Attitudes Of Service Providers Research Articles

Family planning integration in Ethiopia’s primary health care system: a qualitative study on opportunities, challenges and best practices

BackgroundFamily planning (FP) service integration into primary health care (PHC) is an effective approach to realize reproductive autonomy, increase the use of contraceptives, and improve maternal and child health outcomes. The Ethiopian government promotes integration of FP services into primary health care (PHC). However, there is paucity of evidence on the status of FP service integration. The aim of this study is to explore the state of FP integration into PHC services and identify facilitators and barriers to integration.MethodsA qualitative study nested with a larger national study was conducted from July to October 2022. A total of 60 interviews were conducted with FP stakeholders including, government organizations, non-governmental organizations, donors, service providers, and clients. Interviews were audio recorded, transcribed, and coded using OpenCode 4.03. The coded data were analyzed using framework analysis approach, using the Primary Health Care Performance Initiative (PHCPI) framework. Direct quotes and results from the coding and categorization were used to develop the report.ResultsFamily planning is largely provided in designated units by dedicated staff within PHC facilities. The provision of integrated FP service within each service unit is in its early stage. Successful examples of integration include integration of FP with postnatal care, abortion care, and youth-friendly service centers. Facilitators of integration include commitment of the government and partners, the presence of policies and guidelines, and positive attitude of service providers and clients. However, integration of FP also faces challenges that are largely related to challenges of the FP program even before integration. These include resource shortage, health workers shortage, health workers’ capacity/skill gaps, misconceptions about FP, religious and socio-cultural norms, and lack of awareness.ConclusionsIntegration of FP with PHC services in the Ethiopian public health facilities is viable. Pre-existing challenges of the FP program continued to be barriers to integration. Expanding the experiences of good practices in the integration of FP with post abortion care, post-natal care, and youth-friendly service centers to other components of PHC warrants attention. Addressing both supply- and demand-side challenges of the FP program is needed to facilitate the integration of FP with other PHC services.

Perspectives of healthcare workers on the challenges with obstetric referrals in rural communities in Ghana: a descriptive phenomenology study

ObjectiveWe explored and document healthcare workers’ (HCWs’) perspectives on the challenges encountered during obstetric referrals.DesignThe study adopted a qualitative research approach and a descriptive phenomenology design. HCWs permanently working in...

A Qualitative Systematic Review of Experiences and Barriers Faced by Migrant Women with Perinatal Depression in Canada

Perinatal depression is the onset of depressive symptoms during pregnancy and up to one year after childbirth. Migrant women are at higher risk of experiencing perinatal depression due to numerous psychosocial stressors related to their experiences. This qualitative review aims to aggregate the experiences and barriers to care faced by immigrant and refugee women in Canada who have perinatal depression. Qualitative research can elucidate the barriers to treatment and culturally-impacted experiences of Canadian migrant women with perinatal depression. Following PRISMA and Joanna Briggs Institute (JBI) guidelines for conducting qualitative systematic reviews, 13 eligible studies representing 10 samples (N = 262 participants) were identified and included in this review. Participants included service providers, immigrant women, and refugee women. Three synthesized themes were identified by this review using the JBI meta-aggregative approach: (1) culture-related challenges; (2) migration-related challenges; and (3) service accessibility and quality. Within these themes were experiences of migrant women that encompass six categories: (1) conceptualization of perinatal depression; (2) childbirth-specific challenges; (3) migration-related challenges; (4) social isolation; (5) accessibility of services; and (6) quality of care. The role of family, cultural differences, financial challenges, and the effects of these on service accessibility are impactful in the experiences of migrant women. A greater understanding of the role of both culture and migration in the delivery of care, especially regarding service provider attitudes in more representative samples, is recommended.

Service Provider Attitudes toward Evidence-Based Programs in an Australian Place-Based Initiative: Examining Organisational Roles and Evidence-Supportive Environments

Positive service provider attitudes toward evidence-based programs, and evidence-supportive organizational environments are essential for effective implementation in community settings. Few studies have examined whether there are differences in attitudes between managers and providers. This study investigates attitudes toward evidence-based programs across three levels of manager and provider roles in an Australian place-based initiative for children delivered by a heterogenous, multiskilled social services workforce, and investigates whether attitudes are influenced by an evidence-supportive organizational environment. An online survey was conducted between 2018 and 2019, yielding 205 participants: 70 Facilitating Partner managers, 93 Community Partner managers, and 42 direct service providers. Nine attitudes toward evidence-based programs were assessed using multiple linear regression, with an evidence-supportive organizational environment included as a moderating variable. Differences in attitudes were found between the three roles, with direct service providers more likely to be supportive of evidence-based programs compared to Facilitating Partner managers. An evidence-supportive environment was a strong predictor of more positive attitudes, and moderated the effects for Facilitating Partner managers for three measures. This study highlights the importance of positive leadership and supportive organizational environments in social services community settings. Future studies could examine associations between attitudes, organizational environment and effective implementation for this workforce.

