PRIMASYS: Comprehensive case study from Bangladesh

Overview

The purpose of the report is to provide an overview of Bangladesh’s PHC system. Key informant data were used to provide a critical review of some of the main strengths and weaknesses regarding the sector’s structure and governance, financing, human resources, planning and implementation, regulatory processes, and systems for monitoring and data management. The research team followed the framework and template provided by the Alliance for Health Policy and Systems Research, slightly adapted for the local context as data collection proceeded. This framework adopts what could be called the “medical model” of PHC, which focuses on the provision of medical care to ambulatory patients. Given that it is the 40th anniversary of the Alma-Ata Declaration and that so much of PHC provision in Bangladesh has sought to follow the social model of health care, some commentary on this aspect of PHC in Bangladesh is provided.

This case study was developed by the Alliance for Health Policy and Systems Research, an international partnership hosted by the World Health Organization, as part of the Primary Health Care Systems (PRIMASYS) initiative. PRIMASYS is funded by the Bill & Melinda Gates Foundation, and aims to advance the science of primary health care in low- and middle-income countries in order to support interventions worldwide. The PRIMASYS case studies cover key aspects of primary health care systems, including policy development of care, governance and organization, and monitoring and evaluation of system performance. The Alliance has developed full and abridged versions of the 20 PRIMASYS case studies. The abridged version provides an overview of the primary health care system, tailored to a primary audience of policy-makers and global health stakeholders interested in understanding the key entry points to strengthen primary health care systems. The comprehensive case study provides an in-depth assessment of the system for an audience of researchers and stakeholders who wish to gain deeper insight into the determinants and performance of primary health care systems in selected low- and middle-income countries.