COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh

KEY:
1 Not present, needs to be developed
2 Needs a lot of strengthening
3 Needs some strengthening
5 Already present/no action needed
Civil registration & vital statistics Situation analysis
Priority Actions
systems (strengths, weaknesses/gaps)
Assessment & Plan 5 A rapid assessment has been completed in 2012 by MIS, DGHS, Not applicable.
MOHFW. On the basis of the report of this rapid assessment, a full
assessment of the status and practices has been undergoing and
Coordinating Mechanism 2 the draft report of the assessment is available. Data analysis is in Establish, revitalize, reconstitute, whatever appropriate, inter-agency
limited scale and use of data are in practice partially. Quality and coordination committee at national, district, upazilla and community
completeness of data is a concern. Use of CRVS data by Health level involving all key stakeholders. Establish CRVS technical
Ministry is minimal as they use BDHS data. Duplication of reporting committee at national level with representatives from relevant
and recording by MIS unit in DGHS and DGFP. agencies. Hold regular meetings. Pilot strengthening data collection
There is coordination committees at district and divisional level for effort in project areas.
CRVS. Few official interactions between LGRD, BBS, MOHFW and
other stakeholders regarding implementation of CRVS. At the
Hospital reporting implementation level we are in process of jointly working together Establish a central team and provide training to appropriate staffs to
2 for strengthening CRVS. help improve practice of ICD 10 coding and death certification using
Recording and reporting of death is available from public facility international death certificate form, both in public and private
and national level data are available. Deaths from most of the hospitals through establishing uniform electronic recording and
Private and NGO facilities are not reported. Hospital deaths are not reporting system in hospitals from national to upazila level with
reported to MOLGRD/other relevant agency. The causes of death system of data flow to relevant national agency. Start with pilot, then
are not recorded/mentioned properly in the death register national scale-up.
following ICD 10. Accuracy, completeness and quality of recording
and reporting are not always at acceptable standard.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Community reporting 2 Community births and deaths are reported using ICT covering Strengthen community awareness on reporting of births and deaths
whole country. Maternal-Perinatal Death Review (MPDR) based on through designing efficient process flow strategies, training of
verbal autopsy without medical certification is in place in selected registrars and strengthening community reporting capacity using of
areas. Online registration of vital events are in place/progress. verbal autopsy by community workers, preferably by automation.
Resource is very minimal to conduct the verbal autopsy. Lack of
coordination between MOLGRD and Health Ministry. Both are
Vital statistics collecting data independently. (i) Data on fertility and mortality Develop a mechanism to establish interoperability between systems,
2.5
under SVRS is in place and publish every year. (ii) Several survey strengthen the analytical capacity and data quality assessment of
data on vital statistics are also generated by the MOHFW from time relevant sector (including statisticians). Create a mechanism to
to time. Quality of data is a concern. Lack of coordination between publish vital statistics (fertility and mortality) every year using SVRS
MOLGRD, BBS, MOLPA and MOHFW data. and CRVS data and simultaneously in web portal.
MPDR is in pilot phase in 4 districts and will be scaled up in another
3 districts. There are no HDSS that provide regular and timely vital
Local studies for mortality statistics including cause of death. Continues SVRS to obtain vital statistics until CRVS is complete,
2
reliable and accurate.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh

Situation analysis
Monitoring of results Priority Actions
(strengths, weaknesses/gaps)
M&E Plan 2.5 The Results framework for HPNSDP reflects the national M&E plan Review and strengthen the M&E plan for HPNSDP 2011-16 with
for RMNCH. However it is not fully comprehensive in terms of all focus on RMNCH M&E, involving all relevant stakeholders (public,
the subsectors (urban, rural; private etc.) and indicators. The M&E DPs, NGO, private, MOHFW, MOLGRDC) and various data sources
plan is aligned with MDGs, Sixth Five Year Plan and Vision 20/21 (urban, rural) and improve implementation.
plan. Data sources: SVRS, BDHS, FSNSP, MICS, HMIS, FPMIS. Collaborate with PMMU to include COIA indicators in the RFW
National level M&E Task group exists with MoHFW, DPs and indicators.
technical support agencies as members to follow up on M&E
related issues of the sector program. However it does not include
all the constituencies and is not fully functional. There is a national
M&E Coordination household survey plan (PIP HPNSDP) including timeframes for Extend membership of M&E task group as appropriate along with
2
BDHS, MICS, SVRS, UESD and BFS etc. Current national HH surveys constitution of a national M&E Technical group led by MIS-DGHS
are SVRS, HIES ,BDHS, HDS, MICS, BMMS,CES, nutrition survey involving relevant stakeholders. Facilitate holding of regular meetings
(covers both urban, rural). CES is conducted annually; BDHS and of M&E taskgroup & concerned technical group.
MICS every three years; BMMS has been conducted after more
than 10 years. However none of these include all the CoIA
indicators. BMMS 2010 and BDHS 2011 recently disseminated;
Health Surveys Next BDHS planned for 2014. MICS 2013 is underway. HMIS and Strengthen the national household survey plan (DHS) under HPNSDP
2.5 FPMIS are in place and data and reports are available on the web. 2011-16 along with inclusion of COIA indicators and to develop for 10
Coordination and harmonization of RMNCH indicators across years; Improve GO-NGO collaboration for regular reporting of
public, NGO and private sectors is absent and duplication of data population based data. Consider inclusion of SARA framework in next
exist in all the systems. Bangladesh Facility Surveys are carried out Bangladesh Health Facility Survey.
every 2 to 3 years.

