Private Sector Assessment for Health, Nutrition and Population in Bangladesh
The objectives of this Private Sector Assessment (PSA) are to gain a better understanding of the private health care markets in Bangladesh, and to identify areas for increased collaboration between the government, and the private sector. While the...
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| Format: | Other Health Study |
| Language: | English en_US |
| Published: |
Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2003/11/2827313/bangladesh-private-sector-assessment-health-nutrition-population-hnp-bangladesh http://hdl.handle.net/10986/14667 |
| Summary: | The objectives of this Private Sector
Assessment (PSA) are to gain a better understanding of the
private health care markets in Bangladesh, and to identify
areas for increased collaboration between the government,
and the private sector. While the study analyzes private
health care markets in general, it uses maternal and child
health (MCH) as an area of special focus to illustrate
general principles, and/or draw lessons for the broader
health, nutrition, and population (HNP) sector. MCH was
chosen for this emphasis in view of its importance in
Bangladesh, and because MCH outcomes constitute a
significant part of the Millennium Development Goals (MDG).
The PSA analysis confirmed that the private sector dominates
the provision of basic care, nursing homes, laboratory and
ambulatory diagnostic services; the public sector, however,
remains the main provider of inpatient care. The private
sector is used for the overwhelming majority of outpatient
curative care, while the public sector is used for a larger
proportion of hospital deliveries, and preventive care. The
higher proportion of institutional deliveries in the public
sector, should be understood by the fact that overall, the
proportion of institutional deliveries is only 8%.
Nonetheless, the dependence on the private sector for
curative care is also true for the poor in the country: the
poorest 20 percent of children have a higher dependence on
the private sector for the management of acute respiratory
infections, and diarrhea than the richest quintile. So,
while expectedly the richest quintile spends more than the
poorest quintile (by a factor of 6) on health care, the
proportion of the spending that goes to the private sector,
is higher among the poor than among the rich. Yet, financial
barriers and lack of basic insurance coverage - public or
private - appear to be major constraints for access to care
for the poor, and, efforts need to address the financial,
physical, and social barriers, especially for the women and
the poorer population groups. Key issues stipulate: the
public sector is not strategically using the scarce
resources that are available in the private sector,
aggravated by a low level of public expenditure on health
care, conducing to a low level care provision, with the
consequent shortages of formally trained staff. In
particular, the following three areas appear to deserve
priority in government actions: under-consumption of
services by the poor and women; service quality and
outcomes; and, the knowledge base. |
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