Making Voices Heard and Count in Bangladesh

 

The Leave No One Behind coalition in Bangladesh was founded in 2018. Since then, the country lead organisation is BRAC.

Current members (July 2024) are:

  • ActionAid Bangladesh
  • BRAC
  • CARE Bangladesh
  • CBM Bangladesh
  • Islamic Relief Bangladesh
  • Manusher Jonno Foundation
  • Save the Children Bangladesh
  • Transparency International Bangladesh
  • Plan Bangladesh
  • VSO Bangladesh

The country coalition has delivered a project, focussing on street dwellers and floating populations. Target SDG was SDG 3.8.

The scaled up project focused on the accessibility of various public programmes for marginalised groups. This included assessments of basic public health services, district-level COVID-19 responses, and cash assistance programmes. They worked with 10 different marginalised communities in 64 districts, reaching around 6,400 community members.  

The project ‘Basic Public Services for the Marginalised Groups in Bangladesh’ aimed to measure the accessibility, quality, and satisfaction of public services among marginalised communities. They conducted data collection and analysis through focus group discussions (FGDs) and key informant interviews (KIIs) in eight divisions of Bangladesh. 

Some of the key findings of the study include: 

– Marginalised groups such as Dalits, people with disabilities, sex workers and third gender people often face financial challenges, with household expenses exceeding income. 

– Discontinuation of education, especially after the COVID-19 pandemic, is common among these groups, particularly among the children of sex workers. 

– There remains a lack of awareness of government social safety net programmes, with the Dalit community being the least informed. 

– Dissatisfaction with legal aid services was particularly high among respondents. 

To address these findings, the country team produced a comprehensive report, which was disseminated nationally and consulted with policymakers and academics. The project indirectly benefited marginalised communities by raising awareness of their needs and facilitating their participation in policy-making processes. It also trained grassroots organisations to engage sensitively with marginalised groups. 

Overall, the project has successfully achieved its objectives and the aim is to expand its scope in the future by including more marginalised groups and SDG-based indicators and to develop a pilot dashboard for real-time data monitoring. 

The results of the assessments have been widely shared and discussed with district and national government leaders. In particular, the government is considering adopting the methodology in the public health sector. LNOB Bangladesh is currently negotiating an MoU with the Bangladesh Bureau of Statistics to develop a national CDD policy. 

Pilot Project Other Projects

Country PublicationsTargeted SDGs

Bangladesh Pilot

 

SDG Target

Target 3.8:

    Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

Target groups

    Street dwellers and floating populations.

How did we engage marginalised groups in SDG monitoring?

    LNOB partners undertook a desk study to identify knowledge gaps, then convened group discussions, in depth interviews and key informant interviews in 3 sites with floating populations/street dwellers, govt. and non-govt. healthcare providers and policy makers (government officials). Using these methods, the survey team collected rich qualitative data to understand the experiences of the target populations.

Ways target groups are left behind

  • Street dwellers and floating populations in Bangladesh do not have access to quality healthcare and are excluded from almost all services offered by the government of Bangladesh.
  • Living on the street prevents street dwellers and floating populations from maintaining regular hygiene practices. They have low nutritional status and spend most of their income on food. Women are more vulnerable than men in terms of safety and security.
  • Street dwellers and floating populations generally do not visit health facilities or hospitals for common illnesses. Nearby drug shops are usually the first contact point for any treatment. In severe cases, they go to the Government Medical College Hospitals.
  • Financial hardship, long hospital queues, absence of identity cards and distance from services are the main reasons why they do not seek health care.
  • While there is a limited amount of free healthcare services available, these groups are excluded due to lack of money for tests or medicine and lack of information on the free services they are able to access.

What is missed in national reporting?

  • National surveys are based on the household, so they systematically exclude street dwellers/floating populations who do not have a fixed household address.
  • More broadly, national databases do not collect and represent disaggregated data on marginalized people.
  • Existing policies have failed to address the problems of healthcare in depth and identify the needs and priorities of marginalised people.

National advocacy impact so far

    The Bangladesh national coalition has collaborated informally with UNDP and WHO for technical support and resource mobilization. It has engaged government offices, including the NGO Affairs Bureau and the Bangladesh SDG Coordinator, who attended the first annual Leave No One Behind stakeholder meeting.

