IPS HPP Occasional Paper No. 12
GOB faces significant resource constraints in funding the proposed Essential Package of Services (ESP). Previous reports have found that the potential for additional resource mobilisation is limited, and suggested that improvements in the internal efficiency of MOHFW-delivered health services must be an essential component of efforts to provide the ESP to the whole population. This study was conceived as an effort to provide the basic data required to develop a strategy for raising the efficiency of all facilities, particularly the Thana Health Complexes and District Hospitals of Bangladesh, to provide baseline data on performance of MOHFW facilities before commencement of the Fifth Population and Health Project, and to demonstrate the feasibility of survey methods to collect the necessary information to assess facility unit costs and efficiency.

At the inception of the study, data on actual unit costs of delivering services at the Thana and District level were extremely limited. In addition to making it difficult to estimate the likely cost of the Essential Package when implemented, it was impossible to quantify the likely costs of existing inefficiencies. Absence of detailed facility cost data prevented any assessment of the scope for improvements in facility efficiency.
This report presents the results of the first phase of the Facility Efficiency Study, during which survey instruments were developed and used on a sample of facilities. Findings for the sample of facilities surveyed are presented. Some preliminary implications are developed, but these must be subject to further analysis and investigation.

by Ravi P. Rannan-Eliya and Aparnaa Somanathan