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e,
ef
f
ec
ti
v
e,
an
d
af
f
o
r
d
ab
le
[
2
]
.
I
m
p
le
m
e
n
ted
on
b
o
th
an
in
d
i
v
id
u
a
l
an
d
p
o
p
u
latio
n
le
v
el,
U
HC
e
n
s
u
r
es
ev
er
y
o
n
e
can
ac
ce
s
s
q
u
alit
y
h
ea
lt
h
s
er
v
ices
to
i
m
p
r
o
v
e
t
h
eir
h
ea
lt
h
w
h
ile
not
f
ac
i
n
g
e
x
tr
e
m
e
ec
o
n
o
m
ic
co
n
s
eq
u
en
ce
s
.
By
ac
h
iev
in
g
UH
C
,
co
u
n
tr
ies
w
i
ll
m
a
k
e
p
r
o
g
r
ess
in
o
t
h
er
h
e
alth
-
r
elate
d
g
o
als
a
n
d
s
u
b
s
eq
u
en
t
l
y
p
r
o
v
id
e
f
o
r
h
ea
lt
h
ier
ch
ild
r
en
,
a
s
tr
o
n
g
er
w
o
r
k
f
o
r
ce
an
d
lo
n
g
-
ter
m
ec
o
n
o
m
ic
d
ev
elo
p
m
e
n
t.
WH
O
f
ra
m
ew
o
rk
,
SD
G
in
di
ca
t
o
rs,
a
nd
UH
C
To
p
r
o
v
id
e
g
u
id
a
n
ce
in
t
h
e
i
m
p
le
m
en
ta
tio
n
of
U
HC
,
th
e
W
o
r
ld
Hea
lth
Or
g
a
n
izatio
n
(
W
H
O)
cr
ea
ted
th
e
Fra
m
e
w
o
r
k
f
o
r
A
ct
io
n
co
n
s
i
s
ti
n
g
of
s
i
x
b
u
i
ld
in
g
b
lo
ck
s
to
d
escr
ib
e
a
h
ea
lth
s
y
s
te
m
s
f
r
a
m
e
w
o
r
k
.
T
h
ese
s
ix
b
u
ild
i
n
g
b
lo
ck
s
i
n
cl
u
d
in
g
s
er
v
ice
d
eli
v
er
y
;
h
ea
lt
h
w
o
r
k
f
o
r
ce
;
in
f
o
r
m
atio
n
;
m
ed
ical
p
r
o
d
u
cts,
v
ac
ci
n
es
an
d
tech
n
o
lo
g
ies;
f
i
n
an
c
in
g
;
a
n
d
lead
er
s
h
ip
an
d
g
o
v
er
n
a
n
ce
[
2
]
.
Su
cc
ess
f
u
l
h
ea
lt
h
s
er
v
ice
d
eliv
er
y
p
r
o
v
id
es
ef
f
ec
tiv
e,
s
af
e,
q
u
al
it
y
p
er
s
o
n
al
an
d
n
o
n
-
p
er
s
o
n
al
h
ea
l
th
in
ter
v
e
n
tio
n
to
th
e
p
o
p
u
latio
n
w
h
e
n
an
d
w
h
er
e
n
ee
d
ed
,
as
ef
f
icien
tl
y
as
p
o
s
s
ib
le.
A
w
el
l
-
p
er
f
o
r
m
i
n
g
h
ea
lth
w
o
r
k
f
o
r
ce
is
r
esp
o
n
s
i
v
e,
f
air
an
d
ef
f
icie
n
tl
y
d
esig
n
ed
to
ac
h
iev
e
th
e
b
est
h
ea
lt
h
o
u
tco
m
es
p
o
s
s
ib
le,
g
i
v
en
t
h
e
n
ec
es
s
ar
y
r
eso
u
r
ce
s
an
d
cir
cu
m
s
ta
n
ce
s
.
W
ell
-
f
u
n
ctio
n
in
g
h
ea
lt
h
in
f
o
r
m
atio
n
s
y
s
te
m
s
p
r
o
v
id
e
ac
ce
s
s
ib
le,
r
eliab
le,
an
d
ti
m
el
y
i
n
f
o
r
m
at
io
n
on
h
ea
lt
h
d
eter
m
in
a
n
ts
,
h
ea
lt
h
s
y
s
te
m
p
er
f
o
r
m
an
ce
a
n
d
h
ea
lt
h
s
t
atu
s
.
A
w
ell
-
f
u
n
ctio
n
in
g
h
e
alth
s
y
s
te
m
e
n
s
u
r
es
eq
u
itab
le
ac
ce
s
s
to
ess
en
t
ial
m
ed
ical
p
r
o
d
u
cts,
v
ac
cin
e
s
an
d
tech
n
o
lo
g
ies
of
as
s
u
r
ed
q
u
a
lit
y
,
s
a
f
et
y
,
e
f
f
icac
y
an
d
co
s
t
-
ef
f
ec
ti
v
e
n
es
s
,
an
d
t
h
eir
s
cien
tific
all
y
s
o
u
n
d
a
n
d
co
s
t
-
e
f
f
ec
ti
v
e
u
s
e
[
2
]
.
F
u
r
th
er
,
s
u
cc
es
s
f
u
l
lead
er
s
h
ip
an
d
g
o
v
er
n
a
n
ce
in
v
o
l
v
es
d
ev
e
lo
p
in
g
s
tr
ate
g
ic
p
o
lic
y
f
r
a
m
e
w
o
r
k
s
an
d
ar
e
co
m
b
in
ed
w
it
h
ef
f
ec
ti
v
e
o
v
er
s
i
g
h
t,
co
alitio
n
b
u
ild
i
n
g
,
r
e
g
u
latio
n
,
an
d
atten
tio
n
to
s
y
s
te
m
-
d
e
s
ig
n
[
2
]
.
T
h
e
2
0
1
3
W
o
r
ld
Hea
th
R
ep
o
r
t
also
id
en
ti
f
ied
ess
e
n
tial
m
e
th
o
d
s
f
o
r
h
ea
lth
s
y
s
te
m
s
to
s
u
p
p
o
r
t
r
esear
ch
f
o
cu
s
ed
on
ac
h
ie
v
in
g
UH
C
:
s
et
tin
g
r
esear
ch
p
r
io
r
ities
,
b
u
ild
in
g
r
esear
ch
ca
p
ac
it
y
,
d
e
f
in
in
g
n
o
r
m
s
a
n
d
s
ta
n
d
ar
d
s
f
o
r
r
esear
ch
,
an
d
tr
an
s
lati
n
g
ev
id
en
ce
i
n
to
p
r
ac
tice
[
4
]
.
T
h
ese
b
u
ild
i
n
g
b
lo
ck
s
an
d
p
r
ac
tices
ar
e
cr
u
cial
to
en
s
u
r
e
th
e
av
ailab
ili
t
y
a
n
d
ac
ce
s
s
ib
ilit
y
of
all
e
s
s
e
n
tial
h
e
alth
s
er
v
ices
[
5
]
.
To
s
u
p
p
o
r
t
th
e
h
ea
lth
s
y
s
te
m
f
r
a
m
e
w
o
r
k
an
d
m
o
n
ito
r
p
r
o
g
r
ess
to
w
ar
d
s
UHC,
W
HO
estab
l
is
h
ed
t
w
o
in
d
icato
r
s
w
ith
i
n
t
h
e
s
u
s
tai
n
ab
le
d
ev
elo
p
m
e
n
t
g
o
als
(
SD
Gs).
T
h
e
f
ir
s
t
in
d
icato
r
is
th
e
co
v
er
ag
e
of
all
ess
e
n
tial
h
ea
lth
s
er
v
ice
s
(
SD
G
in
d
icato
r
3
.
8
.
1
)
.
A
h
ea
lt
h
s
y
s
te
m
s
h
o
u
ld
p
r
o
v
id
e
ess
en
t
ial
h
ea
lt
h
s
er
v
ices
in
cl
u
d
in
g
r
ep
r
o
d
u
ctiv
e,
m
at
er
n
al,
n
e
w
b
o
r
n
an
d
ch
ild
h
ea
lth
(
R
MN
C
H)
,
in
f
ec
ti
o
u
s
d
is
ea
s
e,
n
o
n
-
co
m
m
u
n
icab
le
d
is
ea
s
e,
an
d
in
j
u
r
ies
[
6
]
.
T
h
ese
h
ea
lth
s
er
v
ic
es
s
h
o
u
ld
in
clu
d
e
p
r
ev
en
t
io
n
s
er
v
ices
in
t
h
e
f
o
r
m
of
h
ea
lt
h
p
r
o
m
o
tio
n
a
n
d
illn
e
s
s
p
r
ev
en
tio
n
,
tr
ea
t
m
e
n
t
s
er
v
i
ce
s
th
r
o
u
g
h
cu
r
ati
v
e
s
er
v
ices,
r
eh
ab
ilit
atio
n
an
d
p
alliatio
n
,
an
d
co
v
er
ag
e
in
p
r
i
o
r
ity
g
lo
b
al
h
ea
lt
h
ar
ea
s
.
W
it
h
g
o
o
d
s
er
v
ice
d
eli
v
er
y
,
a
p
r
o
d
u
ctiv
e
an
d
tr
ai
n
ed
h
ea
l
th
w
o
r
k
f
o
r
ce
,
a
w
ell
-
f
u
n
ct
io
n
in
g
h
ea
lt
h
in
f
o
r
m
a
tio
n
s
y
s
t
e
m
,
ad
eq
u
ate
m
ed
ical
p
r
o
d
u
ct
s
,
an
d
v
ac
ci
n
es
a
n
d
tech
n
o
lo
g
ies,
a
co
u
n
tr
y
ca
n
p
r
o
v
id
e
eq
u
itab
le
an
d
ac
ce
s
s
ib
le
ess
en
tial
h
ea
l
th
s
er
v
ice
s
.
W
h
ile
estab
li
s
h
i
n
g
a
n
d
s
tr
u
ct
u
r
in
g
ac
ce
s
s
ib
le
h
ea
lth
s
er
v
ic
es
is
v
ital
to
UH
C
,
t
h
e
f
in
a
n
c
ial
co
s
t
of
h
ea
lt
h
ca
r
e
on
p
o
p
u
latio
n
s
is
a
l
s
o
a
cr
u
cial
co
m
p
o
n
e
n
t
of
ac
c
ess
ib
ilit
y
.
T
h
e
s
ec
o
n
d
i
n
d
icato
r
of
UH
C
(
3
.
8
.
2
)
is
d
ef
in
ed
as
th
e
―
p
r
o
p
o
r
tio
n
of
th
e
p
o
p
u
latio
n
w
it
h
lar
g
e
h
o
u
s
eh
o
ld
ex
p
en
d
it
u
r
e
on
h
ea
lt
h
as
a
s
h
ar
e
of
to
tal
h
o
u
s
e
h
o
ld
ex
p
en
d
it
u
r
e
or
in
co
m
e‖
[
7
]
.
T
w
o
th
r
es
h
o
ld
s
ar
e
u
s
ed
to
d
eter
m
i
n
e
w
h
eth
er
h
o
u
s
eh
o
ld
ex
p
en
d
it
u
r
es
ar
e
ca
tast
r
o
p
h
ic
by
w
h
et
h
er
th
e
h
o
u
s
e
h
o
ld
ex
p
e
n
d
itu
r
e
on
h
ea
lth
is
g
r
ea
ter
t
h
an
10%
an
d
g
r
ea
ter
th
a
n
25%
[
7
]
.
L
ar
g
e
o
u
t
of
p
o
ck
et
p
a
y
m
en
t
s
o
f
ten
p
o
s
e
a
d
i
f
f
icu
l
t
c
h
allen
g
e
f
o
r
f
a
m
ilies
w
h
o
m
u
s
t
c
h
o
o
s
e
b
et
w
ee
n
h
ea
l
th
a
n
d
o
th
er
p
r
io
r
ities
li
k
e
ed
u
ca
tio
n
or
f
o
o
d
[
7
]
.
Ho
w
ev
er
,
a
s
u
cc
ess
f
u
l
h
ea
lt
h
f
i
n
a
n
ci
n
g
s
y
s
te
m
an
d
g
o
v
er
n
an
ce
can
r
ai
s
e
ad
eq
u
ate
f
u
n
d
s
f
o
r
h
ea
lt
h
,
en
s
u
r
i
n
g
p
o
p
u
lat
io
n
s
ca
n
u
tili
ze
n
ee
d
ed
s
er
v
ices
w
it
h
o
u
t
ex
p
er
ien
ci
n
g
f
in
a
n
cial
ca
tas
tr
o
p
h
e
ass
o
ciate
d
w
i
th
h
ea
lth
ca
r
e
co
s
t
s
.
T
h
ese
b
u
ild
i
n
g
b
lo
ck
s
p
r
o
tect
p
o
p
u
latio
n
s
f
r
o
m
f
i
n
an
c
ial
r
u
in
by
h
o
ld
in
g
t
h
e
g
o
v
er
n
m
e
n
t
ac
co
u
n
tab
le
f
o
r
p
r
o
v
id
in
g
t
h
e
af
o
r
e
m
e
n
tio
n
ed
ac
ce
s
s
ib
le
an
d
e
f
f
ec
t
iv
e
h
ea
lt
h
ca
r
e
[
8
]
.
T
h
r
o
u
g
h
t
h
e
SDG
in
d
icato
r
s
an
d
th
e
Hea
lth
S
y
s
te
m
Fra
m
e
w
o
r
k
,
W
HO
cr
ea
tes
tan
g
ib
le
g
o
als
f
o
r
co
u
n
tr
ies
to
o
b
tain
s
tan
d
ar
d
s
of
U
HC
.
Fu
r
t
h
er
,
th
e
s
e
f
r
a
m
e
w
o
r
k
s
an
d
i
n
d
icato
r
s
p
r
o
m
o
te
―a
co
m
m
o
n
u
n
d
er
s
ta
n
d
in
g
of
w
h
at
a
h
ea
lth
s
y
s
te
m
is
an
d
w
h
a
t
co
n
s
titu
te
s
h
ea
lt
h
s
y
s
te
m
s
s
tr
e
n
g
t
h
en
i
n
g
‖
[
2
]
.
T
h
is
f
r
a
m
e
w
o
r
k
h
elp
s
c
lear
l
y
d
ef
i
n
e
W
HO‘
s
cu
r
r
e
n
t
p
r
io
r
ities
an
d
r
eq
u
ir
e
m
e
n
ts
f
o
r
UHC,
w
h
ic
h
can
a
s
s
i
s
t
in
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
.
J
.
P
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b
lic
Hea
lth
Sci
.
I
SS
N:
2252
-
8806
Hea
lth
fa
cilities
r
o
les
in
mea
s
u
r
in
g
p
r
o
g
r
ess
of
u
n
ivers
a
l
h
e
a
lth
co
ve
r
a
g
e
(
Mu
h
iu
d
d
in
Ha
i
d
er
)
105
id
en
ti
f
y
i
n
g
g
ap
s
in
th
e
c
u
r
r
en
t
p
o
lic
y
.
C
o
u
n
tr
ie
s
can
u
s
e
th
ese
b
asic
g
u
id
eli
n
es
to
ad
d
r
ess
th
eir
u
n
iq
u
e
h
ea
lt
h
ca
r
e
is
s
u
e
s
a
n
d
id
en
ti
f
y
g
ap
s
in
t
h
eir
c
u
r
r
en
t
s
y
s
te
m
d
eliv
er
y
an
d
p
o
licies
[
9
]
.
