, Neonatal, and Child Health Program in Urban Slums: the BRAC Manoshi Project’s Experience with Community Engagement, Social Mapping, and Census Taking in Bangladesh
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The processes for implementing effective programs at scale in low-income countries have not been well-documented in the peer-reviewed literature. This article describes the initial steps taken by one such program—the BRAC Manoshi Project, which now reaches a population of 6.9 million. The project has achieved notable increases in facility births and reductions in maternal and neonatal mortality. The focus of the paper is on the initial steps—community engagement, social mapping, and census taking. Community engagement began with (1) engaging local leaders, (2) creating Maternal, Neonatal, and Child Health Committees for populations of approximately 10,000 people, (3) responding to advice from the community, (4) social mapping of the community, and (5) census taking. Social mapping involved community members working with BRAC staff to map all important physical features that affect how the community carries out its daily functions—such as alleys, lanes and roads, schools, mosques, markets, pharmacies, health facilities, latrine sites, and ponds. As the social mapping progressed, it became possible to conduct household censuses with maps identifying every household and listing family members by household. Again, this was a process of collaboration between BRAC staff and community members. Thus, social mapping and census taking were also instrumental for advancing community engagement. These three processes—community engagement, social mapping, and census taking—can be valuable strategies for strengthening health programs in urban slum settings of low-income countries.
KeywordsCommunity health Primary health care Urban health Slums Maternal health Neonatal health Child health Bangladesh
Formerly Bangladesh Rural Advancement Committee
Community health workers
Urban birth attendants
We thank the people of slum communities in Bangladesh and the staff of the BRAC Manoshi Project for their assistance in gathering the information used for this article. We also thank the Lipitz Public Health Policy Fund for its support of Dr. Marcil’s participation in this study. The Bill & Melinda Gates Foundation provided funding from 2007 to 2011 for the BRAC Manoshi Project.
- 1.UN. World Urbanization Prospects: the 2014 Revision, (ST/ESA/SER.A/366). 2015. Available at http://esa.un.org/unpd/wup/FinalReport/WUP2014-Report.pdf. Accessed Dec 20 2015.
- 2.United Nations. The Millennium Development Goals Report 2014. 2014. Available at http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf. Accessed Dec 20 2015.
- 3.UN-Habitat. The Challenge of Slums: Global Report on Human Settlements 2003. 2003. http://www.unhabitat.org.jo/pdf/GRHS.2003.pdf. Accessed Dec 20 2015.
- 4.UN. Population Distribution, Urbanization, Internal Migration and Development: an International Perspective. 2011. Available at http://www.un.org/esa/population/publications/PopDistribUrbanization/PopulationDistributionUrbanization.pdf. Accessed Dec 20 2015.
- 5.UN. End Poverty: Millennium Development Goals and Beyond 2015. Goal 7. Environmental Sustainability 2014. Available at http://www.un.org/millenniumgoals/environ.shtml. Accessed Dec 20 2015.
- 18.BRAC. BRAC Annual Report, 2014. 2014. Available at http://www.brac.net/sites/default/files/ar2014/BRAC-annual-report-14.pdf. Accessed Dec 20 2015.
- 19.Manoshi Project. Manoshi Internal Data Report, 2012. Dhaka, Bangladesh: BRAC; 2013.Google Scholar
- 20.Manoshi Project. Manoshi Internal Data Report, 2013. Dhaka, Bangladesh: BRAC; 2014.Google Scholar
- 21.National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2014: Key Indicators. Dhaka, Bangladesh, and Rockville, Maryland, USA: NIPORT, Mitra and Associates, and ICF International; 2015.Google Scholar
- 22.Streatfield P, Arifeen S. Bangladesh Maternal Mortality and Health Survey 2010. Dhaka, Bangladesh: icddr,b; 2010.Google Scholar
- 33.Mridha MK, Hossain A, Alam B, et al. The Perceptions of Community Groups to Improve MNCH in Urban Slums: an Exploratory Case Study of Korail Slum in Dhaka. Dhaka, Bangladesh: icddr,b and BRAC; 2009.Google Scholar
- 35.Khan M, Ahmed S. The “Birthing Hut” Facilities of Manoshi: a two-part paper exploring the inception and post-inception phases of urban delivery centers. Dhaka, Bangladesh: icddr,b and BRAC; 2009.Google Scholar
- 36.Banu M, Nahar S, Nasreen H. Assessing the MANOSHI Referral System: addressing delays in seeking emergency obstetric care in Dhaka’s slums. Dhaka, Bangladesh: icddr,b and BRAC; 2010.Google Scholar
- 39.Roy T, Marcil L, Chowdhury R, Afsana K, Perry H. The BRAC Manoshi Approach to Initiating a Maternal, Neonatal and Child Health Project in Urban Slums with Social Mapping, Census Taking, and Community Engagement2014. Available at http://www.brac.net/sites/default/files/portals/Manoshi-book-v3-1.pdf. Accessed Dec 20 2015.