The CCs would be managed by the NGOs and community groups and supervised by union parishads by the end of this year, official sources said.

Of the CCs, 350 in 112 selected unions have already been contracted out to the NGOs and community groups for three years for primary healthcare delivery services. These CCs are in the remote areas with very high levels of poverty, infant and maternal mortality and low utilisation of services.

A total of 13,500 CCs at a cost of Tk 280 crore were built during the last five-year health plan under the Health and Population Sector Programme (HPSP).

"The idea is to build local level capacity in healthcare delivery and grow a sense of ownership so that the community who needs the services does not have to depend on us," Health Secretary A F M Sarwar Kamal said.

The contracts already given are targeted at supporting the delivery of basic, field level health and family planning services through the CCs in the remotest and most disadvantaged rural areas.

The NGOs and local CC management groups (CCMGs) would select and hire the existing government staff to deliver the services. Family Welfare Visitors (FWVs) and health assistants would be in charge of each CC. All 'clients' at the CCs, excepting the extremely poor ones, would have to pay 'user fees' which would be used as 'revolving funds' to improve facilities at the CC, an official said.

The government employees would continue to receive salaries as usual but the CC management committees would also make additional payments as incentive to them. The government will also provide medicines and logistics like small apparatus and furniture of the CCs while the NGOs and community groups would simply act as service delivery agencies.

Each CC will have to register newly married couples in the union, distribute vitamin tablets, provide vaccines, identify pregnant women and give them pre-and post-delivery care and provide limited treatment for diarrhoea, acute respiratory infection, malaria and fungus infection of the skin.

The CCs would also build a referral system for complicated cases and provide home services to clients unable to visit the CCs.

The government wants to strengthen the linkage with the NGOs to reach healthcare to the poorest people. Accordingly, the health ministry decided after a series of meetings with the stakeholders to promote contracting and commissioning the NGOs for providing reproductive healthcare, family planning and mother and child healthcare services to supplement the public health sector services, officials mentioned.