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Abstract

One of the priorities of the Bangladesh Health and Family Planning Programme is to focus on a cost recovery policy by the introduction of user fees to improve quality and financial sustainability. To assist the policy we propose an operations research-based cost recovery model to find the best ‘service mix’ from outdoor, indoor, emergency and diagnostic services for sub-district-level health facilities. The model considers budget, patient flow patterns, resource availability, service demand and equity principal constraints. The study offers proposals to assist the decision-making process for the introduction of a user fee and considers how much to charge, which services to start with, and which to include later.

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Introduction of User Fees

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