Regulation in the Doldrums:: the State and the Private Health Care Sector in Bangladesh

Bangladesh?s private health care sector has grown substantially since the 1980s, providing approximately 25 per cent of hospital beds and employing almost 66 per cent of physicians. In this study of the capacity of state regulatory institutions to oversee the private health sector, data were gathered by in-depth interviews with 66 participants, comprising officials from the civil service, private providers, members of the medical profession and consumer and health rights groups. Other sources included journals, databases, government documents and press reports. Regulatory problems related to legislation, the structure and dynamics of the regulatory system and the enforcement of regulation were identified. Legislation was found to be out-dated and fragmented. The regulatory system is largely dysfunctional due to over-centralization, the absence of accountability and transparency, a lack of coordination and cooperation between regulatory agencies and stakeholders, clientism, poor governance and inadequate personnel, finances and logistics.