Facility data (HMIS) 2 Develop a comprehensive integrated national MIS (across all the
MOHFW directorates, MOLGRDC, NGO, Private, Birth & death
registration project); establish interoperability through adoption of
health data standards. Review and align RMNCH indicators within
relevant OPs of HPNSDP with COIA. Build consensus through M&E
Technical Group with all the stakeholders (public, private, NGOs,
urban, rural) to align the RMNCH indicators (common definitions and
set of indicators) and harmonize parallel data reporting.

Undertake SARA in 150 sample sites, carryout data quality

assessments and feed reports to the annual review. Scale up SARA to
all facilities by 2015. Update existing inventory tool of DGHS in
consideration of the SARA tool. Using this tool, conduct facility
inventory to determine the coverage of IT infrastructure, data
reporting systems and human resources. (NOTE: this activity is
comprehensive and will take into account all components necessary
for assessing the eHealth readiness for COIA implementation).
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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
National survey reports (BDHS, CES of EPI, MICS, BMMS, SVRS)
Analytical capacity including analysis of the data are available. Annual and mid term Strengthen capacity of managers and MIS personnel at all levels, for
2 review reports, HMIS and FPMIS reports and monthly newsletter, analysing routine data including equity analysis, by engaging relevant
DP supported project review reports exist. However these may not and credible national and international institutions where necessary.
have adequate data analysis and there is paucity of qualitative Conduct national workshop to implement WHO analytical tools.
data. Sub-national managers have limited skill to interpret the Include detail analysis (including sub-national and equity data) in all
data. Disaggregated health data on key indicators is used as national survey and review reports.
needed. Sex, age, socioeconomic tracers, geographical
(urban/rural/municipality/other urban) are available in the national
surveys related to health, population and nutrition. Annual reports
Equity 2 have limited data on equity e.g data for slums. Minority by Include data on equity in surveys/reviews/routine MIS/NGO and
ethnicity is not included. National health data repository does not private facility report as much as possible. Increase use of equity
exist. Data are maintained by different ministries and entities (BBS, data for policy planning and programme progress tracking by
MoP, NIPORT, HMIS/DGHS, FPMIS/DGFP). BDHS covers only strengthening capacity of relevant officials. Implement WHO equity
national and divisional level data. MICS, SVRS, HIES, CES data analyzer if possible.
include district level data. Only SVRS, MICS and DGHS & DGFP MIS
reports are available on line.
Data sharing 2.5 Establish an up-to-date national data repository that will eventually
cover entire health sector performance including public, NGO and
private and make available on-line. Using WHO's Regional Health
Observatory (RHO) platform, develop Bangladesh National Health
Observatory (NHO).

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh

Maternal death surveillance & Situation analysis

Priority Actions
response (strengths, weaknesses/gaps)
Notification 1 There is a national policy to report all deaths that include maternal Develop national strategic guideline on maternal death notification.
death, under MoLGRD. There is no separate policy under
MoH&FW/or other Ministry for MPD registration and notification
within 24 hours. Pilot intervention on MPDR is ongoing in two
districts by DGFP and in four districts by DGHS/DGFP. BRAC and GK
Capacity to review and act 1 Strengthen national capacity through training in MDSR.
are working on MPDR. T. Capacity to review, analyse and formulate
action is limited as the pilot interventn has started in 2009/2010. Strengthen district capacity through training in MDSR also with
The districts, under pilot interventions, have basic understanding optimization through cooridination with research institutes and
about the MPDR. MPDR district committees conducted fact finding multistakeholders participation.
rather falt findings and actions were taken accordingly. Hospital
recording and reporting on maternal death within 24 hours exist.
The causes of death are mentioned, however not in line with ICD-
Hospitals/facilities 1 Improve reporting by hospitals (both by public and private);
10. The reporting mechnism varies and availabe only in pilot
Strengthen capacity through provision of training in ICD certification
districts. The review takes place only at public health facilitites in
and coding (links with CRVS) for the service providers both in public
pilot districts. The strategy and guideline to carry out the review
and private health facilities along with a system for review and
has not yet been developed. The system for quality of care
response.
assessment is ongoing only in limited facilities in pilot districts.
Different methodologies and tools are being applied for QII and
there is no coordination among partners. The one national tool for
QoCA is not available. The system for community maternal deaths
Quality of care 2 within 24 hours exists only in pilot districts. The reporting is in Support a regular system of QoC (Quality of Care) assessment along
manual method and ICT based reporting has not yet been with dissemination of results for policy and planning.
introduced. Verbal autopsies are ongoing in pilot districts only.
There is no community feedback mechanism. Does not exist for
Community reporting & feedback 1 nationwide and as part of national policy. Develop and strengthen a community system including strengthening
verbal autopsy for maternal death reporting, review and response
preferably using ICT with in-built mechanism for providing feedback
to community.

