The First Health Systems in Transition (HiT) Review of Bangladesh Released

The first HiT review of Bangladesh is released by APO (The Asia Pacific Observatory on Health Systems and Policies). The APO is a collaborative partnership of interested governments, international agencies, foundations, and researchers that promotes evidence-informed health system policy regionally and in all countries in the Asia Pacific region. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or development. HiTs examine approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health-care policies; and highlight challenges and areas that require more in-depth analysis. HiT profiles seek to provide information to support policy-makers and analysts in the development of health systems.

Since independence in 1971, the health system of Bangladesh has gone through a number of reforms and established an extensive health infrastructure in the public and private sectors. Bangladesh has achieved impressive improvements in population health status by achieving MDG 4 by reducing child death before the 2015 target, and rapidly improving on other key indicators including maternal death, immunization coverage, and survival from some infectious diseases including malaria, tuberculosis, and diarrhoea. However, some challenges for the health system remain critical.

First, lack of coordination across two different ministries for implementing primary health-care service delivery in rural and urban areas; second, critical shortage of trained health providers with appropriate skill-mix in the public sector and widespread increase in unregulated informal providers for an alternative source of care; third, low annual allocation to health in the government budget and high out-of-pocket payments by households; and finally, inequitable access to health services between urban and rural areas including variable health financing mechanisms, which have slowed achieving universal health coverage.

Mobilizing the private sector to increase the production of health work force and bringing informal health-care providers within the mainstream health system may facilitate reducing the gap in human resources in a relatively shorter time period. There is an urgent need for more investment of public funds and stronger local accountability to improve the quality of public services, and monitoring the quality of care provided by the private and informal

 
The report can be downloaded from this link: http://www.wpro.who.int/asia_pacific_observatory/hits/series/bgd/en/