Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households.
Entries in Sabrina Rasheed (3)
Previous work from ICDDR,B established village doctors as an important player Bangladesh’s healthcare system, as they are often the first port of call for the rural poor. Considering this importance and the huge shortfall of formally trained health workforce in the country, there is a clear need to improve the quality of the services offered by these semi-trained village doctors. In response, a team of ICDDR,B researchers tested a package of interventions, which included training of the village doctors, establishing a community watch for improved accountability and establishing branded franchise of better trained village doctors.
In Bangladesh the rates of maternal mortality have not reduced appreciably over the past decade. Although many of these deaths could be prevented by providing safe motherhood services through skilled birth attendants, equitable access to these services for the poor remains a problem. This article illustrates how a performance based payment scheme can decrease this inequity and provide lessons for future programs.