Review of the system 1 Institutionalize national maternal death surveillance and review.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Situation analysis
Innovation and eHealth Priority Actions
(strengths, weaknesses/gaps)
Policy 1 A national e-health committee has been formed. No national Complete development of a Bangladesh MoHFW eHealth Strategy
eHealth strategy exists. However, there are National ICT policy and document, under the direction of National eHealth Steering
National Health Policy which cover some aspects of eHealth. The Committee that accounts for innovation in collection & management
MoHFW administered health facilities of the rural areas have of data in all aspects of health sector, including COIA thematic areas.
internet connectivity. In rural areas, all community clinics (about
18,000) will be connected before July 2013 and all health assistants
Infrastructure (community health workers) will be given hand held Internet Update existing inventory tool of DGHS in consideration of the SARA
2.5 devices before 2014. However, internet connectivity for health tool. Using this tool conduct facility inventory to determine the
facilities in urban areas including city corporations is being coverage of IT infrastructure, data reporting systems and human
provided by MOLGRD. There is limited or no information available resources. (NOTE: this activity is comprehensive and will take into
for health facilities serviced by private sector. Using DHIS2, HMIS account all components necessary for assessing the eHealth
data (aggregated) are being collected from facilities located at readiness for COIA implementation).
districts and sub-districts as well as from some National level
facilities. Below sub-district level, the HMIS data are being
collected manually (paper-based) which later are incorporated into
electronic system. Electronic patient records (using OpenMRS) at
Services 2 the point of clinical care will be piloted in three tertiary level Conduct pilot activities in selected community clinics to review and
hospitals. Efforts are underway to improve population based consolidate data related to MNCH from existing routine data
MNCH data collection in select community clinics. Several mHealth- collection efforts of DGHS, DGFP, CC, NGO and private workers; and
services from the non-government sectors are underway including update DHIS2; Use the result to amend the current HMIS form to
pregnancy risk categorization using mobile phones, MAMA etc. include all the COIA related indicators which are being collected by
Effective data sharing between systems are lacking, largely due to the above mentioned agencies. Include in eHealth strategy specific
lack of standardized data systems. However, NGO's and private data-sharing mechanism within different systems.
sector facilities will be installing DHIS2 for reporting routine HMIS
data. DGFP has an web based LMIS system for the inventory of
birth control materials. Currently FWA are collecting house-hold
level detailed information which is paper based only. MoLGRD & C
are conducting web based birth & death registration at union
(through Union Parishad) levels. There is no commonly agreed
Standards 2 standards for interoperability of eHealth services. However, there Establish standards-based common platform for COIA related data
are few standard-based national registries developed by DGHS. A collection and management through eHealth steering committee.
national eHealth Steering Committee has been set up with the
Senior Secretary of the MOHFW as the chair. Representatives of
other stakeholder ministries, agencies, NGOs and private
Governance organizations are members of the committee. Other initiatives also Facilitate process for regular meeting of eHealth steering committee.
2.5
exist to improve coordination. However, the progress needs to be
expedited. There is no regulatory framework and legislation policy.
Protection 1 Develop national guidelines for implementation of data privacy,
security and confidentiality at all levels as part of the National
eHealth strategy, privacy, security and confidentiality of data.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Situation analysis
Monitoring of resources Priority Actions
(strengths, weaknesses/gaps)
National health accounts 2 So far 3 rounds of National Health Accounts have been done (1998, Institutionalize, from 2013 onwards, resource tracking as a routine
2003 and 2010). In the third round BNHA frame work was built process for monitoring resources in the health sector, using the
upon SHA 1.0. For the fourth round onward the BNHA frame work institutionalization work plan already developed.
is being updated following SHA 2011. The ongoing NHA will include
disease specific accounts (DSA). Make provision for making RMNCH as a focal topic.
There is a mechanism to review the budget implementation at the
policy level (task force at the ministerial level within Ministry of
Health and Family Welfare among the Line Programmes). The
Compact 2 system of resource tracking is in place and regularly being Bring up the issue through subgroup led by HEU at LCG-Health to
monitored, however, the capacity of compilation and efficient further promote the issue among DPs.
resource flow and RMNCH need further strengthening in order to
establish the governance mechanism. System for donor
expenditure (RPA) reporting by health sector programme
operational plans is in place, however DPA expenditure reporting
needs to be strengthened on regular basis.
Implementation/enforcement by MoHFW needs improvement
(donor compliance still weak).

