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High-quality healthcare services in rural areas

Achieving Sustainability Towards Healthcare Access (ASTHA) aims to train young adults (60% women) from twelve rural districts to become qualified healthcare professionals. By doing so, the project contributes to the development and expansion of a sustainable and high-quality healthcare system in rural areas. This not only improves the health and living conditions of the local population but also directly addresses underemployment and unemployment among many young people in Bangladesh.
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Nilphamari
25.943674
88.866156
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Sunamganj
25.059394
91.401355
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Patuakhali
22.357842
90.333032
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Lalmonirhat
25.9923398
89.28472510000002
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Rangpur
25.7438916
89.275227
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Sylhet 
24.8949294
91.8687063
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Barguna 
22.0952915
90.11206960000001
Bangladesh
Project duration
2023 - 2026

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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 inhabitants. The availability of primary healthcare services and skilled healthcare professionals is very limited in rural areas in particular.

The Project

The project was launched in 2011 to address the shortage of skilled healthcare professionals in Bangladesh. It initiated and successfully established the training program for "Community Paramedics." Private training institutes offer the program, while the Bangladesh Nursing and Midwifery Council, under the Ministry of Health and Family Welfare, oversees its administration. Young men and women acquire medical knowledge and specialised competence in the two-year course for Community Paramedics. Apart from theoretical training 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) and works in the following three areas:

  1. the modernisation and effective promotion of the Community Paramedic course,
  2. the establishment of 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
  • Providers of incubation services

Expected Results 2023 - 2026

Improved healthcare services for people in remote communities

  • 185 000 community members (60% women) 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% women)

Strengthened Community Paramedic service provision

  • 1 440 Community Paramedics (60% women) 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, Happel 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.

Downloads

Live Mag: Priming Paramedics (June 2017)
460 kB
Beneficiary Story - Marzia Akhtar Popi (2017)
702 kB

News

View all news from High-quality healthcare services in rural areas
Bangladesh
Initial vocational education and training, Growth entrepreneurship
14.05.2026
From Paramedic To Entrepreneur: Santona Akter Brings Modern Healthcare to Jaldhaka
On 14 May 2026, Santona Akter officially launched the second ASTHA CARE centre in Tengonmari Bazar, Jaldhaka, Nilphamari, bringing modern, tech-enabled healthcare to her community for the first time.  
Bangladesh
Initial vocational education and training
05.05.2026
The first ASTHA CARE launches in Gaibandha, bringing bundled, technology-enabled healthcare to rural Bangladesh
ASTHA CARE, a locally owned, technology-enabled community healthcare centre, has been formally inaugurated in Gaibandha, established through local entrepreneurial investment and supported jointly by Swisscontact Bangladesh and Carnival Care Limited. 
Bangladesh
Initial vocational education and training
18.02.2026
Government Approves Hospital Attachments for Community Paramedic Students at Upazila Health Complexes
The DGHS has formally approved a six-month hospital attachment for Community Paramedic students. This establishes a structured clinical placement within government health facilities.