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Decentralized Provision of Primary Healthcare in Rural Bangladesh: a study of government facilities

Ahmad, Alia LU (2007) In Working Papers, Department of Economics, Lund University
Abstract
Bangladesh has made significant progress in health indicators in recent years in spite of her low level of income. This is mainly due to the commitment of the state supported by donors in providing preventive care with respect to child health and family planning. However, there are serious problems related to both access and quality of curative care that hurt the poor most. Infrastructures for service delivery exist at local level in rural areas but they function inefficiently. This paper deals with the systemic weaknesses of decentralized service provision of primary healthcare in Bangladesh and focuses on accountability links between different actors and functions of delegation, finance, performance, information and enforcement. The... (More)
Bangladesh has made significant progress in health indicators in recent years in spite of her low level of income. This is mainly due to the commitment of the state supported by donors in providing preventive care with respect to child health and family planning. However, there are serious problems related to both access and quality of curative care that hurt the poor most. Infrastructures for service delivery exist at local level in rural areas but they function inefficiently. This paper deals with the systemic weaknesses of decentralized service provision of primary healthcare in Bangladesh and focuses on accountability links between different actors and functions of delegation, finance, performance, information and enforcement. The study is based on facility- and household-based data collected during 2005 in Khulna Division. The main findings of the study are: the health system in rural areas represents deconcentration rather than decentralization of central government functions where inter-sectoral discipline works poorly; local health providers are not accountable to local government, and poor citizens/clients are neither aware of their rights nor are capable of expressing their needs as effective channels do not exist. (Less)
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author
organization
publishing date
type
Working Paper
publication status
published
subject
keywords
decentralization, accountability, governance, primary healthcare
in
Working Papers, Department of Economics, Lund University
issue
11
publisher
Department of Economics, Lund Universtiy
language
English
LU publication?
yes
id
245d524a-8479-4dda-8f7c-5b37f37b2c9e (old id 1385239)
alternative location
http://swopec.hhs.se/lunewp/abs/lunewp2007_011.htm
date added to LUP
2009-04-20 12:27:16
date last changed
2016-04-16 08:11:07
@misc{245d524a-8479-4dda-8f7c-5b37f37b2c9e,
  abstract     = {Bangladesh has made significant progress in health indicators in recent years in spite of her low level of income. This is mainly due to the commitment of the state supported by donors in providing preventive care with respect to child health and family planning. However, there are serious problems related to both access and quality of curative care that hurt the poor most. Infrastructures for service delivery exist at local level in rural areas but they function inefficiently. This paper deals with the systemic weaknesses of decentralized service provision of primary healthcare in Bangladesh and focuses on accountability links between different actors and functions of delegation, finance, performance, information and enforcement. The study is based on facility- and household-based data collected during 2005 in Khulna Division. The main findings of the study are: the health system in rural areas represents deconcentration rather than decentralization of central government functions where inter-sectoral discipline works poorly; local health providers are not accountable to local government, and poor citizens/clients are neither aware of their rights nor are capable of expressing their needs as effective channels do not exist.},
  author       = {Ahmad, Alia},
  keyword      = {decentralization,accountability,governance,primary healthcare},
  language     = {eng},
  note         = {Working Paper},
  number       = {11},
  publisher    = {Department of Economics, Lund Universtiy},
  series       = {Working Papers, Department of Economics, Lund University},
  title        = {Decentralized Provision of Primary Healthcare in Rural Bangladesh: a study of government facilities},
  year         = {2007},
}