Community Health Services in Pabna, Bangladesh: Assessing Effectiveness and SDG Contributions

Abstract Achieving the United Nations Sustainable Development Goals (SDGs) requires strengthening community health systems, especially in resource-limited settings. This study evaluates the effectiveness and availability of community health services in Pabna Sadar Upazila, a sub-district in northwest Bangladesh, and analyzes their contributions toward select SDG targets. Using mixed methods including a population-based survey (n=625 households), in-depth interviews with health workers (n=15) and district managers (n=5), and direct observation of community clinics (n=12), we assess service utilization, population coverage, quality of care, and alignment with SDG 3 (Good Health and Well-Being). The study finds relatively high utilization of services targeting maternal and child health, but limited provision of services addressing non-communicable diseases and the needs of the rapidly growing elderly population. Significant inequities exist in service access and quality between urban and rural areas. While making important contributions to SDG targets 3.1 (maternal mortality), 3.2 (neonatal/child mortality) and 3.7 (sexual/reproductive health services), existing community health services only partially support other critical SDG 3 targets. We identify key health systems constraints as well as promising strategies to strengthen community-based health service delivery as a pathway for further progress on the SDGs in Bangladesh and other low-income countries.