Conduct an in-depth study of the public's willingness and ability to pay by income group before setting final guidelines for maternal health care fees. Ann Levin, Tania Dmytraczenko, Freddie Ssengooba, Mark McEuen, Florence Mirembe, Margaret Nakakeeto, Olico Okui, and Peter Cowley, Costs of Maternal Health Care Services in Masaka District, Uganda, Special Initiatives Report 16, Partnerships for Health Reform, Abt Associates Inc., Bethesda, MD, May 1999. As specified by WHO, these reviews will be done every three years to resolve barriers to attaining program targets and to reassess Bangladesh's EPI's strategy in a continually changing environment. Policy Issues Economic growth in Bangladesh has barely kept pace with population growth in recent years. Health status indicators have improved over the past 10 years, but most remain low and the gains are not equally distributed throughout the population.
Poverty is still severe, with more than a quarter of the population considered extremely poor.
Additional efforts involving NGOs and integrating immunization with primary care have further increased coverage. Some portion of the new World Bank Fifth Health and Population Project credit will be devoted to achieving these EPI goals. At this juncture in the EPI program, the MOH is grappling with several key cost, cost-effectiveness, and financing issues. They need to know if their program could be more cost-effective, if cost savings could be achieved without hurting coverage or quality, and what options are available to fill the financing gap over the next five years as donors withdraw their funding support. They gathered cost data from the EPI Unit accounts, the Directorate of Health, EPI officials, and other individuals knowledgeable about EPI activities and resource use.