In
f
ac
t,
m
a
n
y
lo
w
er
-
a
n
d
m
id
d
le
-
i
n
co
m
e
co
u
n
tr
ies
in
L
atin
Am
er
ica,
Af
r
ica,
an
d
A
s
i
a
h
av
e
s
u
cc
e
s
s
f
u
ll
y
i
m
p
le
m
e
n
ted
or
ar
e
cu
r
r
en
tl
y
i
m
p
le
m
en
t
in
g
p
o
licies
to
ac
h
i
ev
e
UHC
t
h
r
o
u
g
h
th
i
s
f
r
a
m
e
wo
r
k
[
1
0
-
1
8
]
.
Univ
er
s
a
l
hea
lt
h
ca
re
in
B
a
ng
la
des
h
Fo
r
s
ev
er
al
d
ec
ad
es,
B
an
g
lad
esh
h
as
r
e
m
ai
n
ed
co
m
m
itted
to
i
m
p
r
o
v
in
g
its
h
ea
lt
h
ca
r
e
s
y
s
te
m
a
n
d
ess
e
n
tial
s
er
v
ices.
T
h
r
o
u
g
h
s
u
p
p
o
r
t
f
r
o
m
in
ter
n
atio
n
al
d
o
n
o
r
s
,
th
e
co
u
n
tr
y
h
a
s
i
m
p
le
m
en
ted
a
n
u
m
b
er
of
p
lan
s
a
n
d
p
o
licies
to
s
u
cc
ess
f
u
ll
y
ad
h
er
e
to
W
HO
‘
s
d
ef
i
n
e
d
UHC
cr
iter
io
n
[
1
9
]
.
In
2
0
1
1
,
Natio
n
al
Hea
l
t
h
P
o
licy
(
NHP
)
w
a
s
r
elea
s
ed
,
co
m
p
r
is
ed
of
s
p
ec
if
ic
p
o
licy
estab
li
s
h
i
n
g
p
r
in
cip
les
of
h
ea
lt
h
d
esi
g
n
ed
to
p
r
o
d
u
ce
th
e
m
o
s
t
ef
f
icie
n
t
an
d
eq
u
al
h
ea
lt
h
ca
r
e
s
y
s
te
m
p
o
s
s
ib
le
[
2
0
]
.
T
h
e
s
a
m
e
y
ea
r
,
P
r
i
m
e
M
in
i
s
ter
S
h
ei
k
h
Hasin
a
co
m
m
itted
to
ac
h
ie
v
i
n
g
UH
C
by
2032,
o
u
ts
o
u
r
cin
g
ad
d
itio
n
al
r
eso
u
r
ce
s
to
cr
ea
te
a
f
ea
s
ib
le
p
lan
[
2
1
]
.
T
h
ese
p
lan
s
ar
e
s
u
p
p
o
r
ted
an
d
r
ein
f
o
r
ce
d
b
y
t
h
r
ee
m
aj
o
r
p
r
o
g
r
am
s
d
ed
icate
d
to
i
m
p
r
o
v
in
g
t
h
e
h
ea
lth
,
n
u
tr
i
tio
n
,
a
n
d
p
o
p
u
latio
n
s
e
cto
r
s
th
r
o
u
g
h
tar
g
eted
p
o
lic
y
d
ev
e
lo
p
m
en
t
[
2
1
]
.
T
h
ese
p
o
licies
ar
e
f
u
r
t
h
er
s
u
p
p
le
m
e
n
ted
by
s
i
m
u
lta
n
eo
u
s
p
r
o
j
ec
ts
f
u
n
d
ed
by
t
h
e
W
o
r
ld
B
an
k
a
n
d
v
ar
io
u
s
b
ilater
al
o
r
g
an
izat
io
n
s
th
a
t
h
elp
o
p
er
atio
n
alize
an
d
s
p
ec
if
y
th
e
g
o
als
of
t
h
ese
p
la
n
s
[
2
1
]
.
B
an
g
lad
es
h
cu
r
r
e
n
tl
y
i
m
p
le
m
en
ts
t
h
ese
p
r
o
g
r
a
m
s
a
n
d
p
o
licies
u
n
d
er
a
p
lu
r
alis
tic
h
ea
lt
h
s
y
s
te
m
[
2
2
]
.
P
lu
r
alis
tic
h
ea
lth
s
y
s
te
m
s
ar
e
h
ig
h
l
y
u
n
r
e
g
u
la
ted
an
d
co
n
s
i
s
t
of
m
u
ltip
le
p
r
iv
ate
a
n
d
p
u
b
l
ic
k
e
y
p
la
y
er
s
t
h
at
p
r
o
v
id
e
h
ea
lth
ca
r
e,
r
ath
er
th
an
a
r
eg
u
lated
o
r
g
an
izat
io
n
of
p
r
o
v
id
er
s
u
n
d
er
o
n
e
lar
g
e
f
o
r
ce
s
u
ch
as
t
h
e
g
o
v
er
n
m
e
n
t
[
2
3
]
.
In
B
an
g
lad
esh
,
th
e
h
ea
lth
d
eli
v
er
y
ch
ai
n
is
an
in
tr
icate
n
et
w
o
r
k
of
p
r
o
v
id
er
s
.
T
h
e
f
o
u
r
k
e
y
p
lay
er
s
ar
e
th
e
g
o
v
er
n
m
e
n
t,
f
o
r
-
p
r
o
f
it
p
r
iv
ate
s
ec
to
r
,
n
o
t
-
f
o
r
p
r
iv
ate
an
d
n
o
n
-
g
o
v
er
n
m
en
t
al
o
r
g
a
n
izatio
n
(
NGO
)
s
ec
to
r
s
,
an
d
i
n
ter
n
ati
o
n
al
d
ev
elo
p
m
e
n
t
o
r
g
a
n
izati
o
n
s
[
2
4
]
.
T
h
e
Min
i
s
tr
y
of
Hea
lth
a
n
d
Fa
m
il
y
W
elf
ar
e
is
th
e
lar
g
es
t
e
m
p
lo
y
er
f
o
r
h
ea
lt
h
s
er
v
i
ce
s
in
B
an
g
lad
esh
.
Ho
w
e
v
er
,
th
er
e
ar
e
a
l
s
o
m
a
n
y
p
la
y
er
s
in
th
e
p
r
iv
a
te
s
ec
to
r
,
w
h
ic
h
ac
c
o
u
n
t
s
f
o
r
60%
of
h
ea
lt
h
ca
r
e
s
er
v
ices
[
2
5
]
.
T
h
is
in
cl
u
d
es
b
u
t
is
n
o
t
li
m
ited
to
o
u
ts
o
u
r
ce
d
h
ea
l
th
ca
r
e
p
r
o
v
id
er
s
f
r
o
m
i
n
ter
n
atio
n
al
o
r
g
a
n
iz
atio
n
s
,
NGO
‘
s
,
th
e
f
o
r
-
p
r
o
f
it
p
r
iv
ate
s
ec
to
r
,
an
d
in
d
iv
id
u
al
p
r
o
v
id
er
s
[
2
2
]
.
In
f
ac
t,
co
m
m
u
n
it
y
-
b
ased
h
ea
lt
h
w
o
r
k
er
s
ar
e
o
f
ten
t
h
e
f
ir
s
t
p
o
in
t
of
co
n
tact
in
t
h
e
h
ea
lt
h
d
eliv
er
y
c
h
ai
n
f
o
r
m
a
n
y
p
atie
n
ts
.
W
h
i
le
h
ea
lt
h
i
n
s
u
r
an
ce
is
n
o
t
ea
s
il
y
o
b
tain
ed
an
d
ac
ce
s
s
ib
le,
th
e
p
u
b
lic
h
ea
lth
s
y
s
te
m
is
h
i
g
h
l
y
s
u
b
s
id
ized
an
d
s
et
up
to
ef
f
e
ctiv
el
y
r
e
m
o
v
e
t
h
e
b
u
r
d
en
of
p
ay
m
e
n
t
f
o
r
p
atien
t
ca
r
e
[
2
2
]
.
T
h
e
s
tr
u
ct
u
r
e
of
th
is
s
y
s
te
m
d
eliv
er
i
n
g
ca
r
e
is
o
u
tli
n
ed
by
t
h
e
af
o
r
e
m
en
tio
n
ed
p
o
lic
y
th
a
t
d
eter
m
in
e
s
w
h
at
h
ea
lt
h
ca
r
e
tr
u
l
y
lo
o
k
s
li
k
e
in
B
an
g
lad
es
h
.
T
h
e
p
lu
r
alis
tic
s
y
s
te
m
is
g
u
id
ed
by
th
e
p
r
i
n
cip
les
of
UH
C
;
to
r
ec
o
g
n
ize
h
ea
lt
h
as
a
h
u
m
an
r
ig
h
t,
en
s
u
r
e
p
r
i
m
ar
y
a
n
d
e
m
er
g
en
c
y
h
ea
l
th
ca
r
e
f
o
r
all,
in
cr
ea
s
e
an
d
ex
p
an
d
citize
n
ce
n
tr
ic
q
u
alit
y
h
ea
lt
h
ca
r
e
en
s
u
r
in
g
eq
u
it
y
,
en
ab
le
p
eo
p
le
to
s
ee
k
h
ea
l
th
ca
r
e
a
n
d
u
n
d
er
tak
e
h
ea
lt
h
y
li
f
est
y
les,
a
n
d
i
m
p
r
o
v
e
p
u
b
lic
h
ea
lt
h
an
d
n
u
tr
itio
n
[
2
6
]
.
To
m
ee
t
t
h
ese
o
b
j
ec
tiv
es
a
n
d
p
r
o
v
id
e
all
ess
e
n
tial
s
er
v
ice
s
,
th
e
s
y
s
t
e
m
is
d
i
v
id
ed
in
to
d
is
tin
ct
le
v
els
of
s
er
v
ice
d
eliv
er
y
.
T
h
e
m
o
s
t
b
asic
lev
el
of
p
r
i
m
ar
y
ca
r
e
co
n
s
is
t
s
of
u
p
az
il
a
h
ea
lth
co
m
p
le
x
es
in
s
u
b
d
is
tr
ict
s
,
co
m
m
u
n
i
t
y
c
li
n
ics
in
v
il
lag
e
s
,
an
d
t
h
e
U
n
io
n
Hea
lt
h
a
n
d
Fa
m
il
y
W
elf
ar
e
C
en
ter
s
(
UHFW
C
)
at
th
e
Un
io
n
le
v
el.
T
h
e
s
ec
o
n
d
ar
y
lev
el
co
n
s
is
t
s
of
lo
ca
l
m
ater
n
al
an
d
ch
ild
w
el
f
ar
e
ce
n
ter
s
an
d
d
is
tr
ict
h
o
s
p
itals
eq
u
ip
p
ed
wi
th
s
p
ec
i
alis
t
s
er
v
ice
s
s
u
c
h
as
in
ter
n
al
m
ed
icin
e,
p
ath
o
lo
g
y
,
o
b
s
tetr
ic
s
an
d
g
y
n
ec
o
lo
g
y
,
an
d
s
u
r
g
er
y
to
s
u
p
p
o
r
t
th
e
p
r
i
m
ar
y
lev
el
p
r
o
v
id
er
s
.
T
h
e
ter
tiar
y
lev
e
l
en
co
m
p
ass
e
s
n
atio
n
a
l
h
o
s
p
ital
s
,
m
ed
ical
u
n
i
v
er
s
i
ties
,
s
p
ec
ialt
y
h
o
s
p
ital
s
,
an
d
m
ed
ical
co
lle
g
e
h
o
s
p
ita
ls
[
2
7
]
.
W
h
ile
th
ese
le
v
el
s
do
co
llab
o
r
ate
to
ca
r
e
f
o
r
th
e
p
o
p
u
latio
n
,
t
h
e
y
ea
c
h
c
o
n
tr
ib
u
te
u
n
iq
u
e
s
er
v
ice
s
a
n
d
o
cc
u
p
y
i
n
d
iv
id
u
al
r
o
les
in
th
e
h
ea
lt
h
ca
r
e
s
y
s
te
m
.
T
h
is
d
eleg
atio
n
of
s
er
v
ices
allo
w
s
f
o
r
UHC
r
eq
u
ir
e
m
en
t
s
an
d
r
esp
o
n
s
ib
ilit
ies
to
be
ev
en
l
y
d
is
tr
ib
u
ted
b
et
w
ee
n
a
m
u
ltit
u
d
e
of
p
r
o
v
id
er
s
b
ased
on
th
eir
ac
ce
s
s
ib
ili
t
y
,
r
eso
u
r
ce
s
,
an
d
ex
p
er
tis
e.
B
an
g
lad
es
h
‘
s
co
m
m
i
t
m
en
t
to
i
m
p
r
o
v
i
n
g
i
ts
h
ea
lt
h
s
y
s
te
m
h
as
m
a
n
i
f
ested
in
m
a
n
y
s
u
cc
e
s
s
es,
m
o
s
t
n
o
tab
l
y
th
e
i
m
p
r
o
v
e
m
e
n
t
in
m
ater
n
a
l
a
n
d
ch
ild
h
ea
lth
[
2
7
,
2
8
]
.
Fro
m
2010
to
2016,
in
f
a
n
t
m
o
r
tali
t
y
h
ad
r
ed
u
ce
d
by
6
.
9
%,
m
ater
n
al
m
o
r
talit
y
h
ad
r
ed
u
ce
d
by
6
.
6
%,
an
d
u
n
d
er
5
m
o
r
talit
y
h
ad
r
ed
u
ce
d
by
1
.
5
2
%
[
2
6
]
.
A
f
u
r
th
er
s
u
cc
e
s
s
e
m
er
g
in
g
as
B
an
g
lad
es
h
d
ev
elo
p
s
a
n
d
in
cr
ea
s
e
s
p
r
io
r
itizatio
n
of
h
ea
lt
h
ca
r
e
is
t
h
e
p
io
n
ee
r
in
g
of
m
an
y
i
n
n
o
v
ati
o
n
s
an
d
h
ea
lt
h
ca
r
e
s
tr
ateg
ies
th
at
h
av
e
b
ee
n
s
ca
led
up
[
2
9
]
.
Stra
teg
ies
lik
e
ex
p
an
d
in
g
t
h
e
b
r
o
ad
r
ea
ch
of
co
m
m
u
n
it
y
h
ea
lt
h
ca
r
e
w
o
r
k
er
s
to
r
ea
ch
all
h
o
u
s
eh
o
ld
s
lar
g
el
y
i
m
p
r
o
v
e
ac
ce
s
s
to
h
ea
lt
h
ca
r
e
an
d
co
n
s
eq
u
en
tl
y
i
m
p
r
o
v
e
h
ea
lt
h
o
u
tco
m
e
s
[
2
9
]
.
I
m
m
u
n
izat
io
n
r
ates,
ac
ce
s
s
to
clea
n
w
ater
,
an
d
s
an
ita
tio
n
h
av
e
b
ee
n
i
m
p
r
o
v
i
n
g
as
w
ell
[
2
6
]
.
Ho
w
e
v
er
,
B
an
g
lad
e
s
h
‘
s
h
ea
lt
h
s
y
s
te
m
is
ac
co
m
p
a
n
ied
by
a
n
u
m
b
er
of
u
n
iq
u
e
c
h
alle
n
g
e
s
.
On
l
y
2
.
6
4
p
er
ce
n
t
of
to
tal
g
r
o
s
s
d
o
m
e
s
tic
p
r
o
d
u
ct
(
GDP
)
ex
p
en
d
i
tu
r
e
g
o
es
to
w
ar
d
s
h
ea
l
th
.
