Scaling-up in health: two decades of learning in Bangladesh.
The Bangladesh Rural Advancement Committee (BRAC) was established in 1972 as a small charitable group whose goal was to help reconstruct Bangladesh after the Liberation War. Following the social unrest of 1971, 10 million refugees had returned to destroyed homes and crops. By the end of 1990, BRAC had organized 600,000 of the poorest rural men and women into more than 10,000 grassroots organizations in more than 9000 villages. As such, by 1991, BRAC had grown into one of the largest indigenous nongovernmental organizations in the world. It is staffed by approximately 4250 regular employees and 4000 part-time primary school teachers with an annual budget of approximately US$20 million. Growing at the rate of 2000 new village groups and 100,000 new members each year, BRAC is evolving a strategy to lead its members to sustainable self-reliance. The authors explain how BRAC expanded its health program from home-based oral rehydration therapy to a full range of health and development activities focusing upon the poorest women in the community. The organization remains dynamic, evolving to meet the needs of the people of Bangladesh.