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Universal health coverage

We evaluate gaps in access, delivery, quality, financing, policy and governance in the health sector in Bangladesh, and test interventions to remedy deficiencies.

 

Programme lead

Dr Mahbub E Elahi Khan Chowdhury (Acting)

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Our approach

icddr,b is committed to the principle that all people, irrespective of their social and economic position, should have access to affordable, acceptable, high quality and responsive health care. 

The conceptual framework for our work is provided by the six building blocks of health systems identified by the WHO: 

  • Service delivery
  • The health workforce
  • Information systems
  • Medical products
  • Financing 
  • Leadership and governance.

We have particular expertise in areas such as urban health, health care financing mechanisms, gender-related issues, innovative use of new technologies, implementation research and systematic reviews, strengthening capacity building of the national health programme, and demographic surveillance.

Discovery

An important aspect of our work is to provide a clearer picture of the healthcare landscape in Bangladesh and people’s care-seeking behaviour. This information provides an evidence base to inform the development of interventions and evidence-based policy. 

For example, we have developed a GIS-based tool to map the distribution of healthcare facilities and to compare their location with population centres. This tool is being used to guide planning of emergency obstetric and newborn care facilities.

We have also developed a tab-based quality-monitoring scorecard to improve the quality of maternal and neonatal health care in urban private-sector health facilities.

Development

We have developed a range of interventions to enhance access to healthcare and improve the quality of services. These include micro health insurance schemes designed to reduce the impact of large out-of-pocket expenditure on healthcare.

We also have a particular interest in the use of IT systems and mobile phone-based (‘mhealth’) approaches to improve access and as way of delivering care.

We are working with programme managers, policy-makers and service providers to promote gender equity and social inclusion in health policy and health governance, to make public health institutes more inclusive, especially of women and disadvantaged groups.

Our field site in Chakaria in south-east Bangladesh allows us to test interventions and monitor equity indicators over time.

Delivery

We actively engage with policy-makers and implementers in Bangladesh at national
and grassroots levels, promoting universal health coverage and encouraging the use of evidence to inform decision-making and to strengthen health systems. 

The Research Policy Communication Cell established within the Government of Bangladesh’s Directorate General of Health Services, with our support, provides a formal means to channel evidence to policy.

We are developing a road map to establish the practical steps by which universal health coverage can be achieved. We are also establishing as ‘learning platform’ to support the sharing of knowledge on universal health coverage.

We are actively engaged in capacity building of Government officials to strengthen management and service delivery. We are also working closely with Government officials to strengthen Bangladesh’s district health information system, and to ensure health systems monitoring and evaluation are in place and that local evidence is used for health planning.