Operations research on ESP delivery and community clinics in Bangladesh. Preliminary assessment of performance of two selected community clinics.

Health-sector reform is either underway or under consideration in various countries throughout the world. While it is difficult to define precisely what constitutes a true reform there is however a common consensus that reform is a process of change involving what who and how relating to health-sector actions. Thus the term health-sector reform has a wide appeal. Like other developing countries interest in health-sector reform in Bangladesh is widespread. One of the reform agenda adopted in the Bangladesh National Health and Family Planning Programme is the shift from home-based to a static centre-based service-delivery system. Interventions have been carried out by the government and non-government organizations to implement the reorganized service-delivery strategy along with restructuring of the programme management and supervisory systems. The present report describes the field experiences of an operations research on implementation of Community Clinic (CC)-based delivery of essential health and family planning services as suggested in the new reform programme. Although the document reports early experiences the initial trends may provide useful information to researchers programme managers and policy-makers in assessing the future implications of the changed strategies. (excerpt)