Exploring Sexual and Reproductive Health Needs and Associated Barriers of Homeless Young Adults in Urban Ghana: A Qualitative Study.

BackgroundHomelessness has become a major global and public health challenge, especially in low- and middle-income countries. This phenomenon predisposes young adults to severe psychosocial and health challenges.AimTo explore the sexual and reproductive health needs and behaviours of homeless young adults and challenges in accessing these services.MethodsA semi-structured interview guide was used for data collection from in-depth interviews, focus group discussions, and key informant interviews. Data were collected between 01 June and 31 July 2020 from 30 participants using in-depth interviews, two focus group discussions involving 12 participants, and one key informant interview. Thematic analysis was used to analyse transcripts from the interviews.ResultsThe findings show that certain behavioural patterns associated with homelessness impact the lives of homeless young adults in their sexual and reproductive health (SRH) choices, beliefs, and perspectives. This group faces several challenges in accessing sexual and reproductive health services (SRHS) such as modern contraceptives and abortion care. The high cost, and undesirable and unfriendly attitude of service providers in health facilities pose as barriers to accessing SRHS by homeless young adults.ConclusionSustainable and proactive measures must be put in place to address the identified barriers. Timely delivery of accurate information and educative materials, ensuring affordability, and setting up of accessible and friendly facilities could improve SRHS for this group.Social and Public Policy ImplicationsThis study may inform and support policy guideline development to address homelessness and SRH needs of young adults in urban Ghana.

Quality of Tuberculosis Services in Lusaka, Zambia; Patients’ Perspective

Zambia is among the 30 countries with high Tuberculosis (TB) burden, with an estimated 455 new cases per 100,000 people annually. Zambia and its partners are committed to accelerating the response to end TB through the provision of good quality of TB services, among other things. Despite the coordinated effort in addressing TB, little is documented about patients’ perceptions regarding the quality of TB services in Zambia. This study was conducted to assess the quality of TB services from the patient’s perspective. A facility-based cross-sectional study that utilized both quantitative and qualitative data collection. The study sample was 352 randomly selected patients on TB treatment and 58 purposefully selected TB treatment support persons. The patient’s perceived quality of care was measured by their perceived satisfaction of TB services in relation to accessibility of the TB clinic, timeliness of service provision, availability of qualified service providers, access to health education, the perceived attitude of service providers, and availability of drugs. Results revealed a high level of perceived good quality of TB services. The TB patients were more satisfied with the attitude of service providers, followed by the timeliness of service provision. Overall, 94.9% of the TB patients reported being satisfied with TB services. There is a high perception of good quality of TB services among the patients. Despite the high level of good quality, the study revealed limitations with regard to drug dispensation and the availability of qualified staff.

Opportunities for Integrating Palliative Care in Ghana.

The integration of palliative care (PC) services is characterized by several barriers and challenges, which may include misperception of PC services as end-of-life care, poor referral systems, inadequate financial support, regulatory barriers, and the small size of PC professional workforce. Beyond these barriers, the question remains: what opportunities exist to facilitate the integration of PC in managing patients' conditions? Notably, for a resource-constrained country like Ghana, unearthing existing facilitating factors would enable the country to leverage the opportunities these factors present to promote PC integration. The aim of this study is to explore opportunities that exist to facilitate PC integration from the perspective of PC service providers. An exploratory descriptive qualitative research design was used. Using semi-structured interview guides, seven face-to-face interviews were conducted with PC service providers in a tertiary hospital in Ghana. Data were managed using QSR NVivo-12. Inductive thematic analysis was carried out following Haase's modification of Colaizzi's approach to qualitative research analysis. From the inductive thematic analysis, it was revealed that four main opportunities exist to facilitate PC integration. These included the availability of a PC team and teamwork, knowledge level of service providers, enabling attitudes of service providers, and the incorporation of PC in the medical school curriculum. The study concludes that to facilitate the integration of PC in a tertiary health facility, there is a need to leverage on the supportive attitudes of service providers. Also, there is a need to expand the incorporation of PC education in the curriculum of all health and allied health courses. This could help create a pool of primary healthcare providers who can provide generalist PC services promptly. The study also underscores a need for continuous professional development.

