Field Actions Science Reports www.field-actions-sci-rep.net 1867-139X 1867-8521 2 1 2009 10.5194/facts-2-93-2009 http://www.field-actions-sci-rep.net/2/93/2009/ http://www.field-actions-sci-rep.net/2/93/2009/facts-2-93-2009.html http://www.field-actions-sci-rep.net/2/93/2009/facts-2-93-2009.pdf 93 100 2009-03-02 Innovations in community physiotherapy M. Ellangovin mani_mpt@hotmail.com MPT Senior Consultant, Gonoshasthaya Kendra and Head & Associate Professor, Gono Bishwabidyalay, Bangladesh Background In the last 35 years, Bangladesh has produced only 415 physiotherapists to meet the demands of a total population of 150 million. Most of them practice in the capital city of Dhaka because of better business prospects. The need to formulate an innovative strategy to meet the huge demand is obvious. According to a World Bank report (2005), 44% (poor) and 33% (very poor) people approach local pharmacists or medicine sellers for their ailments due to poor accessibility to healthcare facilities and also to avoid consultation fees. Methods Due to scarcity in the number of professionals, community physiotherapists have become popular with rural patients. They use innovative treatment approaches, which combines traditional Physiotherapy and ancient Ayurvedic massage. Targeting equitable access to all, Gonoshasthaya Kendra (GK) has its own health insurance policy. The fee is determined by the socio-economic status of the patient. Results Experienced paramedics are now able to administer treatment without direct supervision all the time. The number of patients seen by them is multiplying at a fascinating rate every year due to the growing recognition of their work. Conclusion Gonoshasthaya Kendra (GK) was established in 1972 and provides primary health care to a rural population of over 1.08 million across 629 villages in Bangladesh. The strategies and methods adopted by Gonoshasthaya Kendra in bridging the gap and promoting community physiotherapy by training health workers or "paramedics'' in Bangladesh, has been successful. Even though training of many more paramedics is required, success is guaranteed. Bose, A.: Women's Empowerment thtough capacity building – Enduring efforts in Bangladesh, 2004. Canadian Alliance of Physiotherapy Regulators & the Canadian Physiotherapy Association: Physiotherapy Health Human Resources, Background paper, 2002. Chaudhury, N. and Hammer, J.: Ghost doctors: absenteeism in Bangladeshi health facilities, Policy Research Working Paper No. 3065, Washington, D.C., The World Bank, 2003. Chowdhury, S. and Chowdhury, Z.: Tubectomy by Paraprofessional Surgeons in Rural Bangladesh, Lancet, 2(7935), 567–569, 1975. Editorial, Gonoshasthaya Kendra, The Lancet, 1(7949), 26–27, 1976. Gonoshasthaya Kendra: Evaluation Report, Gonoshasthaya Kendra, Savar, 2008. Haque, T.: With The People, For The People, Gonoshasthaya Kendra, Bangladesh, The People's Health Centre, 2003. Impact Foundation Bangladesh, Disability statistics, 2002. Japan International Cooperation Agency Planning and Evaluation Department, Country Profile on Disability, People's Republic of Bangladesh, 2002. National Health Policy – An Update, Ministry of Health and Family Welfare Government of the People's Republic of Bangladesh, http://www.mohfw.gov.bd/New_Folder/Health%20Policy_english.pdf, August 2008. Ray, B.: Human Resource Planning in Health Care, Tata Main Hospital, Jamshedpur India, Health Administrator, 11–13(1–2), 14-6, Jul–Dec 2001. The World Bank Office, Dhaka: To the MDG's and Beyond: Accountability and Institutional Innovation in Bangladesh, Bangladesh Development Series Paper No 14, 2007. World Health Organization (WHO): The World Health Report, Health workers: a global profile, Chapter 1, 2006.