High-quality healthcare services in rural areas (IRHSCPP) ASTHA

In Bangladesh, around 47 million people still live below the poverty line. In the future, too, the significant lack of high-quality and affordable healthcare services as well as trained personnel in the health sector will pose a great challenge. The situation is particularly critical in rural areas where the majority (75%) of the population lives. The well trained physicians and caregivers work in urban centres and for the most part are not quite ready to provide care to the local population in remote areas.

The project fosters health knowledge in the population and motivates young adults to participate in a two-year course for skilled health workers (community paramedics) who are desperately needed in rural areas and can provide first-line medical assistance. After completing the training course, the community paramedics will be able to diagnose and treat both frequent and relatively uncomplicated diseases. In addition, they will be able to provide professional support during pregnancies and assistance during births. As independent professionals (e.g. private practices and community pharmacies) or employees at local clinics and health centres, they can provide their services to the rural population.

Swisscontact is working closely with local training institutions to ensure they can provide high-quality training to health workers and comprehensive support to graduates in their efforts to find jobs in their home communities.

The Project

Project activities

  1. Strengthening training institutes and training young adults
    Young men and women from the rural project regions undergo two years of classroom-based training and a six-month internship at a health centre, during which time they learn medical skills. Swisscontact helps local training institutions to upgrade their training curricula and teaching methodologies, as well as to structure their management more efficiently while fostering active exchange with local and national health authorities.
  2. Market development for local skilled health workers
    Together with local doctors and health centres, the project is building a referral system so that patients of health professionals can consult other qualified specialists when needed.
  3. Informing the population
    People living in the project districts can participate in information events, marketplace meetings, and theatre productions on topics such as nutrition, hygiene, and health. Swisscontact is working together with civil society organisations to ensure they establish a presence in the communities and learn local realities to the best extent possible. These activities strengthen trust in the new health professionals and present these young people as an effective alternative or supplement to traditional healers.

2015 – 2018 objectives

  • 480 young adults (at least 50% ♀) will have completed the two-year training course and 260 will become independent professionals.
  • Around 180,000 people in the project districts will be informed and have access to the health services being offered.
  • At least 39,000 will be using the locally-provided services.


  • Six local training institutes offering high-quality medical training courses.
  • The number of prenatal diagnostic procedures will rise by 15% and post-natal procedures by 10% in the project districts.
  • By late 2019, incomes of three-quarters of independent medical professionals will have risen by 20%.


Project progress in 2015-2016

  • In 2016, 428 community paramedics were in training (in 2015 there were 188)
  • Women continue to make up more than half of course participants (57%)
  • Around 83,000 people in the project regions were informed on the healthcare services offered by medical training graduates through information events, marketplace meetings, and theatre productions.
  • 59 trainers (22 ♀) were coached in content and methodology and improved the quality of their teaching.
  • Increase in incomes: The project’s overarching objective is to increase incomes among 75% of independent skilled healthcare professionals in project districts by at least 10%. Graduates from 2014 (graduates from an earlier project with a similar approach) started out with a monthly income of 72 Swiss francs (5,787 BDT). By 2015, they earned a monthly average of 96 Swiss francs (7,718 BDT), and by 2016 their incomes had risen markedly to 173 Swiss francs (13,625 BDT). Thus, we exceeded our objective by 95%.

High-quality healthcare services in rural areas

Project partner

Novartis, Laguna Foundation 

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
E-Mail info@STOP-SPAM.swisscontact.org