Sustainability-focused rural tourism development in Western Serbia

Rural tourism is seen as one of the aspects of sustainable economic growth and socio-cultural development of rural Serbia. During the Covid-19 pandemic, international tourist traffic declined, and tourism and hospitality as service activities suffered serious economic consequences. The aim of this paper is to examine the impact of pandemics on rural areas of Western Serbia, bearing in mind that the natural environment and rural areas have gained in importance as safer to live in. The research was conducted through an electronic questionnaire, by surveying the providers of catering services in this part of Serbia. The obtained results indicate a decline in the number of tourists (domestic and foreign) during the pandemic, but mostly positive attitudes of service providers regarding the prospects and sustainability of their business in the coming period. The data obtained in this research can be useful to local governments and tourism representatives in finding the best solutions to provide support to the bearers of the tourist offer of rural areas.

A systematic review to determine how service provider practises impact effective service provision to lesbian, gay and bisexual consumers in a mental health setting.

Lesbian, gay and bisexual (LGB) consumers utilize mental health services at a similar rate to their heterosexual counterparts yet report greater dissatisfaction with service quality. This dissatisfaction may be explained by service provider's microaggressions, stemming from a lack of cultural competence in working with LGB consumers. This systematic review examines how the practises of mental health service providers impacted effective service provision to LGB people in a clinical practice. Five health databases (Scopus, MEDLINE, PsycINFO, Web of Science and CINAHL) were examined to determine relevant studies for this review. Twenty four qualitative and quantitative studies between 2000 and 2020 examining data related to how service provider practises impacted effective service provision to LGB people were included in the final review. A narrative synthesis, thematic summary approach was employed to account for the multi-method nature of the data. Themes developed in our analysis are organized under the three components of cultural competence, service provider attitudes, knowledge and skills. Provider attitudes ranged from positive to negative towards LGB people and heterosexism were present in several services. Poor service provider knowledge about the issues impacting LGB consumers leads to a weakened therapeutic alliance and service providers often lacked a comprehensive understanding of the issues impacting LGB people. Service providers were seen as more skilful if they were LGB, created a safe space and had completed cultural competence training. Trends within the characteristics (explorative nature, mixed service provider samples, potential for bias) of the 24 studies included in the review are discussed. Based on the results, recommendations are included to ensure services demonstrate cultural competence in working with LGB consumers.

Young Carers in Australia: Understanding Experiences of Caring and Support-Seeking Behaviour

ABSTRACT Although young carers experience several challenges associated with their roles, little is known about the current effects of those challenges on their education, work, and social life. Their support-seeking behaviour is also under-researched. Based on findings from 25 interviews and a focus group discussion, this qualitative study presents insights into the effects of providing informal care on the lives of young carers and their support-seeking behaviour. Participants reported several physical, mental, and social effects of caring that have either positive or negative implications for their lives. Whereas providing care influenced early maturity, self-efficacy, and formation of stronger bonds with care recipients, it also limited participants’ ability to find work, focus on their education, and socialise with peers. Utilisation of formal community-based and professional support services was low among the participants. Stigma associated with the label “carer”; lack of youth-friendly service settings; lack of self-identification of carer status; and a lack of cultural, age, and specific support services for different stages of caring constrained the use of support services among participants. In contrast, positive attitudes of service providers encouraged the use of support services. These findings highlight an urgent need for more professional support for young carers. IMPLICATIONS Failure to provide sufficient professional support to young carers can aggravate the negative consequences associated with their caring roles. Social workers and other professionals can strengthen their collaboration with educators, work supervisors, and other support agencies to address the challenges of providing care at a young age. Given that caring roles often influence early maturity and self-efficacy for young carers, social workers and other professionals can consider using strength-based approaches in addressing challenges associated with providing care, including those related to support-seeking behaviour.

