SUSTAINABILITY OF RURAL HEALTH SERVICES THROUGH PUBLIC-PRIVATE PARTNERSHIP

Abstract

Achieving universal health coverage is one of the key preferences of Bangladesh where people can receive health care without financial hardship. However, resource allocation is insufficient in health sector to ensure health service for all socio-economic groups. The disadvantaged and poor people still have notably less access to health care facility than the privileged and rich in Bangladesh. Globally growing resources limitations have increased the demand for and willingness of organizations to work together as partnership program. Thus, Public-private partnerships have become a familiar method to address health care issues in many countries. As a means of coping with these challenges, Bangladesh is also trying to ensure health service to all through organizational reform. As a result, community clinics have taken place as one of the crucial reforms in Bangladesh aiming cost-effective, responsive and sustainable initiative to ensure primary health service to all. In this context, this research seeks to find out the nature of this PPP, the extent of community participation, strengths and challenges of this program. In order to achieve the inquiry, purposive selection sampling was dealt at three unions in two districts. A qualitative research approach was used for the purpose of exploring into the research objective. Interview, case study, focus group discussion, review of secondary literature, key personnel interview and a personal observation were used as the research tools. From the empirical investigation, the research found that this PPP is a distinctive example of partnership between government and community people. This PPP is followed by contemporary public governance model where goal is not only cost reducing good designed contract mechanism but also a standard of mutual trust and collaboration between parties. There is a well-built structure of community involvement in this program by empowering community people through decentralization of power. This involvement is a sustainable attempt by the government as this partnership enhances greater capability of administration to focus on function that is not generally performed well by central government. However, though this service is satisfactory to most of the respondents, there is a gap between structure and practice in execution. The study has shown that some amount of caution is essential to mitigate the coordination gap between central government and community groups. The research provides some policy recommendations that will facilitate further useful attempt to ensure the goal of this PPP and concludes with a persuasion for further research on this study area.