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Coordination 5 Steering Committee headed by the Senior Secretary, stakeholder No additional action is necessary regarding the NHA steering
coordination committee and technical working committee steer committee that provides technical oversight on data needs, methods
the NHA efforts in country. Additionally, Bangladesh NHA cell led of production and data use.
by Health Economics Unit (includes institutional partners such as Organise NHA related hands on training for BNHA cell members and
Institute of Health Economics, Bangladesh Bureau of Statistics, HEU (including capacity building/fellowship of IHE students through
ICDDR,B and Data International) is given responsibility to collect, internships at BNHA cell).
analyse and produce the BNHA.. Capacity at national level is almost
available. However, capacity building for the Govt. health
Production managers and concerned officials particularly national and Further strengthen capacity of national level government staffs to
1
subnational level is necessary. Government expenditure data use NHA data for policy making and programming needs.
conversion into NHA format, including for expenditure by
beneficiaries is not fully automated. The automation process needs Sensitize and aware the relevant stakeholders on Resource Tracking
to be strengthened. NHA Data repository needs to be established Tool as a regular practice. Develop blueprint to lead to the
within HEU. NHA prior to this was based on SHA 1. Reports are implementation of the tool.
already available in public domain (www.heu.gov.bd). Besides, Keep a central database for automated production of standard NHA
hard copies are distributed among the stakeholders. First 3 rounds tables in view, including tables by beneficiaries; automated
of NHA using SHA 1.0 was essential for health sector reviews (APR, production of key indicators (including COIA indicators); methods
MTR) and policy making (Health Policy, Health Sector Programme and sources should be well documented and accessible. Depending
Documents). on resource tracking tool adoption, strengthen of HEU capacity.

Analysis 3 Adopt in NHA post-2013 SHA 2011. Make available RMNCH

subaccounts after next round of BNHA.
Continue dissemination of NHA to wide audience through upgrading
the website.

Data Use 2 Continue advocacy and promotion for use of NHA data in policy
making.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Situation analysis
Review processes Priority Actions
(strengths, weaknesses/gaps)
Reviews 2 The Annual Program Review (APR) with stakeholders take place Make inventory of all relevant public and private stakeholders
annually. Partial involvement of the stakeholders. Independent related to RMNCAH activities.
review by third party is in place. Key stakeholders are involved in Liaise with PMMU and Planning unit of MOHFW for holding national
annual sector program review process, however participation by stakeholders sensitization meeting(s).
pvt sector and civil societies are limited. Hold expert consultation meeting to integrate RMNCAH (COIA)
indicators into routine APR. Facilitate for conducting annual quality
There is no separate/independent annual programme review for review exercise.
RMNCH. MNCA&H Task group reviews the progress as part of APR,
Synthesis of information & policy context not as separate review for RMNCH only. Source and generation of Strengthen monitoring exercises to improve data availability and
2.5
data is not always accurate. Lack of analytic capacity at subnational reliability.
level. Recent data for national and subnational level analysis are
available from HMIS and LMIS.
From review to planning 2.5 Organize workshop to develop single M&E framework for program
implementation.
Qualitative data were analysed in APR and recommendations made
for corrective actions. Qualitative data is not generated from all
Compacts or equivalent mechanisms 2 relevant stakeholders. The system is in place to take actions of APR Organize a national orientation program to ensure that the RMNCAH
recommendations. However, not all recommendations were appraisals are held and that findings feed into the health sector
translated into actions. reviews.

MoH&FW conducts annual review of Operational Plans. There is

active participation of key stakeholders. However, wider
stakeholders participation is limited. Agreement between
development partners and Govt was signed but duplication of fund
pulling and programme intervention is still a challenge.

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 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Bangladesh
Situation analysis
Advocacy & outreach Priority Actions
(strengths, weaknesses/gaps)
Parliament active on RMNCH issues 1 There is a well functioning Parliamentary Standing Committee on Form an all party parliamentary caucus on RMNCH to facilitate
Health chaired by an influential Member of Parliament. members of the caucus work with parliamentary standing
Parliamentary Standing committee is playing important role in committees on health and women affairs. Establish a coordination
moving forward the agenda of Universal Health Coverage. The mechanism to work with the caucus and other stakeholders.
committee includes several medical doctors. A all party
parliamentary caucus on Maternal and newborn health is on the
Civil Society Coalition process of being formed. There is also a national chapter of an Create relationship with the civil society coalitions with a view to
2 international advocacy network focused on maternal and newborn inclusion of RMNCH issues in their agenda. Coordinate with national
issues which looks into the accountability of the policy makers and maternal health and child health strategy working group for inclusion
law makers (White Ribbon Alliance). of COIA recommendations in their respective agenda. Develop
Currently, few civil society organizations exist. Among them the appropriate advocacy message and dissemination strategy.
prominent coalitions are Health Rights Movement Bangladesh,
Bangladesh Base of Peoples Health Movement, Bangladesh Health
Watch and White Ribbon Alliance Bangladesh and few others.
Among them the white ribbon alliance is working exclusively to
promote safe motherhood and newborn health and could play a
critical advocacy role. Health needs to be viewed through a human
Media role 2 Undertake appropriate program to sensitize the media on the
rights lens. Health rights campaigns are not adequate.
importance of RMNCH. Help building capacity of the local journalists
Reporting on health related issues are increasing day by day. There
and engage them to report and work as watch dog on RMNCH
are few prominent health journalists in the country who writes
related issues along with updating them on the current problems and
quality health reports. There is also a coalition of health reporters
advancement in RMNCH.
by the name of Health Reporters Union. White Ribbon Alliance
already has members who are prominent journalists. Health issues
are not prioritized by the media houses. Updated information are
Countdown event for RMNCH 1 not released to the journalists on systematic basis. Limited scope Organize with help from RMNCH advocacy forum and other national
for career development in health reporting. and international stakeholders annual countdown event in 2014.
No count down event on RMNCH issues are currently held. Publish an Annual Countdown Report during the annual count down
However there are a few events focusing on maternal and child event.
health are organized every year ( Beast feeding week, national safe
motherhood day, world health day, international day of the
midwives, international women's day, etc.).

