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The path to universal health coverage in Bangladesh : bridging the gap of human resources for health (English)

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. The Path to Universal Health Coverage in Bangladesh assesses the current status of HRH in terms of production, recruitment, and deployment as well as related policy-making processes. It then explores policy options based on evidence from international experience that will help Bangladesh improve the availability and skill-mix of its health workforce. To reach its goal of UHC by 2032, the government will have to commit itself to policies to expand health financing options and, at the same time, tackle HRH challenges head on. This study presents an economic analysis model of different scenarios that accelerate closing the HRH gap for nurses and community midwives by 2020 within the government's fiscal space, thus improving the skill-mix of its health workforce. The study also presents detailed policy options to address HRH shortages, improve the skill mix, address geographic imbalances, retain health workers in rural areas, and adopt strategic payments and purchasing mechanisms. In presenting these options, the study provides evidence from literature as well as cogent cases from low- and middle-income countries, such as Afghanistan, Chile, Indonesia, Malawi, Nepal, Tanzania, and Thailand, to demonstrate the effect of these policies.


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    El-Saharty,Sameh, Sparkes,Susan Powers, Barroy,Helene, Ahsan,Karar Zunaid, Ahmed,Syed Masud

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    South Asia,

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    The path to universal health coverage in Bangladesh : bridging the gap of human resources for health

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    Health Workers;maternal and child welfare;quality of health care;Demographic and Health Survey;quality health care;rural area;high rate of absenteeism;Human Resources for Health;retention of health workers;primary health care system;national health;quality of health services;inefficiency in service delivery;equity in health care;scheme will;maternal and child health;poverty head count;shortage of health worker;clear lines of accountability;Acquired Immune Deficiency Syndrome;nurses and midwives;policy option;health workforce;public health service;purchasing power parity;skilled birth attendants;traditional birth attendant;health care cost;gross domestic product;quality of care;bed occupancy rate;government entity;public health facility;infant mortality rate;point of care;enforcement of regulation;budget for health;children under age;expenditure per capita;social development outcome;partnerships with ngos;emergency obstetric care;financing for health;total fertility rate;children per woman;mental health issues;Human Immunodeficiency Virus;skilled birth attendance;midwifery education program;privileges and immunity;private sector provider;service delivery system;comments and feedback;gap in knowledge;rural health worker;career progression pathway;health outcome indicators;public education campaign;national health system;human resource development;public sector provision;private sector contract;health care facility;state service provider;restrictive civil service;number of seats;female health workers;health care budget;public health expenditure;source of financing;government health service;career development system;community health worker;study in terms;public sector worker;mandatory retirement age;health care facilities;informal sector;financial incentive;budget projection;Medical care;live birth;Basic Drugs;policy-making process;pregnant woman;geographic distribution;remote area;work environment;production capacity;health benefit;increased demand;performance incentive;health coverage;Contracting Mechanism;government process;government body;Maternal Health;payroll tax;contributory scheme;financial resource;urban bias;Antenatal Care;noncommunicable diseases;children of ages;government plan;government hospital;bureaucratic system;targeted training;life expectancy;



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El-Saharty,Sameh Sparkes,Susan Powers Barroy,Helene Ahsan,Karar Zunaid Ahmed,Syed Masud

The path to universal health coverage in Bangladesh : bridging the gap of human resources for health (English). A World Bank Study Washington, D.C. : World Bank Group.