The USAID Bhitti Activity: Strengthening Local Level Health Systems in Bangladesh

Enabling a robust local health system that uses evidence-based planning, optimizes resources, is resilient, and transitions leadership to local actors.

Over the past five decades, Bangladesh has made tremendous progress in health. With support from USAID, maternal and child mortality has reduced by two-thirds and the number of births in health facilities has increased from 17 percent in 2011 to 65 percent. Despite this progress, child stunting continues to be a challenge, needs for family planning remain unmet, out-of-pocket healthcare expenditures are high, and Bangladesh is one of eight countries that account for more than two-thirds of the global tuberculosis burden.

Objective of the USAID Bhitti Activity

To expand on the country’s progress and to counter current challenges, the USAID Bhitti Activity (meaning “foundation”) supports Bangladesh in its goal of achieving universal health coverage by delivering high-performing, responsive, equitable, resilient, and adaptive services at the local level.

The USAID Bhitti Activity’s Approach to Improving Bangladesh Health Care

In close partnership with local health system actors, the USAID Bhitti Activity aims to strengthen local-level health systems to:

• Conduct evidence-based epidemiological and health system analysis as well as develop evidence-based health systems improvement plans.
• Deliver quality public health services.
• Better implement national technical and operational guidelines and strategies.
• Improve coordination between local and national health authorities to better plan for, monitor, and budget government financial resources.
• Facilitate emergency preparedness, response, and recovery.

The USAID Bhitti Activity’s Bangladesh Health Care Goals

To establish a strong local health system capable of conducting evidence-based planning, optimizing resources for planned activities, maintaining improvements, demonstrating resilience against shocks and stressors, and transitioning leadership and ownership of health sector goals to local entities, the USAID Bhitti Activity is concentrating its efforts on three key areas:

1. Cultivating and supporting local health leaders

The USAID Bhitti Activity equips local health authorities with the skills, tools, and technologies to provide enhanced technical and operational leadership within their districts or upazilas. Targeted training, combined with evidence-based and innovative governance tools, allows these leaders to improve coordination between local and national health authorities to better plan for, monitor, and budget government financial resources.

2. Improved data for decision-making

The USAID Bhitti Activity strengthens local health authorities’ capacity to capture, access, analyze, and interpret data, including from community-level sources, to better utilize resources. The activity also helps authorities use data to identify, prioritize, and better understand local climate risks that contribute to the prevalence of climate-sensitive diseases.

3. Making systems improvements at scale 

In alignment with USAID’s Vision for Health Systems Strengthening 2030, the USAID Bhitti Activity works with local leaders to apply global best practices to help address gaps in access to quality health care, including smart purchasing, enhanced funding access, digital tools, and peer-to-peer learning.

Learn more about RTI’s work in global health and in Bangladesh.