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)

Finalize the Strategic Action Plan of 1 Finalize the Strategic Action Plan for MIS-DGHS, BBS, BRP-MOLGRD MOHFW, x $5,000 $5,000 $0 Not applicable
CRVS and then implement. CRVS in national stakeholders and MOLGRD, UNICEF,
make it ready for implementation. DPs, NGOs

Establish, revitalize, reconstitute, 1 Hold multi-stakeholders MIS-DGHS Relevant partner X x x $19,500 $7,500 $12,000 To be explored
whatever appropriate, inter-agency coordination committee meetings at organizations
coordination committee at national, national and local level. Introduce
district, upazilla and community monitoring and tracking system for
level involving all key stakeholders. data collection for scaling up upon
Establish CRVS technical committee success.
at national level with
representatives from relevant
agencies. Hold regular meetings.
Pilot strengthening data collection
effort in project areas.

Establish a central team and provide 2 Continue ICD-10 capacity building MIS-DGHS MOHFW, x x x $521,000 $1,000 $520,000 To be explored
training to appropriate staffs to help initiative with TA from WHO. MOLGRD, WHO,
improve practice of ICD 10 coding Provide training on ICD-10 to UNICEF
and death certification using relevant staffs in pilot areas from
international death certificate form, resource of catalytic fund. [The
both in public and private hospitals electronic reporting system is
through establishing uniform addressed in eHealth section]
electronic recording and reporting
system in hospitals from national to
upazila level with system of data
flow to relevant national agency.
Start with pilot, then national scale-
up.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Strengthen community awareness 3 Identify short list of variables for MIS-DGHS, BRP-MOLGRD MOHFW, X X X $850,000 $5,000 $845,000 Local resources,
CIVIL
on REGISTRATION
reporting of births and deaths AND VITAL STATISTICS SYSTEMS
birth and death reporting (health (CRVS) MOLGRD, UNICEF, other DPs
through designing efficient process data standards). Provide training to WHO, NGOs
flow strategies, training of registrars community health workers, and to
and strengthening community birth & death registrars on
reporting capacity using of verbal registration process, verbal autopsy,
autopsy by community workers, recording and electronic updating
preferably by automation. (initially in pilot areas and to scale
up later nationally).

Develop a mechanism to establish 2 Addressed in monitoring of results Not applicable

interoperability between systems, section
strengthen the analytical capacity
and data quality assessment of
relevant sector (including
statisticians). Create a mechanism
to publish vital statistics (fertility
and mortality) every year using
SVRS and CRVS data and
simultaneously in web portal.

Continues SVRS to obtain vital 2 Continue collection of VS by BBS BBS NA Not applicable
statistics until CRVS is complete, through existing system
reliable and accurate.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
MONITORING AND VITAL STATISTICS SYSTEMS (CRVS)
OF RESULTS

Review and strengthen the M&E 1 Review M&E component, revise MIS-DGHS, PMMU, GIZ MOHFW, DGHS, X x x $120,000 $4,500 $115,500 To be explored
plan for HPNSDP 2011-16 with focus according to WHO/IHP+ guidance. DGFP, MOLGRDC,
on RMNCH M&E, involving all Hold two national consultative DP (M&E TG
relevant stakeholders (public, DPs, workshops in 2013. members), NGOs,
NGO, private, MOHFW, MOLGRDC) WHO
and various data sources (urban,
rural) and improve implementation.

Collaborate with PMMU to include 1 Conduct advocacy and MIS-DGHS, , PMMU, GIZ MOHFW, x $6,000 $6,000 $0 Not applicable
COIA indicators in the RFW communications preceded by a MOLGRD, DPs,
indicators. national workshop to prepare NGOs
advocacy materials.
Extend membership of M&E task 1 Hold meetings with policy makers to MIS-DGHS, PMMU, GIZ MOHFW, DGHS, x x x $6,500 $2,000 $4,500 To be explored
group as appropriate along with identify needs for integration in DGFP, MOLGRDC,
constitution of a national M&E policy process. DPs, NGOs,
Technical group led by MIS-DGHS
involving relevant stakeholders.
Facilitate holding of regular
meetings of M&E taskgroup &
concerned technical group.

