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 (50% women) from seven 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 - 2022

Bangladesh suffers from both a shortage and geographic maldistribution of Human Resources for Health. There are only 8.3 health professionals per 10 000 population in Bangladesh, 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 second four-year project phase (2019-2022). The project works in the four areas:

•    Strengthening Capacity of Community Paramedic Training Institutes in the areas of delivering trainings, marketing, and organisational management.
•    Enhancing Capacity and Service Provision of Community Paramedics to develop, promote and retain quality primary healthcare services in underserved rural areas.
•    Raising awareness on Community Paramedics and their High-Quality Services in the rural communities
•    Sensitising Public and Private Agents to advocate and promote the Community Paramedic Programme at a national scale.

ASTHA Phase II (2019 – 2022) is being implemented in seven districts of Bangladesh: Nilphamari, Lalmonirhat and Rangpur in the north, Sunamganj and Sylhet in the north-east and Barguna and Patuakhali in the south.

Project partners

  • Bangladesh Nursing and Midwifery Council
  • Ministry of Health and Family Welfare
  • Community Paramedic Training Institutes
  • Alliance of Community Paramedic training institutes
  • Local NGOs
  • Grameen Telecom Trust
  • Auleek Limited

Expected Results

  • 638 participants (at least 50% women) complete the 2-year training.
  • 370 Community Paramedics are self-employed, or salary employed
  • 270 000 community people are informed about the Community Paramedics and their services in their neighbourhood
  • 183 250 community people accessed improved healthcare services

Financing partners

This project is financed by Novartis, the Evi Diethelm Winteler Stiftung, the Laguna Foundation, the Leopold Bachmann Stiftung, 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 organized a Basic Training of Trainers (ToT) on Enhancing Training Quality and Facilitation Skills for newly registered Community Paramedic Training Institute (CPTIs) 
To strengthen the capacity of newly registered CPTIs, ASTHA arranged a Basic Training of Trainers (ToT) on Enhancing training quality and facilitation skills for the faculties of a few selected CPTIs
Initial vocational education and training
LNOB Community of Tea Garden Workers is being served by Community Paramedics 
Leave No One Behind (LNOB) is the central, transformative promise of the 2030 Agenda for Sustainable Development, focusing on the poorest of the poor and society's most vulnerable populations. Community Paramedics (CPs) in Sylhet district are actively working to provide door-to-door services to the LNOB communities of the tea garden areas.
Initial vocational education and training
The Community Paramedic (CP) training is now interactively digitized
ASTHA provided training on how to create interactive content using h5p for the teachers of Radda MCH-FP Centre.

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