The voice of Indian women on family planning: A qualitative systematic review

ObjectiveThe systematic review explores personal experiences and perceptions of (and on) resident Indian women on family planning. MethodsWe included qualitative studies conducted among women, husbands and mothers-in-law. Search on five databases (published between 2000 and May 8, 2019) and forward and backward citations search of included studies were undertaken (April 2020). Three-stage screening and data extraction were done independently. Iterative process was followed to thematically analyse the data and presented it using the World Health Organization conceptual framework on social determinants of health. ResultOf 857 citations, we included 48 qualitative studies. Women's intent of using family planning services/methods was influenced by multiple factors such as socio-demographic characteristics. Women's agency and social status affected their standing in family planning decision-making. Fear of side-effects of contraception methods, access to information and support, and cultural and religious beliefs hindered the use of modern methods of contraceptive. Undesirable attitudes of service providers influenced underutilisation of family planning services. Ineffective contraceptive choice counselling, particularly for poor section of the community and high-risk groups were reported. While considering inter-pregnancy interval, some of the women opted for induced abortion to terminate unplanned pregnancy however, had meagre acceptance for using modern contraceptive methods. ConclusionThe findings call for reinvigorated efforts to provide effective and individually, religiously, regionally and culturally appropriate interventions to improve family planning access and ultimately support better health and rights of women in India.

Access Differentials in Primary Healthcare among Vulnerable Populations in a Health Insurance Setting in Kumasi Metropolis, Ghana: A Cross-Sectional Study

Background. Access to healthcare remains a challenge towards the achievement of the Sustainable Development Goals in Ghana. There still remain inequalities in the distribution of health services especially among vulnerable groups despite sustained efforts to strengthen the health system. This study was conducted to analyze access differentials among different vulnerable groups in the context of primary healthcare under a National Health Insurance Scheme (NHIS) in Ghana. Methods. This study was a descriptive cross-sectional study conducted among multilevel participants of vulnerable groups in Kumasi Metropolis: 710 vulnerable people constituting elderly/aged (n = 359), pregnant women (n = 117), head poters (teenage girls who migrated from the northern Ghana mainly to the capital cities of the Ashanti and Greater Accra region to help in carrying of goods for their livelihood) (n = 86), sex workers (n = 75), and other vulnerable groups (people with disabilities and street participants) (n = 73). Data were collected using a semistructured questionnaire. Poisson regression with robust variance was used to access the association between vulnerability and access to healthcare. Results. Close to a fifth, 18.5% of the study respondents were unable to access care at any point in time during the last 12 months. Reasons for the inability to access healthcare included limited funding (69.7%), poor attitude of service providers (7.6%), distance to health centers (8.3%), and religious reasons (6.2%). More than 95% of respondents were insured under the NHIS, but acceptability of service provision under the NHIS was low among the vulnerable groups. In the crude models, pregnant women had lower prevalence of access to medications as compared to the elderly (prevalence ratio (PR): 0.88; 95% CI: 0.80–0.98). Head poters and other vulnerable groups were also less likely to view healthcare as affordable as compared to the elderly. The differences in healthcare access observed were attenuated after adjustment for sociodemographic characteristics and healthcare-related factors. Conclusions. Despite the introduction of a NHIS in Ghana, this study highlights challenges in healthcare access among vulnerable populations independent of the type of vulnerability. This suggests the need for stakeholders to work to address access differentials in the NHIS and adopt other innovative care strategies that may have broader applicability for all populations.

Intimate Partner Violence: Understanding Barriers in Seeking Formal Support Services in a Rural Area in Zimbabwe

Intimate partner violence (IPV) remains a global problem that requires intervention, yet women residing in rural areas still face challenges in dealing with it. There are no specific studies on the barriers to the use of formal support systems by victims of IPV in rural areas in Zimbabwe. Therefore, this study explored barriers that exist in the use of formal support systems by victims of IPV residing in rural areas in Zimbabwe. A qualitative study was conducted with 25 women between the ages of 19 and 49 years who reside in a rural area in Chimanimani District (Zimbabwe). Study participants were recruited using purposive sampling and on the basis that they had experienced IPV in their former intimate relationships and were not current victims. In-depth face-to-face interviews were conducted with the study participants. Interviews were audio-recorded with the consent of participants and data transcribed verbatim. The data was analysed using thematic analysis. Findings from the study suggest that the desire to preserve marriages, the attitudes of service providers, concerns with confidentiality, and lack of resources were barriers that victims of IPV faced in seeking formal help. Women in rural areas face challenges in accessing and using formal support systems even though they have the same risks of IPV perpetration as women in residing in urban areas. Therefore, there is a need for more resources and context-specific interventions to ensure the protection and uphold the rights of women residing in rural areas.

Communities and service providers address access to perinatal care in postconflict Northern Uganda: socialising evidence for participatory action

ObjectivesDescribe participatory codesign of interventions to improve access to perinatal care services in Northern Uganda.Study designMixed-methods participatory research to codesign increased access to perinatal care. Fuzzy cognitive mapping, focus groups...

