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Swisscontact: how to tackle the shortage of health workers in Bangladesh

The Julius Baer Foundation collaborates with Swisscontact in the area of Vocational Training and supports its partner’s activities in Bangladesh. Fazlek Razik, the project coordinator on site, gives insights into the work of the organisation in his homeland.




Swisscontact was established in 1959 in Switzerland. It promotes sustainable economic growth in developing countries. In Bangladesh, the organisation trains Community Paramedics (CPs), who are urgently needed, particularly outside the urban areas. The cooperation with Swisscontact is fully in line with one of the three core areas of the Julius Baer Foundation, namely Vocational Training (for further information, please refer to the box at the end of this article).

In Bangladesh, child and maternal mortality rates have been substantially reduced during the last 15 years, in combination with improvements in family planning and ameliorated access to sanitation. However, securing these successes, especially in rural areas, is anything but easy: only five medically trained persons per 10,000 people are available in this huge country, with just three of them being trained doctors and two health assistants – a striking imbalance between supply and demand.

Provision of initial medical care the top priority     

Swisscontact has successfully run projects in the agricultural sector and in skills development. Healthcare trainings, however, were established only in 2011, when the need to close the above-mentioned gap between the number of patients and medical personnel became a top priority. Thus, Swisscontact started a vocational training programme in the health sector together with the government and specialised service providers: ‘Achieving Sustainability Towards Healthcare Access’ (ASTHA) aims to train skilled health workers, so-called Community Paramedics (CPs), in a two-year course to provide basic healthcare services, in particular to the poorer population in the countryside.

If you think of doing something meaningful: what better sector could there be?

From difficult beginnings to an established profession

Most medical doctors and nurses in Bangladesh work in the big cities and hospitals – an unattainable dream for most youngsters. In the countryside with hardly any medical doctors, on the other hand, it is mostly pharmacists and traditional shamen who cure diseases. So the new concept of CPs had to be promoted and the scope of their services explained, which was met with skepticism at the beginning. The previously unknown profession only gained in recognition when the first students of the course told about the curriculum and took up their work upon graduation. Only then did the villagers actually see their added value and also realise that CPs could make a living from their occupation, which attracted more young people to join the courses. Even the number of female CPs has increased – notably in a country where women are still primarily expected to be good housewives and mothers, and whose career opportunities are usually limited by this traditional view.

In order to establish the highest possible standards, Swisscontact and the government have also developed a monitoring system for CPs, some of whom now even work in hospitals, complementing the services of medical doctors by taking care of easier cases.  

A close collaboration in the best interest of the patients 

Nowadays, CPs and pharmacists often cooperate and also recommend each other’s services to their customers and patients, which is beneficial to both businesses. And the patients, who are at the core of all these efforts, also profit, as they can be monitored more closely by specialists from two different angles.   

“You directly contribute to people’s health improvement. So to be engaged in this particular programme makes me very happy,” Fazlek Razik concludes.