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HPNSDP
Supported by:
Management Information System (MIS)
Directorate General of Health Services (DGHS)
Ministry of Health & Family Welfare (MOHFW)
Mohakhali, Dhaka-1212

Preface

It is a matter of glad that the “health bulletin” of Khagrachari Hill District has been published like every year. It is the health bulletin that reflects the overall summary of the health activities of the district and the performance as well. From the programmatic aspect, if we want to start with a complete set of data, it should be started from the beginning of the year. It should be started from the Ward to Union to Upazila, then to District. Information generated at the locality should be collected and documented by the Health, Family Planning, & NGO collectively. Then they must go through it together in a convenient place on last working day, except on the day of EPI, of every month. They will share all the information collected from the field and will scrutinize and compile in a common prescribed format from the District which will be supervised by respective Union supervisors and signed by them at the bottom of the report. Before signing, the must check and monitor the process of information collection and documentation by presenting in the field. The meeting we called as “Union Follow-up Meeting”. Then the copy of signed Union Follow-up Meeting will be sent to the respective Upazila Authorities (Health, Family Planning, and NGO). Then all Union Follow-up Formats will be collected in Upazila for consolidation. Upazila managers/representatives must attend at the Union Follow-up Meeting at the Union level and they will compile and scrutinize the whole paper and at the end of the Upazila consolidation, the report will be sent to the District for compilation to have a complete scenario of the District. I believe, this report will help the respective reader understand the overall health activities and performance of the Khagrachari Hill District. I wish for the well being of everybody who had contribution behind the formulation of this Health Bulletin.

Dr.Nishit Nandi Majumder
Civil Surgeon
Khagrachari Civil Surgeon Office
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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EDITORIAL BOARD

Chief Editor

Dr.Nishit Nandi Majumder, Civil Surgeon,Khagrachari.


Editors

1. Dr. Miton Chakma, MOCS, Khagrachari

2. Thowaila Prue Chowdhury, Statistical Assistant, CS Office, Khagrachari

Contributors

1. M. A. Rifat, DNSO, Khagrachari


Certificate of Authentication

We, the above members of the Editorial Board, hereby certify that we collectively examined the content and data used in this LHB 2016 and to the best of our knowledge they represent the true picture of the local situation.

Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Basic Information
Name of District Khagrachhari
Organization Code 10000975
Name of Civil SurgeonDr.Nishit Nandi Majumder
Land Phone No. 1 37161681
Land Phone No. 2 037161660
FAX No. 0371-738
Mobile No. 01717720137
Email khagrachari@cs.dghs.gov.bd
GPS location of CS Office Lati: 23.1126 And Long: 91.9896
No. of Upazila in the District08
No. of Households in the District 128766
Population in the District 668833
Area of District in sq km 2699.55
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Existing Health Facilities
Facility Type Total No.of Faciliti(es) No. of Beds
Medical College Hospital 0 0
District Hospital 01 100
General Hospital 0 0
Upazila Health Complexes 07 254
Union Sub Centers 11 0
Union Health & Family Welfare Centers (under DGHS) 0 0
Union Health & Family Welfare Centers (under DGFP) 0 0
Rural Dispensaries 01 0
Community Clinics 67 0
Trauma Centers 0 0
MCWCs (belong to DGFP) 01 20
Chest Disease (TB) Clinics/Hospitals 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Existing Health Facilities
Facility Type Total No.of Faciliti(es) No. of Beds
Private Clinics/Facilities 1 15
NGO Clinics/Facilities 1 10
10 Bed Hospitals 0 0
20 Bed Hospitals 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of Live Births & Child Deaths in the District (Jan-Dec, 2015)
Total No. of live births: 18,427



Neonatal Mortality Rate: 6.3 (Per 1,000 live births)
Total No. of Children Treated under IMCI Program : 75,568
Fully Vaccinated Children (<= 12 months): 99 %
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of Maternal Health Services Provided in the District (Jan-Dec, 2015)
R.P.W. (No.) : Reg. Pregnent Women; 1st ANC (No.) : At least 1 ANC; 4th ANC (No.) : ANCs (4+); N.deli(No.) : Normal Delivery; C.deli(No.) : Cesarean Section; O.deli(No.) : Other Assisted Delivery; PNC(No.) : PNC Within 2 days;

Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of Maternal Health Services Provided in the District (Jan-Dec, 2015)