T
h
is
is
t
h
e
lo
w
e
s
t
ex
p
en
d
it
u
r
e
p
er
ce
n
ta
g
e
in
t
h
e
s
o
u
t
h
A
s
ia
r
eg
io
n
[
2
2
]
.
T
h
is
ec
o
n
o
m
ic
i
n
s
u
f
f
ic
ien
c
y
co
m
b
i
n
ed
w
it
h
o
v
er
p
o
p
u
latio
n
an
d
h
a
n
d
lin
g
s
u
c
h
a
lar
g
e
p
o
p
u
latio
n
in
ev
itab
l
y
lead
s
to
o
v
er
cr
o
w
d
in
g
,
u
n
d
er
s
ta
f
f
i
n
g
,
s
h
o
r
tag
e
of
q
u
ali
f
ied
p
r
o
f
es
s
i
o
n
als,
a
n
d
an
u
n
eq
u
al
s
p
r
ea
d
of
r
eso
u
r
ce
s
b
et
w
ee
n
r
u
r
al
a
n
d
u
r
b
an
ar
ea
s
[
2
1
,
2
8
]
.
R
u
r
al
p
o
p
u
latio
n
s
ac
co
u
n
t
f
o
r
6
2
.
6
%
of
t
h
e
to
tal
p
o
p
u
l
atio
n
,
y
et
s
till
lac
k
f
u
n
d
i
n
g
an
d
ca
r
e
[
3
0
]
.
T
h
is
is
also
d
u
e
to
a
lar
g
e
p
r
o
b
lem
of
ab
s
en
t
ee
i
s
m
a
n
d
lo
w
r
et
en
tio
n
r
ates
of
p
h
y
s
icia
n
s
in
r
u
r
al
ar
ea
s
[
3
1
]
.
Ov
er
cr
o
w
d
i
n
g
a
n
d
a
lack
of
r
eso
u
r
ce
s
also
m
ak
e
B
an
g
lad
es
h
a
h
o
ts
p
o
t
f
o
r
co
m
m
u
n
icab
le
d
is
ea
s
e
s
,
p
ar
ticu
lar
l
y
T
u
b
er
cu
lo
s
is
,
a
n
d
n
o
n
-
co
m
m
u
n
icab
le
d
is
ea
s
e
s
lik
e
d
iab
etes
[
6,
3
2
]
.
A
lar
g
e
p
o
r
tio
n
of
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N:
2252
-
8
8
0
6
I
n
t
.
J
.
P
u
b
lic
Hea
lth
Sci
.
Vo
l.
10,
No
.
1,
Ma
r
ch
20
2
1
:
1
03
–
1
12
106
p
o
p
u
latio
n
also
s
u
f
f
er
s
f
r
o
m
m
al
n
u
tr
i
tio
n
an
d
s
a
n
itatio
n
is
s
u
es
[
2
9
,
3
3
]
.
Oth
er
s
ch
o
lar
s
ar
g
u
e
t
h
at
is
s
u
e
s
s
u
c
h
as
p
u
b
lic
d
is
tr
u
s
t
of
t
h
e
h
ea
l
th
f
i
n
an
ci
n
g
s
y
s
te
m
c
h
alle
n
g
e
B
a
n
g
lad
e
s
h
‘
s
i
m
p
le
m
e
n
tatio
n
of
UHC
[
3
4
]
.
2.
RE
S
E
ARCH
M
E
T
H
O
D
I
n
an
e
f
f
o
r
t to
ev
al
u
ate
t
h
eir
h
ea
lth
f
ac
ilit
ies a
n
d
th
e
ir
p
r
o
g
r
ess
to
w
ar
d
s
UH
C
,
B
an
g
lad
es
h
co
n
d
u
cted
th
e
2017
B
an
g
lad
es
h
Hea
lth
Facilit
y
Su
r
v
e
y
(
2
0
1
7
B
HFS)
.
Sev
er
al
s
tu
d
ie
s
h
a
v
e
ass
es
s
e
d
th
e
r
o
le
of
h
ea
lth
ca
r
e
f
ac
ilit
y
s
u
r
v
e
y
s
a
n
d
ev
al
u
ated
th
e
t
y
p
es
of
i
n
f
o
r
m
atio
n
t
h
ese
s
u
r
v
e
y
s
g
at
h
er
[
3
5
,
3
6
]
.
Usi
n
g
t
h
e
d
ata
a
n
d
in
f
o
r
m
atio
n
co
llected
f
r
o
m
h
ea
lt
h
ca
r
e
f
ac
ilit
y
s
u
r
v
e
y
s
,
s
u
c
h
as
t
h
e
2017
B
HFS,
p
o
licy
m
a
k
er
s
an
d
r
esear
ch
er
s
ca
n
e
v
al
u
ate
th
e
cu
r
r
en
t
s
tate
of
th
e
h
ea
lth
s
y
s
te
m
.
S
u
b
s
eq
u
e
n
tl
y
,
h
ea
lt
h
f
a
cilit
y
s
u
r
v
e
y
s
can
d
ef
in
e
f
u
tu
r
e
r
esear
ch
o
p
p
o
r
tu
n
itie
s
,
r
eso
u
r
ce
allo
ca
tio
n
,
p
o
lic
y
s
tr
ate
g
ies
a
n
d
p
r
io
r
ity
ar
ea
s
f
o
r
ac
tio
n
[
3
7
]
.
T
h
e
t
y
p
e
of
d
ata
co
llected
t
h
r
o
u
g
h
h
ea
lt
h
f
ac
ilit
y
s
u
r
v
e
y
s
v
ar
ies
an
d
is
o
f
ten
r
ef
lecte
d
in
th
e
s
u
r
v
e
y
‘
s
m
ai
n
o
b
j
ec
tiv
es
[
3
,
3
7
]
.
Da
ta
can
r
ef
l
ect
in
f
o
r
m
at
io
n
r
eg
ar
d
in
g
in
p
u
t
s
or
s
tr
u
ctu
r
e,
p
r
o
ce
s
s
es
an
d
/o
r
o
u
tco
m
es.
I
n
p
u
t
or
s
tr
u
ct
u
r
e
d
ata
r
ef
er
s
to
―
av
ailab
ili
t
y
an
d
q
u
an
ti
t
y
of
i
n
p
u
ts
‖
of
c
o
m
p
o
n
en
t
s
s
u
ch
as
in
f
r
astru
ct
u
r
e,
s
u
p
p
lies
a
n
d
e
q
u
ip
m
e
n
t,
m
an
a
g
e
m
e
n
t
a
n
d
i
n
f
o
r
m
atio
n
s
y
s
te
m
s
[
3
7
]
.
P
r
o
ce
s
s
or
o
u
tp
u
t
d
ata
r
ef
er
s
to
ac
ti
v
ities
p
er
f
o
r
m
ed
w
it
h
i
n
an
i
n
ter
v
e
n
tio
n
.
T
h
i
s
t
y
p
e
of
d
ata
in
cl
u
d
es
t
h
e
u
tili
za
t
io
n
of
s
er
v
ices
a
n
d
ca
p
ac
it
y
of
ca
r
e.
L
astl
y
,
o
u
tco
m
e
d
ata
is
a
m
ea
s
u
r
e
m
e
n
t
of
i
m
p
ac
t
s
u
c
h
as
h
ea
lth
s
tatu
s
s
t
atis
tics
or
esti
m
ates
of
h
ea
lt
h
y
liv
e
s
p
er
d
o
llar
ex
p
en
d
ed
[
3
7
]
.
T
h
is
m
ea
s
u
r
e
m
e
n
t
p
r
o
v
id
es
in
f
o
r
m
atio
n
on
th
e
h
ea
lth
i
m
p
ac
t
of
t
h
e
o
v
er
all
an
d
i
n
d
iv
id
u
al
co
m
p
o
n
en
t
s
of
a
h
ea
lt
h
s
y
s
te
m
.
C
o
ll
ec
tiv
el
y
,
in
p
u
t,
p
r
o
ce
s
s
,
o
u
tp
u
t,
an
d
o
u
tco
m
e
d
ata
can
p
r
o
v
id
e
p
er
f
o
r
m
an
ce
m
ea
s
u
r
es
in
t
h
e
f
o
r
m
of
ef
f
ec
t
iv
e
n
es
s
,
eq
u
it
y
,
a
n
d
e
f
f
icie
n
c
y
.
T
h
ese
p
er
f
o
r
m
a
n
ce
m
ea
s
u
r
es
ca
n
cr
ea
te
a
h
o
lis
tic
p
ictu
r
e
of
th
e
f
u
n
ct
io
n
alit
y
of
a
h
ea
lth
s
y
s
te
m
.
Usi
n
g
t
h
e
W
HO
f
r
a
m
e
w
o
r
k
f
o
r
h
ea
lth
s
y
s
te
m
s
a
n
d
t
h
e
s
ix
p
illar
s
of
h
ea
lt
h
s
y
s
te
m
s
,
we
q
u
alitati
v
el
y
ev
alu
a
te
w
h
at
i
n
f
o
r
m
a
tio
n
th
e
B
an
g
lad
esh
‘
s
Hea
lth
Facil
i
t
y
Su
r
v
e
y
2
0
1
7
(
B
HFS)
p
r
o
v
id
es
r
eg
ar
d
in
g
th
e
av
ailab
ilit
y
of
e
s
s
e
n
tial
s
er
v
ic
es
a
n
d
th
e
f
in
a
n
ci
n
g
of
t
h
is
s
y
s
te
m
to
av
o
id
ca
ta
s
tr
o
p
h
ic
s
p
en
d
in
g
.
We
s
i
tu
ate
o
u
r
d
is
cu
s
s
io
n
b
ased
on
h
ea
lt
h
s
y
s
te
m
i
n
p
u
ts
s
u
ch
as
p
o
lic
ies
a
n
d
g
u
id
eli
n
es,
t
h
e
o
r
g
a
n
i
za
tio
n
of
p
r
o
v
id
er
s
an
d
f
ac
ilit
ie
s
,
an
d
p
r
o
ce
s
s
in
d
icato
r
s
on
th
e
ac
ce
s
s
ib
ilit
y
a
n
d
q
u
alit
y
of
s
er
v
ice
s
.
We
co
n
n
ec
t
o
u
r
an
al
y
s
is
to
th
e
s
i
x
p
illar
s
of
a
h
ea
lt
h
s
y
s
te
m
i
n
cl
u
d
in
g
s
er
v
ice
d
eliv
er
y
;
h
ea
lt
h
w
o
r
k
f
o
r
ce
;
in
f
o
r
m
atio
n
;
m
ed
ical
p
r
o
d
u
cts,
v
ac
cin
e
s
a
n
d
tec
h
n
o
lo
g
ies;
f
in
an
c
in
g
;
an
d
lead
er
s
h
ip
a
n
d
g
o
v
er
n
an
ce
.
Su
b
s
eq
u
e
n
tl
y
,
we
e
v
al
u
ate
w
h
at
ad
d
itio
n
al
in
f
o
r
m
atio
n
is
n
ee
d
ed
to
ad
e
q
u
atel
y
e
v
alu
a
te
B
an
g
lad
es
h
‘
s
p
r
o
g
r
ess
to
w
ar
d
s
U
HC
.
3.
RE
SU
L
T
S
AND
D
I
SCU
SS
I
O
N
Ov
er
all,
B
an
g
lad
es
h
‘
s
Hea
lt
h
Facilit
y
S
u
r
v
e
y
2017
(
B
HFS)
p
r
o
v
id
es
ex
ten
s
i
v
e
s
tr
u
ct
u
r
al
an
d
i
n
p
u
t
d
ata
to
ass
ess
th
e
a
v
ailab
ili
t
y
of
h
ea
lt
h
s
er
v
ice
s
ac
r
o
s
s
t
h
e
c
o
u
n
tr
y
.
T
h
e
m
ai
n
o
b
j
ec
tiv
es
of
t
h
e
s
u
r
v
e
y
w
er
e
to
ass
es
s
av
ailab
il
it
y
of
s
er
v
ice
s
;
ass
ess
p
r
ep
ar
ed
n
ess
of
h
ea
lt
h
f
ac
ilit
ie
s
;
ass
e
s
s
s
er
v
ice
s
p
ec
if
ic
r
ea
d
in
es
s
;
a
n
d
co
m
p
ar
e
f
i
n
d
in
g
s
a
m
o
n
g
f
ac
ilit
ies
an
d
m
a
n
ag
in
g
a
u
t
h
o
r
ities
[
1
]
.
Mo
r
e
s
p
ec
if
ical
l
y
,
t
h
e
s
u
r
v
e
y
ai
m
s
to
p
r
o
v
id
e
in
f
o
r
m
at
io
n
r
eg
ar
d
in
g
h
ea
lt
h
f
ac
il
ities
a
n
d
th
eir
r
ea
d
in
es
s
to
o
f
f
er
t
h
e
f
o
llo
w
in
g
h
e
alth
s
er
v
i
ce
s
:
c
h
il
d
h
ea
lt
h
,
f
a
m
il
y
p
la
n
n
i
n
g
,
an
t
en
atal
ca
r
e,
d
eliv
er
y
an
d
n
e
w
b
o
r
n
ca
r
e,
n
o
n
-
co
m
m
u
n
ic
ab
le
d
is
ea
s
es,
an
d
tu
b
er
cu
lo
s
i
s
.
W
it
h
in
each
h
ea
l
th
to
p
ic,
t
h
e
s
u
r
v
e
y
d
is
c
u
s
s
es
d
ata
r
eg
ar
d
in
g
t
h
e
a
v
ailab
ilit
y
of
s
er
v
ices,
s
er
v
ic
e
r
ea
d
in
ess
,
a
n
d
b
asic
m
a
n
a
g
e
m
en
t
a
n
d
ad
m
i
n
is
tr
ati
v
e
s
y
s
te
m
s
.
Data
is
co
m
p
ar
ed
ac
r
o
s
s
f
ac
ilit
y
t
y
p
e,
p
r
o
v
id
er
t
y
p
e
an
d
f
ac
i
lit
y
lo
ca
tio
n
.
W
ith
t
h
is
b
r
ea
d
th
of
i
n
f
o
r
m
at
io
n
,
we
a
n
ticip
ated
t
h
e
B
HFS
w
o
u
ld
p
r
o
v
id
e
in
f
o
r
m
at
io
n
to
an
al
y
z
e
th
e
h
ea
l
th
f
ac
ilit
y
‘
s
co
n
tr
ib
u
ti
o
n
to
UHC
in
B
an
g
lad
es
h
.
H
o
w
e
v
er
,
th
e
d
ata
d
id
n
o
t
p
r
ese
n
t
s
u
ch
an
an
al
y
s
is
.
I
n
s
tead
,
we
a
n
al
y
ze
d
w
h
at
t
y
p
e
of
in
f
o
r
m
atio
n
w
a
s
p
r
o
v
id
ed
w
it
h
i
n
th
e
B
HF
S,
an
d
w
h
at
t
y
p
e
of
in
f
o
r
m
atio
n
is
n
ee
d
ed
to
s
u
cc
es
s
f
u
ll
y
an
a
l
y
ze
t
h
e
p
o
s
itio
n
of
UHC
in
B
an
g
lad
es
h
.
C
ate
g
o
r
icall
y
,
we
in
ter
p
r
eted
t
h
ese
in
p
u
t
s
,
o
u
tp
u
t
s
an
d
o
u
tco
m
e
s
b
ased
on
Ku
r
k
an
d
Fre
ed
m
an
‘
s
[
3
8
]
h
ea
lth
f
ac
ili
t
y
p
er
f
o
r
m
an
ce
m
ea
s
u
r
es
as
s
h
o
w
n
in
F
ig
u
r
e
1.
