High-quality healthcare services in rural areas

Achieving Sustainability Towards Healthcare Access (ASTHA) aims at contributing to the development and expansion of sustainable and high-quality healthcare at the community level by training young adults (60% women) from twelve rural districts as skilled health workers. The ASTHA-project improves the health and living conditions of the local population and, at the same time, addresses the problem of the high number of un- and underemployed youth in Bangladesh. 
Project duration
2019 - 2026

Bangladesh suffers from both a shortage and geographic maldistribution of Human Resources for Health. The country had four nurses and midwives and six physicians per 10 000 people in 2019 while the World Health Organization (WHO) recommends 44.5 skilled health professionals per 10 000 population. The availability of primary healthcare services and skilled healthcare professionals is very limited in rural areas in particular.

The Project

ASTHA, formerly known as TARSAN, started in 2011 to address this gap in Bangladesh’s health sector. As a result of the project’s previous efforts, the Community Paramedic Training Programme is now an established professional training offered by private and public training institutes and governed by the Bangladesh Nursing and Midwifery Council under the Ministry of Health and Family Welfare. Young men and women acquire medical knowledge and specialised competence in the two-year course for Community Paramedics. Apart from theoretical training with a strong focus on mother-child health, they complete a six-month internship in a hospital. This qualifies them for diagnosis and treatment of frequently occurring diseases that are not complex. Moreover, the graduates are able to provide professional support during pregnancies and assistance at births.

ASTHA is currently in its third four-year project phase (2023-2026). The project works in the three areas:

  1. the modernisation and effective promotion of the Community Paramedic course,
  2. establishing private sector driven service offers for Community Paramedics that allow them to improve their business activities and service quality,
  3. fostering a strong engagement from relevant authorities to strengthen and promote the Community Paramedic profession nationwide.

ASTHA Phase III (2023 – 2026) is being implemented in twelve districts of Bangladesh: Nilphamari, Lalmonirhat, Dinajpur, Rangpur, Gaibandha, and Bogura in the north, Sunamganj, Moulovibajar, and Sylhet in the north-east and Barishal, Barguna, and Patuakhali in the south.

Project partners

  • National and local healthcare authorities
  • Bangladesh Nursing and Midwifery Council
  • Community Paramedic Training Institutes
  • Community Paramedic Association
  • Technology companies
  • Business incubation service providers
  • Financial service providers

Expected Results

Improved healthcare services for people in remote communities

  • 185 000 community members (60% ♀) receive high-quality affordable healthcare services from Community Paramedics

Strengthened Community Paramedic training system

  • 30 Community Paramedic training institutes access training modernisation services
  • 1 350 Community Paramedic trainees complete the two-year training (60% ♀)

Strengthened Community Paramedic service provision

  • 1 440 Community Paramedics (60% ♀) access services that help them establish their business and improve their service offer
  • As a result, their annual average income increases by CHF 280

Financing partners

This project is financed by Novartis, the Evi Diethelm Winteler Stiftung, and the Laguna Foundation, among other donors. It is part of the Swisscontact Development Programme, which is co-financed by the Swiss Agency for Development and Cooperation (SDC), Federal Department of Foreign Affairs FDFA.

Videos for Community Paramedics

General service guideline in the time of Covid-19
(in Bengali)
COVID Symptoms
(in Bengali)


Initial vocational education and training
ASTHA successfully organised a day-long divisional workshop in Sylhet
On August 21, 2023, ASTHA conducted a workshop in Sylhet to sensitise the local government officials about the Community Paramedic program and enable them towards a sustainable career.
Initial vocational education and training
Orientation for the newly registered Community Paramedic Training Institutes (CPTIs) on promotional strategy
ASTHA organised a day-long orientation on 20th August 2023, for supporting the newly registered CPTIs in developing promotional strategy. Representatives from ten institutes attended the session in Dhaka. The main objective of this session was to disseminate basic knowledge and tools required to design effective marketing campaigns.
Initial vocational education and training
Novartis visits ASTHA project: insights into improving healthcare in Bangladesh
Isabel Dalli, Global Head of Sponsoring & Donations, Novartis visited ASTHA project activities in Patuakhali and Dhaka from 19 to 22 June. She was accompanied by Eliane Herrmann, Head of Development Programme, Swisscontact, Mujibul Cezanne Hasan, Country Director, Swisscontact Bangladesh and ASTHA team. The purpose of the visit was to observe the ongoing project activities and to interact with the local and national stakeholders of the project. This visit is important to assess the progress of the ASTHA project in improving healthcare in rural Bangladesh and to set the strategic framework for Phase III of the project.

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