USAID Advancing Universal Health Coverage - AUHC

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USAID Advancing Universal Health Coverage - AUHC

Advancing Universal Health Coverage (AUHC) is a flagship USAID health project in Bangladesh

The United States Agency for International Development's (USAID) Advancing Universal Health Coverage (AUHC) Activity is a six-year, project designed to transform an NGO healthcare network, the Surjer Hashi Network (formerly Smiling Sun) into a sustainable, gender-sensitive, and pro-poor social enterprise providing quality and affordable health services for the population of Bangladesh. The AUHC activity contributes to the Government of Bangladesh’s universal health coverage (UHC) commitments by addressing the health needs of every client, especially the poor, through the delivery of high-quality maternal and child health, nutrition, tuberculosis, noncommunicable diseases, and family planning services; and ensuring access to care for all, through a combination of pro-poor pricing, discount policy and outreach activities for people who live far from the clinics, particularly women, adolescents, and children. USAID's AUHC Activity has the following objectives:

Objective 1: Develop and implement a program to transform the Smiling Sun Network into a centrally managed, sustainable private social enterprise. Objective 2: Adopt proven and innovative approaches to expand access to and uptake of essential service packages. Objective 3: Develop and implement sustainable financial systems to facilitate expanded coverage and ensure equitable access to health services

Objective 4: Improve the quality of care (QoC)

Objective 5: Improve program strategies drawn from lessons learned (crosscutting)

06/12/2023

01/12/2023

Surjer Hashi Network (SHN) has undergone major transformations over the years regarding accessibility and efficiency. There are many notable highlights and major milestones that SHN has achieved while serving maternal and child healthcare in Bangladesh.

08/11/2023

Our event was featured in The Daily Star

06/11/2023

Expert panelists from private health networks spoke about the challenges of sustaining large-scale operations with pro-poor mandate. Industry specialists such as Shaila Purvin - CEO of Hashi Network, Moin Chowdhury - Managing Director of Grameen Kalyan, and Kishwar Imdad - Country Director of Marie Stopes shared the common threads in their accounts which helped outline an agenda for enhancing the private-sector role in the health sector. Dr. Syeda Naushin Parnini of the Health Economics Unit (MoHFW) touched upon the ministry's efforts to facilitate collaboration between the public and private sectors. The engaging and interactive session was moderated by Mohammad Asheque – Chief of Party, USAID's Advancing Universal Health Coverage (AUHC) activity.

05/11/2023

https://www.thedailystar.net/star-health/news/homegrown-model-sustainable-primary-healthcare-3461876

The United States Agency for International Development (USAID) established Surjer Hashi (SH), meaning Smiling Sun clinics, the agency’s flagship health service delivery project in Bangladesh in 1997. Designed to complement the government of Bangladesh’s efforts, USAID’s investment signified im...

02/11/2023

For 25 years, the Surjer Hashi clinics have been powered by its people, especially the clinic staff and managers. At every instance, they go above and beyond to ensure that everything runs smoothly and that no client is turned away. Their resilience and dedication to serve every individual in the best possible way is truly inspiring. They are – as we like to say – the keepers of the smiling sun.

02/11/2023

In Bangladesh, access to quality healthcare has long been a challenge, but with the support of USAID Bangladesh and the Government of Bangladesh, a transformation is underway. This is the story of USAID along with its Advancing Universal Health Coverage (AUHC) activity in Bangladesh, pioneering a nationwide healthcare social enterprise and revolutionizing the Surjer Hashi Network - SHN of clinics for the last 25 years across Bangladesh. This is a tribute to how a legacy of over two decades came to be.

