Bangladesh Bangladesh Health Facility Survey 2014 Health Facility Survey 2014 FINAL REPORT Bangladesh Health Facility Survey 2014 Final Report National Institute of Population Research and Training (NIPORT) Ministry of Health and Family Welfare Dhaka, Bangladesh Associates for Community and Population Research (ACPR) Dhaka, Bangladesh ICF International Rockville, Maryland, USA Funded by Government of the People’s Republic of Bangladesh U.S. Agency for International Development (USAID), Bangladesh March 2016 ACPR This report presents final findings of the 2014 Bangladesh Health Facility Survey (2014 BHFS), which was implemented by the National Institute of Population Research and Training (NIPORT). ICF International provided technical assistance. Associates for Community and Population Research (ACPR), a private research agency, collected the data. The 2014 BHFS is part of the worldwide DHS Program, which assists countries in the collection of data to monitor and evaluate population, health, and nutrition programs. The survey was funded by the government of Bangladesh and United States Agency for International Development (USAID). Additional information about the 2014 BHFS may be obtained from the National Institute of Population Research and Training (NIPORT), 13/1 Sheikh Shaheb Bazar Road, Azimpur, Dhaka-1205 Bangladesh. Telephone: 88-02-5861-1206; Internet: http://www.niport.gov.bd. Information about The DHS Program can be obtained from ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA. Telephone: 301-407-6500; Fax: 301-407-6501; E-mail: [email protected]; Internet: http://www.DHSprogram.com. Cover photos: Left: ©2013 Japan International Cooperation Agency (JICA); Center: ©2014 Ministry of Health and Family Welfare (MOHFW). Used with permission; Right: ©2013 bdnews24.com. Recommended citation: National Institute of Population Research and Training (NIPORT), Associates for Community and Population Research (ACPR), and ICF International. 2016. Bangladesh Health Facility Survey 2014. Dhaka, Bangladesh: NIPORT, ACPR, and ICF International. CONTENTS TABLES AND FIGURES .................................................................................................................................. vii FOREWORD ....................................................................................................................................................... xi PREFACE .......................................................................................................................................................... xiii CONTRIBUTORS TO THE REPORT ............................................................................................................ xv ACRONYMS AND ABBREVIATIONS ......................................................................................................... xvii KEY FINDINGS ................................................................................................................................................ xxi MAP OF BANGLADESH ............................................................................................................................... xxvi 1 OVERVIEW OF THE HEALTH SYSTEM IN BANGLADESH ...................................................... 1 1.1 Health Status in Bangladesh....................................................................................................... 1 1.2 Health, Population, and Nutrition (HPN) Sector Program ......................................................... 2 1.3 Health Service Delivery System of Bangladesh ......................................................................... 3 1.3.1 Management Structure and Health Facilities under DGHS ......................................... 4 1.3.2 Management Structure and Health Facilities under DGFP .......................................... 5 1.3.3 Urban Primary Health Care Services Delivery Project (UPHCSDP) .......................... 6 1.3.4 NGO Health Programs ................................................................................................. 6 1.3.5 Private Health Sector ................................................................................................... 7 1.4 Health Financing ........................................................................................................................ 7 1.5 Health Stewardship .................................................................................................................... 8 2 METHODOLOGY ................................................................................................................................. 9 2.1 Overview .................................................................................................................................... 9 2.2 Institutional Framework and Objectives of the 2014 BHFS ...................................................... 9 2.2.1 Institutional Framework ............................................................................................... 9 2.2.2 Objectives of the 2014 BHFS .................................................................................... 10 2.3 Data Collection Methods ......................................................................................................... 10 2.4 Survey Implementation ............................................................................................................ 11 2.4.1 Questionnaire Adaptation .......................................................................................... 11 2.4.2 Pre-test ....................................................................................................................... 11 2.4.3 Main Training ............................................................................................................ 11 2.4.4 Data Collection .......................................................................................................... 12 2.4.5 Data Management and Report Writing ...................................................................... 12 2.4.6 Data Analysis and Report Preparation ....................................................................... 12 2.5 Sampling .................................................................................................................................. 13 2.5.1 Sample Design ........................................................................................................... 13 2.5.2 Sampling Frame ......................................................................................................... 13 2.5.3 Sample of Health Facilities and Outcomes ................................................................ 14 2.5.4 Sample of Health Service Providers .......................................................................... 15 3 FACILITY-LEVEL INFRASTRUCTURE, RESOURCES, MANAGEMENT, AND SUPPORT .................................................................................................................................... 17 3.1 Background .............................................................................................................................. 17 3.2 Availability of Services ............................................................................................................ 18 3.2.1 Overall Availability of Specific Client Services ........................................................ 18 3.2.2 Availability of Basic Client Services ......................................................................... 19 3.2.3 General Service Preparedness .................................................................................... 21 3.3 Basic Management Systems to Support and Maintain Quality Services and Appropriate Client Utilization .................................................................................................. 42 3.3.1 Supportive Management Practices for Providers ....................................................... 42 3.3.2 Quality Assurance ...................................................................................................... 44 3.3.3 Client Feedback ......................................................................................................... 45 3.4 Availability of Human Resources for Health ........................................................................... 45 Contents • iii 4 CHILD HEALTH SERVICES ............................................................................................................ 49 4.1 Background .............................................................................................................................. 49 4.2 Availability of Child Health Services ...................................................................................... 50 4.2.1 Provision of Outpatient Curative Care, Child Growth Monitoring, and Child Vaccination Services ................................................................................................. 50 4.2.2 Vitamin A Supplementation ...................................................................................... 52 4.2.3 Availability of Guidelines, Trained Staff, and Basic Equipment for Child Curative Care ............................................................................................................. 52 4.2.4 Availability of Medicines and Commodities for Sick Child Care ............................. 54 4.2.5 Infection Control in Sick Child Services ................................................................... 56 4.2.6 Laboratory