Indicator DH's Total UHC Total Govt. Facilities NGO Facilities Private Facilities MCWCs (belongs to DGFP) Not in Facilities (Home, Camps, etc. by govt. & other providers) Total
Reg. Pregnent Women 881 742 2173 2263 0 773 14253 21085
At least 1 ANC 881 742 2947 2231 0 773 11700 19274
ANCs (4+) 591 248 895 1742 0 78 8025 11579
Normal Delivery 1092 470 1064 465 0 560 14176 17827
Cesarean Section 332 0 0 0 0 205 0 537
Other Assisted Delivery 55 0 0 0 0 8 0 63
PNC Within 2 days 1705 458 1312 1098 0 213 8383 13169
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of Maternal Health Services Provided in the District (Jan-Dec, 2015)

Indicator DH's Total UHC Total Govt. Facilities NGO Facilities Private Facilities MCWCs (belongs to DGFP) Not in Facilities (Home, Camps, etc. by govt. & other providers) Total
Maternal Death 2 1 0 0 0 0 11 14
Total Deliveries 1479 470 1064 465 0 773 14176 18427
Valid TT5 Coverage (%) 58
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of OPD & Emergency visits, Admissions & Deaths
Health Facility OPD visits (Year 2023)
Male
(Age
<= 5)		 Female
(Age
<= 5)		 Total Male
(Age
> 5)		 Female
(Age
> 5)		 Total Grand-Total
Male Female Both
District Hospital 6395 6290 12,685 26642 31804 58,446 33037 38094 71131
Upazila Health Complex 32221 35968 68,189 113600 136489 250,089 145821 172457 318278
Union Sub-Centers 4281 5732 10,013 18219 51572 69,791 22500 57304 79804
Union Health & Family Welfare Centers (under DGHS) 153 205 358 445 1057 1,502 598 1262 1860
Union Health & Family Welfare Centers (belong to DGFP) 4882 6354 11,236 8806 22452 31,258 13688 28806 42494
Rural/Urban/Thana Health Centers 0 0 0 0 0 0 0 0 0
Community Clinics 16476 21083 37,559 98191 149674 247,865 114667 170757 285424
Trauma Centers 0 0 0 0 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of OPD & Emergency visits, Admissions & Deaths
Health Facility OPD visits (Year 2023)
Male
(Age
<= 5)		 Female
(Age
<= 5)		 Total Male
(Age
> 5)		 Female
(Age
> 5)		 Total Grand-Total
Male Female Both
MCWCs (belong to DGFP) 1146 5588 6,734 403 1609 2,012 1549 7197 8746
Chest Disease (TB) Clinics/Hospitals 0 0 0 0 0 0 0 0 0
Private Clinics/Facilities 0 0 0 0 0 0 0 0 0
NGO Clinics/Facilities 5594 7391 12,985 24106 38273 62,379 29700 45664 75364
10 Bed Hospitals 510 765 1,275 1124 2910 4,034 1634 3675 5309
20 Bed Hospitals 0 0 0 0 0 0 0 0 0
Medical College Hospital 0 0 0 0 0 0 0 0 0
Any other health facility 0 0 0 0 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of OPD & Emergency visits, Admissions & Deaths
Health Facility Emergency visits (Year 2023)
Male
(Age
<= 5)		 Female
(Age
<= 5)		 Total Male
(Age
> 5)		 Female
(Age
> 5)		 Total Grand-Total
Male Female Both
District Hospital 364 199 563 2456 1245 3,701 2820 1444 4264
Upazila Health Complex 1365 1362 2,727 5823 5747 11,570 7188 7109 14297
Trauma Centers 0 0 0 0 0 0 0 0 0
Chest Disease (TB) Clinics/Hospitals 0 0 0 0 0 0 0 0 0
10 Bed Hospitals 0 0 0 0 0 0 0 0 0
20 Bed Hospitals 0 0 0 0 0 0 0 0 0
Medical College Hospital 0 0 0 0 0 0 0 0 0
Any other health facility 0 0 0 0 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of OPD & Emergency visits, Admissions & Deaths
Health Facility Admissions (Year 2023)
Male
(Age
<= 5)		 Female
(Age
<= 5)		 Total Male
(Age
> 5)		 Female
(Age
> 5)		 Total Grand-Total
Male Female Both
District Hospital 1233 678 1,911 3982 5906 9,888 5215 6584 11799
Upazila Health Complex 1477 1944 3,421 5295 6726 12,021 6772 8670 15442
Trauma Centers 0 0 0 0 0 0 0 0 0
Chest Disease (TB) Clinics/Hospitals 0 0 0 0 0 0 0 0 0
10 Bed Hospitals 0 0 0 0 0 0 0 0 0
20 Bed Hospitals 0 0 0 0 0 0 0 0 0
Medical College Hospital 0 0 0 0 0 0 0 0 0
Any other health facility 0 0 0 0 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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No. of OPD & Emergency visits, Admissions & Deaths
Health Facility In Patient deaths (Year 2023)
Male
(Age
<= 5)		 Female
(Age
<= 5)		 Total Male
(Age
> 5)		 Female
(Age
> 5)		 Total Grand-Total
Male Female Both
District Hospital 71 44 115 85 51 136 156 95 251
Upazila Health Complex 13 5 18 35 21 56 48 26 74
Trauma Centers 0 0 0 0 0 0 0 0 0
Chest Disease Clinics (TB Clinics) 0 0 0 0 0 0 0 0 0
10 Bed Hospitals 0 0 0 0 0 0 0 0 0
20 Bed Hospitals 0 0 0 0 0 0 0 0 0
Medical College Hospital 0 0 0 0 0 0 0 0 0
Any other health facility 0 0 0 0 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Morbidity Profile

