A TCV+ Study on Simplifying Government Hospital Health Service
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A TCV+ Study on Simplifying Government Hospital Health Service Prepared By Results Management Team CONTENT i. List of Figure ...................................................................................................................................... iii ii. List of Table ........................................................................................................................................ iii iii. ACRONYMS ...................................................................................................................................... iv iv. ACKNOWLEDGEMENT ................................................................................................................... v v. EXECUTIVE SUMMARY ................................................................................................................. vi 1. INTRODUCTION AND BACKGROUND .......................................................................................... i 2 OBJECTIVES ...................................................................................................................................... ii 3 METHODOLOGY .............................................................................................................................. iii 3.1 Study Approach and Design .................................................................................................... iii 3.2 The Study Population ............................................................................................................... iii 3.3 Study area .................................................................................................................................. iii 3.4 Data Collection ........................................................................................................................... v 3.5 Limitations of data collection .................................................................................................... v 3.6 Data Analysis .............................................................................................................................. v 4 FINDINGS .......................................................................................................................................... vi 4.1 Demographic characteristics of beneficiary .......................................................................... vi 4.2 TCV Analysis ............................................................................................................................. vii 4.3 TCV+ Analysis ........................................................................................................................... ix 5 RECOMMENDATIONS ...................................................................................................................xiii 6 CONCLUSION .................................................................................................................................. xiv ii i. List of Figure Figure 1: Gender of the service receiver ............................................................................................... vi Figure 2: Way of receiving the service ................................................................................................... vi Figure 3: Required time to get service using both processes ........................................................... vii Figure 4: Cost required getting service from process ......................................................................... vii Figure 5: Required visit to get service using ticket and health card ................................................ viii Figure 6: Average Time, cost and visit................................................................................................... ix Figure 7: Advantages for receiving service using health card............................................................. x Figure 8: Disadvantages for receiving service using health card ....................................................... x Figure 9: Disadvantages of ticket counter ............................................................................................. xi Figure 10: Satisfaction level by getting the health card service ........................................................ xii Figure 11: Reasons of satisfaction level for getting health card service ......................................... xii ii. List of Table Table 1: Mode of data collection .............................................................................................................. v iii iii. ACRONYMS a2i Access to Information BBS Bangladesh Bureau of Statistics SIF Service Innovation Fund SPSS Statistical Package for the Social Sciences TCV Time, cost and visit UNDP United Nations Development Programs iv iv. ACKNOWLEDGEMENT The a2i team would like to express sincere gratitude to all the stakeholders of this survey. a2i is thankful to the people of Wazirpur upazilla who provided their valuable time during interview. a2i is also indebted to Wazirpur health complex authority for their cooperation and information regarding health card service. The team also acknowledges the contribution of Fahmida Sarwar, Saifunnahar Shanty, Sharika Naureen and Sarmin Akter Simul for collecting, editing, and analyzing data. v v. EXECUTIVE SUMMARY The simplification of government health services is one of the prominent sub-sectors. Sometimes it is difficult to get treatment from the government hospitals as there are many steps to get the treatment. It takes time, consumes more cost and often requires more number of visits for a single service. Through the introduction of the health card system, it helps the poor people to get the health services with less time, cost and visit. To evaluate government hospital health card services at Barisal, a study was conducted using single random sampling method for data collection and interviewed 161 beneficiaries for this purpose. Main purpose of this study was to analysis TCV of service recipients who used health card service. The overall findings reveal that, through the implementation of extension facility of health cards turns the required expenditure of time, cost and visit of beneficiaries into the least. Findings showed the replacing system has reduced the average time and cost of beneficiary at 66% and 47% to receive a medical treatment service. Regarding the non- monetary benefits; correlation between people’s satisfaction level and provided health card service, study found that health card service is more appropriate. About 33% and 31% of informants opined they are satisfied because of ‘examine with importance’ and ‘less cost consumption respectively. They also see the health card system as a less consuming way of getting a medical service. According to the service providing authority, the extension facilities of this project meet the needs of the people as well as put an impact in the social and economic context. However, in terms of better service qualities, this extension facility needs to be strengthened further with more equipment and medicine. There must be adequate involvement of skilled doctors. vi 1. INTRODUCTION AND BACKGROUND One of the fundaments of any govt. is to ensure better health facilities for its citizen. In spite of significant improvement in health sector, there are scopes for providing quality health services especially in Bangladesh. Therefore, Information and communication technology has been introducing in various sectors. In this aspect, the government of Bangladesh introduced the health card services at Wazirpur upazilla in Barisal as a pilot project. In the previous process, patients had to go to the Barisal Zilla hospital, about 25 km far from Wazirpur. Previous services required a ticket from the hospital counter by paying 5 taka. Also they had to wait a long time for receiving health services. Again they need to wait in front of the doctors’ rooms. Thus, patients had to spend their time, money and at the same time they needed to visit more times. With the purpose of providing quality and better health service, Wazirpur Upazilla health complex in Barisal introduced health card for its service recipients. To assess TCV of health card services, a study was conducted entitled, Simplifying Government Hospital Health Service. Better health rate is the key indicator of a successive nation. As defined by the World Health Organization (WHO), it is a "State of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity." Health is considered as one of the basic human rights. A high proportion of the population of developing countries is not getting the quality health services. However, in a developing country like Bangladesh, people especially poor are deprived of this basic need. In the new process, patients need not to take ticket from the hospital counter. Now the card holders can go to the doctors’ room directly. There, separate doctors’ chambers are assigned to the patients with cards. A sample of health cards is shown below: The extension facility here introduces the health card system. In this process, first, the authority select people eligible for health card and then health cards were distributed for health services. However, this initiative aimed to provide health services with minimum time, cost, and visit. 2 OBJECTIVES The broad objective of this study was to analyze health service through the health card and ticket counter systems. It investigated to find out the monetary and non-monetary