Management in Health, Vol 22, No 4 (2018)

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EQUALITY OF GEOGRAPHICAL DISTRIBUTION OF PUBLIC HOSPITAL BEDS IN BANGLADESH: A SPATIO-TEMPORAL ANALYSIS

Asraful ALAM, Israt Irean RIA

Abstract


BACKGROUND: Geographic distribution of healthcare resources is an important component of healthcare access. Bangladesh is a developing country with well-structured health system but unfair distribution of healthcare resources creates inequalities. Hospital bed is a major health care indicator for general health. Hence, the present study focuses on the geographic distribution and equality of public hospital beds at upazila level in Bangladesh.

METHODS: We used data of Ministry of Health and Family Welfare of 2012 and 2017 for public hospital beds and population data from Population and Housing Census, 2011 providing by Ministry of Planning. The density of public hospital beds for 1000 people and also for 1km2 was calculated for each upazila. We used Gini Coefficient to measure inequalities and Location Quotient to calculate supply of beds at country level.

RESULT: Bangladesh public hospital beds increased by 20%, from 2011 to 2016, but variation in minimum and maximum values of beds/1000 inhabitants increased by 9 times to 23 times. At geographic distribution, south-western and central part of the country has minimum beds and less than 0.0002 bed/1000 inhabitants has the highest percentage. Gini Coefficient values suggest that equality decreased in divisions such as Dhaka, Khulna and Chittagong and increased in other divisions: Rangpur, Sylhet and Mymensing. Location quotient model indicates very moderate supply with hospital beds all over the country and it is increased in the five years. Also, intensive supply decreased in some regions.

CONCLUSION: Geographic distribution of hospital beds and Gini coefficient reveals a high degree of inequalities. Also, supply of hospital beds at upazila level is moderate. Therefore, in order to remove such inequalities health system managers are urged to consider those findings in their large scale health planning.

 

Keywords: Gini Coefficient, Hospital bed inequality, Location Quotient, Geographic distribution, Bangladesh, Hospital bed


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