Top (5) causes of child morbidity (age <= 5 years)

Total No. of admitted patients reviewed for under five morbidity profile 4694
No. ICD-10 Code Disease name No. of Cases %
1 A09 A09 Diarrhoea and gastroenteritis of presumed infectious origin 1647 35.1
2 J189 J189 Pneumonia, unspecified 1269 27.0
3 R509 R509 Fever, unspecified 504 10.7
4 A419 A419 Septicaemia, unspecified 292 6.2
5 P219 P219 Birth asphyxia, unspecified 216 4.6

Top (5) 30+ population disease profile

Total No. of cases reviewed for 30+ population disease profile 10960
No. ICD-10 Code Disease name No. of Cases %
1 R104 R104 Other and unspecified abdominal pain 1327 12.1
2 Y09 Y09 Assault by unspecified means 1125 10.3
3 O809 O809 Single spontaneous delivery, unspecified 1092 10.0
4 A09 A09 Diarrhoea and gastroenteritis of presumed infectious origin 1041 9.5
5 R509 R509 Fever, unspecified 479 4.4
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Mortality Profile

Top (5) causes of death for age <= 5 years

Total No. of cases reviewed for age <= 5 years 133
No. ICD-10 Code Disease name No. of Cases %
1 J189 J189 Pneumonia, unspecified 57 42.9
2 P210 P210 Severe birth asphyxia 30 22.6
3 A419 A419 Septicaemia, unspecified 23 17.3
4 P071 P071 Other low birth weight 7 5.3
5 P361 P361 Sepsis of newborn due to other and unspecified streptococci 2 1.5

Top (5) Maternal causes of death

Total No. of cases reviewed for maternal deaths 11
No. ICD-10 Code Disease name No. of Cases %
1 O679 O679 Intrapartum haemorrhage, unspecified 5 45.5
2 O150 O150 Eclampsia in pregnancy 1 9.1
3 O152 O152 Eclampsia in the puerperium 1 9.1
4 O72 O72 Postpartum haemorrhage 1 9.1
5 O759 O759 Complication of labour and delivery, unspecified 1 9.1
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Mortality Profile

