Protection Through Care
Shurokkha
Health System Strengthening Project (HSSP)
A gender-transformative initiative to strengthen integrated MNCAH+N&FP and SRHR primary healthcare services for the most underserved communities of rural Nilphamari, Bangladesh.
Duration: 24 Months (Jan 2026 – Dec 2027)
Location: Panchpukur Union, Nilphamari Sadar
Focus: MNCAH+N&FP and SRHR
Approach: Gender Transformative
In collaboration with: Union Parishad (UP)· Ministry of Health & Family Welfare (DGHS & DGFP)· UH&FWC· Community Clinics
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Context & Problem Statement
Despite meaningful progress in Bangladesh’s national health indicators, persistent inequities remain at the union level — particularly in northern districts such as Nilphamari, where geographic remoteness, provider shortages, and deeply embedded gender norms continue to restrict access to quality primary healthcare for women, girls, and adolescents.
Utilization of existing government health infrastructure — Union Health and Family Welfare Center (UH&FWC) and Community Clinics — remains suboptimal due to supply-side quality gaps and demand-side social barriers. Maternal and neonatal mortality, adolescent reproductive health, and malnutrition remain critical concerns requiring both service delivery strengthening and a deliberate shift in gender power dynamics.
The challenge is not only the absence of services — it is the invisible architecture of norms and power relations that determines who can access them, when, and on whose terms.
Shurokkha is IRDA’s programmatic response to this intersection of structural and social barriers, designed to create lasting, system-embedded change at the union level.
02
Project Overview
The Shurokkha (সুরক্ষা) Health System Strengthening Project is a 24-month initiative of IRDA, piloting in Panchpukur Union under Nilphamari Sadar Upazila. The project will strengthen primary healthcare service delivery through government platforms while simultaneously addressing the social determinants and gender inequities that impede health-seeking behaviour and outcomes.
Working through a rights-based, gender-transformative framework, Shurokkha targets change at three interconnected levels — individuals, communities, and institutions — to create a sustainable enabling environment for health equity. The pilot is designed for evidence-based scale-up across Nilphamari district upon demonstrated results.
Months Duration
Jan 2026 – Dec 2027
Direct Beneficiaries
Estimated (pilot phase)
Indirect Beneficiaries
Within the union
03
Target Beneficiaries
The project prioritizes inclusivity and equity in beneficiary selection, ensuring that marginalized and hard-to-reach groups — including persons with disabilities — are explicitly and meaningfully reached.
Primary Beneficiaries
Secondary Beneficiaries
04
Gender Transformative Strategy
Shurokkha adopts an explicit gender-transformative approach — not merely gender-sensitive. The project goes beyond improving conditions for women and girls to directly challenging and reshaping the unequal power relations that perpetuate health inequity. Change is pursued simultaneously across three interconnected levels.
Level 01
Right Holders
Individual Girls, Women & Adolescents
Building personal agency, health literacy, and confidence to make informed decisions about their own bodies and wellbeing.
Level 02
Moral Duty Bearers
Family & Community
Promoting supportive norms, reducing harmful practices, and building shared responsibility for health within households and communities.
Level 03
Primary Duty Bearers
Institutions
Strengthening the gender sensitivity, accountability, and responsiveness of UHFWC, Community Clinics, and Union Parishad.
05
Key Interventions
Community Engagement & Behaviour Change Communication (BCC)
Structured community dialogues, awareness campaigns, and social mobilization activities targeting health-seeking behaviour, harmful gender norms, and community rights awareness.
Strengthening Primary Healthcare & SRHR Services
Improving quality, inclusivity, and accountability of services delivered through UHFWCs and Community Clinics; ensuring rights-based, respectful care for all community members.
Maternal, Neonatal, Child & Adolescent Health, Nutrition & Family Planning (MNCAH+N&FP)
Targeted support for antenatal, postnatal, and newborn care; adolescent health programming; nutrition counselling; and family planning service access and uptake.
Referral System Strengthening
Establishing functional referral and follow-up mechanisms between community, primary care, and higher-level facilities to ensure continuity of care for all patients.
Capacity Building of Local Health Systems
Training and mentoring health workers, FWAs, FWVs and CHCPs; strengthening Union Parishad health governance; and building institutional accountability mechanisms.
Inclusive Programming for Marginalized Groups
Ensuring persons with disabilities and other marginalized populations are meaningfully included in all programme activities and have equitable access to all services.
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Expected Results
Shurokkha is designed to deliver measurable change across health outcomes, systems performance, and social determinants.
Increased utilization of quality primary healthcare and SRHR services
Improved maternal, neonatal, child and adolescent health outcomes
Enhanced nutrition status and family planning uptake in target communities
Strengthened, functional referral and follow-up systems across care levels
Improved capacity and accountability of local health institutions
Measurable positive shifts in gender norms and household health decision-making
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Evidence Base & Learning Foundation
Evidence-Based Design
Shurokkha’s design draws on evidence, tools, and lessons from internationally recognized, nationally implemented health programmes in Bangladesh. IRDA has contextualized these frameworks for the specific realities of Panchpukur Union and Nilphamari district — ensuring the approach is grounded, locally relevant, and proven.
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Sustainability & Scale-Up Pathway
Systemic Integration Strategy
Shurokkha’s design draws on evidence, tools, and lessons from internationally recognized, nationally implemented health programmes in Bangladesh. IRDA has contextualized these frameworks for the specific realities of Panchpukur Union and Nilphamari district — ensuring the approach is grounded, locally relevant, and proven.