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          A World Bank (WB) study has said that there are good prospects for contracting-out some medical services at certain administrative and facility levels in Bangladesh.
"At the upazila level NGO facilities yield the best value indicators, as well as the best accessibility indicators from the perspective of patients," said the WB study-Comparative Advantages of Public and Private Health Care Providers in Bangladesh.
"Thus, in principle government could purchase from Private/NGO sector certain preventive, promotional, or simple curative services, at low additional cost and with large quality improvements," it said.
The main findings of the study indicated that public facilities tend to deliver services of lower quality than NGO and private facilities, but at a much lower price. The NGO facilities show some of the best performances, it added.
The report attempts to provide new evidence on the comparative advantage of public and private providers in order to explore the alternatives for the government with regards to which health services it might consider to contract-out, if any.
It said the vibrant private health care system exists along with the health care through the public health system and in fact 50 per cent of the population from all income segments are already seeking treatment care from the private sector.
However, high prices in the private sector and their potential impact on access to services by the poorest as well as quality issues remain a concern for the government.
The inpatient facilities for both the private and the public sector are similar, but the average size of private facilities is one-fifth of that of public hospitals, it said adding that while the public sector is useful for inpatient services and preventive care, the private sector handles most of the outpatient services.
The study identifies a number of possible areas in which the government might consider to undertake certain initiatives that include guaranteeing the quality of service delivery in the public sector, particularly in terms of medical treatment protocols and cleanliness.