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https://shnnetwork.org/

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ADVANCING UNIVERSAL HEALTH COVERAGE (AUHC) ACTIVITY IN BANGLADESH

Bangladesh has seen improvements in health outcomes over the past 20 years. There have been marked reductions in maternal, infant, and under-five mortality rates; and a significant decline in the total fertility rate. Despite many achievements, the health system in Bangladesh still struggles to provide quality, affordable health services to its population, particularly the poor and marginalized groups. With government spending on health services at less than one percent of the gross domestic product, out-of-pocket expenditure for health is high (67 percent), accounting for two-thirds of total health expenditures. Less than 1 percent of the population has health insurance, but the demand for quality health services is increasing, and the gap in financing is a potential barrier for achieving Universal Health Coverage and the Sustainable Development Goals. While access to public health services has improved in recent years, with the government in many cases purchasing services from private service providers, gaps in quality, availability and accessibility, of public-sector services remain.

As continuation of support to the Government of Bangladesh’s essential health service delivery towards ensuring Universal Health Coverage, USAID has awarded a new activity- USAID’s Advancing Universal Health Coverage (AUHC) - to provide the people of Bangladesh with high-quality primary care, while offering financial protection for those who cannot pay for services. Building on the strong brand recognition of Smiling Sun (Surjer Hashi) Clinics, the AUHC project will support a transition of the Smiling Sun (Surjer Hashi) clinics to a unified, sustainable, gender sensitive pro-poor social enterprise through developing innovative business models, creating evidence-based health service packages for the poor, and experimenting with new health service delivery options that will increase access to a wider range of services. The AUHC project will systematically use scientific evidence and technical knowledge to design, develop, test, and evaluate potential new products and services to advance Universal Health Coverage in Bangladesh.

The USAID-supported Smiling Sun Network provides more than 38 million client contacts a year across all 64 districts in Bangladesh through 399 clinics and more than 10,000 satellite clinics. However, the current network-wide cost recovery of 40 percent warrants the need for external assistance to meet the operational costs of the network. Mainstreaming interventions across the network is a challenge as the clinics are currently managed by multiple NGOs. Introducing a social enterprise model offers an opportunity to create a unified and harmonized operational and management approach that can expand access to and uptake of health services for the poor.

Surjer Hashi Network: A not-for-profit Social Enterprise Company

Surjer Hashi Network (SHN) is a group of people with philanthropic interests who, at the request of USAID, are eager to form a Company limited by guarantee complying with the provisions of section 28 of the Companies Act 1994. The network will transpire that:

1. It will be a Company limited by guarantee under the name and style “SURJER HASHI NETWORK” without the word “Limited” after its name.

2. The Company will be an association not for profit.

3. The Company will be promoting charity, as mentioned in Sec. 28 of the Company Act. 1994.

4. The Company will apply its profit or other income in promoting its objects and prohibit payment of dividend in any form to its members.

5. The Company will be entitled to receive donation from sources other than USAID including that of corporate social responsibility (CSR) fund from private sector.

Over the life of the activity, SHN will become an independent organization capable of generating income to be sustainable and effectively run a national network of health service delivery outlets in the private sector while serving poor and vulnerable populations. USAID will continue funding the service delivery for the poor through SHN for a considerable period, as deemed necessary to transform it into a sustainable enterprise.

USAID’s AUHC project will support SHN’s development and maturation. AUHC and SHN will ensure the continuity of services provided in Smiling Sun clinics. SHN will receive grants from AUHC to support its establishment and overall functioning, and the strategic purchasing of health services for the poor.

AUHC will continue to provide continuation funding to clinics through their respective NGOs during the transition period which will maintain the current management structures in place through the NGOs. Following the full transfer of clinics to SHN, AUHC will ensure that SHN has the required staff in place with the requisite resources and experience to provide full management support to the clinics. It is imperative that the management structure of SHN be as efficient, fit-to-purpose and cost-efficient as possible. Finding the right level of staffing and structure will evolve during the course of AUHC as SHN gains experience, realizes efficiencies, and expands the network.

06/12/2023

01/12/2023

08/11/2023

06/11/2023

05/11/2023

02/11/2023

02/11/2023

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ADVANCING UNIVERSAL HEALTH COVERAGE (AUHC) ACTIVITY IN BANGLADESH