Bangladesh

Key research question:

What can be done to improve the performance of informal health care systems in meeting the health-related needs of the poor in Bangladesh?

In Bangladesh, even with a sizable public health sector infrastructure, the majority of outpatient health services are provided by the private sector, which includes around 300,000 informal health care providers.

Members of the Bangladesh research team

The majority of people living in rural areas of Bangladesh use these informal health care providers as their first line of care. It is also likely that poorer people use services provided by the informal health care providers more than the better offs.

Despite this, systematic attempts to engage with informal health care providers to help improve the quality of their services have been rare. This is one issue we want to address in our research and the other issue is to what extent health care providers are accountable towards the constituency they serve. This is mostly unknown at the moment.

This study in Bangladesh aims to generate a pool of information about:

• who and how many people the informal providers serve
• the types of health conditions they treat
• the nature and quality of services they provide
• the cost of their services
• the training and background of the providers
• how the community perceives the informal providers
• the link between local governance and the providers

The findings will be used to develop a package of interventions to engage with the informal health care providers. The aim is to improve the quality of services and establish accountability to improve the health of the villagers, especially the poor.