Strengthen the national household 1 Link national HH surveys with NIPORT, BBS DGHS, DGFP, x x x $45,000 $0 $45,000 Implementing
survey plan (DHS) under HPNSDP National Statistical Plan, mapping all NIPORT, DPs agencies
2011-16 along with inclusion of health surveys. Liaise with MICS, (USAID), ICDDRB,
COIA indicators and to develop for DHS, raise funding, determine NGOs, BBS, WHO
10 years; Improve GO-NGO contents. SARA is addressed in
collaboration for regular reporting Monitoring of Results section.
of population based data. Consider
inclusion of SARA framework in next
Bangladesh Health Facility Survey.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Develop a comprehensive 1 Dialogue with experts from public MIS-DGHS MOHFW, x $128,000 $128,000 $0 Not applicable
CIVIL REGISTRATION
integrated national MIS (across all AND VITAL STATISTICS
and private sectorsSYSTEMS
(2 workshops).(CRVS) MOLGRD, MOPL,
the MOHFW directorates, Customization of DHIS 2.x and DPs, NGOs, Private
MOLGRDC, NGO, Private, Birth & OpenMRS for collection of data sectors
death registration project); based on COIA indicators and
establish interoperability through development of eHealth enterprise
adoption of health data standards. architecture.
Review and align RMNCH indicators
within relevant OPs of HPNSDP with
COIA. Build consensus through M&E
Technical Group with all the
stakeholders (public, private, NGOs,
urban, rural) to align the RMNCH
indicators (common definitions and
set of indicators) and harmonize
parallel data reporting.

1 Holding bi-weekly meetings in pilot MIS-DGHS MOHFW, NGOs x $24,000 $18,000 $6,000 To be explored
areas through GO-NGO
collaboration for improved
collection of data on COIA
indicators. Institutionalize a central
mechanism for monitoring of data
collection, review, analysis &
feedback.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Undertake SARA in 150 sample 1 Plan sample survey of facility (about PMMU, MIS-DGHS WHO, RCBHCIB, x x x $258,500 $8,500 $250,000 Partners
CIVIL
sites, REGISTRATION
carryout data quality AND VITAL STATISTICS
100) prior to reviewSYSTEMS
using WHO (CRVS) DGHS, DGFP,
assessments and feed reports to the standard instrument. Use WHO BRAC, PLAN, SCF,
annual review. Scale up SARA to all analytical approach including data ICCDRB, UNICEF,
facilities by 2015. Update existing quality score card analysis. UNFPA, giz, JICA
inventory tool of DGHS in Meanwhile conducting SARA
consideration of the SARA tool. (Service Availability and Readiness
Using this tool, conduct facility Assessment Study) in pilot area by
inventory to determine the catalytic fund.
coverage of IT infrastructure, data
reporting systems and human
resources. (NOTE: this activity is
comprehensive and will take into
account all components necessary
for assessing the eHealth readiness
for COIA implementation).

Strengthen capacity of managers 1 WHO analysis and data quality tools MIS-DGHS, MIS-DGFP MOHFW, WHO, x x x $100,000 $0 $100,000 To be explored
and MIS personnel at all levels, for used (including equity analyzer), UNICEF, GIZ
analysing routine data including introduced through a national
equity analysis, by engaging workshop. TA by WHO.
relevant and credible national and
international institutions where
necessary. Conduct national
workshop to implement WHO
analytical tools. Include detail
analysis (including sub-national and
equity data) in all national survey
and review reports.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Include data on equity in surveys/ 2 Technical assistance and training on HEU MOHFW, WHO, X X x $100,000 $0 $100,000 To be explored
CIVIL routine
reviews/ REGISTRATION
MIS/NGO and AND VITAL STATISTICS SYSTEMS
equity analyses. Disaggregated (CRVS)
data WB, ADB, GIZ
private facility report as much as collection.
possible. Increase use of equity data
for policy planning and programme
progress tracking by strengthening
capacity of relevant officials.
Implement WHO equity analyzer if
possible.

Establish an up-to-date national 2 Technical assistance, national and MIS-DGHS MOHFW, x x $160,000 $0 $160,000 MOHFW, WHO,
data repository that will eventually regional observatory approaches, MOLGRD, BBS, WB
cover entire health sector WHO analysis and data quality tools. WHO, UNICEF, GIZ,
performance including public, NGO WB
and private and make available on-
line. Using WHO's Regional Health
Observatory (RHO) platform,
develop Bangladesh National Health
Observatory (NHO).

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
MATERNAL AND VITAL STATISTICS
DEATH SURVEILLANCE SYSTEMS (CRVS)
AND RESPONSE

Develop national strategic guideline 1 National consultant (4 man- MIS-DGHS BBS, MOLGRDC, 17500 $7,500 $7,500 $0 Not applicable
on maternal death notification. months). National consensus JICA, WHO, NGOs,
workshop to finalize the strategic UNICEF
guidelines. Preparation, printing and
distribution of guidelines.

Strengthen national capacity 1 National Capacity building MIS-DGHS WHO, UNICEF, JICA x $20,000 $0 $20,000 To be explored
through training in MDSR. workshops. Pilot in 2 districts, then
scale-up.
Strengthen district capacity through 1 District capacity building workshops. MIS-DGHS WHO, UNICEF, X X $60,000 $0 $60,000 To be explored
training in MDSR also with Develop a coordination mechanism JICA, ICDDRB, BIDS
optimization through coordination with research institutes and other
with research institutes and stakeholders.
multistakeholders participation.

Improve reporting by hospitals 3 Training of hospital staffs in ICD and MIS-DGHS WHO, UNICEF, X x $11,000 $0 $11,000 To be explored
(both by public and private); coding (link with CRVS) along with JICA, ICDDRB, BIDS
Strengthen capacity through routine reviews and audits.
provision of training in ICD
certification and coding (links with
CRVS) for the service providers both
in public and private health facilities
along with a system for review and
response.