Ku
r
k
a
n
d
Fre
ed
m
a
n
‘
s
[
3
8
]
f
r
am
e
w
o
r
k
o
u
tlin
e
s
h
o
w
t
h
e
f
lo
w
of
in
p
u
ts
a
n
d
o
u
tp
u
t
s
t
h
at
c
o
n
tr
ib
u
te
to
a
f
ac
ilit
y
‘
s
e
f
f
ec
tiv
e
n
e
s
s
,
eq
u
it
y
,
a
n
d
ef
f
icie
n
c
y
of
s
er
v
ices.
A
d
d
itio
n
all
y
,
th
e
f
r
a
m
e
w
o
r
k
e
m
p
h
a
s
ize
s
m
u
ltis
ec
to
r
al
in
v
o
l
v
e
m
en
t
in
r
esear
ch
an
d
es
s
en
t
ial
s
er
v
ices
w
it
h
i
n
UH
C
.
Usi
n
g
th
i
s
f
r
a
m
e
w
o
r
k
,
o
u
r
a
n
al
y
s
is
r
esu
lted
in
t
h
e
f
o
llo
w
in
g
d
is
c
u
s
s
io
n
of
B
HF
S‘
co
n
tr
ib
u
tio
n
of
in
f
o
r
m
atio
n
on
o
r
g
an
iza
ti
o
n
,
g
u
id
eli
n
e
s
an
d
p
o
licy
,
a
v
ailab
ilit
y
,
an
d
f
in
a
n
c
e
of
B
an
g
lad
es
h
‘
s
h
ea
lt
h
f
ac
il
i
ties
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
.
J
.
P
u
b
lic
Hea
lth
Sci
.
I
SS
N:
2252
-
8806
Hea
lth
fa
cilities
r
o
les
in
mea
s
u
r
in
g
p
r
o
g
r
ess
of
u
n
ivers
a
l
h
e
a
lth
co
ve
r
a
g
e
(
Mu
h
iu
d
d
in
Ha
i
d
er
)
107
Fig
u
r
e
1
.
Hea
lth
f
ac
ilit
y
p
er
f
o
r
m
an
ce
m
ea
s
u
r
es,
s
o
u
r
ce
d
f
r
o
m
K
u
r
k
an
d
Fre
ed
m
an
[
3
8
]
3
.
1
.
O
rg
a
niza
t
io
n
In
each
s
ec
tio
n
,
t
h
e
2017
B
HFS
ev
al
u
ate
s
in
d
icato
r
s
of
av
ailab
ilit
y
an
d
r
ea
d
in
es
s
of
its
h
ea
lt
h
s
er
v
ices
co
m
p
ar
ed
by
f
ac
ilit
y
an
d
p
r
o
v
id
er
t
y
p
e.
T
h
e
s
u
r
v
e
y
p
r
o
v
id
es
an
in
-
d
ep
th
o
v
er
v
ie
w
of
t
h
e
h
ea
lt
h
s
y
s
te
m
in
B
an
g
lad
e
s
h
an
d
th
e
o
r
g
an
izatio
n
of
th
e
m
an
a
g
e
m
en
t
s
tr
u
c
tu
r
e
of
h
ea
lt
h
f
ac
i
liti
e
s
u
n
d
er
d
ir
ec
to
r
ate
g
en
er
al
o
f
h
ea
lt
h
s
er
v
ices
(
D
GHS
)
.
By
d
is
t
in
g
u
is
h
i
n
g
b
et
wee
n
f
ac
ilit
y
t
y
p
e
an
d
lo
ca
tio
n
,
th
e
s
u
r
v
e
y
p
r
o
v
id
e
s
d
ata
on
th
e
lo
ca
lit
y
of
p
ar
ticu
lar
s
er
v
ice
s
an
d
h
ig
h
li
g
h
ts
w
h
a
t
t
y
p
es
of
f
ac
i
liti
es
ta
k
e
r
esp
o
n
s
ib
ilit
y
f
o
r
p
ar
ticu
lar
s
er
v
ice
s
.
Fo
r
ex
a
m
p
le,
m
o
t
h
er
an
d
ch
i
ld
w
e
lf
ar
e
ce
n
tr
es
(
MCW
C
)
ar
e
th
e
m
o
s
t
p
r
ep
ar
ed
f
ac
ilit
ies
f
o
r
f
a
m
il
y
p
lan
n
i
n
g
w
h
ile
d
i
s
tr
ict
h
o
s
p
ital
s
an
d
p
r
iv
ate
h
o
s
p
itals
h
a
v
e
t
h
e
lo
w
est
le
v
e
ls
of
r
ea
d
in
es
s
an
d
av
ailab
ilit
y
of
f
a
m
il
y
p
la
n
n
in
g
s
er
v
ice
s
.
In
co
n
tr
ast,
p
r
iv
ate
h
o
s
p
itals
ar
e
th
e
m
o
s
t
li
k
el
y
to
h
a
v
e
ess
e
n
tia
l
eq
u
ip
m
e
n
t
a
n
d
s
er
v
ice
s
f
o
r
tr
ea
tin
g
n
o
n
-
co
m
m
u
n
icab
le
d
is
ea
s
es
s
u
c
h
as
ca
r
d
io
v
a
s
cu
lar
d
is
ea
s
e,
an
d
c
h
r
o
n
i
c
r
esp
ir
ato
r
y
d
i
s
ea
s
e.
R
esear
c
h
e
r
s
can
ef
f
ec
ti
v
el
y
u
s
e
th
is
t
y
p
e
of
o
r
g
a
n
izatio
n
al
d
at
a
to
m
ak
e
co
n
cl
u
s
io
n
s
on
th
e
p
r
iv
ate/p
u
b
lic
p
r
o
v
id
er
r
atio
s
,
th
e
d
is
tr
ib
u
tio
n
of
f
ac
ilit
ies
in
r
elatio
n
to
m
ap
p
in
g
an
d
th
e
ce
n
s
u
s
.
Su
b
s
eq
u
e
n
tl
y
s
u
c
h
d
ata
can
be
u
s
ed
to
s
u
g
g
e
s
t
w
h
et
h
er
th
e
f
ac
ilit
ie
s
ar
e
lo
ca
ted
in
ac
ce
s
s
ib
le
lo
ca
tio
n
s
to
d
is
ad
v
an
ta
g
ed
g
r
o
u
p
s
.
T
h
e
B
HFS
co
u
ld
h
a
v
e
p
r
o
v
i
d
ed
s
o
m
e
ad
d
itio
n
al
i
n
f
o
r
m
a
tio
n
r
eg
ar
d
i
n
g
t
h
e
o
r
g
a
n
izati
o
n
of
its
f
ac
ilit
ies.
Fo
r
e
x
a
m
p
le,
d
ata
is
o
f
te
n
p
r
ese
n
ted
in
a
f
o
r
m
of
p
er
ce
n
tag
e
s
f
o
r
co
m
p
ar
is
o
n
.
T
h
is
ca
n
be
m
is
lead
in
g
w
h
e
n
o
n
l
y
a
f
e
w
f
ac
ilit
ies
w
it
h
i
n
th
at
p
ar
ticu
lar
f
ac
ilit
y
ca
teg
o
r
y
w
er
e
i
n
ter
v
ie
w
ed
.
A
d
d
itio
n
all
y
,
th
e
s
u
r
v
e
y
co
u
ld
h
a
v
e
elab
o
r
ated
on
th
e
d
i
v
is
io
n
of
s
er
v
ice
d
eliv
er
y
lev
el
s
a
n
d
th
e
d
i
s
tr
ib
u
t
io
n
of
f
ac
ilit
ies
by
d
is
tr
ict.
3
.
2
.
G
ui
delin
e
s
a
nd
po
licy
Stru
ct
u
r
al
in
p
u
ts
i
n
to
a
h
ea
lt
h
ca
r
e
s
y
s
te
m
,
s
u
ch
as
p
o
lici
es,
g
u
id
elin
e
s
,
an
d
s
tr
ateg
ie
s
,
cr
ea
te
a
f
r
a
m
e
w
o
r
k
f
o
r
th
e
co
llectiv
e
f
u
n
ctio
n
i
n
g
of
a
h
ea
lt
h
s
y
s
te
m
.
T
h
ese
p
o
licy
f
r
a
m
e
w
o
r
k
s
co
n
tr
ib
u
te
to
lead
er
s
h
ip
an
d
g
o
v
er
n
a
n
ce
,
a
p
illar
of
W
HO‘
s
h
ea
l
th
s
y
s
te
m
f
r
a
m
e
w
o
r
k
,
a
n
d
en
s
u
r
e
th
at
s
tan
d
ar
d
q
u
alit
y
ca
r
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N:
2252
-
8
8
0
6
I
n
t
.
J
.
P
u
b
lic
Hea
lth
Sci
.
Vo
l.
10,
No
.
1,
Ma
r
ch
20
2
1
:
1
03
–
1
12
108
is
p
r
o
v
id
ed
.
T
h
e
2017
B
FHS
p
r
o
v
id
es
d
is
cu
s
s
io
n
of
n
atio
n
al
p
o
licies
an
d
s
p
ec
if
ic
g
u
id
el
in
es
f
o
r
a
f
e
w
of
its
s
er
v
ices
ar
ea
s
.
Ho
w
e
v
er
,
m
o
r
e
in
f
o
r
m
atio
n
co
u
ld
be
p
r
o
v
id
e
d
to
s
tr
en
g
t
h
en
it
s
r
es
u
lts
.
T
h
e
B
FHS
s
u
cc
ess
f
u
ll
y
ar
tic
u
lates
n
at
io
n
al
g
u
id
elin
e
s
a
n
d
p
o
licy
f
o
r
a
f
e
w
of
it
s
es
s
en
tial
h
ea
l
t
h
s
er
v
ices,
m
ai
n
l
y
c
h
ild
h
ea
l
th
,
d
eliv
er
y
/
n
e
w
b
o
r
n
ca
r
e
an
d
t
u
b
er
cu
lo
s
is
.
Sp
ec
i
f
icall
y
,
t
h
e
s
u
r
v
e
y
d
is
c
u
s
s
es
t
h
e
ad
o
p
tio
n
of
an
in
teg
r
ated
m
an
ag
e
m
e
n
t
of
ch
ild
h
o
o
d
illn
es
s
s
tr
ateg
y
(
I
M
C
I
)
as
ad
v
is
ed
by
th
e
W
HO.
W
ith
in
th
is
s
tr
ate
g
y
,
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
s
h
o
u
ld
u
s
e
ap
p
o
in
t
m
e
n
t
s
to
e
v
al
u
ate
c
u
r
r
en
t
h
ea
lt
h
,
u
n
d
er
l
y
i
n
g
p
r
o
b
le
m
s
as
w
ell
as
p
r
ev
e
n
ti
v
e
i
n
ter
v
e
n
tio
n
s
to
p
r
ev
e
n
t
f
u
t
u
r
e
ill
n
es
s
[
1
]
.
As
a
h
i
g
h
b
u
r
d
en
co
u
n
tr
y
f
o
r
t
u
b
er
cu
lo
s
i
s
,
B
an
g
lad
es
h
also
estab
li
s
h
ed
t
h
e
Natio
n
a
l
TB
C
o
n
tr
o
l
Pro
g
r
a
m
(
NT
P
)
[
3
9
]
.
T
h
is
p
r
o
g
r
am
u
tili
ze
s
a
m
o
d
el
of
d
ir
ec
tl
y
o
b
s
er
v
ed
tr
ea
t
m
e
n
t
(
DOT
S)
th
at
o
u
tli
n
es
f
i
v
e
n
ec
es
s
ar
y
g
u
id
eli
n
es
in
cl
u
d
i
n
g
s
ec
u
r
e
p
o
liti
ca
l
co
m
m
i
t
m
e
n
t
an
d
s
u
s
tai
n
ed
f
i
n
an
ci
n
g
,
ea
r
l
y
ca
s
e
d
etec
t
io
n
an
d
d
iag
n
o
s
i
s
,
s
ta
n
d
ar
d
ized
tr
ea
t
m
e
n
t,
e
f
f
ec
t
iv
e
d
r
u
g
s
u
p
p
l
y
a
n
d
m
an
a
g
e
m
en
t
,
an
d
m
o
n
ito
r
in
g
a
n
d
ev
al
u
at
in
g
p
er
f
o
r
m
a
n
ce
[
4
0
]
.
T
h
e
s
u
r
v
e
y
also
o
u
tli
n
es
p
o
licies
in
p
lace
to
i
m
p
r
o
v
e
Deliv
er
y
an
d
Ne
w
b
o
r
n
C
ar
e.
B
an
g
lad
es
h
h
a
s
d
ev
elo
p
ed
a
―
P
r
o
m
is
e
R
en
e
w
ed
Dec
lar
atio
n
:
B
an
g
lad
es
h
C
al
l
to
A
ctio
n
2013‖
p
o
licy
an
d
in
cl
u
d
ed
a
Natio
n
al
Ne
w
b
o
r
n
Hea
lt
h
P
r
o
g
r
a
m
(
NNHP
)
in
th
e
4
th
Hea
l
th
,
P
o
p
u
latio
n
a
n
d
Nu
tr
itio
n
Secto
r
Dev
elo
p
m
e
n
t
P
r
o
g
r
a
m
(
HP
NSDP
)
.
A
Ma
ter
n
al,
Neo
n
atal,
C
h
ild
,
an
d
A
d
o
lesc
en
t
Hea
lt
h
(
MN
C
&
AH)
p
lan
is
k
n
o
w
n
as
‗
B
an
g
lad
es
h
E
v
e
r
y
Ne
w
b
o
r
n
A
ctio
n
P
lan
‘
(
B
E
NA
P
)
h
as
al
s
o
b
ee
n
cr
ea
ted
an
d
o
p
er
atio
n
alize
d
u
n
d
er
th
e
HP
NSDP
[
1
]
.
T
h
e
B
HFS
d
escr
ib
es
th
e
s
p
ec
if
ic
g
o
als
th
e
s
e
p
la
n
s
ai
m
to
ac
h
ie
v
e
in
r
eg
ar
d
s
to
Deliv
er
y
an
d
Ne
w
b
o
r
n
C
ar
e
i
m
p
r
o
v
e
m
en
t.
By
d
is
cu
s
s
i
n
g
t
h
e
r
es
u
lt
s
of
th
e
s
u
r
v
e
y
in
r
elatio
n
to
e
s
tab
lis
h
e
d
p
o
licy
g
u
id
elin
e
s
,
th
e
s
u
r
v
e
y
cr
ea
tes
a
s
tan
d
ar
d
f
o
r
h
ea
l
th
f
ac
ilit
ie
s
to
ac
h
ie
v
e.
T
h
e
s
u
r
v
e
y
also
a
n
c
h
o
r
s
t
h
eir
f
i
n
d
in
g
s
b
ased
on
e
x
is
t
in
g
p
o
lic
y
a
n
d
g
o
v
er
n
a
n
ce
,
h
ig
h
li
g
h
ti
n
g
t
h
e
i
n
ter
p
la
y
of
t
h
e
h
ea
lth
s
y
s
te
m
p
illar
s
.
In
s
e
v
er
al
s
ec
tio
n
s
,
t
h
e
B
HF
S
m
in
i
m
al
l
y
d
is
c
u
s
s
e
s
g
u
id
el
in
es
an
d
p
o
licie
s
f
o
r
p
ar
ticu
l
ar
s
er
v
ice
s
.
