The widespread collection of unofficial fees at health facilities is a common form of rent-seeking behaviour in Bangladesh. Typically, unofficial fees come in the form of cash payments for the performance of required services, for direct purchase of drugs and medical-surgical requisites, and for service access. Using observational and interview methods, this study explores linkages between official and unofficial fees at three Bangladesh health facility levels; primary care Thana Health Complexes, secondary or district hospitals, and medical college hospitals. The study estimates payment levels for different income classes and different payor types at these facilities, thereby highlighting potential equity, price and institutional questions associated with unofficial fees. Not only does the practice have clear income and equity effects, there also appear to be direct effects upon patient satisfaction, perception of quality, and the ability to pay for health services. The article concludes with a discussion of 'rent capture' processes at Bangladesh facilities and the effect of unofficial fees in six areas of health sector reform: displaced official policies, reduced merit goods production, upward income redistribution, distorted human resource development, growth of facility inefficiency, and obstruction of market reforms.

No abstract

Abstract:The surface pressure-area relationships at the air-waterinterface of spread films of the milk proteins a-casein, fl-casein, fl-lactoglobulin and a-lactalbumin have been examined in the absence and presence of glyceryl monostearate, glyceryl distearate and 1/1 mixtures of glyceryl monostearate and glyceryl distearate. The data indicated that glyceryl monostearate and glyceryl distearate associate when used alone. When the two glycerides are used in conjunction with one of the milk proteins it is this "complex" which combines with the protein, primarily through hydrophobic binding. The "complex" is probably located in the train regions of the adsorbed protein. It is not expected to influence the resistance to flocculation of oil drops in O/W emulsions stabilised by the same protein plus glyceryl monostearate and glyceryl distearate, but it should reduce the rate of drop coalescence significantly.

Context: In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reason behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study was designed to find out the prevalence of typhoid fever and related factors like sanitation facilities and food practice among the children of low income group people living in Kamrangir char and its adjacent areas in the semi urban Dhaka. Methodology: Data were collected from June 2009 to May 2010, from a sample of 96 patients with fever of more than seven days duration, who presented in the paediatric outpatient department of Dhaka Medical College Hospital, Dhaka. Detailed history, comprehensive physical examination and other relevant informations of the patients were recorded by following standard procedures. A raised anti O level with titre of >1:160 as well as other blood parameters were considered significant of having typhoid fever. Results: This study shows that 84(87.50%) patients had typhoid fever based on clinical examination and serological test results (widal test). It was observed that prevalence of enteric fever was high among the patients of school going age group (66.67%), habituated with unsafe drinking water (58.33%) and junk foods (72.92%). Statistical analysis showed that SSC level education in the parents who remain outside during the major part of the day for their livelihood had significant positive relationship with prevalence of typhoid fever. It was concluded that prevalence of typhoid fever was high among the children of school going age, who consume unsafe drinking water and food from outside source. Keywords: Typhoid fever; semi urban area; children. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8570 J Dhaka Med Coll. 2011; 20(1) :37-43