On 26 December 2017, a discussion on “Community Participation in Healthcare Services in Jhenaidah Paurashava” was held at the AID Foundation, Jhenaidah. This discussion was organized to involve local communities in program planning and execution, to ensure that healthcare strategies are suitable for and acceptable to the local community members.

Tarikul Islam Palash, CEO, AID Foundation; Dr. Rabiul Hossain, Professor, Islamic University, Kushtia; Anisur Rahman, Social Worker, Jhenaidah; Md. Saidul Karim, Mayor, Jhenaidah Purashabha; Sharifa Khatun, Director, Welfare Efforts; were among the notable attendees at the event. Dr. Md. Emdadul Haque, Senior Consultant, Gynae & Obs, Jhenaidah Hospital, a distinguished public figure in healthcare service delivery in Bangladesh, presided over the meeting. Dr. Iqbal Anwar, Scientist and Project Director, SHARE project, icddr,b, facilitated the discussion by engaging the crowd in fruitful exchange of knowledge, information and ideas on issues related to community participation in healthcare services.

Summary of the discussion:
Participation of community members in improving local healthcare institutions is an established approach in addressing healthcare issues in Bangladesh and has long been facilitated in this country, in projects varying from sanitation to maternal and child health, clean water and health infrastructure. However, the quantity and quality of involvement vary from locations to locations. Moreover, despite the disappointment of many health programs’ facilitation without the participation of target communities, healthcare professionals continue to address and discuss the importance of community members’ participating in the existing healthcare scenarios.

Though commitments to community contribution are common in healthcare in Bangladesh, yet ways to make the most of health service delivery and care remain unclear. Proper research and statistics are needed to assess the existing situation in this regard.

To be beneficial, the training of healthcare providers in district and upazilla levels should outcome in the improvement of the quality of health-related services they provide to local communities. It is also important to ensure that their helping roles in the community are not troubled by their excessive private practice schedules and political tension taking place in and around the health facilities.
Gradually it is being accepted that the constant increase in human resources and facilities in health may not essentially result in an improvement in the public health scenarios, if caregivers aren’t trained properly; and health professionals at the hospitals and clinics cannot provide timely and necessary services because of being bound to budget constraints and political restrictions.
Outcomes and recommendations:
•The multidimensional approach to healthcare development is in need. Community leaders, academics, public representatives, health professional, students and general people from all walks of life should collaborate to contribute to change the existing situation and work for betterment. Intellectuals should come up with strong public opinion and support regarding improving healthcare practices. Community involvement encourages shared responsibility by service providers, community members, and local political organizations for cultivating healthcare facilities in the community.

•Community members and doctors involved in providing healthcare in the community levels should have a positive and humanitarian attitude towards it. Ethical education and professional empathy can also pave way for better health care, especially for the members of financially challenged households living in rural and remote locations.

•When community members “own” local healthcare facilities, they often assemble resources and capital that may not otherwise be accessible and obtainable. People from all sorts of professions can work together to advocate for better programs, services and policies. It can also reduce the number of emergencies and unexpected admissions to hospitals or clinics.

•Timely support from local political communities can reduce barriers to maternal health information and services for grassroots community members and can raise responsiveness regarding patients’ right to access, information and affordable treatment. It can also increase the answerability of primary and secondary health programs in district and upazilla settings.

•Blood banks and related information database can easily be created with the help of local education institutions, which can give easy access to required fluids for patients in case of emergency. This can also be made available online.

In conclusion, public engagement of this sort reciprocally benefits all actors involved in local healthcare scenarios. By taking notes of observation, viewpoint and requirements of local community members on health issues, this discussion increased the understanding of the strengths and weaknesses of the local medical system in Jhenaidah and surrounding areas. Information exchanged in the discussion will help to modify and adapt health service delivery according to the existing and future needs of the local communities. Policies and strategies were also chalked out for the ensuing year, to promote similar successful community participation in healthcare services in other hard-to-reach areas of Bangladesh.