Sp
ec
if
icall
y
,
t
h
e
s
u
r
v
e
y
lac
k
s
in
f
o
r
m
atio
n
r
e
g
ar
d
in
g
p
o
lici
es
an
d
g
u
id
eli
n
es
f
o
r
th
e
d
ia
g
n
o
s
is
a
n
d
tr
ea
t
m
en
t
f
o
r
v
ar
io
u
s
n
o
n
-
co
m
m
u
n
icab
le
d
is
ea
s
e
s
i
n
cl
u
d
in
g
d
iab
et
es,
ca
r
d
io
v
asc
u
lar
d
is
ea
s
e,
c
h
r
o
n
ic
r
e
s
p
ir
ato
r
y
d
is
ea
s
e
an
d
ce
r
v
ical
ca
n
ce
r
.
It
o
n
ly
b
r
ief
l
y
m
e
n
tio
n
ed
p
o
licies
s
u
c
h
as
th
e
Natio
n
al
P
o
p
u
latio
n
P
o
licy
(
MO
HFW
2012)
an
d
th
e
4
t
h
Hea
l
th
,
P
o
p
u
latio
n
a
n
d
N
u
tr
itio
n
Secto
r
De
v
elo
p
m
e
n
t
P
r
o
g
r
am
(
HP
NSP
)
cr
ea
te
d
to
im
p
r
o
v
e
f
a
m
il
y
p
la
n
n
i
n
g
s
er
v
ice
s
.
T
h
e
s
u
r
v
e
y
d
o
es
n
o
t
p
r
o
v
id
e
in
f
o
r
m
atio
n
r
eg
ar
d
in
g
g
u
id
elin
e
s
or
p
o
licies
f
o
r
an
ten
a
tal
s
er
v
i
ce
s
.
T
h
e
lack
of
d
is
cu
s
s
io
n
of
th
e
s
e
g
u
id
eli
n
es
s
u
g
g
e
s
ts
s
u
ch
p
o
licies
ar
e
n
o
t
estab
lis
h
ed
.
Hea
lth
f
ac
i
liti
e
s
al
s
o
n
ee
d
to
e
n
s
u
r
e
t
h
eir
p
r
o
v
id
er
s
ad
h
er
e
to
g
u
id
eli
n
es,
at
ten
d
co
n
s
i
s
te
n
t
t
r
ain
in
g
to
en
s
u
r
e
co
m
p
lia
n
ce
a
n
d
h
av
e
ad
eq
u
ate
eq
u
ip
m
e
n
t
an
d
m
ed
i
ca
tio
n
s
to
p
r
o
v
id
e
q
u
alit
y
ca
r
e
[
3
7
]
.
T
h
e
s
u
r
v
e
y
d
is
cu
s
s
es
th
e
s
e
ele
m
en
ts
t
h
r
o
u
g
h
th
e
ir
ev
al
u
atio
n
of
r
ea
d
in
ess
to
p
r
o
v
id
e
p
ar
ticu
l
ar
h
ea
lt
h
s
er
v
ices.
Sp
ec
if
icall
y
,
t
h
e
s
u
r
v
e
y
d
ef
i
n
es
r
ea
d
i
n
ess
by
th
e
f
ac
i
liti
e
s
‘
s
to
ck
of
eq
u
ip
m
e
n
t,
m
ed
i
cin
es
an
d
w
h
et
h
er
p
r
o
v
id
er
s
ar
e
in
co
m
p
lia
n
ce
with
h
ea
lt
h
s
er
v
ice
g
u
id
eli
n
es.
In
m
an
y
h
ea
lt
h
s
er
v
ice
ca
teg
o
r
i
es,
th
e
s
u
r
v
e
y
u
s
ed
W
HO
g
u
id
elin
e
s
an
d
i
n
d
icat
o
r
s
as
a
r
ef
er
en
ce
p
o
in
t.
Ho
w
e
v
er
,
w
h
ile
r
ea
d
in
es
s
w
a
s
d
eter
m
in
ed
b
ased
on
W
HO
tr
ac
er
in
d
icato
r
s
,
th
e
s
u
r
v
e
y
o
f
te
n
m
o
d
i
f
ied
in
d
icato
r
s
to
be
―
less
r
es
t
r
ictiv
e
an
d
co
n
te
x
t
ap
p
r
o
p
r
iate‖
[
1
]
.
By
m
o
d
i
f
y
in
g
th
e
s
e
i
n
d
icato
r
s
,
th
e
s
u
r
v
e
y
ma
k
e
s
it
m
o
r
e
d
if
f
ic
u
lt
to
ef
f
e
ctiv
el
y
co
m
p
ar
e
th
e
d
ata
to
W
HO
s
tan
d
ar
d
s
.
Ov
er
all,
tr
ain
i
n
g
an
d
co
m
p
lia
n
ce
to
g
u
id
eli
n
es
r
e
m
ain
ed
lo
w
w
it
h
i
n
each
h
ea
lth
s
er
v
ice
t
y
p
e.
Ur
b
an
ar
ea
s
w
er
e
m
o
r
e
li
k
el
y
to
h
av
e
ad
eq
u
ate
tr
ai
n
i
n
g
w
it
h
i
n
th
eir
f
ac
ili
ties
th
a
n
r
u
r
al
f
a
cilities
.
To
ev
al
u
ate
f
ac
ilit
ies
‘
r
ea
d
in
es
s
to
p
r
o
v
id
e
ch
ild
h
ea
lt
h
s
er
v
ices,
t
h
e
s
u
r
v
e
y
e
v
alu
a
ted
th
e
p
r
esen
ce
of
I
MCI
g
u
id
eli
n
es,
I
MCI
tr
ain
ed
s
ta
f
f
,
ad
eq
u
ate
e
q
u
ip
m
e
n
t
an
d
m
ed
icin
e.
W
h
i
l
e
th
e
co
u
n
tr
y
h
as
r
o
b
u
s
t
p
o
lici
es
m
atc
h
i
n
g
W
HO
r
ec
o
m
m
e
n
d
atio
n
s
,
o
n
l
y
5%
of
all
h
ea
lth
f
ac
ilit
ie
s
h
a
v
e
all
10
item
s
w
it
h
in
t
h
e
I
MCI
ca
teg
o
r
ies
[
1
]
.
A
n
te
n
atal
ca
r
e
r
ea
d
in
ess
w
a
s
d
eter
m
i
n
e
d
by
av
ailab
ili
t
y
of
ite
m
s
a
n
d
eq
u
ip
m
en
t.
O
v
er
all
―
o
n
l
y
4%
of
f
ac
ili
ties
ar
e
at
th
e
lev
el
of
r
ea
d
in
es
s
n
ec
es
s
a
r
y
to
p
r
o
v
id
e
q
u
alit
y
A
NC
s
e
r
v
ices‖
[
1
]
.
Sim
ilar
l
y
,
r
ea
d
in
e
s
s
f
o
r
d
eliv
er
y
an
d
n
e
w
b
o
r
n
s
er
v
ices
w
as
d
eter
m
i
n
ed
b
ased
on
f
ac
i
lit
y
g
u
id
eli
n
es,
tr
ain
ed
s
ta
f
f
,
an
d
s
p
ec
ializ
ed
eq
u
ip
m
e
n
t.
6
out
of
10
h
ea
l
th
f
ac
ilit
ie
s
w
er
e
ab
le
to
o
f
f
er
q
u
ali
t
y
d
eliv
er
y
s
er
v
ices
[
1
]
.
Hea
lth
s
er
v
ic
es
w
it
h
e
s
tab
lis
h
ed
g
u
id
eli
n
e
s
an
d
p
o
licies,
s
u
ch
as
tu
b
er
cu
lo
s
is
s
er
v
ices,
h
ad
m
u
ch
h
i
g
h
er
r
ates
of
g
u
id
elin
e
c
o
m
p
lia
n
ce
.
Ov
er
all,
th
e
s
u
r
v
e
y
o
p
en
l
y
d
i
s
cu
s
s
es
th
e
i
m
p
o
r
tan
ce
of
tr
ai
n
in
g
a
n
d
g
u
id
elin
e
co
m
p
l
ian
ce
.
T
h
e
d
at
a
s
h
o
w
s
t
h
is
t
y
p
e
of
r
ea
d
in
es
s
co
u
ld
b
e
im
p
r
o
v
ed
w
it
h
i
n
th
e
h
ea
lt
h
f
ac
ilit
ies.
Ho
w
e
v
er
,
t
h
e
s
u
r
v
e
y
co
u
ld
h
av
e
p
r
o
v
id
ed
ad
d
itio
n
al
in
f
o
r
m
ati
o
n
r
eg
ar
d
in
g
w
h
o
w
as
r
ec
ei
v
in
g
tr
ai
n
i
n
g
an
d
w
h
et
h
er
th
is
in
f
o
r
m
a
tio
n
w
a
s
s
u
b
s
eq
u
en
t
l
y
d
is
s
e
m
in
ated
w
it
h
in
t
h
e
f
ac
ilit
ie
s
.
3
.
3
.
Av
a
ila
bil
it
y
of
s
er
v
ices
T
h
e
2
0
1
7
B
HFS
ai
m
s
to
ev
alu
ate
t
h
e
av
ailab
ili
t
y
of
h
e
alth
s
er
v
ices
a
n
d
its
in
d
i
v
id
u
al
h
ea
l
th
f
ac
ilit
ies.
Fo
r
t
h
i
s
s
u
r
v
e
y
,
a
v
ai
lab
ilit
y
is
d
e
f
i
n
ed
as
t
h
e
p
r
ese
n
ce
of
th
e
h
ea
lth
s
er
v
ice
at
th
e
h
ea
lt
h
f
ac
ili
t
y
[
1
]
.
Mo
s
t
d
ata
p
r
o
v
id
ed
on
av
ailab
ilit
y
w
as
b
ased
on
w
h
e
th
er
t
h
e
p
ar
ticu
lar
s
er
v
ice
w
as
o
f
f
er
ed
at
a
f
ac
i
lit
y
on
t
h
e
d
ay
th
e
s
u
r
v
e
y
w
a
s
ad
m
in
is
t
er
ed
.
Usi
n
g
t
h
is
d
ef
i
n
itio
n
of
a
v
ailab
ilit
y
,
r
ea
d
er
s
ca
n
e
v
alu
ate
d
i
f
f
er
en
ce
s
b
et
w
ee
n
f
ac
ili
ties
an
d
w
h
a
t
s
er
v
ices
th
e
y
o
f
f
er
.
Fo
r
ex
a
m
p
le,
b
ased
on
th
e
B
HFS,
ch
ild
h
ea
lt
h
s
er
v
ice
s
ar
e
av
ailab
le
ac
r
o
s
s
all
f
ac
ili
ties
.
Ho
w
e
v
er
,
p
u
b
lic
f
ac
i
liti
es
a
n
d
NGO
f
ac
i
liti
es
p
r
o
v
id
e
c
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N:
2252
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8806
Hea
lth
fa
cilities
r
o
les
in
mea
s
u
r
in
g
p
r
o
g
r
ess
of
u
n
ivers
a
l
h
e
a
lth
co
ve
r
a
g
e
(
Mu
h
iu
d
d
in
Ha
i
d
er
)
109
at
h
ig
h
er
r
ates
th
a
n
in
p
r
iv
ate
f
ac
ilit
ie
s
.
A
d
d
itio
n
all
y
,
a
lth
o
u
g
h
9
in
10
of
all
f
ac
il
ities
p
r
o
v
id
e
ch
ild
v
ac
cin
a
tio
n
,
o
n
l
y
7%
of
th
e
s
e
f
ac
ilit
ie
s
ar
e
p
r
iv
ate
[
1
]
.
Fu
r
t
h
er
,
u
r
b
an
f
ac
il
ities
ar
e
less
li
k
el
y
to
h
a
v
e
ch
ild
s
er
v
ices.
T
h
is
s
u
g
g
est
s
th
e
a
v
a
ilab
ilit
y
of
ch
ild
h
ea
lth
s
er
v
ice
s
is
b
ased
on
lo
ca
tio
n
an
d
t
y
p
e
of
f
ac
ilit
y
.
In
a
f
e
w
s
ec
tio
n
s
,
th
e
B
H
FS
f
u
r
th
er
d
e
f
in
e
s
t
h
eir
d
ef
i
n
it
i
o
n
of
a
v
ailab
ilit
y
.
In
t
h
eir
ev
alu
atio
n
of
f
a
m
il
y
p
la
n
n
i
n
g
s
er
v
ice
s
,
th
e
s
u
r
v
e
y
m
a
k
es
a
d
is
ti
n
ctio
n
b
et
w
ee
n
p
r
o
v
id
in
g
f
a
m
il
y
p
la
n
n
i
n
g
m
et
h
o
d
s
an
d
o
f
f
er
i
n
g
f
a
m
il
y
p
lan
n
i
n
g
s
er
v
i
ce
s
[
1
]
.
T
h
e
latter
in
clu
d
es
f
a
cilities
t
h
at
p
r
o
v
id
e,
p
r
escr
ib
e
or
co
u
n
s
el
f
a
m
il
y
p
lan
n
i
n
g
m
et
h
o
d
s
b
u
t
m
a
y
r
ef
er
clien
t
s
to
o
th
er
f
ac
ilit
ie
s
f
o
r
ac
ce
s
s
ib
ilit
y
to
th
o
s
e
m
eth
o
d
s
or
m
ed
icatio
n
s
.
T
h
u
s
,
th
e
s
tatis
t
ic
th
at
ab
o
u
t
9
in
10
of
all
h
ea
lt
h
f
ac
i
liti
es
o
f
f
er
m
o
d
er
n
m
et
h
o
d
s
of
f
a
m
il
y
p
la
n
n
in
g
s
er
v
ices
d
o
es
n
o
t
g
u
ar
an
tee
clie
n
ts
r
ec
eiv
e
th
e
m
eth
o
d
th
e
y
n
ee
d
[
1
]
.
T
h
is
d
is
tin
c
tio
n
is
s
i
g
n
i
f
ican
t
as
th
e
n
ee
d
to
v
is
it
an
o
th
er
f
ac
ilit
y
co
u
ld
f
u
r
th
er
i
m
p
ed
e
a
clien
t‘
s
ab
ilit
y
to
u
tili
ze
f
a
m
il
y
p
la
n
n
in
g
m
e
th
o
d
s
in
a
ti
m
el
y
a
n
d
ec
o
n
o
m
icall
y
f
ea
s
ib
le
m
an
n
er
.
Ho
w
e
v
er
,
th
e
s
e
d
ef
i
n
itio
n
s
of
av
ailab
ilit
y
d
e
f
in
ed
by
th
e
p
r
esen
ce
of
a
s
er
v
ice
d
o
es
n
o
t
ac
co
u
n
t
or
ad
d
r
ess
th
e
ti
m
el
in
e
s
s
or
u
til
izatio
n
of
th
e
h
ea
lt
h
s
er
v
ice
w
h
ich
h
elp
s
f
u
r
t
h
er
d
ef
in
e
w
h
et
h
er
th
e
h
ea
l
t
h
s
er
v
ice
is
ac
ce
s
s
ib
le.
Dela
y
ed
d
iag
n
o
s
i
s
an
d
tr
ea
t
m
en
t
of
p
ar
ticu
lar
h
ea
l
th
i
s
s
u
es
can
ca
u
s
e
ad
d
itio
n
al
ad
v
er
s
e
h
ea
lt
h
o
u
tco
m
es.
B
ased
on
t
h
e
B
HFS,
tu
b
er
cu
lo
s
is
d
ia
g
n
o
s
is
,
tr
ea
t
m
en
t
an
d
/o
r
tr
ea
t
m
en
t
f
o
llo
w
u
p
s
ar
e
p
r
o
v
id
ed
at
90%
of
d
i
s
tr
ict
h
o
s
p
itals
a
n
d
98%
of
u
p
az
ila
h
ea
lt
h
co
m
p
le
x
es
(
UH
C
)
[
1
]
.
