Health and rehabilitation services that are accessible and affordable for everyone. Working inside Bangladesh’s own health system, 127 rehabilitation centres bring screening, therapy, assistive devices and early intervention to 38 districts and 54 upazilas.
DRRA works with the Ministry of Health and Family Welfare (MoHFW) and its line departments, including the Directorate General of Health Services (DGHS), to make the health system inclusive and affordable for all.
As a result, Community Clinics, Union Health Centres, Upazila Health Complexes, District Hospitals and Medical College Hospitals have become proactive in prioritising persons with disabilities. Rehabilitation units operate inside these facilities with technical resources, and a functional referral system built into the health system links each level to the next.
people reached through a stronger referral system for primary health care and rehabilitation
The model follows a person from the first household visit to the level of care they need. Each level screens, treats what it can and refers on, so no one has to find their own way to a distant hospital.
This practice led to DRRA’s most significant achievement, the Shivalaya Inclusive Health Model: Bangladesh’s first comprehensive disability-inclusive public health model, recognised by the government. The model demonstrated how rehabilitation could be integrated into routine government healthcare by combining accessible infrastructure, rehabilitation corners, referral systems, telemedicine, community engagement and multidisciplinary service delivery. Its successful implementation provided convincing evidence that inclusive rehabilitation could become a sustainable component of the public health system.
Referral works in both directions: people move on for diagnosis and specialist care, and back to their community for therapy and follow-up.
Organisations of persons with disabilities (OPDs) and partner organisations survey every household to find children and adults with disabilities or at risk of disability.
The first point of contact with the health system, close to home.
Checks young children’s development and works to prevent disability, with surveillance camps in the community.
Run with partner organisations. Plans each person’s support and links children to school. Inclusive education
Where diagnosis is confirmed and treatment begins. Eleven DRRA rehabilitation centres operate inside Upazila Health Complexes.
District (Sadar) hospitals and national specialist institutes such as NITOR, NIMS and NINS, for people who need specialist treatment beyond the upazila.
The government’s national foundation for persons with disabilities, and its service centres.
The model works in three places at once: inside upazila hospitals, among people with disabilities in their own communities, and with government at local and national level.
Making health and rehabilitation services inclusive and affordable for all. Both diagrams on this page are also available as a two-page infographic to print or share.
Download the infographic (PDF, 600 KB)
Page 1: from the home to specialist care
Page 2: quality and inclusive health for allDRRA co-developed national disability screening and diagnosis protocols with the Directorate General of Health Services (DGHS). They were piloted through NCD corners at upazila and district hospitals, and professionals have been trained to use the protocol to diagnose disability and refer people to appropriate services.
Community health workers use the protocol to identify need early. Clinical staff at the nearest rehabilitation unit confirm the diagnosis and a care plan, and therapy and assistive devices are provided at or near the person’s home.
This is not a single project but an institutional journey: built over many years with government, bilateral development partners, knowledge partners and the communities where screening happens, and renewed across many grant cycles.
Indicative amounts. DRRA confirms current costs when a gift is designated.
Children found through health screening are linked to school through the same community resource centres.
Mobility and independence open the door to livelihood training.
See how DRRA’s programmes add up, from people to lasting change.