BRAC has made health interventions an integral part of its development work since its inception in 1972. By improving the health of the population, especially the poor, the BRAC Health Programme (BHP) contributes to achieving BRAC’s twin objectives of poverty alleviation and empowerment of the poor. Over the years, BHP has evolved reflecting changing national and global health priorities and knowledge.
Though originally administered on a small scale, BRAC’s health programmes had a nationwide infrastructure in place by the 1980s. With its extensive reach, BRAC carried out the large-scale Oral Therapy Extension Programme in the fight against the massive number of diarrhoeal deaths and successfully implemented the Child Survival Programme. During the 1990s, BRAC gradually turned its focus to comprehensive service-based programmes such as the Women’s Health and Development Programme and the Reproductive Health and Disease Control Programme. The present BHP is a logical extension of BRAC’s health interventions of the past. BHP has evolved, gradually incorporated a holistic set of services that accentuate community empowerment, health, human resources development, service provision and private and public sector linkages. Through this holistic approach, BHP aims to improve maternal, neonatal and child health, reduce vulnerability to common illnesses and control infectious diseases.
BRAC has a history of successful collaboration with the government in scaling up and implementing national health programmes. As a partner, BRAC shares the success of many health achievements in the country such as family planning and child immunization and the phenomenal declines in childhood and maternal mortality and morbidity. Currently, BRAC is the principal NGO partner in the Tuberculosis (TB) and Malaria Control Programmes, and is actively participating in the government’s health, nutrition and population programmes.
In 1977, BRAC first started training villagers to promote family planning services and health and hygiene education. This effort has grown into one of the largest national-scale community health volunteer programmes in the world. The exclusively female community health volunteers, the Shasthya Shebikas, or Shebikas, currently number 70,000 in Bangladesh and the Shebika model has been successfully replicated in Afghanistan and Uganda. Scaling up successful interventions is an important hallmark of BRAC generally and BHP specifically.
Today, BHP reaches over 92 million people with its core programme – the Essential Health Care Programme (EHC), including over 86 million people through the Tuberculosis Control Programme. As BHP’s core programme, EHC is a platform for other BHP programmes. The EHC structure has enabled broad introduction of other programmes such as the Tuberculosis Control and the Maternal, Neonatal and Child Health Programmes. EHC’s structure also ensures integration of service delivery at the community level and has successfully integrated the comprehensive approaches with selective primary health care approaches, evidencing that both are necessary for sustainability and scale up of healthcare programmes.