Exclusion, cohesion and health While access to healthcare should be guaranteed by the state, there are a number of situations in which this is not possible given the existing infrastructure and capacity, with detrimental impact on large portions of the population. In such circumstances, other sectors can supplement public sector services. MHI is an example of the private sector, or private- sector with NGO partnership, stepping in to supple- ment inadequate public-sector service-delivery. As currently offered in Bangladesh, MHI inadequately addresses the economic and other barriers that prevent the poor from accessing healthcare. More research is needed to identify whether expanded MHI or other strategies can better serve the needs of the population. Corporate social responsibility (52) Corporate social responsibility (CSR) is another private sector-based strategy with the potential to reduce economic, social, cultural and political ex- clusion. CSR is an evolving concept globally but, in Bangladesh, it has been defined as a set of business practices based on ethical norms and transparency that contribute to the sustainable development of internal and external stakeholders in the best inter- est of business society and environment. A socially- responsible firm holds a holistic view of itself in relation to its stakeholders and measures its per- formance via a triple bottom-line: economic/finan- cial, environmental, and social. CSR seeks a path which advances all three measures, none at the cost of the others. Although CSR as a concept may have roots in philanthropic activities, the modern view of CSR is more strategic and complex. Most strategic CSR programmes share three com- mon characteristics: (a) they are part of the com- pany’s core business operations; (b) they use part- nerships with NGOs, civil society, or development partners; and (c) they benefit both excluded popu- lations and businesses by matching skills, capa- bilities, and resources. Three examples of CSR are presented: first, a collaboration between an NGO and two manufacturing firms to address drug-abuse relapse; second, a social business enterprise; and third, the example of Bangladesh’s leading phar- maceuticals manufacturers supporting their work- ers and the local community. Rehabilitation of drug-addicts: Drug-users in Bangladesh are often discriminated against and have significant difficulty when returning to soci- ety after rehabilitation. Typically, more than 90% of rehabilitated drug-addicts relapse after leaving 434 Johnston HB treatment. A pilot initiative by the NGO—Family Health International—provided skills training and employment for rehabilitated injecting drug-users in private-sector companies and fostered the devel- opment of a supportive community. Two manu- facturing companies provided job placements. Among project participants, the relapse rate back to drug-use was less than 10%. Most programme par- ticipants placed in the factories had high attend- ance levels and strong job performance. Some par- ticipants have been promoted. The pilot initiative shows promise as a strategy to give rehabilitated drug-users the skills and social abilities to build a new life and reduce risk of relapse. Employment for marginalized women: Hathay Bunano, a Social Business Enterprise, manufactures export-quality handicrafts, toys, and knitwear pro- duced in rural areas. The company actively seeks as employees individuals who are typically excluded from social and economic participation in society, including divorced, illiterate and disabled women. The Hathay Bunano business model is based on ru- ral production centres. The company finds a group of women in a rural area interested in working and willing to undertake 1-2 month(s) of training. After training, a small production facility is estab- lished. Women in the rural centres are given the responsibility to manufacture the knitted items at the required quality level. Since Hathay Bunano’s customers are high-end boutiques and retailers in Europe and UK, the quality of the products is critical to the success of the company. This trust by the company greatly empowers women who have previously rarely worked outside the home. Hathay Bunano provides a number of services for its em- ployees, including childcare, a healthcare social worker, and literacy classes. Women with minimal previous social contact benefit from the social net- works, economic gains, and cultural change associ- ated with regular women’s employment. Rural development: The Square Group is a large Bangladeshi corporation involved in pharmaceuti- cals, toiletries, chemicals, and consumer food prod- ucts for domestic and export markets. Square op- erates a number of manufacturing facilities in the rural Pabna district of Bangladesh. Square’s investments in rural community develop- ment help the company maintain a skilled work- force. Investments in local education include the modern Square Kindergarten which is open to chil- dren of employees, management, and the general community. Square provides free pharmaceuticals JHPN