Private Sector Health Services in Bangladesh

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Private Sector Health Services in Bangladesh: An Exploratory Study

Abul Barkat AKM Maksud

Human Development Research Centre (HDRC)

Prepared for

EngenderHealth, Dhaka
February 2003

ACRONYMS

BDS BMA BPMPA DGHS DPHE ESP GDP GOB HEU HNPSP HPSP MCH MOHFW NGO PHSA PIP TFR UMIS WHO

Bangladesh Dental Society Bangladesh Medical Association Bangladesh Private Medical Practitioner’s Association Director General of Health Services Department of Public Health and Engineering Essential Services Package Gross Domestic Product Government of Bangladesh Health Economics Unit Health, Nutrition Population Sector Programme Health and Population Sector Programme Maternal and Child Health Ministry of Health and Family Welfare Non-Governmental Organization Private Health Sector Assessment Project Implementation Plan Total Fertility Rate Unified Management Information Systems World Health Organization

CONTENTS
Section # Title Page #

1. 2. 3. 4.

Introduction ................................................................................................................... 1 Objective and Methodology ........................................................................................... 1 Concept of Private Health Sector .................................................................................. 3 Types, Number and Locations of Private Sector Health Personnel and Facilities ......... 4 4.1. Private Medical Practitioners and Human Resource Situation for Health .............. 4 4.2. Number of Medical Professionals in Private Medical Colleges and Institutions..... 6 4.3. Registered Private Hospitals/Clinics by Number of Beds and Medical Human Resource by District .............................................................................................. 7

5. 6. 7. 8. 9.

Networks of Private Health Practitioners and Health Facilities ...................................... 9 Health Policies in Bangladesh ....................................................................................... 10 Government and Professional Organization’s Regulations to Oversee and Regulate the Private Health Sector ............................................................................... 11 Economics of Private Sector Health Services : Some Relevant Issues ........................ 12 Health Financing Approaches in Private Sector ............................................................ 15

10. Discussion and Conclusions ......................................................................................... 18 References ............................................................................................................................ 21 Annex 1: Annex 2: Proposed Scope of Work (Supplied by EngenderHealth) The Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance, 1982

1.

Introduction

Bangladesh, a small country with a large population of about 130 million contained in 147,570 square kilometres (56977 sq. miles) is almost entirely surrounded by India (North, West, East) except for a short frontier with Myanmar at south-east, and a southern coast line on the Bay of Bengal. The country has agro-based economy with GDP growing at a rate of 4.0-4.5%. The country for administrative purpose is divided into 6 Divisions, 64 Districts (Zilas), 507 Thanas/Upazila (sub-districts) and 4,484 Unions, 87319 villages1. The country has a unitary form of government run by democratically elected representatives of the people. Although there has been success in health services, still more than 60 percent of the population has no access to basic health care. According to government’s documents less than 40 percent of the population has access to basic health care.2 Other issues include overall poor utilization of government facilities, as well as cost effectiveness, sustainability and quality of public sector services. So the proportion of the global burden of disease carried solely by...
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