GRAUS is committed to improving the health and well-being of communities in the Chittagong Hill Tracts (CHT) through an integrated approach that combines health system strengthening, nutrition, Maternal, Newborn and Child Health (MNCH), and Water, Sanitation and Hygiene (WASH) interventions. Recognizing the unique challenges of the CHT—including geographic isolation, difficult terrain, limited healthcare infrastructure, seasonal water scarcity, poverty, and disparities affecting Indigenous and marginalized populations—GRAUS works to ensure that essential health and WASH services are accessible, equitable, and sustainable.
Health system strengthening lies at the heart of GRAUS’s approach. Many remote communities in the CHT face significant barriers to accessing quality healthcare due to long distances from health facilities, shortages of skilled health personnel, inadequate transportation, and limited health information. To bridge these gaps, GRAUS supports community-based healthcare delivery through trained community nurses, health volunteers, and local health workers who provide basic health services, disease prevention education, health screening, and referrals. These frontline workers serve as critical links between communities and formal healthcare systems, ensuring that vulnerable populations receive timely and appropriate care.
A major focus of GRAUS’s health programming is the improvement of Maternal, Newborn, and Child Health (MNCH) outcomes. Maternal mortality, neonatal complications, malnutrition, and limited access to skilled birth attendance remain important concerns in many hard-to-reach areas of the CHT. GRAUS promotes safe motherhood through antenatal and postnatal care awareness, birth preparedness planning, maternal nutrition counseling, and community education on danger signs during pregnancy and childbirth. The organization establishes and strengthens referral systems that connect pregnant women, newborns, and emergency patients to appropriate healthcare facilities, helping to ensure safe deliveries and timely medical interventions. By improving coordination between communities and health facilities, GRAUS contributes to reducing preventable maternal and child deaths and improving overall family health.
Nutrition is integrated across all health interventions, recognizing its critical role in child growth, cognitive development, maternal health, and community resilience. The CHT experiences persistent challenges related to food insecurity, inadequate dietary diversity, micronutrient deficiencies, and child undernutrition, particularly among vulnerable households. GRAUS promotes improved nutrition practices through community awareness campaigns, infant and young child feeding education, maternal nutrition support, kitchen gardening initiatives, and behavior change communication. Special attention is given to the nutritional needs of pregnant and lactating women, infants, and young children to reduce stunting, wasting, and other forms of malnutrition. Through community engagement and local capacity building, GRAUS helps families adopt healthier dietary practices and improve household nutrition security.
GRAUS recognizes that sustainable health outcomes cannot be achieved without adequate access to safe water, sanitation, and hygiene services. Therefore, WASH interventions are fully integrated into its health and nutrition programming. In many CHT communities, access to safe drinking water remains constrained by seasonal water shortages, unreliable water sources, and difficult terrain. These challenges contribute to waterborne diseases, poor hygiene practices, and increased health risks, particularly for children and women.
To address these issues, GRAUS supports the installation and rehabilitation of community-managed water supply systems that provide reliable access to safe drinking water. The organization promotes innovative and climate-resilient solutions such as gravity flow water systems, which harness natural hill streams to deliver water to remote settlements, and rainwater harvesting systems that help households and institutions store water during the rainy season for use throughout dry periods. These interventions not only improve water security but also reduce the time and physical burden associated with water collection, particularly for women and girls.
The POP Water Systems initiative further enhances access to safe and treated drinking water in underserved communities. By improving water quality and reducing dependence on unsafe water sources, these systems contribute significantly to the prevention of diarrheal diseases, parasitic infections, and other water-related illnesses. Improved access to safe water directly supports better nutrition outcomes, maternal health, and child well-being.
GRAUS also promotes improved sanitation and hygiene practices through community-led and school-based interventions. The organization’s School-Led Total Sanitation (SLTS) approach empowers children and adolescents to become agents of change, encouraging positive hygiene behaviors within schools, households, and communities. Through hygiene education, handwashing campaigns, menstrual hygiene management awareness, and sanitation promotion activities, GRAUS fosters long-term behavior change that contributes to healthier environments and reduced disease transmission.
The organization supports the development of safe, inclusive, and gender-responsive sanitation facilities in schools and communities while promoting proper waste management and environmental health practices. These efforts are particularly important in reducing the prevalence of waterborne diseases, respiratory infections, and hygiene-related illnesses that disproportionately affect children.
By integrating health system strengthening, nutrition, MNCH, and WASH interventions, GRAUS adopts a holistic approach that addresses both the immediate and underlying determinants of health in the CHT. Through community nurses, strengthened referral systems, preventive healthcare, safe water solutions, improved sanitation, and nutrition-sensitive programming, GRAUS is helping to build healthier and more resilient families and communities. This integrated model not only reduces disease and vulnerability but also strengthens local capacities, enhances community ownership, and contributes to long-term sustainable development across the Chittagong Hill Tracts.
