In Bangladesh, TRAction is funding a research study investigating strategies to improve 24/7 (24 hours; 7 days a week) Emergency Obstetric Care (EmOC) service availability. In Bangladesh there is one comprehensive EmOC facility for every 500,000 population. However, 24/7 services are not available in most of these facilities, mainly due to unavailability of providers. This problem stems from inefficient human resource configurations leading to inadequate 24/7 service availability. It is further compounded by poor retention of providers in peripheral health facilities, particularly in hard-to-reach areas. There is little evidence on incentivized interventions to address gaps in human resources for health (HRH) in Bangladesh, and the need to develop and test additional interventions is imminent. Potential strategies to mitigate this problem are identifying minimum HRH needs, sharing of providers within the public sectors, exploring public-private-partnership, and incentivizing the EmOC work force in public facilities to ensure 24/7 services.
The major components of the proposed intervention is to:
This study has major implications in making EmONC services available in hard-to-reach areas, and for accelerating progress in achieving MDG 4&5 by 2015 and beyond. Ministry of Health stakeholders will be directly informed of potential strategies to mitigate the problem of HRH shortage from the results of this study, contributing to the overall strengthening of health systems in Bangladesh.
International Centre for Diarrheal Disease Research (icddr,b)