Health Centre Status and Accessibility in Rural Bangladesh: A Location-Allocation Model-Based Analysis

There is a considerable body of evidence that geographical access to health facilities is very difficult for rural people in Bangladesh. In recent years, Bangladesh has given high priority to the development of primary health care in order to extend coverage of health services in rural areas and improve overall national health. This involves two approaches (Tanahashi 1978): ■ deployment of more resources and technologies ■ effective utilisation of available resources While the government of Bangladesh has been gradually increasing funding for health over the years, these increased allocations are insignificant (Rahman 1991). This is due to limited availability of resources. Decision-makers and health planners must therefore make effective use of the available resources. In particular, decisions about the location of service facilities have frequently been taken locally by government officials concerned with a small region and/or elected leaders of the community concerned. In the absence of any formal analysis and generation of alternatives, the final decision is made on political or pragmatic considerations. As a result, decisions can often be far from optimal (Fisher and Rushton 1979; Hodgson and Valadares 1983; Rahman and Smith 1996).