Top (5) causes of death between ages 30 & 70 years

Total No. of cases reviewed for causes of death (30 to 70 years) 158
No. ICD-10 Code Disease name No. of Cases %
1 X68 X68 Intentional self-poisoning by and exposure to pesticides 19 12.0
2 I64 I64 Stroke, not specified as haemorrhage or infarction 15 9.5
3 J449 J449 Chronic obstructive pulmonary disease, unspecified 10 6.3
4 I679 I679 Cerebrovascular disease, unspecified 7 4.4
5 V892 V892 Person injured in unspecified motor-vehicle accident, traffic 6 3.8
Water & sanitation
Indicators District %
Coverage of households having access to safe drinking water (%) 71.0
Coverage of households having access to sanitary latrines (%) 68.0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Surgeries done under the CS Office
Type No.
Major Surgeries 413
Minor Surgeries 4062
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - designation grade wise)
Grade Sanctioned Filled-up Vacant Vacancy %
Male Female Total (M+F)
District Total
Grade 1 0 0 0 0 0 0.0
Grade 2 0 0 0 0 0 0.0
Grade 3 0 0 0 0 0 0.0
Grade 4 0 0 0 0 0 0.0
Grade 5 5 3 0 3 2 40.0
Grade 6 22 5 2 7 15 68.2
Grade 7 13 7 3 10 3 23.1
Grade 8 32 20 3 23 9 28.1
Grade 9 40 18 6 24 16 40.0
Grade 10 101 10 79 89 12 11.9
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - designation grade wise)
Grade Sanctioned Filled-up Vacant Vacancy %
Male Female Total (M+F)
District Total
Grade 11 114 75 22 97 17 14.9
Grade 12 9 9 0 9 0 0.0
Grade 13 52 33 17 50 2 3.8
Grade 14 143 69 65 134 9 6.3
Grade 15 19 14 0 14 5 26.3
Grade 16 200 119 66 185 15 7.5
Grade 17 45 27 18 45 0 0.0
Grade 18 23 11 11 22 1 4.3
Grade 19 3 2 1 3 0 0.0
Grade 20 118 73 37 110 8 6.8
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - designation grade wise)
Grade Sanctioned Filled-up Vacant Vacancy %
Male Female Total (M+F)
Civil Surgeon Office
Grade 1 0 0 0 0 0 0.0
Grade 2 0 0 0 0 0 0.0
Grade 3 0 0 0 0 0 0.0
Grade 4 0 0 0 0 0 0.0
Grade 5 0 0 0 0 0 0.0
Grade 6 0 0 0 0 0 0.0
Grade 7 0 0 0 0 0 0.0
Grade 8 0 0 0 0 0 0.0
Grade 9 4 3 0 3 1 25.0
Grade 10 5 4 1 5 0 0.0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - designation grade wise)
Grade Sanctioned Filled-up Vacant Vacancy %
Male Female Total (M+F)
Civil Surgeon Office
Grade 11 5 2 1 3 2 40.0
Grade 12 1 1 0 1 0 0.0
Grade 13 2 0 0 0 2 100.0
Grade 14 10 6 0 6 4 40.0
Grade 15 5 5 0 5 0 0.0
Grade 16 3 2 1 3 0 0.0
Grade 17 0 0 0 0 0 0.0
Grade 18 0 0 0 0 0 0.0
Grade 19 1 1 0 1 0 0.0
Grade 20 7 5 1 6 1 14.3
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - personal grade wise)
Grade Filled-up
Male Female Total (M+F)
District Total
Grade 1 0 0 0
Grade 2 0 0 0
Grade 3 0 0 0
Grade 4 0 0 0
Grade 5 5 2 7
Grade 6 3 2 5
Grade 7 20 2 22
Grade 8 31 10 41
Grade 9 11 3 14
Grade 10 22 55 77
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - personal grade wise)
Grade Filled-up
Male Female Total (M+F)
District Total
Grade 11 50 21 71
Grade 12 28 17 45
Grade 13 119 73 192
Grade 14 68 66 134
Grade 15 7 1 8
Grade 16 43 16 59
Grade 17 52 38 90
Grade 18 9 8 17
Grade 19 4 2 6
Grade 20 23 14 37
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - personal grade wise)
Grade Filled-up
Male Female Total (M+F)
Civil Surgeon Office
Grade 1 0 0 0
Grade 2 0 0 0
Grade 3 0 0 0
Grade 4 0 0 0
Grade 5 1 0 1
Grade 6 0 0 0
Grade 7 4 0 4
Grade 8 0 0 0
Grade 9 1 0 1
Grade 10 4 1 5
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources (Pay scale - personal grade wise)
Grade Filled-up
Male Female Total (M+F)
Civil Surgeon Office
Grade 11 2 1 3
Grade 12 1 0 1
Grade 13 8 1 9
Grade 14 1 0 1
Grade 15 0 0 0
Grade 16 2 0 2
Grade 17 3 1 4
Grade 18 1 0 1
Grade 19 1 0 1
Grade 20 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Status of Human Resources under DGHS updated during this report preparation
