FINAL ICHW End Line Assessment Report May 28 2020

The assessment conducted a secondary data analysis on health service utilization and listed lessons learned and recommendations for future programming. The project employed a mixed-methods design, combining qualitative and quantitative methods, including key informant interviews, focus group discussions, and secondary data analysis. The assessment was conducted from March 1 to March 12, 2020, at the national level, with a focus on the Barisal region. The ICHW project provided technical assistance to reform community groups (CGs) and community support groups (CSGs), resulting in the establishment of functional CGs and CSGs in all community clinics. These groups played a crucial role in generating community awareness, collecting household information, and extending support to community health workers (CHWs). The project also focused on strengthening the capacity of CHWs, with 741 CHWs receiving training on data analysis and data analysis for decision-making. Additionally, 125 supervisors of CHWs were trained on supervision, monitoring, and follow-up, and 16 upazila health and family welfare managers were trained on leadership and management skills. The project's efforts led to significant improvements in health service utilization, with 92 percent of community clinics in the intervention area receiving support from unions, compared to 12 percent in the control area. Furthermore, 86 percent of CHWs in focus areas reported receiving oversight from local government representatives, up from 44 percent at baseline. The project's success can be attributed to its ability to establish a collaborative effort, laying the groundwork for a sustainable process, protecting the process through leadership from community groups and community support groups, and keeping the focus on the common goal of improving community clinics. The project's orientation and training programs also played a crucial role in capacitating CHWs and community health care providers, enabling them to mobilize local resources and provide effective services. The project's achievements demonstrate the importance of community-led initiatives, community microplanning meetings, and the role of CHWs in improving health service utilization. The project's lessons learned and recommendations for future programming highlight the need for continued support for community groups and community support groups, as well as the importance of capacitating CHWs and community health care providers.