Assessment of the Second Urban Primary Health Care Project in Bangladesh

With rapid urbanization in recent decades and over 40 million people living in urban areas in Bangladesh in 2011, the country faces challenges in providing adequate health services for the burgeoning urban population. Given the need to improve basic health conditions and provision of health services in urban areas, especially for the poor, the Government of Bangladesh launched the first Urban Primary Health Care Project (UPHCP I) in 1998 and continued with a second phase (UPHCP II) from 2005 to 2012. Provision of services is through contracted non-government organizations (NGOs) in partnership areas (PAs). Assessment of the evidence show that there have been interim achievements with UPHCP II, namely, improvements across several service quality indicators, increasing equity of maternal and child health service coverage for the poor, and decreased cost over time in some PAs. Most rankings of PA performance across health service quality, cost, and maternal and child health coverage are weakly correlated, with only a few PAs scoring in the top-ranked half across all indicators. However, service quality indicators, such as training of staff, functioning of equipment, availability of drugs, infection prevention, waste disposal, use of registers, and overall and waiting time satisfaction of non-poor patients, have improved over time.