Are 'Village Doctors' in Bangladesh a curse or a blessing?

Bangladesh is one of the health workforce crisis countries in the world. In the face of an acute shortage of trained professionals, ensuring healthcare for a population of 150 million remains a major challenge for the nation. To understand the issues related to shortage of health workforce and healthcare provision, this paper investigates the role of various healthcare providers in provision of health services in Chakaria, a remote rural area in Bangladesh.

Photo courtesy: Goggle 

Bangladesh is suffering from lack of adequate doctors, especially in the rural areas. Most of the posts for the doctors of the rural health facilities are vacant. Moreover, the absence rate of doctors is very high in the peripheral health centres. On the other hand, urban centres are overcrowded with doctors in the hospitals and their own private clinics. Many previous studies tried to identify the factors behind the dichotomous reality of the placement of doctors in rural and urban areas, but few of them explain the puzzle theoretically in Bangladeshi context. Therefore, this study focuses on how individual rationality and institutional constraints are reflected in the studied literature.

Doctors in Bangladesh do not want to serve in rural areas and avoid appointment there, or remain absent often, mostly because of institutional weakness. For the doctors, non-appointment or absence is rational, utility-maximising behaviour, given their preference maps. Therefore, there is a clear relationship between the two concepts: institutional weakness and rational behaviour of doctors: that is, as the institutional constraints become more weak, individual rational conduct of the doctors, contrary to the interest of the institution, becomes more common.

 

Photo courtesy: Goggle 

With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.