Abstract
The Bangladesh Smiling Sun Franchise Program (BSSFP) is a United States Agency for International Development (USAID)/Bangladesh funded health care delivery program providing a package of essential health services through a network of local non-governmental organizations (NGOs). It is a continuation of the NGO Service Delivery Program (NSDP), which had been in place in various forms since the late 1990s. BSSFP operated in areas that had been identified by the Government of Bangladesh (GOB) to have inadequate public health service delivery systems here the government sought assistance from partners to fill the service gap (henceforth referred to as project areas). USAID committed US$46 million for BSSFP over a four-year period (2007-2011). The program was later extended for another year with additional funding of around US$11 million. The programs overall objectives were to increase the use of family planning, maternal, child, and other basic health services in areas served by BSSFP, with an emphasis on serving the poor and on improving the sustainability of local NGOs in continuing to provide these services. The program was developed at a time when funding for USAID/Bangladesh was expected to decline drastically. Thus, improving financial sustainability of local NGOs within a four-year period was a major emphasis of the program. This evaluation report assesses the impact of the BSSFP on increasing use of selected Family Planning, Maternal and Child Health (FP-MCH) services. The results are based on the comparative analysis of a baseline survey conducted in 2008, soon after the programs initiation, and an endline survey conducted in 2011. The survey results reveal that the coverage rate of the three indicators considered increased in rural BSSFP project areas between 2008 and 2011 to the same extent that was observed in comparison areas where the public sector is the primary provider of services. Modern contraception use increased from 50 to 52 percent (49 to 52 percent in comparison areas), ANC use from any provider increased from 52 to 57 percent (50 to 56 percent in comparison areas) and childhood vaccination of DPT-3/Penta-3 coverage increased from 89 to 95 percent (from 89 to 96 percent in comparison areas). (Excerpt, modified)