Decentralized Provision of Primary Helathcare in Rural Bangladesh: a study of government facilities

Research output: Contribution to conferencePaper, not in proceeding


Bangladesh has made significant progress in health indicators in recent years in spite of her low level of income. This is mainly due to the commitment of the state supported by donors in providing preventive care with respect to child health and family planning. However, there are serious problems related to both access and quality of curative care that hurt the poor most. Infrastructures for service delivery exist at local level in rural areas but they function inefficiently. This paper deals with the systemic weaknesses of decentralized service provision of primary healthcare in Bangladesh and focuses on accountability links between different actors and functions of delegation, finance, performance, information and enforcement. The study is based on facility- and household-based data collected during 2005 in Khulna Division. The main findings of the study are: the health system in rural areas represents deconcentration rather than decentralization of central government functions where inter-sectoral discipline works poorly; local health providers are not accountable to local government, and poor citizens/clients are neither aware of their rights nor are capable of expressing their needs as effective channels do not exist.


  • Alia Ahmad
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Economics


  • decentralization, accountability, governance, primary healthcare
Original languageEnglish
Publication statusPublished - 2007
Publication categoryResearch
EventAnnual Conference of the Norwegian Association for Development Research "Making Institutions Work for the Poor" - Bergen, Norway
Duration: 2007 Nov 52007 Nov 7


ConferenceAnnual Conference of the Norwegian Association for Development Research "Making Institutions Work for the Poor"

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