Service provision and barriers to care for men who have sex with men engaging in chemsex and sexualised drug use in England

BackgroundChemsex and sexualised drug use (SDU) among men who have sex with men (MSM) has become a public health issue because of its associated sexual risks. Some MSM engaging in SDU require further help and support, but it is not clear if this need is being met. This research seeks to understand MSM and service provider (SP) perspectives of the current standard of service provision for MSM engaging in SDU. MethodSemi-structured interviews were conducted with 13 MSM and 16 SPs in England (January-December 2019). MSM who reported taking one of ten substances for sex in the past 12 months were recruited from a mailing list or a community organisation providing chemsex support. Potential SP participants were recruited via an email sent from their local healthcare NHS Trust. Data for MSM and SPs were analysed separately using thematic analysis. ResultsMSM participants had a median age of 34 years (range 23–66).The majority of SPs recruited were genitourinary medicine (GUM) consultants. We found that the main reason for engagement in SDU was because of the enhanced sexual experience. Most MSM recruited were satisfied with their sexual health service provision, but barriers to care were highlighted by both MSM and SPs. Four themes relating to barriers to care were identified: accessibility of sexual health services, funding of services, SP's attitudes towards MSM who engage in SDU, and services outside sexual healthcare. ConclusionSPs appeared to have adopted a harm reduction approach to MSM engaging in SDU, but for MSM wanting further help and assistance in relation to their SDU additional barriers to care existed. Training healthcare providers outside of sexual health services regarding chemsex and SDU may reduce some of these barriers, but funding for sexual health services needs to be improved to maintain and further develop services.

Early Termination of Child Welfare Clinic (CWC) Attendance, the Case of Dungu Community, Tamale, Ghana

In 2018, an estimated 6.2 million children and adolescents under the age of 15 years died, mostly from preventable causes. 5.3 million of these deaths occurred in the first five years of life. More than half of these early child deaths are preventable or can be treated with simple affordable interventions including childhood immunizations. Studies have found that, termination of child welfare services has been a major challenge to combating under-five mortality all over Africa, including Ghana. This study was conducted to assess the prevalence of Child Welfare Clinic (CWC) termination in the Dungu community, a suburb of Tamale, the northern regional capital. The objectives of the study were to assess mother’s knowledge on CWC attendance in the Dungu community, assess the prevalence of early termination of CWC attendance in the Dungu community, to ascertain the reasons for early termination of CWC attendance among mothers/ caregivers in the Dungu community and to find out the effects of child spacing on CWC attendance in the Dungu community. The study found that, termination of child welfare services is prevalent in the dungu community as it is in many parts of Ghana and Africa. Majority of the mothers were found to terminate after two years of patronizing services, when the scheduled immunization is completed. Several reasons were attributed to the termination of service attendance, some which include; attitude of service providers, few working days of CWC facilities, spacing of children and financial challenges (which was found to be the major reason for termination). Some recommendations proposed by the study includes; child welfare clinics should be operational on each working day of the week in the Dungu community, service providers should intensify public education on child welfare services in the Dungu community as well as during child welfare services. Immunizations should be spaced out to cover the entire five years if possible, this will encourage the mothers to patronize the service till the mandated five years as most of the mothers tend to terminate after the immunization schedule is completed.

A collaborative learning approach to improving health worker performance in adolescent sexual and reproductive health service provision: a descriptive feasibility study in six health zones in the Democratic Republic of the Congo

ABSTRACT Poor performance among health service providers is a key barrier to high quality, adolescent-responsive health services. Collaborative learning has been shown to strengthen health service provider performance, but few studies have examined its implementation in adolescent health services. In this paper, we describe a collaborative learning approach for adolescent health service providers implemented as part of a project aiming to prevent HIV in adolescent girls and young women in the Democratic Republic of the Congo (DRC) and explore its feasibility, acceptability, benefits and challenges. To do so, we reviewed plans, budgets and progress reports, as well as nested implementation research related to the project. We also carried out a quantitative analysis of the number, location, participants and topics of collaborative learning sessions conducted as part of this initiative, and thematic analysis to synthesise findings on perceived benefits and challenges. Under the project, 32 collaborative learning sessions of approximately two-hour duration were held with up to 15 participants, most of whom were nurses, between June 2018 and May 2019. The project cost was approximately USD 135,000 over three years. Reported benefits included improving health service provider attitudes, knowledge and skills; ensuring delivery of non-judgemental, empathic and confidential health services; and improving communication and collaboration between health services and adolescents together with their parents. While the novelty of the approach in this context presented challenges, our results suggest that collaborative learning in adolescent health services is feasible, acceptable, and inexpensive. It may help strengthen the knowledge and skills of health service providers, build positive attitudes and motivation, and improve their performance and thereby the adolescent-responsiveness of health services. Further research is needed to confirm these results in other settings and to examine the impact of collaborative learning on the acceptability and uptake of health services.