Recommendations

Service provision

  • Initiate mobile health clinics through public-private partnership (PPP) model to make services available for street-dwellers in a time and place convenient for them.
  • Introduce special identity cards to ease priority access to healthcare for floating populations/street dwellers and minimize the cost, especially of diagnosis and medicines.

Programme level

  • Improve coordination of interventions for floating populations/street dwellers.
  • Organise interventions to improve safety and basic amenities for floating population/street dwellers, including night shelters; day care centres; locker services; low cost hygienic food shops; free toilets and washing facilities.
  • Develop coordinated campaigns to build the awareness of floating populations/street dwellers on the existing low-cost services provided by public and private sectors.

Policy and health system level

  • Conduct a census of the floating population/street dwellers in Dhaka and other large cities to inform policy and programme planning.
  • Implement further research on floating populations and street dwellers to find out the best model for service provision for these populations including barriers and enablers that are accessible and acceptable to them, towards achieving universal healthcare by 2030 as envisaged by the government, leaving no one behind.

Other Projects

Country PublicationsTargeted SDGs

Bangladesh Ongoing Project

Bangladesh Publications

Infographic - Basic Public Services for the Marginalised Groups in Bangladesh

This infographic visualizes the key findings and methodologies from the coalition's recent MVHC project.

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Basic Public Services for the Marginalised Groups in Bangladesh

This report highlights the key findings and methodologies from the coalition's recent MVHC project, and offers recommendations to the duty bearers to address the gaps in government services.

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Report on Citizen Scorecard Project

The report summarises the national coalition's project "Citizens’ Assessment of District Level COVID-19 Responses"

Cover image of the report from the LNOB Bangladesh coalition titled "Citizens’ Assessment of District Level COVID-19 Responses: Focus on food-cash assistance and health services for the marginalised groups"

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Infograph on Citizen Scorecard Project

Infograph on the national coalition's project "Citizens’ Assessment of District Level COVID-19 Responses"

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COVID-19 Wreaking Havoc on Bangladesh’s Poor: A Story of Food, Cash, and Health Crises

This article highlights the situation of ten marginalised groups in Bangladesh, including ethnic minorities (indigenous peoples), river gypsies, elderly people involved in begging, people living with HIV/AIDS, people living in hard-to-reach areas, sex-workers, and Dalits.

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Summary - Pilot study Bangladesh

This document outlines the findings from the Bangladesh LNOB coalition's work during the pilot phase 2018 - 2019

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Our Target SDGS in Bangladesh

Click on the SDG to reveal more information

3. Ensure healthy lives and promote well-being for all at all ages
3. Ensure healthy lives and promote well-being for all at all ages

3. Ensure healthy lives and promote well-being for all at all ages

Ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality. Major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV/AIDS. However, many more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues.

Learn more from the UN here >>

Related Bangladesh Targets

3.7

By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

3.8

Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

10. Reduce inequality within and among countries
10. Reduce inequality within and among countries

10. Reduce inequality within and among countries

The international community has made significant strides towards lifting people out of poverty. The most vulnerable nations – the least developed countries, the landlocked developing countries and the small island developing states – continue to make inroads into poverty reduction. However, inequality still persists and large disparities remain in access to health and education services and other assets.

Additionally, while income inequality between countries may have been reduced, inequality within countries has risen. There is growing consensus that economic growth is not sufficient to reduce poverty if it is not inclusive and if it does not involve the three dimensions of sustainable development – economic, social and environmental.

To reduce inequality, policies should be universal in principle paying attention to the needs of disadvantaged and marginalized populations.

Learn more from the UN here >>

Related Bangladesh Targets

10.2

By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

16. Promote just, peaceful and inclusive societies
16. Promote just, peaceful and inclusive societies

16. Promote just, peaceful and inclusive societies

Goal 16 of the Sustainable Development Goals is dedicated to the promotion of peaceful and inclusive societies for sustainable development, the provision of access to justice for all, and building effective, accountable institutions at all levels.

Learn more from the UN here >>

Related Bangladesh Targets

16.6

Develop effective, accountable and transparent institutions at all levels

16.7

Ensure responsive, inclusive, participatory and representative decision-making at all levels