Support a regular system of QoC 3 Technical assistance and training for MIS-DGHS MOP, WHO, JICA, x $5,000 $0 $5,000 To be explored
(Quality of Care) assessment along facility assessment UNICEF
with dissemination of results for
policy and planning.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Develop and strengthen a 2 Pilot regular review system of MDSR MIS-DGHS MOHFW, BBS, X x x $33,000 $12,000 $21,000 To be explored
CIVIL REGISTRATION
community system including AND VITAL STATISTICS SYSTEMS
inclusive of verbal autopsy in (CRVS) WHO, JICA, UNICEF
strengthening verbal autopsy for community (workshops & training in
maternal death reporting, review pilot areas). Introduce community
and response preferably using ICT reporting using ICT. Develop system
with in-built mechanism for for review and feedback.
providing feedback to community.

Institutionalize national maternal 2 Human resource and secretarial MIS-DGHS MOHFW, X X X $42,000 $8,500 $33,500 To be explored
death surveillance and review. assistance initially for six months MOLGRDS, MOPL,
and extension thereafter. WHO, UNICEF, DPs

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
INNOVATION AND VITAL STATISTICS SYSTEMS (CRVS)
AND E-HEALTH

Complete development of a 1 Hiring consultancy service for MIS-DGHS MOHFW, X $12,500 $12,500 $0 Not applicable
Bangladesh MoHFW eHealth eHealth strategy and guideline MOLGRD, MOPL,
Strategy document, under the (please see below) development; DPs, NGOs, Private
direction of National eHealth printing and distribution of eHealth sectors
Steering Committee that accounts strategy and guideline.
for innovation in collection &
management of data in all aspects
of health sector, including COIA
thematic areas.

Update existing inventory tool of 1 Addressed under Monitoring of Not applicable

DGHS in consideration of the SARA Results section
tool. Using this tool conduct facility
inventory to determine the
coverage of IT infrastructure, data
reporting systems and human
resources. (NOTE: this activity is
comprehensive and will take into
account all components necessary
for assessing the eHealth readiness
for COIA implementation).

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Conduct pilot activities in selected 1 Conduction of data collection efforts MIG-DGHS UNICEF, WHO, X $2,000 $2,000 $0 Not applicable
CIVIL REGISTRATION
community clinics to review and AND VITAL STATISTICS SYSTEMS
in pilot areas (includes (CRVS)
6 workshops) RCBHCIB, DGHS,
consolidate data related to MNCH DGFP, BRAC, PLAN,
from existing routine data collection SCF, ICCDRB,
efforts of DGHS, DGFP, CC, NGO and UNFPA,
private workers; and update DHIS2;
Use the result to amend the current
HMIS form to include all the COIA
related indicators which are being
collected by the above mentioned
agencies. Include in eHealth
strategy specific data-sharing
mechanism within different
systems.

Establish standards-based common 1 Addressed under Monitoring of Not applicable

platform for COIA related data results
collection and management
through eHealth steering
committee.
Facilitate process for regular 1 Hold regular meeting of eHealth MIS-DGHS MOHFW, x x x $10,000 $0 $10,000 MOHFW-SWAp, RF
meeting of eHealth steering Steering Committee MOLGRD, MOPL,
committee. DPs, NGOs, Private
sectors
Develop national guidelines for 1 Addressed above.
implementation of data privacy,
security and confidentiality at all
levels as part of the National
eHealth strategy, privacy, security
and confidentiality of data.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
MONITORING AND VITAL STATISTICS SYSTEMS (CRVS)
OF RESOURCES

Institutionalize, from 2013 onwards, 1 Implement roadmap for resource HEU NA x x x To be done from
resource tracking as a routine tracking. HEU regular
process for monitoring resources in resource
the health sector, using the
institutionalization work plan
already developed.

Make provision for making RMNCH 1 Hold workshops to build consensus MIS-DGHS, HEU HEU, DPs, NGOs x $6,000 $6,000 $0 Not applicable
as a focal topic. on developing a model of resource
tracking for RMNCH. Develop tools
for resource tracking through
outsourcing.

Organise NHA related hands on 1 Provide hands on training for BNHA HEU NA x $15,000 $0 $15,000 HEU
training for BNHA cell members and cell members.
HEU (including capacity
building/fellowship of IHE students
through internships at BNHA cell).

Further strengthen capacity of 1 Provide training on NHA and RT HEU NA x x x $15,000 $0 $15,000 HEU
national level government staffs to methods.
use NHA data for policy making and
programming needs.

Sensitize and aware the relevant 2 Hold workshops and seminars and HEU NA x x x $5,000 $0 $5,000 HEU
stakeholders on Resource Tracking knowledge management.
Tool as a regular practice. Develop
blueprint to lead to the
implementation of the tool.

Keep in view, depending on 2 Review RT tools by BNHA cell HEU NA x x x HEU regular
resource tracking tool adoption, budget
strengthening need of HEU capacity.