Man
power		 Commu-
nity
Clinic		 USC/
UHFWC/
RD		 UHC DH/GH Others IM-
CI
Trai-
ned		 Basic
EOC
Trai-
ned		 CS-
BA
Tr-
-ai-
ned
San-
cti-
on-
ed		 Fill-
ed-
up		 San-
cti-
on-
ed		 Fill-
ed-
up		 San-
cti-
on-
ed		 Fill-
ed-
up		 San-
cti-
on-
ed		 Fill-
ed-
up		 San-
cti-
on-
ed		 Fill-
ed-
up
Physician 0 0 9 6 72 37 20 8 7 3 23 17 6
Nurse 0 0 0 0 64 54 32 30 3 1 25 19 3
Medical Assistant 0 0 12 11 19 14 0 0 9 2 10 1 0
Medical Technologist 0 0 6 4 41 38 3 3 1 1 0 0 0
CHCP 117 108 0 0 0 0 0 0 0 0 12 2 35
HI 0 0 0 0 13 4 0 0 0 0 0 0 0
AHI 0 0 0 0 41 33 0 0 0 0 0 0 0
HA 0 0 0 0 204 192 0 0 0 0 33 0 12
Total 117 108 27 21 454 372 55 41 20 7 103 39 56
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Equipment report is up-to-date
Equipment   Not installed (No.) Total (No.)
Functional (No.) Non-functional
Repairable (No.) Non-Repairable (No.)
Vehicles
Ambulance 0 0 0 0 0
Bus 0 0 0 0 0
Jeep 1 0 0 0 1
Microbus 0 0 0 0 0
Pickup 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Equipment report is up-to-date
Equipment   Not installed (No.) Total (No.)
Functional (No.) Non-functional
Repairable (No.) Non-Repairable (No.)
Air conditioner
Air conditioner (split type) 0 0 0 0 0
Air conditioner (window) 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Equipment report is up-to-date
Equipment   Not installed (No.) Total (No.)
Functional (No.) Non-functional
Repairable (No.) Non-Repairable (No.)
Generator
Generator (diesel/petrol) 1 0 0 0 1
Generator (Gas) 0 0 0 0 0
Solar panel 0 0 0 0 0
IPS 1 0 0 0 1
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Equipment report is up-to-date
Equipment   Not installed (No.) Total (No.)
Functional (No.) Non-functional
Repairable (No.) Non-Repairable (No.)
ICT equipment
Computer (desktop) 8 1 0 2 11
Laptop 3 1 0 0 4
Printer (dot matrix) 0 0 0 0 0
Printer (inkjet) 0 0 0 0 0
Printer (laser) 8 1 0 0 9
Scanner 1 0 0 0 1
UPS 0 0 0 0 0
Fax 0 1 0 0 1
Intercom 0 0 0 0 0
Internet fixed line 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Equipment report is up-to-date
Equipment   Not installed (No.) Total (No.)
Functional (No.) Non-functional
Repairable (No.) Non-Repairable (No.)
ICT equipment
Internet wireless line (Modem) 1 0 0 0 1
Multimedia 0 1 0 0 1
OHP 0 0 0 0 0
PA system 0 1 0 0 1
Land phone 2 1 0 0 3
Mobile phone 0 0 0 0 0
Photocopier machine 0 0 0 0 0
Digital camera 0 0 0 0 0
Video camera 0 0 0 0 0
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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Important information and necessary issues you want to raise
At the end, I would like to express my gratitude to all who contributed for completing this health bulletin. It is demanded that there should be some trainings, both basic and refresher on a periodic basis, like Nutrition, IMCI etc conducted for the staffs to increase the capacity and performance as well. Logistic supply should be kept smooth to ensure the services. Where there is HR gap should be met as per demand. For 2016, an annual plan has been formulated for improving the health status of Khagrachari District. I think if we work as per annual plan, the areas where we need to improve will be covered. Khagrachari is one of the three hill districts in Bangladesh with its unique and distinct characteristics in terms of demography, geography etc. If we ensure the quality services for the people here that would really be a matter of success. And to do so, the best effort must be ensured from all sites to improve the indicators and to drag us toward another step into Digital Bangladesh. Dr Nishit Nandi Majumder Civil Surgeon,Khagrachari.
Local Health Bulletin 2016 for Khagrachari Civil Surgeon Office, Khagrachhari Sadar, Khagrachhari

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