The Impact of Transparency on Quality of Health Service Delivery in Bangladesh: Findings of a Field Survey of Rural and Urban Health Service Organisations

Abstract

Bangladesh has gained a glorious achievement in the quantitative reduction of maternal and child mortality in the recent past. But, the quality health service delivery still needs much improvement. This is considered as a big challenge facing the Government of Bangladesh in general and the agencies providing health care services to the people. This study endeavours to explore how organisational management, electronic devices, socio-economic and political factors impact on transparency in delivering good quality health care. This study selects two health service organisations of rural and urban areas for understanding the issues surrounding transparency and quality health service provision. This study used 68 in-depth interviews and five focus group discussions for gathering the required data. The urban health service organisation provides slightly improved transparent health care delivery because of better physical communication, adequate supervision and participative civil society organisation. However, general community has limited participation to both the rural and the urban health service organisations for lack of their education, poverty and bureaucratic mis-management in the organisations. Electronic devices contribute significantly for promoting transparent health service delivery, although resource constraints have posed a big challenge. Inadequate transparency contributes to corruption and absenteeism of health professionals which has an impact on quality health care provision. Participation of local elected representatives through adequate decentralisation and strengthening information management system in health care organisations can improve transparency and quality health service delivery.