Ho
w
e
v
er
,
a
n
o
th
er
s
tu
d
y
r
ev
ea
led
an
a
v
er
a
g
e
h
e
alth
s
y
s
te
m
d
ela
y
in
t
h
e
m
a
n
ag
e
m
e
n
t
of
t
u
b
er
cu
lo
s
is
p
atie
n
ts
to
be
6
8
.
5
d
ay
s
[
3
7
]
.
W
h
ile
f
ac
ilit
ies
m
a
y
be
p
r
o
v
id
in
g
s
er
v
ices,
m
o
r
e
i
n
f
o
r
m
at
io
n
r
e
g
ar
d
in
g
ti
m
eli
n
e
s
s
of
s
er
v
ice
s
w
o
u
ld
p
r
o
v
id
e
m
o
r
e
tan
g
ib
le
ev
id
en
c
e
of
th
e
q
u
ali
t
y
a
n
d
ef
f
icie
n
c
y
of
th
e
s
er
v
ices
w
i
th
i
n
t
h
ese
f
a
cilities
.
W
ith
in
th
e
s
ec
tio
n
on
a
n
te
n
ata
l
h
ea
lt
h
s
er
v
ices,
th
e
s
u
r
v
e
y
d
escr
ib
es
th
e
p
er
ce
n
tag
e
of
w
o
m
en
u
s
i
n
g
s
er
v
ices
d
u
r
i
n
g
p
r
eg
n
an
c
y
b
ased
on
d
ata
f
r
o
m
th
e
2017
B
an
g
lad
esh
De
m
o
g
r
ap
h
ic
a
n
d
Hea
lth
S
u
r
v
e
y
(
B
DHS)
.
T
h
e
r
esu
lt
s
r
ev
ea
led
th
at
82%
of
w
o
m
e
n
a
g
e
15
-
49
w
ith
a
l
iv
e
b
ir
t
h
in
t
h
e
3
y
ea
r
s
p
r
ec
ed
in
g
t
h
e
s
u
r
v
e
y
r
ec
ei
v
ed
A
N
C
f
r
o
m
a
m
ed
icall
y
tr
ain
ed
p
r
o
v
id
er
[
1
]
.
A
d
d
itio
n
al
l
y
,
―
t
h
e
2017
B
DHS
r
es
u
lts
s
h
o
w
ed
th
at
o
n
l
y
43%
of
r
u
r
al
w
o
m
en
,
as
co
m
p
ar
ed
w
it
h
59%
of
u
r
b
an
w
o
m
en
,
h
ad
at
least
f
o
u
r
A
N
C
v
i
s
it
s
‖
[
1
:
9
4
]
.
W
ith
th
e
s
e
s
tati
s
tics
,
t
h
e
B
FHS
is
in
d
icati
n
g
th
e
u
tili
za
t
i
o
n
of
an
te
n
atal
ca
r
e
s
er
v
ice
s
.
T
h
is
ad
d
itio
n
al
in
f
o
r
m
atio
n
is
n
ec
e
s
s
ar
y
to
ca
teg
o
r
ize
th
e
av
ailab
ili
t
y
of
s
er
v
ice
s
f
u
r
th
er
.
A
d
d
itio
n
all
y
,
th
e
d
ata
w
as
co
m
p
ar
ed
to
p
r
ev
io
u
s
s
u
r
v
e
y
r
esu
lt
s
f
r
o
m
2014
an
d
2
0
1
1
,
in
d
icati
n
g
an
in
cr
ea
s
e
in
u
tili
za
tio
n
of
an
ten
ata
l
h
ea
lt
h
s
er
v
ice
s
.
T
h
er
e
is
no
d
is
cu
s
s
io
n
or
d
ata
p
r
o
v
id
ed
r
eg
ar
d
in
g
th
e
u
tili
za
tio
n
or
ti
m
el
in
e
s
s
of
c
h
ild
h
ea
lt
h
s
er
v
ices,
n
o
n
-
co
m
m
u
n
icab
le
d
is
ea
s
e,
or
tu
b
er
cu
lo
s
is
.
T
h
e
f
r
eq
u
e
n
c
y
of
f
a
m
il
y
p
lan
n
i
n
g
s
er
v
ices
w
a
s
m
en
tio
n
ed
;
―n
ea
r
l
y
80%
of
f
ac
ilit
ies
r
ep
o
r
ted
th
at
th
e
y
p
r
o
v
id
e
FP
s
er
v
ices
e
v
er
y
d
a
y
‖
[
1
]
.
Ho
w
e
v
er
,
th
i
s
in
f
o
r
m
atio
n
w
a
s
n
o
t
e
x
p
an
d
ed
o
n
.
W
h
ile
th
e
2017
B
FH
S
ad
d
r
e
s
s
es
t
h
e
av
a
ilab
ilit
y
of
s
er
v
ic
es
b
ased
on
th
e
p
r
esen
ce
of
in
d
iv
id
u
al
h
ea
lt
h
s
er
v
ices,
t
h
e
s
u
r
v
e
y
d
i
d
n
o
t
ad
d
r
ess
o
th
er
f
ac
to
r
s
t
h
at
co
n
tr
ib
u
te
to
t
h
e
ac
ce
s
s
ib
il
it
y
of
t
h
ese
h
ea
lt
h
s
er
v
ices.
Util
izatio
n
an
d
ti
m
elin
es
s
of
th
e
h
ea
l
th
s
er
v
ices
s
h
o
u
ld
be
d
is
cu
s
s
ed
.
Fu
r
t
h
e
r
,
th
er
e
is
no
d
ata
co
llected
r
eg
ar
d
in
g
p
atien
t
lo
ad
at
th
e
f
ac
ili
ties
or
q
u
alit
y
of
ca
r
e
f
r
o
m
th
e
p
er
s
p
ec
ti
v
e
of
th
e
p
atie
n
t.
As
m
en
tio
n
ed
by
J
o
ar
d
er
et
al
.
[
2
2
]
an
d
An
d
alee
b
et
al
.
[
4
1
]
lo
w
u
til
izatio
n
of
h
ea
lt
h
f
ac
il
ities
a
n
d
i
n
cr
ea
s
ed
p
atien
t
to
p
r
o
v
id
er
r
atio
s
h
a
v
e
h
is
to
r
icall
y
i
m
p
ac
ted
B
an
g
lad
es
h
‘
s
ab
ilit
y
to
p
r
o
v
id
e
ess
e
n
tial
s
er
v
ice
s
.
Fu
r
t
h
er
m
o
r
e,
d
ata
r
eg
ar
d
in
g
q
u
alit
y
of
ca
r
e
can
in
f
o
r
m
th
e
ef
f
icien
c
y
,
eq
u
it
y
,
an
d
ef
f
ec
ti
v
en
e
s
s
of
t
h
e
h
ea
lt
h
ca
r
e
s
y
s
te
m
.
3
.
4
.
F
ina
ncing
As
an
i
n
te
g
r
al
p
ar
t
of
SDG
3
.
8
.
2
an
d
W
HO‘
s
Hea
lt
h
S
y
s
te
m
Fra
m
e
w
o
r
k
,
a
w
ell
-
f
u
n
ct
io
n
in
g
h
ea
l
t
h
f
i
n
an
ci
n
g
s
y
s
te
m
p
r
o
v
id
es
f
u
n
d
s
f
o
r
h
ea
lt
h
s
er
v
ices
t
h
at
e
n
s
u
r
e
all
i
n
d
iv
id
u
als
ca
n
ac
ce
s
s
a
n
d
u
s
e
s
er
v
ice
s
w
it
h
o
u
t
i
m
p
o
v
er
is
h
m
e
n
t.
T
h
e
2017
B
HFS
d
o
es
n
o
t
p
r
o
v
id
e
an
y
i
n
f
o
r
m
atio
n
r
eg
ar
d
in
g
f
in
an
c
in
g
or
f
u
n
d
i
n
g
f
o
r
an
y
h
ea
lt
h
s
er
v
ice.
T
h
e
o
n
l
y
i
n
f
o
r
m
atio
n
d
is
c
u
s
s
ed
is
in
r
ef
er
en
ce
to
t
u
b
er
cu
lo
s
i
s
.
Sp
e
cif
icall
y
,
as
p
ar
t
of
th
e
NT
P
,
―
d
iag
n
o
s
tic
an
d
tr
ea
t
m
e
n
t
s
er
v
ice
s
ar
e
av
ailab
le
f
r
ee
of
ch
ar
g
e
in
p
u
b
lic
an
d
p
r
iv
ate
f
ac
ilit
ie
s
th
r
o
u
g
h
o
u
t
t
h
e
co
u
n
tr
y
‖
[
1
]
.
W
ith
o
u
t
t
h
i
s
es
s
en
tial
i
n
f
o
r
m
atio
n
r
eg
ar
d
in
g
o
t
h
er
h
ea
l
th
s
er
v
ices,
it
is
u
n
clea
r
w
h
et
h
er
i
m
p
r
o
v
e
m
e
n
ts
h
a
v
e
b
ee
n
m
ad
e
to
w
ar
d
s
UHC
s
p
ec
if
ical
l
y
in
in
d
icato
r
3
.
8
.
2
.
A
d
d
itio
n
all
y
,
in
f
o
r
m
atio
n
r
e
g
ar
d
in
g
f
i
n
a
n
ci
al
ac
ce
s
s
i
b
ilit
y
w
o
u
ld
p
r
o
v
id
e
in
f
o
r
m
atio
n
r
e
g
ar
d
in
g
th
e
e
f
f
icien
c
y
a
n
d
eq
u
it
y
of
th
e
h
ea
lt
h
s
er
v
ice
s
p
r
o
v
id
ed
.
3
.
5
.
I
nco
ns
i
s
t
encies
T
h
e
s
u
r
v
e
y
co
n
tai
n
s
v
ar
io
u
s
i
n
co
n
s
is
te
n
cies
a
n
d
g
ap
s
in
d
ata
r
eq
u
ir
ed
f
o
r
o
p
tim
al
co
m
p
r
eh
en
s
io
n
.
Firstl
y
,
t
h
er
e
ar
e
i
n
co
n
s
i
s
te
n
ci
es
in
lab
eli
n
g
d
ata
t
h
r
o
u
g
h
o
u
t
th
e
c
h
ap
ter
.
So
m
e
d
ata
ar
e
ci
ted
in
p
er
ce
n
ta
g
e
s
w
h
ile
o
th
er
d
ata
w
it
h
i
n
t
h
e
s
a
m
e
c
h
ap
ter
ar
e
cited
as
f
r
ac
tio
n
s
.
W
h
ile
th
i
s
is
a
m
in
o
r
i
s
s
u
e,
it
lo
w
er
s
t
h
e
cr
ed
ib
ilit
y
an
d
s
tan
d
ar
d
of
t
h
e
w
o
r
k
as
a
w
h
o
le.
A
d
d
itio
n
all
y
,
th
e
tr
an
s
latio
n
of
d
ata
f
r
o
m
t
ab
les
to
tex
t
w
it
h
in
each
ch
ap
ter
is
in
ad
eq
u
ate.
W
h
ile
th
e
tab
le
s
o
f
ten
p
r
o
v
id
e
s
u
f
f
icie
n
t
e
x
p
lan
atio
n
of
s
u
r
v
e
y
d
ata
co
llected
,
th
i
s
is
o
f
te
n
n
o
t
ex
p
r
es
s
ed
in
t
h
e
c
h
ap
ter
w
h
er
e
g
r
ap
h
s
ar
e
e
x
p
la
in
ed
by
v
ag
u
e
s
tate
m
en
t
s
.
Fo
r
ex
a
m
p
le,
f
ir
s
t
aid
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N:
2252
-
8
8
0
6
I
n
t
.
J
.
P
u
b
lic
Hea
lth
Sci
.
Vo
l.
10,
No
.
1,
Ma
r
ch
20
2
1
:
1
03
–
1
12
110
s
ig
n
al
f
u
n
ctio
n
s
f
o
r
o
b
s
tetr
ic
an
d
n
e
w
b
o
r
n
ca
r
e;
g
r
o
u
p
ed
as
B
E
m
O
NC
,
E
m
ONC,
a
n
d
C
E
m
ON
C
w
er
e
d
is
cu
s
s
ed
in
th
e
Deli
v
er
y
a
n
d
Ne
w
b
o
r
n
C
ar
e
s
ec
t
io
n
[
1
]
.
Ho
w
e
v
er
,
th
e
s
ig
n
al
f
u
n
c
tio
n
s
w
er
e
later
li
s
ted
in
th
e
d
ata
tab
le
w
it
h
o
u
t
r
e
f
er
en
ce
to
B
E
m
ON
C
,
E
m
O
NC
,
or
C
E
m
ON
C
,
cr
ea
tin
g
co
n
f
u
s
io
n
r
eg
ar
d
i
n
g
t
h
e
s
ig
n
i
f
ica
n
ce
of
t
h
ese
s
i
g
n
al
f
u
n
ctio
n
s
a
n
d
t
h
eir
co
n
n
e
ctio
n
to
n
e
w
b
o
r
n
h
ea
lt
h
ca
r
e.
T
h
er
e
ar
e
also
in
co
n
s
is
te
n
cie
s
b
et
w
ee
n
c
h
ap
ter
s
r
eg
ar
d
in
g
th
e
b
ala
n
ce
b
e
t
w
ee
n
te
x
t
a
n
d
g
r
ap
h
s
,
as
w
e
ll
as
w
h
ich
d
ata
is
g
r
ap
h
icall
y
r
ep
r
esen
ted
.
T
h
e
Deliv
er
y
a
n
d
Ne
w
b
o
r
n
C
ar
e
ch
ap
ter
is
tex
t
h
ea
v
y
a
n
d
t
h
o
r
o
u
g
h
l
y
e
x
p
lain
s
t
h
e
d
ata
co
llected
w
ith
f
e
w
er
g
r
ap
h
s
,
w
h
ile
ch
ap
ter
s
li
k
e
Fa
m
i
l
y
P
lan
n
i
n
g
h
av
e
m
a
n
y
v
is
u
a
ls
b
u
t
m
o
r
e
v
a
g
u
e
tex
t
u
al
d
escr
ip
tio
n
s
.
T
h
e
g
r
ap
h
s
ar
e
co
n
d
en
s
ed
f
r
o
m
d
ata
ta
b
les
an
d
ar
e
o
f
ten
m
i
s
s
i
n
g
v
al
u
ab
le
clar
if
icatio
n
an
d
s
u
p
p
le
m
e
n
tal
i
n
f
o
r
m
atio
n
f
r
o
m
t
h
e
o
r
ig
i
n
al
tab
les.
A
d
d
itio
n
al
l
y
,
ce
r
tai
n
c
h
ap
ter
s
li
k
e
Deli
v
er
y
an
d
Ne
w
b
o
r
n
C
ar
e
ex
cl
u
d
e
C
o
m
m
u
n
it
y
C
lin
ics
f
r
o
m
ce
r
ta
in
d
ata
co
llected
in
t
h
e
ch
ap
ter
w
it
h
o
u
t
f
u
ll
y
r
atio
n
alizi
n
g
t
h
is
d
ec
is
io
n
.
3
.
6
.
I
m
pro
v
e
m
ent
s
to
s
urv
ey
m
et
ho
do
lo
g
y
T
h
e
B
HFS
co
u
ld
b
e
n
e
f
it
f
r
o
m
i
m
p
r
o
v
e
m
e
n
ts
to
t
h
e
m
et
h
o
d
o
lo
g
y
of
d
ata
co
llectio
n
.
