Context
Since 1998, to strengthen the health sector, the Government of Bangladesh has conducted a series of five-year programmes that use a sector-wide approach, in coordination with bilateral and multilateral donors. The current programme, running from July 2011 to June 2016, is the Health, Population and Nutrition Sector Development Programme (HPNSDP). This is intended to improve access to relevant and essential services, particularly for the poorest and most vulnerable people, and to encourage people to make greater use of those services.
Objective
The foundations have been put in place for the evidence-based design and implementation of public health reforms, with particular emphasis on ensuring social justice.
Approach
Since mid-2011, on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ), GIZ has been working together with strategic units of the Bangladeshi Ministry of Health and Family Welfare (MOHFW), and with other development partners, in support of the HPNSDP. The project ‘Support to the Health Sector Programme II’ builds on an earlier project of the same name, and works in accordance with national strategies and operational plans to address challenges facing the health system in the following areas.
• Health information system; monitoring and evaluation. The project is working to simplify the existing health information system and make sure that routine data is available in a timely manner for evidence-based decision making. It is introducing information and communications technology to strengthen the system and mainstream the national data warehouse. This should promote the use of the information, while harmonising various data management systems.
• Health financing. The project supports the government in implementing its new Health Care Financing Strategy, which aims to achieve universal health coverage. The support ranges from capacity building activities for the staff of the Health Economics Unit, enabling them to analyse national health accounts and perform health utilisation and expenditure surveys, to the design of alternative health financing concepts. Another important part of the project involves support for MOHFW and the Bangladesh Rehabilitation Assistance Committee (BRAC) – one of the largest NGOs in the country – in introducing a social health insurance scheme for the formal sector.
• Quality management. The project supports the government’s policy-level efforts to improve the quality of health care. There is a need for a strategic plan on improving the quality of care. When this is in place, GIZ will provide technical assistance for various initiatives, such as the adoption, certification and accreditation of uniform standards, capacity development and systems building.
• Occupational health and safety. In cooperation with MOHFW, the project promotes a holistic approach to improving occupational health and safety in industry, especially in the ready-made garment sector. It provides technical support to factories to help them achieve ‘OHSAS 18001’ certification, a widely respected standard for managing occupational health and safety.
Results
The design of the social health insurance model for the formal sector has been finalised. This is now awaiting approval for pilot adoption. The use of a popular open source software called DHIS2 has enabled most of the previously fragmented information system to be integrated on a single platform, opening the way to the seamless generation of accurate data in support of the policy-making processes. Meanwhile, the strategic plan for improving the quality of health care is ready for endorsement by the MOHFW. This paves the way for further reforms that would improve the quality of the care provided by both public and private health services.