The shared experiences of insured members and the uninsured in health care access and utilization under Ghana's national health insurance scheme: Evidence from the Hohoe Municipality.

The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 to remove financial barriers and to promote equitable access to health care services. Post implementation has been characterized by increases in access and utilization of services among the insured. The uninsured have been less likely to utilize services due to unaffordability of health care costs. In this study, we explored the experiences of the insured members of the NHIS, the uninsured and health professionals in accessing and utilizing health care services under the NHIS in the Hohoe Municipality of Ghana. Qualitative in-depth interviews were held with twenty-five NHIS insured, twenty-five uninsured, and five health care professionals, who were randomly sampled from the Hohoe Municipality to collect data for this study. Data was analyzed using thematic analysis. Participants identified both enablers or motivating factors and barriers to health care services of the insured and uninsured. The major factors motivating members to access and use health care services were illness severity and symptom persistence. On the other hand, barriers identified included perceived poor service quality and lack of health insurance among the insured and uninsured respectively. Other barriers participants identified included financial constraints, poor attitudes of service providers, and prolonged waiting time. However, the level of care received were reportedly about the same among the insured and uninsured with access to quality health care much dependent on ability to pay, which favors the rich and thereby creating inequity in accessing the needed quality care services. The implication of the financial barriers to health care access identified is that the poor and uninsured still suffer from health care access challenges, which questions the efficiency and core goal of the NHIS in removing financial barrier to health care access. This has the potential of undermining Ghana's ability to meet the Sustainable Development Goal 3.8 of universal health coverage by the year 2030.

Status of the Implementation of Citizen’s Charter at Public Offices in Bangladesh: An Assessment

Citizen’s Charter is one of the important and commendable governance tools in Public Administration of Bangladesh. In 2007, the Cabinet Division took initiative to introduce Citizen’s Charter in different public offices. This study was conducted to assess the implementation status of Citizen’s Charter in Ministry and field level offices of Bangladesh with its challenges. To achieve the research objectives, this study followed both quantitative and qualitative research approaches. Sample survey with semi-structured questionnaires was used for collecting primary data while secondary data were collected from all relevant sources. The study showed that the implementation status of Citizen’s Charter at public offices in Bangladesh is still in its infancy. The service providers are not strictly following their Citizen’s Charter in their routine work. There are a number of drawbacks in implementation of Citizen’s Charter in the public offices. Lack of adequate public awareness is the leading cause of poor implementation of Citizen’s Charter. In addition, lack of proper knowledge among the citizens or service recipients, lack of positive attitude of service providers, communication gap between the service receivers and the service providers and lack of proper monitoring and feedback mechanism were other barriers. The study has come up with the conclusion that, institutionalization of the awareness-building programme, capacity building of the service providers and strengthening monitoring mechanisms are essential to overcome these challenges

Status of the Implementation of Citizen’s Charter at Public Offices in Bangladesh: An Assessment

Citizen’s Charter is one of the important and commendable governance tools in Public Administration of Bangladesh. In 2007, the Cabinet Division took initiative to introduce Citizen’s Charter in different public offices. This study was conducted to assess the implementation status of Citizen’s Charter in Ministry and field level offices of Bangladesh with its challenges. To achieve the research objectives, this study followed both quantitative and qualitative research approaches. Sample survey with semi-structured questionnaires was used for collecting primary data while secondary data were collected from all relevant sources. The study showed that the implementation status of Citizen’s Charter at public offices in Bangladesh is still in its infancy. The service providers are not strictly following their Citizen’s Charter in their routine work. There are a number of drawbacks in implementation of Citizen’s Charter in the public offices. Lack of adequate public awareness is the leading cause of poor implementation of Citizen’s Charter. In addition, lack of proper knowledge among the citizens or service recipients, lack of positive attitude of service providers, communication gap between the service receivers and the service providers and lack of proper monitoring and feedback mechanism were other barriers. The study has come up with the conclusion that, institutionalization of the awareness-building programme, capacity building of the service providers and strengthening monitoring mechanisms are essential to overcome these challenges