The Persistence of a Service Delivery 'Culture': Findings from a Qualitative Study in Bangladesh

Schuler, Sidney Ruth; Bates, Lisa M.; Islam, Md. Khairul

doi:10.2307/2673855

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…This would be rational if training was provided to educate service providers first. Both public and private sectors promote static and satellite clinics to provide quality services and make services available to clients (Schuler et al, 2001), but one group of client remains underserved-they are young married couples (Haider et al, 1997;Khan et al, 2003;Nahra et al, 1999). With this in mind, the intervention program attempted to motivate service providers to deliver proper services to YMCs.…”

Section: Expanding Quality Access and Use Of Health Servicesmentioning

confidence: 99%

Assessing Public-Private Reproductive Health Efforts to Reach Young Married Couples in Rural Bangladesh

Khatun

Mahboob-E-Alam²,

Qn³

2012

Int Q Community Health Educ

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Young married couples (YMC) in Bangladesh receive insufficient attention from service providers for reproductive health and family planning needs. The ACQUIRE Project, undertaken by EngenderHealth, Bangladesh, provides intervention for service providers, social and local leaders, and mothers-in-law as effective agents of channeling information to YMCs. EngenderHealth, in collaboration with the public sector, examined the extent to which an intervention program enhances overall quality of services, respondents' knowledge and attitude, and service-seeking behavior related to reproductive health issues. A quasi-experimental design with two matching groups, one watching the intervention, was used. The endline survey was carried out 10 months after the Baseline survey. Key informants interviews and FGDs were conducted. The findings were mixed. Importantly, young married men and women need friendly services and service providers with positive attitudes.

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Section: Expanding Quality Access and Use Of Health Servicesmentioning

confidence: 99%

Assessing Public-Private Reproductive Health Efforts to Reach Young Married Couples in Rural Bangladesh

Khatun

Mahboob-E-Alam²,

Qn³

2012

Int Q Community Health Educ

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“…"-urban woman Some women in the study saw the government's practice of providing compensation payments to those who adopt long-acting contraceptive methods (sterilization, the implant and the IUD) as a way of helping them overcome any problems they might encounter as a result of using these methods. 13…”

Section: Making Contraceptive Choices To Minimize Riskmentioning

confidence: 99%

Reconciling Cost Recovery with Health Equity Concerns in a Context of Gender Inequality and Poverty: Findings from a New Family Health Initiative in Bangladesh

Schuler¹,

Bates²,

Islam³

2002

International Family Planning Perspectives

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Following new government and donor mandates, nongovernmental organizations (NGOs) in Bangladesh have changed their strategy for providing family planning and other basic health services. The new service delivery model relies on clinics and satellite clinics, and provides contraceptives through village depots instead of doorstep distribution. The new model expands the range of services and emphasizes quality, but also entails higher costs for clients because of its emphasis on cost recovery. METHODS: To examine client and community reactions to the program changes, qualitative data were collected at three rural and two urban sites through in-depth, individual interviews with clients, their husbands, other community members and service providers; group interviews; and observations in clinics and satellite clinics. The researchers use this information to examine responses to the new model of health care provision in the light of health-seeking strategies commonly used by the poor, and analyze continuing barriers to access and constraints to cost recovery, including gender and poverty. RESULTS: The tension between the mandate to recover costs and the mandate to provide services to the poor presents difficulties for clinic staff. Staff did not provide fee waivers openly and systematically, for fear that this would raise concerns about fairness and make it difficult to enforce the posted prices for the majority of clients. Clients often interpreted fee waivers as personal favors rather than something to which they were entitled. CONCLUSIONS: NGOs want to maximize cost recovery while making the basic services they offer accessible to most people. The findings suggest that a transparent system for providing credit and fee exemptions based on need would help NGOs achieve these goals.

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“…In some instances, the public sector may distort the market by extending subsidies to clients willing and be able to pay higher prices for goods and services. Usually research about providers mainly focuses on the supply side such as training of providers [1], knowledge and practices [2], nature of visit [3], provider characteristics [4], the "culture" of service delivery [5], communication with clients [6], and integration of services [7]. On the other side, the demand in many instances is overlooked [8].…”

Section: Introductionmentioning

confidence: 99%

The Pattern of Women’s Reliance on Family Planning Providers in Egypt

Zaky¹

2020

ARSci

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Understanding choice of family planning provider is fundamental for policy makers and program managers as they seek ways to both improve the coverage and increase the sustainability and efficiency of family planning services for Egypt to achieve its population objectives. This study focuses first on providing a descriptive profile of the patterns of reliance on sources of family planning services during the early 2000s. Binomial logit models are then estimated to obtain a more in depth understanding of the determinants of the choice of family planning providers in Egypt using the 2000 Egypt Demographic and Health Survey. The study offers insights into a number of aspects of family planning service provision about which there has been less previous investigation. There are marked differences in the extent to which Egyptian women rely on public or private providers for family planning services depending on the type of method they are seeking. Among the more important findings is the consistency women display in the choice of provider among women reporting multiple segments of use. With regard to the determinants of the choice of provider for family planning services, perhaps the most interesting finding is that household wealth was not a significant determinant of the choice of provider. This may reflect that private sources met the demand for family planning services of significant proportions of women in rural areas and among those in the low income groups.

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The Persistence of a Service Delivery 'Culture': Findings from a Qualitative Study in Bangladesh

Cited by 8 publications

References 5 publications

Assessing Public-Private Reproductive Health Efforts to Reach Young Married Couples in Rural Bangladesh

Assessing Public-Private Reproductive Health Efforts to Reach Young Married Couples in Rural Bangladesh

Reconciling Cost Recovery with Health Equity Concerns in a Context of Gender Inequality and Poverty: Findings from a New Family Health Initiative in Bangladesh

The Pattern of Women’s Reliance on Family Planning Providers in Egypt

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