Achieving Sustainability towards Healthcare Access (IRHSCPP) ASTHA

Bangladesh is a densely populated country where about 75% of the population lives in rural areas. Limited access to quality healthcare is one of the major problems faced by the people in rural Bangladesh. There is an acute shortage of skilled healthcare service providers in remote locations as there are only 0.58 qualified health workers per 1,000 populations (WHO standard 2.5 per 1,000 populations). Neonatal mortality is as high as 32 per 1,000 live births. Only 22% of the children receive appropriate care within 24 hours after birth. 76.6% of births still take place at home. Although the government has a wide spread network of service delivery facilities, they are not enough for this highly populated region.

In an effort to address this major gap in the national healthcare system, the Government of Bangladesh introduced a mid-level healthcare workforce named Community Paramedics (CPs). In such a context, European Union and Novartis funded project- 'Towards Sustainable Quality Healthcare Delivery at Grassroots Level through Active Participation of Civil Society Organisations' (TARSAN) - Mar 2011 - Feb 2015 - was initiated to help create access to quality healthcare services, and improve retention of healthcare workers in the rural communities through continuous policy dialogues.

The Project

Building on TARSAN's achievements, the project- Improving Rural Healthcare Service through Community Paramedic Programme, branded as ASTHA (January 2015 - December 2018), has been designed to continue with the development and integration of community paramedic services in Nilphamari, Patuakhali, and Sunamganj. Its focus will be to increase medical healthcare outreach in rural areas of Bangladesh, with special attention to Maternal and Child Health (MCH), Family Planning (FP) and Basic Primary Health Care Services. To achieve this, ASTHA targets the following interventions:

  • Enhance the capacity and service provision of Community Paramedics (CPs)
  • Develop capacity of Community Paramedic Training Institutes (CPTIs)
  • Conduct awareness building activities to promote the CP based healthcare service to rural communities
  • Sensitise various relevant government authorities about the importance of monitoring the CP based healthcare service and facilitate to establish a proper monitoring system to ensure the quality of healthcare service


By the end of the project phase (01 January 2015 - 31 December 2018), the following results are expected:

  • Child delivery by skilled health workforce will be increased by 10% in targeted regions
  • 39,000 people in the project location will receive healthcare services from skilled healthcare workforce, community paramedics
  • 180,000 community members will be informed, and they will rely on a better healthcare service through CPs and quality referral to specialist physicians in targeted locations
  • 60% of the Community Paramedics will be employed or self-employed
  • 75% of self-employed CPs' income will be increased within 2019.

Project countries

  • Bangladesh

Project duration

2017 - 2020


  • SDC
  • Novartis
  • Laguna Foundation

Working area


Swiss Foundation for Technical Cooperation
Hardturmstrasse 123
CH-8005 Zurich

Tel. +41 44 454 17 17
Fax +41 44 454 17 97