Adopt in NHA post-2013 SHA 2011. 2 Update BNHA framework to migrate HEU NA x As above
Make available RMNCH from SHA 1 to SHA 2011
subaccounts after next round of
BNHA.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Continue dissemination of NHA to 2 Establish central website for HEU NA X $1,000 $0 $1,000 HEU
CIVIL
wide REGISTRATION
audience through upgrading AND VITAL STATISTICS SYSTEMS
dissemination of results (links with(CRVS)
the website. national observatory)

Continue advocacy and promotion 2 Hold meetings with policy makers to HEU x x $3,000 $0 $3,000 HEU
for use of NHA data in policy identify needs and integration of
making. NHA data in policy process

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
REVIEW PROCESSES AND VITAL STATISTICS SYSTEMS (CRVS)

Make inventory of all relevant 1 Addressed in advocacy & outreach Not applicable
public and private stakeholders
related to RMNCAH activities.

Liaise with PMMU and Planning unit 1 Conduct communication with MIS-DGHS, PMMU, GIZ PMMU, DPs, NGOs x Not applicable
of MOHFW for holding national PMMU & Planning Wing of MOHFW
stakeholders sensitization
meeting(s).

Hold expert consultation meeting to 1 Organize one consultation MIS-Health PMMU, DPs, NGOs $1,000 $1,000 $0 Not applicable
integrate RMNCAH (COIA) indicators workshop.
into routine APR. Facilitate for
conducting annual quality review
exercise.

Strengthen monitoring exercises to 2 Hold workshop. PMMU DGHS, DGFP, x x $9,000 $0 $9,000 To be explored
improve data availability and NIPORT, DPs
reliability. (USAID), ICDDRB,
NGOs, BBS, WHO

Organize workshop to develop 2 Hold workshop. PMMU DGHS, DGFP, $1,500 $0 $1,500 To be explored
single M&E framework for program NIPORT, DPs
implementation. (USAID), ICDDRB,
NGOs, BBS, WHO

Organize a national orientation 2 Hold orientation program. PMMU DGHS, DGFP, $3,000 $0 $3,000 To be explored
program to ensure that the NIPORT, DPs
RMNCAH appraisals are held and (USAID), ICDDRB,
that findings feed into the health NGOs, BBS, WHO
sector reviews.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance

CIVIL REGISTRATION
ADVOCACY AND VITAL STATISTICS SYSTEMS (CRVS)
& OUTREACH

Form an all party parliamentary 1 Hold advocacy meeting with MIS-DGHS MOHFW, x $24,000 $3,500 $20,500 Not applicable
caucus on RMNCH to facilitate selected group of parliament MOLGRD, BBS,
members of the caucus work with members. Engage White Ribbon WHO, UNICEF, GIZ,
parliamentary standing committees Alliance to mobilize/organize WB, DPs, WRA,
on health and women affairs. RMNCH Forum. NGOs
Establish a coordination mechanism
to work with the caucus and other
stakeholders.

Create relationship with the civil 1 Organize meetings with civil society MIS-DGHS MOHFW, x x x $14,000 $0 $14,000 To be explored
society coalitions with a view to coalitions, and with maternal health MOLGRD, BBS,
inclusion of RMNCH issues in their strategy and child health strategy DPs, NGOs, WRA
agenda. Coordinate with national working groups.
maternal health and child health
strategy working group for inclusion
of COIA recommendations in their
respective agenda. Develop
appropriate advocacy message and
dissemination strategy.

Undertake appropriate program to 1 Liaise with print and electronic MIS-DGHS MOHFW, x x x $120,000 $11,500 $108,500 To be explored
sensitize the media on the media. Organize capacity building MOLGRD, BBS,
importance of RMNCH. Help workshops for the journalists to DPs, NGOs, WRA
building capacity of the local write reports on RMNCH issues.
journalists and engage them to Hold meetings for frequent updating
report and work as watch dog on of the media.
RMNCH related issues along with
updating them on the current
problems and advancement in
RMNCH.

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COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Bangladesh

Priority areas/activities Priority Approach/actions Lead govt/ national Partners 2012 2013 2014 2015 Total 2012/13 Unfunded Potential
(1-2=high, institute Estimated Catalytic balance sources for
2=medium, Cost per funding funding unmet
3=low) action balance
Organize with help from RMNCH 2 Hold multiple preparatory meetings MIS-DGHS MOHFW, x x x $50,000 $0 $50,000 To be explored
CIVIL forum
advocacy REGISTRATION
and other nationalAND VITAL STATISTICS SYSTEMS
with relevant stakeholders to (CRVS) MOLGRD, BBS,
and international stakeholders develop and implement Annual DPs, NGOs, WRA
annual countdown event in 2014. Countdown event and publish an
Publish an Annual Countdown Annual Countdown Report during
Report during the annual count the event.
down event.

TOTALS 2,814,000 250,000 2,564,000 -

Needs Catalytic request Unfunded balance

CRVS $1,395,500 $18,500 $1,377,000
Monitoring of results $948,000 $167,000 $781,000
MDSR $178,500 $28,000 $150,500
eHealth & Innovation $24,500 $14,500 $10,000
Monitoring of resources $45,000 $6,000 $39,000
Reviews $14,500 $1,000 $13,500
Advocacy $208,000 $15,000 $193,000
TOTAL $2,814,000 $250,000 $2,564,000

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