Resource Type:  Report
Authors: Najmul Hossain
Published: 1/1/2016

Resource Description: The latest edition of the Bangladesh National Health Accounts (BNHA), also termed as the fourth round of BNHA, tracks the total health expenditure in Bangladesh between the fiscal years 1997 to 2012. It cross-stratified and categorized healthcare expenditures by financing, provision and consumption on an annual basis. For production of BNHA, System of Health Accounts (SHA) guideline is followed and the fourth round of BNHA is produced using the SHA 2011 guideline. Introduction of SHA 2011 has added two new classifications in the financing dimension that provide more specific answers to the questions: “what instruments are used for fund raising?” and “how the health resources are managed?” This new classification offers better interpretation of public and private funding in the healthcare sector.

This paper estimates Reproductive, Maternal and Newborn and Child Health (RMNCH) expenditure for Bangladesh in accordance with the System of Health Accounts 2011 (SHA 2011) framework. A secondary analysis of BNHA data for production of Reproductive, Maternal and Newborn and Child Health (RMNCH) estimates requires additional data sources and methods to analyze each component of spending. More specifically, the secondary analysis includes three separate estimates for (i) reproductive, (ii) maternal and neonatal and (iii) child health. Considerably effort was made to minimize double counting of expenditure, due to definitional overlap. Hospitals, ambulatory providers and pharmacies are the three major providers that offer direct RMNCH healthcare service. Their respective expenditure estimates are accounted under BNHA. Public Health Program of the Government and NGOs also includes RMNCH related expenditure. To estimate the RMNCH share of hospital and outpatient centers expenditures, user level data by age, sex and disease are a prerequisite.

The objective of this analysis is to estimate RMNCH related expenditure made at the patient level by public and private sector institutions as well as households. RMNCH related expenditure made under various public health program of the government and NGOs are also analyzed. Estimating RMNCH expenditure using the BNHA data requires identifying relevant services and programs offered and implemented by various providers in accordance with their respective functions.