Production and use of estimates for monitoring progress in the health sector: the case of Bangladesh

Abstract

Background: In order to support the progress towards the post-2015 development agenda for the health sector, the importance of high-quality and timely estimates has become evident both globally and at the country level.

Objective and methods: Based on desk review, key informant interviews and expert panel discussions, the paper critically reviews health estimates from both the local (i.e. nationally generated information by the government and other agencies) and the global sources (which are mostly modeled or interpolated estimates developed by international organizations based on different sources of information), and assesses the country capacity and monitoring strategies to meet the increasing data demand in the coming years. Primarily, this paper provides a situation analysis of Bangladesh in terms of production and use of health estimates for monitoring progress towards the post-2015 development goals for the health sector.

Results: The analysis reveals that Bangladesh is data rich, particularly from household surveys and health facility assessments. Practices of data utilization also exist, with wide acceptability of survey results for informing policy, programme review and course corrections. Despite high data availability from multiple sources, the country capacity for providing regular updates of major global health estimates/indicators remains low. Major challenges also include limited human resources, capacity to generate quality data and multiplicity of data sources, where discrepancy and lack of linkages among different data sources (local sources and between local and global estimates) present emerging challenges for interpretation of the resulting estimates.

Conclusion: To fulfill the increased data requirement for the post-2015 era, Bangladesh needs to invest more in electronic data capture and routine health information systems. Streamlining of data sources, integration of parallel information systems into a common platform, and capacity building for data generation and analysis are recommended as priority actions for Bangladesh in the coming years. In addition to automation of routine health information systems, establishing an Indicator Reference Group for Bangladesh to analyze data; building country capacity in data quality assessment and triangulation; and feeding into global, inter-agency estimates for better reporting would address a number of mentioned challenges in the short- and long-run.

Keywords: Bangladesh; Health information system; S.D.Gs; global estimates; health data; health indicators.

Figure 1.

Monitoring framework for Bangladesh health sector programme.

Figure 2.

Consistency between local and global estimates for under-five mortality rate. Notes: BDHS – Bangladesh Demographic and Health Survey; UN – United Nations.

Figure 3.

Multiplicity of local data sources for health indicators. Notes: APIR – Annual Programme Implementation Report; SmPR – Six-monthly Progress Report; ADP – Annual Development Program; APR – Annual Programme Review (of the health sector programme).