The allocations of health care resources in Bangladesh are not based on the needs of the population. Equality in health care expenditure can be achieved by the use of needs-based resource allocation formulae. Applying such methods in Bangladesh can provide an essential guideline to achieve equality in resource allocation. This thesis examines the prospect of developing a needs-based allocation of health care resources. It attempts to address the counterfactual question of what would have been the allocation to each district had the needs of the population been accounted for. Two alternative approaches are considered. The first uses a simple capitation formula in which weights for the adjustment of the current allocation are generated directly based on the relative values of proxies for needs. The second approach predicts adjustment weights from the estimation of a standard econometric model of needs, controlling for a range of determinants including individual, household and district characteristics. Important predictors of current allocation were found to be the number of hospital beds and health workers rather than need factors. Important predictors of needs include demographic and socio-economic characteristics. The findings suggest that a needs-based allocation can be developed for Bangladesh. This research provides an alternative approach to generating weights showing systematic relationships between the need adjustment factors. The robustness of the methods used will be sensitive to the quality of the data and the assumptions of the models. As these approaches are based on sound economic analysis and are open to independent assessment, they will help to inform policy debate and can reduce the influence of politically motivated allocations. A gradual process of implementation and regular review of the methods used would be a way forward. Future areas of research may include: re-analysing data at smaller area level and use of different components of allocations.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:571690 |
| Date | January 2012 |
| Creators | Quayyum, Zahidul |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=194789 |
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