The health sector survey was carried out as a part of the quantitative and qualitative surveys on public resources for the provision of primary and secondary education. These combined public expenditure tracking surveys (PETS) with quantitative service delivery surveys (QSDS). The surveys tracked the flow of resources to a national sample of schools and clinics, both in cash and in kind. They assessed the presence of the essential inputs financed with public resources, including staff, equipment and complementary inputs such as textbooks, medicines and maintenance. They assessed the volume and quality of services provided: in education, through tests of student attainment; in health, through a range of measures of clinical quality, including staff knowledge. The surveys identified who benefits from the services and, in particular, whether both the poor and non-poor are beneficiaries. They also assessed the operation of various management and control systems, including accounts and service delivery statistics. Initial stakeholder consultation with the Ministry of Finance and the respective line ministries established the priorities for the work. An ongoing active dissemination process aims to engage key stakeholders through newsletters and briefings, in addition to the reports themselves, and assist them to internalise the findings in daily decision-making, management and policy. The surveys were implemented as part of a consortium supporting the comprehensive reform of public finances in Bangladesh under the Financial Management Reform Programme. A major objective of the programme was to improve the efficiency and effectiveness of public spending in the provision of basic services, particularly to the poor.
The survey examined the flow and management of public money and other inputs from the central level, via upazila and district offices, to their destination either doctors and patients. Other focus was on service delivery in health centers. This part looks at whether public and private resources, together with the non-material support that that health centers receive from local community and administrative system, delivery the desired volume and quality of health services.
The health survey was based on a nationally representative random sample of health centers, draw from a list of Primary Health Care centers. Within each health center, the field teams interviewed a sample of doctors, patients and their households. In addition, the survey teams visited upazila and district offices responsible for managing primary health care.
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