Health Governance in Bangladesh

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Department of Public Administration
Dhaka University

Assignment Topic: Health Governance in Bangladesh

Submitted to
Abu Hossain Muhammad Ahsan
Assistant Professor
Dept of Public Administration
Dhaka University.

Submitted by

Dilruba Islam
Dept of Public Administration
3rd Batch, 6th Semester
Class roll: rk-18




Introduction
Public policy making is not only a simple function, but also a process where different actors interact and try their best to influence the policy. Policy process and dynamics of politics is interrelated. The main aim of this assignment is to uncover the dynamics of politics in the agenda setting of the health governance of Bangladesh through investigation of the role of deferent actors. In every policy process politics play an important role in idea generation, formulation and implementation. Policy reform in health sector is not different from other policy reforms. In the process of health policy making of any country, different actors try to bring the governance in their favor through playing significant role. This interaction of deferent actors in governance is known as politics of public policy. In the complex political process of health sector reform viability of special agenda, type of changes in policy reform, vision of national politics play an important role. In Bangladesh, health is one of the most important sectors since good health ensure more social and economic production and good quality of life. Beyond debate, priority of the health sector is forefront in the development discourse, even though, ‘health sector’ it is associated with multi sectoral factors and actors. Thus, making implementation of health sector policy requires interplay of actors and factors from different sectors and levels: local, national, regional and international.

Health situation in Bangladesh
Till today, health situation in Bangladesh is not quite satisfactory. Lack of broad national health policy or policy vacuum, lack of policy priority setting, discontinuity of policy, lack of policy ownership, lack of resource allocation and lack of proper uses of resources due to lack institutional arrangement and elite dominated health sector are the main characteristics of health sector in Bangladesh. These characteristics create hindrance in the process of achievement of national and international goals and ultimately health situation of common people remains vulnerable. Bangladesh, being a country with small land size of 144,000 sq. km, has the burden of a huge population of 140 million. Still, with low per capita income and low literacy. Though Bangladesh has one of the strongest networks for delivering countrywide health services among developing countries, still the quality of services are not up to the mark and the services are neither client focused nor need based. In the following tables we demonstrated the trends of basic health indicators of Bangladesh

Indicators1970s
(1978-80)1980s
(1990)1990s
(1996-972000s
(2003)2007
Population growth rate2.72.101.741.54NA
Infant mortality rate(per 1000)150116776652
Maternal mortality rate105.74.13NA
Delivery care by trained2581218
Under 5 mortality rate(per 1000)2991101169465

Table 3.1: Trends of Basic Health Indicators of Bangladesh

Heath governance system
The government driven healthcare service has a network in all over the country from the centre to the extreme periphery, having two wings, one concerned with Population and Family Planning and the other concerned with Health in total. The service network has three approaches with primary care at upazilla level; secondary care at district level; and tertiary care at divisional level. To administer administrative activities the country has six administrative divisions and 64 districts and furthermore the districts are divided into upazilas (476 in number) and upazilas into unions (4,770). It is estimated that each of the union...
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