Quality of primary health care services in rural Bangladesh: patients’ perspectives

Abstract

A key aim of the health policy of the Government of Bangladesh (GoB) has been to provide quality health services to all its citizens. In line with the policy objective, the GoB has adopted the primary health care (PHC) approach as a health development strategy. Inspired by the Alma Ata Declaration on PHC, the GoB health policy and programmes aim at ensuring “health for all” (Perry, 2000), with special focus on rural population and the poor. There is now a common mistrust of the public health services in the country and the perceived poor quality of health services push the higher socio-economic groups to seek health services abroad (Mahdy, 2009). I used a narrative interview method to better understand the user perspectives on the quality of PHC to register patients’ voices missed in previous predominantly quantitative studies (e.g., Sohail, 2005). Data for the research came from 10 ex-patients who sought primary health services in a health centre in a sub-district in Bangladesh. This paper demonstrates that lack of adequate health professionals, misuse of resources, provider absenteeism, provider-centric consultations result in patient dissatisfaction and ineffectiveness of services. I argue that there is a need for proper maintenance of resources, better monitoring and supervision and address process-related quality issues to ensure better quality health services for the rural people.