T
h
e
s
u
r
v
e
y
d
o
es
n
o
t
d
is
ti
n
g
u
is
h
b
et
w
ee
n
t
y
p
es
of
s
taf
f
s
u
r
v
e
y
ed
.
T
h
is
cr
ea
tes
p
o
s
s
ib
le
b
ias
as
d
if
f
er
en
t
s
ta
f
f
in
f
ac
ilit
ie
s
h
a
v
e
d
if
f
er
e
n
t
r
o
les,
tr
ain
i
n
g
,
an
d
k
n
o
w
led
g
e
of
t
h
e
f
ac
ilit
y
.
If
al
l
th
e
p
h
y
s
icia
n
s
w
it
h
tr
ain
i
n
g
ar
e
o
cc
u
p
ied
w
h
e
n
th
e
d
ata
w
a
s
co
llected
,
t
h
en
th
e
d
ata
w
ill
o
n
l
y
r
ef
lec
t
t
h
e
tr
ai
n
in
g
of
le
s
s
q
u
ali
f
ied
h
ea
lt
h
ca
r
e
w
o
r
k
er
s
,
s
k
e
w
i
n
g
t
h
e
d
ata.
T
h
er
e
is
als
o
no
clar
if
icat
io
n
on
w
h
e
th
er
d
ata
co
llected
is
b
ased
on
ti
m
e
of
s
u
r
v
e
y
or
at
a
n
y
p
o
in
t
in
ti
m
e.
T
h
is
is
e
s
p
ec
ia
ll
y
p
er
ti
n
en
t
f
o
r
av
ailab
ilit
y
of
eq
u
ip
m
e
n
t
a
n
d
s
er
v
ices.
It
is
u
n
clea
r
w
h
et
h
er
eq
u
ip
m
e
n
t
w
as
n
o
t
av
ailab
le
at
th
e
ti
m
e
of
th
e
s
u
r
v
e
y
or
n
ev
er
av
a
ilab
le.
Ho
w
e
v
er
,
th
i
s
clar
if
icatio
n
d
o
es
ex
is
t
f
o
r
tr
ain
i
n
g
.
Data
is
co
l
lecte
d
f
o
r
tr
ain
i
n
g
w
i
th
in
t
h
e
p
ast
24
m
o
n
th
s
as
w
e
ll
as
tr
ain
i
n
g
at
a
n
y
ti
m
e.
A
d
d
itio
n
al
l
y
,
t
h
er
e
ar
e
ar
b
itra
r
y
cu
to
f
f
s
f
o
r
ce
r
tain
d
at
a.
Fo
r
ex
a
m
p
le,
f
o
u
r
ite
m
s
f
o
r
in
f
ec
tio
n
co
n
tr
o
l
is
co
n
s
id
er
ed
ad
eq
u
ate,
d
esp
ite
t
h
ese
ite
m
s
b
ein
g
b
asic
n
ec
ess
ities
l
ik
e
r
u
n
n
in
g
w
ater
a
n
d
g
l
o
v
es.
F
u
r
t
h
er
m
o
r
e,
th
e
s
u
r
v
e
y
d
o
es
n
o
t
e
m
p
h
a
s
i
ze
th
e
i
m
p
ac
t
of
q
u
a
n
tit
y
of
f
ac
ili
ties
w
h
e
n
co
m
p
ar
ed
to
th
e
a
v
ailab
ilit
y
of
s
er
v
ices
p
r
o
v
id
ed
.
T
h
er
e
ar
e
m
an
y
co
m
m
u
n
it
y
cl
in
ic
s
a
n
d
f
e
w
d
is
tr
icts
a
n
d
u
p
az
ila
p
u
b
l
ic
f
ac
il
ities
,
y
et
th
e
d
ata
r
ev
ea
ls
t
h
at
t
h
ese
f
e
w
p
u
b
lic
f
ac
ilit
ie
s
ar
e
o
f
te
n
b
etter
p
r
ep
ar
e
d
in
r
eg
ar
d
to
av
ailab
i
lit
y
a
n
d
r
ea
d
in
es
s
.
T
h
er
e
ar
e
o
n
ly
f
o
u
r
d
is
tr
ict
h
o
s
p
itals
s
u
r
v
e
y
ed
,
y
et
t
h
ese
f
ac
ilit
ies
ar
e
o
f
ten
u
s
ed
as
ex
a
m
p
le
s
of
h
i
g
h
p
er
ce
n
tag
es
of
a
v
ailab
ili
t
y
.
T
h
is
m
a
n
ip
u
latio
n
is
m
i
s
lead
i
n
g
a
n
d
cr
ea
tes
t
h
e
f
al
s
e
p
er
ce
p
tio
n
th
a
t
f
ac
ilit
ie
s
w
it
h
h
ig
h
p
er
ce
n
ta
g
es
of
av
ail
ab
ilit
y
an
d
tr
ai
n
in
g
ar
e
co
m
m
o
n
.
3
.
7
.
Su
cc
es
s
es
A
lt
h
o
u
g
h
t
h
e
B
FHS
h
as
ele
m
en
ts
t
h
at
ca
n
be
i
m
p
r
o
v
ed
,
it
d
o
es
co
n
tain
p
o
s
iti
v
e
asp
ec
ts
th
at
s
h
o
u
ld
co
n
tin
u
e
to
ap
p
ea
r
in
f
u
t
u
r
e
h
ea
lt
h
f
ac
il
ities
s
u
r
v
e
y
s
.
T
h
e
s
u
r
v
e
y
ac
k
n
o
w
led
g
es
s
h
o
r
tco
m
i
n
g
s
an
d
r
eq
u
ir
ed
ar
ea
s
of
i
m
p
r
o
v
e
m
e
n
t
w
it
h
i
n
each
asp
ec
t
of
UH
C
.
T
h
e
v
is
u
als
p
r
o
v
id
e
co
m
p
ar
is
o
n
s
b
et
w
ee
n
t
h
e
2017
an
d
2014
s
u
r
v
e
y
s
to
s
h
o
w
ch
a
n
g
es
in
h
ea
lt
h
ca
r
e
in
B
an
g
lad
e
s
h
o
v
er
a
th
r
ee
-
y
ea
r
ti
m
e
p
e
r
io
d
.
A
d
d
itio
n
all
y
,
d
esp
ite
th
e
d
ata
r
e
v
ea
li
n
g
t
h
e
lac
k
of
tr
ain
i
n
g
a
m
o
n
g
p
r
o
v
id
er
s
,
m
a
n
y
c
h
ap
ter
s
clea
r
l
y
e
x
p
lain
t
h
e
s
ig
n
i
f
ica
n
ce
of
h
ea
lt
h
tr
ai
n
in
g
an
d
b
r
ea
k
d
o
w
n
th
e
d
i
f
f
er
e
n
t
r
eq
u
i
s
ites
of
tr
ai
n
in
g
b
ase
d
on
h
ea
lt
h
s
er
v
ice.
T
r
ain
in
g
,
ex
p
er
ie
n
ce
,
an
d
k
n
o
w
led
g
e
of
s
ta
n
d
ar
d
s
is
esp
e
ciall
y
cr
u
c
ial
in
n
eo
n
atal
ca
r
e,
as
p
r
o
v
id
er
s
cite
th
ese
f
ac
to
r
s
as
d
eter
r
en
ts
to
p
r
o
v
id
in
g
ca
r
e
[
4
2
]
.
C
er
tain
s
ec
tio
n
s
al
s
o
p
r
o
v
id
e
r
ec
o
m
m
e
n
d
atio
n
s
on
h
o
w
to
ac
h
iev
e
U
HC
a
n
d
i
m
p
r
o
v
e
c
ateg
o
r
ies
w
it
h
lo
w
a
v
ailab
ili
t
y
or
r
ea
d
in
es
s
.
Mo
s
t
i
m
p
o
r
ta
n
tl
y
,
t
h
e
d
ata
tab
les
p
r
o
v
id
e
a
co
m
p
r
eh
en
s
i
v
e
e
x
p
lan
atio
n
of
w
h
a
t
d
ata
is
b
ein
g
m
ea
s
u
r
ed
,
alo
n
g
w
it
h
c
lar
if
icatio
n
s
an
d
f
u
r
th
e
r
ex
p
lan
atio
n
s
f
o
r
g
r
ap
h
s
t
h
r
o
u
g
h
o
u
t
t
h
e
c
h
ap
ter
.
T
h
e
tab
les
ar
e
o
r
g
an
ized
b
a
s
ed
on
u
r
b
an
a
n
d
r
u
r
al
ar
ea
s
,
s
p
ec
if
ic
g
eo
g
r
ap
h
ic
d
iv
i
s
io
n
s
,
an
d
t
y
p
es
of
f
ac
il
ities
.
T
h
e
cle
ar
o
r
g
an
izatio
n
an
d
t
h
o
r
o
u
g
h
b
r
ea
k
d
o
w
n
of
t
h
es
e
tab
les
is
th
e
h
ea
r
t
of
t
h
e
s
u
r
v
e
y
d
ata
an
d
s
h
o
u
ld
be
g
iv
e
n
f
u
r
th
er
s
i
g
n
i
f
ica
n
ce
in
f
u
t
u
r
e
s
u
r
v
e
y
r
ep
o
r
ts
4.
CO
NCLU
SI
O
N
T
h
e
2
0
1
7
B
HFS
h
i
g
h
l
ig
h
t
s
t
h
e
av
ailab
il
it
y
of
s
er
v
ice
s
b
ased
on
th
e
p
r
esen
ce
of
h
ea
lt
h
s
er
v
ice
s
w
it
h
i
n
d
i
f
f
er
en
t
f
ac
ilit
ie
s
in
B
an
g
lad
e
s
h
.
Ov
er
all,
t
h
e
s
u
r
v
e
y
p
r
o
v
id
es
s
u
b
s
ta
n
tial
i
n
f
o
r
m
ati
o
n
on
th
e
p
r
esen
c
e
of
h
ea
l
th
s
er
v
ices
w
h
ic
h
allo
w
s
r
esear
ch
to
ev
a
lu
ate
d
if
f
er
en
ce
s
b
et
w
ee
n
f
ac
ili
ties
a
n
d
t
h
e
t
y
p
e
s
of
s
er
v
ices
th
e
y
o
f
f
er
.
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w
ev
er
,
th
i
s
in
f
o
r
m
atio
n
is
m
o
s
tl
y
i
n
f
r
astr
u
ctu
r
al
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ata
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d
d
o
es
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o
t
s
u
f
f
icie
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ad
d
r
ess
in
f
o
r
m
atio
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e
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ar
d
in
g
p
atien
t
lo
ad
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tim
e
lin
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s
s
,
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tili
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tio
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of
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er
v
ices
or
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er
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ice
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i
n
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n
cin
g
.
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b
s
eq
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e
n
tl
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,
it
is
d
if
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ic
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lt
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ass
es
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av
a
ilab
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ef
f
ec
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of
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to
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tast
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ic
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ea
lt
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.
W
ith
o
u
t
th
i
s
in
f
o
r
m
atio
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,
p
o
licy
m
ak
er
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an
d
r
esear
ch
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s
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ill
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i
n
d
it
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ic
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lt
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alu
ate
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te
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‘
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p
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ess
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ar
d
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UH
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an
d
W
HO‘
s
in
d
icato
r
s
of
h
ea
lt
h
s
er
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ice
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.
In
th
e
f
u
t
u
r
e,
B
an
g
lad
es
h
s
h
o
u
ld
co
n
d
u
ct
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ad
d
itio
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u
ate
th
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p
r
o
g
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its
h
ea
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f
ac
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T
h
is
f
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v
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m
u
s
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i
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cl
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d
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eg
ar
d
in
g
ti
m
eli
n
es
s
of
s
er
v
ice
s
,
q
u
ali
t
y
of
ca
r
e,
p
atien
t
lo
ad
an
d
th
e
h
ea
lt
h
f
i
n
a
n
cial
s
y
s
t
e
m
.
T
h
is
w
il
l
r
eq
u
ir
e
m
o
r
e
d
etailed
d
ef
in
itio
n
s
of
av
aila
b
ilit
y
an
d
s
er
v
ice
s
Evaluation Warning : The document was created with Spire.PDF for Python.
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ical
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ith
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d
eq
u
ate
ass
es
s
m
en
t
of
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co
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n
tr
y
‘
s
p
r
o
g
r
ess
t
o
w
ar
d
s
UHC
a
n
d
SDG
i
n
d
icato
r
s
.
Fu
r
th
er
,
B
an
g
lad
esh
can
p
r
o
v
id
e
m
o
r
e
co
m
p
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h
en
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d
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f
ec
ti
v
e
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v
in
g
UH
C
ef
f
icien
tl
y
.
RE
F
E
R
E
NC
E
S
[1
]
Na
ti
o
n
a
l
In
stit
u
te
of
P
o
p
u
lati
o
n
Re
se
a
rc
h
a
n
d
T
ra
in
in
g
(NIP
ORT
)
a
n
d
ICF
.
Ba
n
g
lad
e
sh
He
a
lt
h
F
a
c
il
it
y
S
u
rv
e
y
2
0
1
7
.
D
h
a
k
a
,
Ba
n
g
lad
e
sh
:
NI
P
O
RT
,
A
CP
R,
a
n
d
ICF
,
2
0
1
9
.
[2
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
.
2
0
0
7
.
Ev
e
r
y
b
o
d
y
‘s
Bu
sin
e
ss
:
S
tren
g
th
e
n
i
n
g
He
a
lt
h
S
y
ste
m
s
to
Im
p
ro
v
e
He
a
lt
h
Ou
tco
m
e
s:
W
HO
‘s
F
ra
m
e
w
o
r
k
f
o
r
A
c
ti
o
n
.
W
o
rld
He
a
lt
h
Or
g
a
n
iza
t
io
n
:
G
e
n
e
v
a
.
[3
]
A.
Ed
w
a
rd
,
et
al
.
,
A
c
o
m
p
a
ra
ti
v
e
a
n
a
l
y
sis
of
s
e
lec
t
h
e
a
lt
h
f
a
c
i
li
ty
su
rv
e
y
m
e
th
o
d
s
a
p
p
li
e
d
in
l
o
w
a
n
d
m
id
d
le
in
c
o
m
e
c
o
u
n
tri
e
s
[
w
o
rk
in
g
p
a
p
e
r
WP
-
09
-
1
1
]
.
C
h
a
p
e
l
Hill
,
NC:
M
E
A
S
URE
Ev
a
lu
a
ti
o
n
,
2
0
0
9
.
[4
]
C.
Dy
e
,
J.
Re
e
d
e
r,
a
n
d
R.
T
e
rr
y
,
―
Re
se
a
r
c
h
f
o
r
Un
iv
e
rsa
l
He
a
lt
h
Co
v
e
ra
g
e
,‖
S
c
ien
c
e
T
ra
n
sla
ti
o
n
a
l
M
e
d
icin
e
,
v
o
l
.
5
,
n
o
.
1
9
9
,
p
p
.
1
9
9
e
d
1
3
-
1
9
9
e
d
1
3
,
2
0
1
3
.
[5
]
T.
M
a
n
y
a
z
e
wa
l,
―
Us
in
g
th
e
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
h
e
a
lt
h
sy
st
e
m
b
u
il
d
in
g
b
lo
c
k
s
th
r
o
u
g
h
s
u
rv
e
y
of
h
e
a
lt
h
c
a
re
p
ro
f
e
ss
io
n
a
ls
to
d
e
term
in
e
th
e
p
e
rf
o
r
m
a
n
c
e
of
p
u
b
li
c
h
e
a
lt
h
c
a
re
f
a
c
il
it
ies
,
‖
Arc
h
ive
s
of
Pu
b
li
c
He
a
lt
h
,
v
o
l.
