Performance of health facilities in Bangladesh: results published and disseminated

WHO Bangladesh

Results of a performance assessment of health facilities in the government sector reveal scope for improvement in their performance . The findings are part of the ‘in-depth analysis of the results of performance of public sector health facilities in Bangladesh in 2017’ report, published in 2019.

The analysis was conducted by the health systems strengthening (HSS) initiative by the Management Information System (MIS) of the Directorate General of Health Services (DGHS) in Bangladesh with technical support from the World Health Organization.

Sixty-eight facilities were shortlisted out of 510 facilities for an in-depth evaluation of their performance after scoring above 60% in the online (based on the DHIS2 reporting platform) and the on-site (conducted by local managers) monitoring tool results. These sixty-eight facilities were then assessed based on a physical assessment tool and a patient satisfaction survey. Health facilities participating in the overall assessment included: upazila health complexes (UHCs), district hospitals (DHs), medical college hospitals (MCHs), and specialty postgraduate institute and hospitals (SpHs).

The analysis drawn in the report compares the scores received by the shortlisted and non-shortlisted facilities with the first two tools. Regions were also compared to show whether there was a difference in performance between the eight divisions in Bangladesh. For the shortlisted facilities, data entered in the online measurement tool were verified for accuracy. The performance of health facilities was classified as “good”, “moderately good”, “moderately poor” and “poor”.

Based on the aggregated standardized score, the performance of 19 (3.73%) health facilities was “good” (>=75%), 269 (52.75%) “moderately good” (50% to <75%), 205 (40.20%) “moderately poor” (25% to <50%) and 17 (3.33%) “poor” (<25%). Performance gaps have been identified as particularly high in upazila health complexes, where the report shows that only 2.38% of the total (10 out of 420) performed at a “good” during 2017.

Based on this result, more attention to the performance of primary care services is needed in order to enable the country to move towards universal health coverage by 2030.