Devising an Appropriate Method of Allocating Resources in the Health Sector of Bangladesh
Notice bibliographique
Résumé
Rationale: The health sector of Bangladesh currently uses incremental budgeting for distributing recurrent resources among the district and sub-district levels. However, the allocation to different geographic areas is not linked to the relative needs (medical, social or economic) for resources of the population, and does not ensure equity of access to services for people at equal needs. As a result, many people with higher need get lower amount of health care - the case of 'inverse-care law' of Gwatkin. It is, therefore, necessary to modify the current method towards a needs based system to make the allocations more responsive to the health care needs of the population. In this context, a study was carried out to assess the potential for devising a needs-based resource allocation method in Bangladesh. Objectives: The specific objectives of the study were to analyse the existing health care resource allocation mechanism of MOHFW, Bangladesh, to assess the extent to which the current health care resource allocation in Bangladesh is equitable and effective for different regions, and to propose a needs-based resource allocation formula for Bangladesh. Methodology: The study reviewed the available literature on different resource allocation methods used in the health sector in UK, Sweden, Canada, New-Zealand, Australia, and Zambia, as these countries consider 'equity' as a guiding principle for allocating health care resources geographically, and trying to adopt the needs-based formulae. To collected information on the current resource allocation and budgeting mechanism of the health sector of Bangladesh, and to find out the appropriate indicators of need and their relative weights, the study interviewed key health sector professionals, which included policy makers, development partners and advisors/consultants who were involved in the resource allocation process. To assess the extent to which the current allocation is related to health care need, a cross-sectional study was carried out in 4 upazillas (sub-district), which included both high and low performing ones. Information on, inter alia, population size, disease profile, remoteness of the area and poverty level, and the current allocation were collected from the study areas. Results: The output of the research was a formula for allocating health care resources among geographic areas in Bangladesh, which was based on the relative needs for health care at the sub-district level. The findings showed that the variables to be included in the capitation formula, in addition to population size, are: disease profile, remoteness of the area, poverty and unmet need for health care. The formula which assigned higher weights on the disease profile and remoteness seems to work better and more realistic. Conclusion: The study suggests that the proposed formula will increase health sector service utilization and will help in improving the equity of resource use in Bangladesh. However, it should be noted that proper allocation of resources is the necessary but not the sufficient condition for improving performances of the sector. Alongside use of an appropriate allocation method, the sector must adopt measures to efficiently utilize the resources allocated.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,054 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,004 | 0,005 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».