Path to Universal Health Coverage in Bangladesh : Bridging the Gap of Human Resources for Health.

Front Cover -- Contents -- Preface -- Acknowledgments -- Executive Summary -- Acronyms -- Chapter 1 Introduction -- Overview -- Two Key Dates: 2021 and 2032 -- Key Challenges -- Chapter 2 The Path to UHC -- The Health Care Financing Strategy -- Chapter 3 HRH -- Introduction -- HRH Stock -- HRH Production -- Public Sector Salaries -- Vacancy Rates and Recruitment -- HRH Distribution-Facts and Factors -- HRH Quality and Productivity -- Work Environment -- Notes -- Chapter 4 HRH Policy-Making Process -- Introduction -- Major HRH Challenges -- A Complex and Sometimes Contradictory Array of National Policies -- A Highly Centralized and Cumbersome Bureaucratic System with Weak Response Capacity -- A Range of Powerful Stakeholders, Some with Competing Interests -- Weak Regulatory and Enforcement Capacity -- Conclusions -- Notes -- Chapter 5 HRH Policy Options for UHC -- Introduction -- Address HRH Shortages -- Improve the Skill-Mix -- Address Geographic Imbalances -- Retain Health Workers -- Adopt Strategic Payment and Purchaser Mechanisms -- Establish a Central Human Resources Information System -- Target HRH Interventions to Improve Maternal and Newborn Health -- Appendix A Health Coverage and Service Delivery System -- Public Service Delivery System -- Staffing of Primary Health Care Centers -- Human Resources for Health Production -- Alternative Medical Care Providers -- Appendix B Summary Implementation of HRH Policies -- Appendix C Economic Analysis for Options to Increase Health Care Providers by 2021 -- Objectives -- Methods -- Analysis and Findings -- Discussion -- Notes -- References -- Boxes -- 1.1 Good in Parts -- 3.1 The Brain Drain and Other Lost Assets -- 3.2 Training Innovations -- 3.3 Push and Pull Factors-All toward Urban Areas -- 3.4 Informal Sector/Semiqualified and Allopathic Providers -- 3.5 Community Health Workers.

5.1 Kenya: An Emergency Hiring Plan to Rapidly Scale Up the Health Workforce -- 5.2 Afghanistan: Community Midwifery Education Program -- 5.3 Nepal: Trained Outreach Workers Linking the Community to the Health System -- 5.4 Thailand: Integrated Interventions Enhance Equitable Distribution of Physicians Nationally -- 5.5 Chile: Well-Designed Incentive Package Successfully Addressed Physician Retention -- Figures -- 2.1 Sequencing of the UHC Plan -- 2.2 Proposed Evolution of Health Financing -- 2.3 THE Per Capita -- 3.1 Density of HCPs per 10,000 Population -- 3.2 Health Workforce Registered with the Bangladesh Medical and Dental Council (BMDC) and Bangladesh Nursing Council (BNC), 1997, 2007, and 2013 -- 3.3 Filled-In Posts as Percentage of Sanctioned Posts by Year -- 3.4 Process and Responsibilities for Creation of a New Post -- 3.5 Rural-Urban Distribution of HCPs by Type -- 3.6 Distribution of HCPs by Divisions (per 10,000 population) -- 4.1 Process to Fill a Vacant Position -- 5.1 Scenario II: Recruitment of Additional HCPs to Reach a Physician: Nurse: CHW Ratio of 1:1.5:1 by 2021 -- 5.2 Physician-to-Nurse Ratio and Health Service Utilization by Division -- 5.3 Physician-to-Nurse Ratio and Health Outcomes by Division -- A.1 Public Service Delivery System -- C.1 Budget for Salary and Allowance for All Health Workers -- C.2 Projection of the Number of Filled Positions (Laissez-Faire Scenario) -- C.3a Projected Numbers of Physicians and Nurses (Laissez-Faire Scenario) -- C.3b Projected Budget for Physicians and Nurses (Laissez-Faire Scenario) -- C.4a Projected Numbers of Physicians and Nurses (HRM Policy) -- C.4b Projected Budget for Physicians and Nurses (HRM Policy) -- C.5a Scenario I: Projections to Reach a Physician: Nurse: CHW Ratio of 1:1:1 in 2021 -- C.5b Scenario I: Budget Projections to Reach a Physician: Nurse: CHW Ratio of 1:1:1 in 2021.

C.6a Scenario II: Projections to Reach a Physician: Nurse: CHW Ratio of 1:1.5:1 in 2021 -- C.6b Scenario II: Budget Projections to Reach a Physician: Nurse: CHW Ratio of 1:1.5:1 in 2021 -- C.7a Scenario III: Projections to Reach a Physician: Nurse: CHW Ratio of 1:2:1 in 2021 -- C.7b Scenario III: Budget Projections to Reach a Physician: Nurse: CHW Ratio of 1:2:1 in 2021 -- CA.1 Methodology Used to Determine Scenarios I, II, and III -- CA.2 Steps in Developing Different Human Resources for Health Policy Options -- Tables -- 2.1 Public Expenditure Required for UHC -- 3.1 Annual Production Capacity of Health Workforce Including Private Sector, 2011 -- 3.2 Basic Pay Scale for Different Cadres of Health Professionals under Public Sector -- 4.1 HRH-Related Plans and Programs -- 5.1 Three Scenarios for Additional HCPs until 2021 -- 5.2 Deployment of New Recruits by Region -- A.1 Staff Mix at Upazila Level and Below in the Formal Sector -- A.2 Informal HCPs at PHC Level -- A.3 Categories of Health Workforce with Training Institutes, Admission Criteria, and Duration -- A.4 Number of Places for Postgraduate Courses Offered by Different Institutions -- A.5 Number of Fellowship and Membership Awardees by Year and Category -- B.1 Summary Implementation of HRH-Related Government Plans and Policies -- C.1 Salary and Allowance per Physician, Nurse, and CHW per Year -- C.2 Cost for Physicians and Nurses/Total Cost for Entire Health Workforce -- C.3 Fiscal Threshold for Physician/Nurse Category and for All Health Care Workers -- C.4 Targeted Numbers of Physicians and Nurses -- C.5 Laissez-Faire Scenario -- C.6 HRM Policy Scenario -- C.7 Scenario I: Physician: Nurse: CHW Ratio = 1:1:1 in 2021 -- C.8 Scenario II: Physician: Nurse: CHW Ratio = 1:1.5:1 in 2021 -- C.9 Scenario III: Physician: Nurse: CHW Ratio = 1:2:1 in 2021.

C.10 Cumulative Number of Physicians, Nurses, and CHWs under Different Scenarios -- Back Cover.

Bangladesh is committed to achieving universal health coverage (UHC) by 2032; to this end, the government of Bangladesh is exploring policy options to increase fiscal space for health and expand coverage while improving service quality and availability. Despite Bangladesh’s impressive strides in improving its economic and social development outcomes, the government still confronts health financing and service delivery challenges. In its review of the health system, this study highlights the limited fiscal space for implementing UHC in Bangladesh, particularly given low public spending for health and high out-of-pocket expenditure. The crisis in the country’s human resources for health (HRH) compounds public health service delivery inefficiencies. As the government explores options to finance its UHC plan, it must recognize that reform of its service delivery system with particular focus on HRH has to be the centerpiece of any policy initiative.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.