7
5
,
n
o
.
1,
2
0
1
7
.
[6
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
a
n
d
th
e
W
o
rld
Ba
n
k
.
2
0
1
5
.
T
ra
c
k
in
g
Un
iv
e
rsa
l
H
e
a
lt
h
Co
v
e
ra
g
e
:
f
irst
g
lo
b
a
l
m
o
n
it
o
rin
g
re
p
o
rt.
W
o
rl
d
He
a
lt
h
Or
g
a
n
iz
a
ti
o
n
:
G
e
n
e
v
a
.
[7
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
.
2
0
1
8
.
M
o
n
it
o
r
in
g
S
u
sta
in
a
b
le
De
v
e
lo
p
m
e
n
t
G
o
a
ls
–
In
d
ica
to
r
3
.
8
.
2
.
W
o
rld
He
a
lt
h
Or
g
a
n
iz
a
ti
o
n
:
G
e
n
e
v
a
.
[8
]
J.
A.
M.
Kh
a
n
,
S.
A
h
m
e
d
,
a
n
d
T.
G.
E
v
a
n
s,
―
C
a
tas
tro
p
h
ic
h
e
a
lt
h
c
a
re
e
x
p
e
n
d
it
u
re
a
n
d
p
o
v
e
rty
re
late
d
to
out
-
of
-
p
o
c
k
e
t
p
a
y
m
e
n
ts
f
o
r
h
e
a
lt
h
c
a
re
in
Ba
n
g
lad
e
sh
—
an
e
sti
m
a
ti
o
n
of
f
in
a
n
c
ial
risk
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.
[9
]
J.
E.
A
t
a
g
u
b
a
a
n
d
M.
-
G.
In
g
a
b
ire,
―
Un
iv
e
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l
H
e
a
lt
h
Co
v
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ra
g
e
:
A
s
se
ss
in
g
S
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r
v
ice
Co
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a
n
d
F
in
a
n
c
ial
P
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tec
ti
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n
f
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r
A
ll
,
‖
Am
e
ric
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rn
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l
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0
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E.
Ba
ra
sa
,
P.
Ng
u
h
iu
,
a
n
d
D.
M
c
in
ty
re
,
―
M
e
a
su
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p
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g
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ss
to
w
a
rd
s
S
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sta
in
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le
De
v
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t
G
o
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l
3
.
8
on
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n
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l
h
e
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lt
h
c
o
v
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ra
g
e
in
Ke
n
y
a
,
‖
BM
J
Glo
b
a
l
He
a
lt
h
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v
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l
.
3,
n
o
.
3,
p
p
.
1
-
1
4
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2
0
1
8
.
[1
1
]
L.
de
A
n
d
ra
d
e
,
et
al
.,
―
S
o
c
ial
d
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ter
m
in
a
n
ts
of
h
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,
u
n
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l
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e
,
a
n
d
su
sta
in
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b
le
d
e
v
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lo
p
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e
n
t:
c
a
se
stu
d
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f
ro
m
Latin
Am
e
ri
c
a
n
c
o
u
n
tri
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s
,‖
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L
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l.
3
8
5
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9
9
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p
p
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1
3
4
3
-
1
3
5
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5
.
[1
2
]
A.
M
a
e
d
a
,
et
al
.,
“
U
n
iv
e
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l
h
e
a
lt
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c
o
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sta
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t
a
s
y
n
th
e
sis
of
11
c
o
u
n
try
c
a
se
stu
d
ies
,‖
W
a
sh
in
g
to
n
,
DC:
W
o
rld
Ba
n
k
,
2
0
1
4
.
[1
3
]
Q.
M
e
n
g
a
n
d
L.
X
u
,
―
M
o
n
it
o
rin
g
a
n
d
Ev
a
lu
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ti
n
g
P
r
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g
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ss
to
w
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r
d
s
Un
iv
e
rsa
l
He
a
lt
h
Co
v
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ra
g
e
in
Ch
in
a
,‖
PL
O
S
M
e
d
icin
e,
v
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l.
11
,
n
o
.
9,
p.
e
1
0
0
1
6
9
4
,
2
0
1
4
.
[1
4
]
V
.
,
T
a
n
g
c
h
a
ro
e
n
sa
th
ien
,
et
al
.,
―
T
h
e
P
o
li
t
ica
l
Eco
n
o
m
y
of
UHC
Re
f
o
r
m
in
T
h
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d
:
L
e
ss
o
n
s
f
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L
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d
M
id
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le
-
In
c
o
m
e
Co
u
n
tri
e
s
,‖
He
a
lt
h
S
y
ste
ms
&
Refo
rm
,
v
o
l.
5
,
no.
3
,
p
p
.
1
95
-
2
0
8
,
2
0
1
9
.
[1
5
]
A.
A
l
e
b
a
c
h
e
w
,
L.
Ha
tt
,
a
n
d
M.
K
u
k
la,
―
M
o
n
it
o
rin
g
a
n
d
Ev
a
lu
a
ti
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g
P
ro
g
re
ss
to
w
a
rd
s
Un
iv
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r
sa
l
H
e
a
l
th
Co
v
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ra
g
e
in
Et
h
io
p
ia
,‖
P
L
o
S
M
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d
icin
e
,
v
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l
.
11
,
n
o
.
9,
p.
e
1
0
0
1
6
9
6
,
2
0
1
4
.
[1
6
]
A.
S
o
m
a
n
a
th
a
n
,
H.
L.
Da
o
,
a
n
d
T.
V.
T
ien
,
―
In
teg
ra
ti
n
g
th
e
P
o
o
r
in
to
Un
iv
e
rsa
l
He
a
lt
h
Co
v
e
ra
g
e
in
V
ietn
a
m
,
‖
UN
ICO
S
tu
d
ies
S
e
ries
;
N
o
.
24.
W
o
rld
B
a
n
k
,
W
a
sh
in
g
to
n
DC
,
2
0
1
3
.
[1
7
]
X.
A
g
u
il
e
ra
,
et
al
.,
―
M
o
n
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o
r
in
g
a
n
d
Ev
a
lu
a
ti
n
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P
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to
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Un
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v
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in
Ch
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.
P
L
o
S
M
e
d
icin
e
,
‖
v
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l.
11
,
no.
9,
p
.
e
1
0
0
1
6
7
6
,
2
0
1
4
.
[1
8
]
M.,
Ba
rre
to
,
e
t
a
l
.,
―
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o
n
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to
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g
a
n
d
Ev
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lu
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ti
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s
Un
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He
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Co
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M
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v
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11
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n
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9,
p
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1
0
0
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9
2
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2
0
1
4
.
[1
9
]
A
.
A
d
a
m
s,
e
t
a
l
.,
―
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n
o
v
a
ti
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f
o
r
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n
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Ba
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,
‖
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L
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3
8
2
,
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9
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p
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2
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0
]
M.
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q
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M
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―
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o
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rn
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a
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An
d
Bi
o
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S
c
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s
,‖
v
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12
,
no.
2
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p
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83
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2
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1
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S.
El
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.
,
―
T
h
e
p
a
th
to
u
n
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l
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lt
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c
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v
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ra
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n
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lad
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sh
:
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a
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of
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m
a
n
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so
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s
f
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r
h
e
a
lt
h
,‖
W
a
sh
in
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to
n
,
DC:
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2
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1
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7
8
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M
a
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,
―
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Co
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Ba
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t
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.,
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rn
e
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in
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p
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f
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h
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a
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in
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,‖
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8
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4
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,
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t
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l
.,
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n
g
lad
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Re
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,‖
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in
T
ra
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siti
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,
v
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5
,
no.
3
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0
15
.
[2
5
]
K.
A
la
m
a
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d
S.
A
h
m
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d
,
―
Co
st
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c
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of
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G
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p
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a
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h
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7
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R.
G
o
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d
a
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et
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He
a
lt
h
and
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u
trit
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o
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in
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a
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Ba
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:
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9
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A
.
M
.
R.
Ch
o
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ry
,
e
t
a
l
.,
―
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o
n
s=
BD>
[3
1
]
E.
Da
rk
wa
,
et
al
.
,
―
A
q
u
a
li
tativ
e
stu
d
y
of
f
a
c
to
rs
in
f
lu
e
n
c
in
g
re
ten
ti
o
n
of
d
o
c
to
rs
a
n
d
n
u
rse
s
at
r
u
ra
l
h
e
a
lt
h
c
a
re
f
a
c
il
it
ies
in
Ba
n
g
lad
e
sh
,‖
BM
C
H
e
a
lt
h
S
e
rv
ice
s
Res
e
a
rc
h
,
v
o
l.
15
,
pp.
1,
p
p
.
1
-
12
,
2
0
1
5
.
[3
2
]
M.
A
b
d
u
r
Ra
h
im
,
―
Dia
b
e
tes
in
Ba
n
g
lad
e
sh
:
P
re
v
a
len
c
e
a
n
d
De
ter
m
in
a
n
ts
,‖
T
h
e
sis,
In
stit
u
te
of
Ge
n
e
ra
l
Pra
c
ti
c
e
and
Co
mm
u
n
it
y
M
e
d
icin
e
,
2
0
0
2
.
[3
3
]
Un
it
e
d
Na
ti
o
n
s
Ch
il
d
re
n
‘s
F
u
n
d
UN
ICEF
.
,
2
0
0
7
.
T
h
e
sta
te
of
th
e
w
o
rld
'
s
c
h
il
d
re
n
2
0
0
8
:
Ch
il
d
S
u
r
v
iv
a
l.
UNICEF:
Ne
w
Yo
rk
.
[3
4
]
N.
A
h
m
e
d
,
et
al
.,
―
Re
a
c
h
in
g
th
e
Un
re
a
c
h
a
b
le:
Ba
rriers
of
th
e
P
o
o
re
st
to
A
c
c
e
s
sin
g
N
G
O
He
a
lt
h
c
a
re
S
e
rv
ice
s
in
Ba
n
g
lad
e
sh
,‖
J
o
u
rn
a
l
of
He
a
lt
h
P
o
p
u
la
ti
o
n
a
n
d
N
u
trit
i
o
n
,
v
o
l.
24
,
no.
4,
p
p
.
4
5
6
-
4
6
6
,
2
0
0
6
.
[3
5
]
B.
M
e
e
ss
e
n
,
e
t
a
l
.,
―
Co
m
p
o
siti
o
n
of
p
lu
ra
li
st
ic
h
e
a
lt
h
sy
ste
m
s:
h
o
w
m
u
c
h
can
we
lea
rn
f
ro
m
h
o
u
se
h
o
ld
su
rv
e
y
s
?
An
e
x
p
lo
ra
ti
o
n
in
Ca
m
b
o
d
ia
,‖
He
a
lt
h
Po
l
icy
a
n
d
Pl
a
n
n
in
g
,
v
o
l.
26
,
S
u
p
p
l.
1,
p
p
.
i
30
-
i4
4
,
2
0
1
1
.
[3
6
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
.
2
0
0
3
.
He
a
lt
h
F
a
c
il
it
y
S
u
rv
e
y
:
T
o
o
l
to
e
v
a
lu
a
te
th
e
q
u
a
li
ty
of
c
a
re
d
e
li
v
e
re
d
to
sic
k
c
h
il
d
re
n
a
tt
e
n
d
i
n
g
o
u
tp
a
ti
e
n
t
f
a
c
il
it
ies
.
W
o
rld
He
a
l
th
Or
g
a
n
iza
ti
o
n
:
G
e
n
e
v
a
.
[3
7
]
L
.
M
a
g
n
u
s
a
n
d
A
.
W
a
g
sta
ff
,
He
a
lt
h
fa
c
il
i
ty
su
rv
e
y
s:
a
n
in
tro
d
u
c
ti
o
n
.
W
a
sh
in
g
to
n
,
D.C.
:
W
o
rld
Ba
n
k
,
De
v
e
lo
p
m
e
n
t
Re
se
a
rc
h
G
ro
u
p
,
P
u
b
li
c
S
e
rv
ice
s,
2
0
0
3
.
[3
8
]
M
.
E.
Kr
u
k
,
a
n
d
L
.
P
.
F
re
e
d
m
a
n
,
―
As
se
ss
in
g
h
e
a
lt
h
s
y
ste
m
p
e
rf
o
r
m
a
n
c
e
in
d
e
v
e
lo
p
in
g
c
o
u
n
tr
ies
:
A
re
v
ie
w
of
th
e
li
tera
tu
re
,
‖
He
a
lt
h
Po
l
icy
,
v
o
l.
85
,
no.
3,
p
.
2
6
5
,
2
0
0
8
.
[3
9
]
K.
Eh
sa
n
u
l
Hu
q
,
e
t
a
l
.,
―
He
a
lt
h
se
e
k
in
g
b
e
h
a
v
io
u
r
a
n
d
d
e
lay
e
d
m
a
n
a
g
e
m
e
n
t
of
tu
b
e
rc
u
lo
sis
p
a
ti
e
n
ts
in
ru
ra
l
Ba
n
g
lad
e
sh
,‖
BM
C
in
fec
ti
o
u
s
d
is
e
a
se
s
,
v
o
l.
18
,
no.
1,
p.
5
1
5
,
2
0
1
8
,
d
o
i
:
h
t
t
p
s
:
/
/
d
o
i
.
o
r
g
/
1
0
.
1
1
8
6
/
s
1
2
8
7
9
-
0
1
8
-
3
4
3
0
-
0
.
[4
0
]
W
o
rld
H
e
a
lt
h
O
rg
a
n
iza
ti
o
n
Ba
n
g
lad
e
sh
,
USA
ID
a
n
d
TB
C
A
RE
II
Ba
n
g
lad
e
sh
,
2
0
1
1
.
Na
ti
o
n
a
l
G
u
id
e
li
n
e
s
f
o
r
T
u
b
e
rc
u
lo
sis
In
f
e
c
ti
o
n
C
o
n
tr
o
l.
[4
1
]
S.
S
.
A
n
d
a
lee
b
,
N
.
S
id
d
iq
u
i,
a
n
d
S
.
Kh
a
n
d
a
k
a
r
,
―
P
a
ti
e
n
t
sa
ti
sf
a
c
ti
o
n
w
it
h
h
e
a
lt
h
se
rv
ice
s
in
Ba
n
g
lad
e
sh
,
‖
He
a
lt
h
Po
li
c
y
a
n
d
Pl
a
n
n
i
n
g
,
v
o
l.
22
,
no.
4
,
p
p
.
2
6
3
-
2
7
3
,
2
0
0
7
,
d
o
i:
h
tt
p
s:/
/
d
o
i.
o
rg
/1
0
.
1
0
9
3
/h
e
a
p
o
l/
c
z
m
0
1
7
.
[4
2
]
S.
Zam
a
n
,
e
t
a
l
.,
―
M
a
n
a
g
e
m
e
n
t
of
Ne
w
b
o
rn
In
f
e
c
ti
o
n
:
Kn
o
w
led
g
e
a
n
d
a
tt
it
u
d
e
a
m
o
n
g
h
e
a
lt
h
c
a
re
p
ro
v
id
e
rs
of
se
lec
ted
su
b
-
d
istri
c
t
h
o
s
p
it
a
ls
in
Ba
n
g
lad
e
sh
,‖
In
ter
n
a
ti
o
n
a
l
J
o
u
r
n
a
l
of
Per
c
e
p
ti
o
n
s
in
Pu
b
li
c
He
a
lt
h
,
v
o
l.
1
,
n
o
.
2,
pp.
1
27
-
132
,
2
0
1
7
.
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