Distribution of 13 million masks in 35 high-risk districts begins
BRAC has undertaken an initiative to provide Covid-19 related services to people in 35 high-risk districts. The Directorate General of Health Services (DGHS) is actively supporting the identification of priority areas for this effort. It is for the first time in Bangladesh that any civil society partnership will provide Covid-19 services with such a wide coverage. Free distribution of 13 million masks in these districts is underway as the first step to this initiative.
Global Affairs Canada and BRAC are the primary contributors to this initiative, being supported by a consortium of donors and partners including the Australian government.
With a community-driven Covid-19 response and local-level health system strengthening approach, BRAC is partnering with the DGHS, recently formed platform Civil Society Organisation (CSO) Alliance, and United Nations agencies to implement this initiative. A total of 41 local NGOs in the identified districts will act as the implementing partners. BRAC’s executive director Asif Saleh made the announcement at a virtual press conference this morning (Tuesday, 1 June).
BRAC is going to deploy 27,500 community health workers in the selected 35 districts under this effort which will put maximum emphasis on the proper use of masks to ward off the transmission. The other approaches include spreading information and motivation about handwashing with soap and water, maintaining coughing etiquettes and social distancing and vaccine registration. Measures will also be taken to address misinformation and rumours around Covid-19.
The high-risk districts are Mymensingh, Sherpur, Kishoreganj, Tangail, Jamalpur, Gazipur, Narayangonj, Dhaka, Jhenaiadah, Bagerhat, Satkhira, Jashore, Chuadanga, Narail, Khulna, Magura, Brahmanbaria, Cumilla, Habiganj, Sylhet, Rajshahi, Chapainawabganj, Bogura, Joypurhat, Natore, Bhola, Barishal, Dinajpur, Rangpur, Lalmonirhat, Cox's Bazar, Chattogram, Feni, Noakhali, and Chandpur. BRAC also plans to scale up the initiative across Bangladesh if the situation demands so.
Moderated by BRAC’s senior director KAM Morshed, the virtual press conference was also attended by Mushfiq Mobarak, professor of economics at Yale University, and Shaheen Anam, executive director of Manusher Jonno Foundation. Dr Morseda Chowdhury, director of BRAC’s health, nutrition and population programme highlighted core components of the initiative in the press conference.
With the rise in the number of Covid cases and rate of deaths, besides the centrally run initiatives in Bangladesh, scaled-up community-level prevention efforts have become imperative at this moment. While the health facilities are struggling to provide essential treatment and care to the patients, many people at the community level are negligent in abiding by the preventive measures and hygiene rules. A scaled up community-driven approach can only address the situation at present as observed by health and behaviour change experts.
During the official announcement of this initiative, BRAC executive director Asif Saleh said, “Community resilience to prevent Covid-19 requires participation from the people of all walks of life, particularly leadership from the local communities. There is no alternative to follow health advisories till all the citizens are vaccinated in the country. Hence we are making an all-out effort to strengthen community resistance against Covid-19 and glad that 41 partner NGOs have joined us in this effort. We urge prominent opinion leaders to join our campaign to bring behavioural change in the community.”
Yale University professor Mushfiq Mobarak said, “Mask usage remains low in Bangladesh, particularly in the public places. A team from Yale University and Stanford University, have conducted a research in 600 unions of Bangladesh, which shows many people are averse to mask use because they lack knowledge about the need to use it, while many others do not wear it as they can’t afford to buy masks. The research also finds that the production of three-ply reusable surgical masks at a low cost is quite possible in Bangladesh. We believe BRAC with its countrywide coverage and strong base of frontline staff will be successful in implementing the initiative.”
Manusher Jonno Foundation executive director Shaheen Anam said, “The inevitable social responsibility arising from the crisis of the pandemic has led us to join this initiative with BRAC along with 41 other NGOs. Our aim is to make people aware of the gravity of the situation and increase their sense of responsibility. Combating the ongoing crisis will become easier if people are aware at every household.”
Earlier, BRAC in partnership with The Foreign, Commonwealth & Development Office (FCDO) of the Government of UK and under a joint initiative with the DGHS and Community Clinic Trust, piloted a community-driven Covid response and health system strengthening initiative in six districts over the past five months. The success of the pilot has resulted in the initiative for the 35 high-risk districts identified by the Institute of Epidemiology Disease Control and Research (IEDCR). The initiative with three key pillars of interventions, namely, prevention, response to Covid case management, and promotion of vaccination is expected to slow down the spread of Covid-19, help flatten the curve and preserve health system capacity in these districts.
Prevention: BRAC’s observation shows that a decrease in mask use is directly related to an increase in the Covid positivity rate. Hence, the initiative will put a strong focus on ensuring mask use, hand hygiene and social distancing through household education. Community groups will be engaged in awareness activities and rapid response. In addition, local government officials, volunteers and community leaders will be empowered with knowledge on Covid-19 related issues to ensure preventive behaviours at the hotspots such as mosques, transport hubs, markets and shops. Periodic assessments will also be conducted to check the level of behavioural change in the community.
Response: Frontline health workers will lead the syndromic surveillance at the household level. BRAC’s proven community support team (CST ) model will be scaled under this initiative that will work to identify suspected Covid-19 cases by household visits with potential cases to conduct screening. Individuals matching with sets of clinical criteria will be connected to the telemedicine services for further support. These households will also receive information on home management of mild and moderate cases, possible referral points and testing facilities, quarantine protocols and best practices to prevent further spread of infection among the other household members. Follow-ups will also be conducted to ensure quarantine compliance.
Vaccination: BRAC and partners will support the local government health offices for Covid-19 vaccination registration and mobilisation. Health workers and volunteers will actively engage in addressing myths and rumours creating vaccine hesitancy at the community level. Furthermore, vaccination will also be promoted through miking and message dissemination via TV and radio channels, print and online mass media and social media.