The determinants of the services of Upazila Health Complexes: A case of Bangladesh
In the context of Bangladesh, Upazila health complexes (UHCs) provide curative care and perform a great role in Primary Health Care.This paper studies the state of services in Upazila Health Complexes in Bangladesh by analysing whether the input resources have any impact in determining the service delivery ofthese hospitals. In order to do so the administrative records of 424 UHCs available at the Director General Health Services were analysed. Service delivery variables studied under this research are: i. Number of patients’ Out Patient Department (OPD) visits, ii. Number of patients’ emergency visits, iii. Hospital admission rate measured by number of patients admitted to the hospital for indoor services and iv. Total number days a patient spent in the hospital. The study also looks into a set of resource factors that may play an important role in determining the UHC service delivery. These factors are: i. availability of doctors and nurses and ii. availability of functional equipment at the UHCs.
The regression analysis indicates that the number of filled-in doctors and functional equipment are the most important determinants for the OPD visits at UHCs whereas OPD visits are not significantly influenced by the availability of nurses at UHCs. Similarly, other results suggest that emergency visits, total hospital visits and total patient days are all strongly correlated with availability of doctors and functional equipment.The positive correlation between functional equipment and OPD visits and emergency visits explains that with better equipment functionality, more emergency patients can be served. The findings of this study also suggest that OPD visits, emergency visits , total hospital admissions and total patient days are all strongly correlated with the availability of male doctors. However, the availability of nurses plays no significant role in affecting any of these four services at UHCs.
Though there might be other influential variables, for example, income level at particular area, distance of UHCs from the city, availability of private health care providers, which, we could not measure due to time constraint and shortage of data. However, from our regression analysis we argued that our selected input variables (availability of doctors and nurses at UHCs, functional equipment and availability of doctors at USC) have considerable impact on the service delivery of UHCs
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