The COVID-19 pandemic poses uniquely difficult challenges for Bangladesh given the country’s high population density, fragile health system, and low awareness of preventing virus transmission at community-level. Innovative measures to ensure that those who show symptoms of the virus are rapidly quarantined and tested are desperately needed.
Through its Pandemic Emergency Financing (PEF) facility, the World Bank is providing Bangladesh with a grant of USD 14.8 million. The Government of Bangladesh has selected UNFPA and WFP to implement this fund, of which UNFPA is receiving USD 8.5 million. Working closely with the Ministry of Health and Family Welfare and other UN agencies and partners, the activities delivered by UNFPA include strengthening laboratory and surveillance capacities for COVID-19 testing, and supporting the government with providing COVID-19 treatment and ensuring infection prevention and control.
The World Bank funding will also support the innovative intervention of establishing ‘Community Support Teams’ (CST) to provide door-to-door screening and quarantining of COVID-19 probable cases. The goal of the initiative is to preserve hospital capacity by slowing down disease spread at community level through targeted home isolation and family quarantine for symptomatic individuals combined with promotion of public mask-wearing.
The CSTs are trained to clinically assess individuals reporting COVID-19 symptoms. Individuals who may be symptomatic are mainly identified through either the national 333 hotline or local word of mouth. The CSTs visit their homes and a strict case definition of presence of both COVID-related symptoms and fever is used to evaluate if these individuals have a higher probability of being COVID-positive. If they meet the case definition, individuals are referred to as ‘Verified Virus Fighters’ (VVF) and then counseled on maintaining home isolation and quarantine of their entire household for 14 days. To support VVFs and their families throughout the quarantine period, CSTs provide essential medicine as well as facilitate delivery of food support to vulnerable households. VVFs are also connected to medical experts via dedicated telemedicine support and can be referred to hospitals in the case of severe or critical disease.
CST is an initiative lead by Director General of Health Services (DGHS), in partnership with FAO, UNFPA, UNICEF, WFP, BRAC, CMED, a2i, Platform, Dhaka North and South City Corporations and other NGOs and volunteer organizations, and was originally piloted for two weeks in Dhaka and Khulna in April 2020 as a proof of concept. The funding from the World Bank helps to support in scaling up this life-saving initiative, in addition to funding received through other donor organizations.
“Innovative initiatives are needed now more than ever, especially at community-level. We thank the World Bank for supporting UNFPA in our COVID-19 response work to safeguard the reproductive health and rights of women and girls, while also increasing awareness on the impact of COVID-19 on gender-based violence and child marriage. The Community Support Teams is a great example of how we can ensure we meet the needs of those most left behind through a targeted approach, while flattening the curve in Bangladesh”, says Dr Asa Torkelsson, UNFPA Representative in Bangladesh.
Highlighting the importance of the CST initiative, Ms. Mercy Tembon, World Bank Country Director for Bangladesh and Bhutan said, “Bangladesh is known for many development innovations and successful community-led initiatives. The Community Support Team is an example of such an innovation that will play a critical role in slowing down the rate of COVID-19 infection. This financing will help to enhance home-based management of COVID-19 symptoms in addition to the wide-ranging measures Bangladesh has taken to respond to the pandemic.”
In addition to the CST, through the Pandemic Emergency Financing Facility, the World Bank is also supporting UNFPA in strengthening the Government’s existing laboratories for COVID-19, increasing the capacity of midwives, nurses, medical doctors, critical care specialists and other healthcare professionals, as well as in procurement of PPE, in efforts to support in implementing the Bangladesh Preparedness and Response Plan for COVID-19.
