# Workforce and Health Care Services for Young Children in Bangladesh

## TL;DR

Public hospitals in Bangladesh offer more pediatric services and trained staff than private hospitals for children under 5, but private hospitals have neonatal intensive care units.

## Contribution

The study reveals significant disparities in pediatric care infrastructure and workforce between public and private hospitals in Bangladesh.

## Key findings

- Public hospitals had more pediatric inpatient departments, newborn wards, and trained nurses compared to private hospitals.
- Private hospitals were the only ones with neonatal intensive care units, but pediatricians were more available for extended consultations in public hospitals.
- Disparities in pediatric services hinder equitable health care access and outcomes for young children in Bangladesh.

## Abstract

Are there disparities in health care workforce and service coverage between public and private hospitals in Bangladesh for children younger than 5 years?

In this cross-sectional study of 102 private and 7 public hospitals, public hospitals had more pediatric inpatient departments, newborn wards, and trained nurses, while private hospitals had more neonatal intensive care unit services. Pediatrician availability for extended consultations was significantly higher in public hospitals.

These findings suggest that addressing disparities in the pediatric workforce and infrastructure is essential for equitable health care access and improved child health outcomes.

This cross-sectional study compares the availability and quality of health care workforce and service coverage in public and private hospitals for children younger than 5 years living in Bangladesh.

Inequities in pediatric health care services persist in Bangladesh, with critical disparities between public and private hospitals, particularly for children younger than 5 years. These disparities hinder progress toward equitable health care access and quality outcomes.

To evaluate the availability and quality of health care workforce and service coverage for children younger than 5 years in public and private hospitals in Bangladesh to identify gaps in infrastructure, workforce distribution, and adherence to pediatric care standards.

This cross-sectional study was conducted from October 13, 2023, to May 24, 2024. Data collection included facility assessments, structured questionnaires, and direct observations using World Health Organization (WHO)–adapted tools. The study covered both private and public hospitals across 6 subdistricts in Bangladesh, representing a mix of urban and rural populations. Senior hospital staff and administrators were surveyed. Inclusion criteria were general inpatient and outpatient pediatric care delivered in hospitals. Diagnostic centers and specialized facilities were excluded.

Availability of pediatric infrastructure, workforce, essential medications, and adherence to clinical guidelines assessed against WHO standards.

The primary outcomes included the presence of pediatric-specific departments, neonatal care facilities, and trained personnel and adherence to WHO care standards. Data were analyzed using descriptive statistics and χ2 tests to highlight disparities.

The study sample included 102 private and 7 public hospitals. A significantly higher proportion of public hospitals compared with private hospitals had pediatric inpatient departments (100% vs 39.2%), newborn wards (100% vs 12.8%), and trained nurses (100% vs 32.4%). Only private hospitals in the sample had neonatal intensive care units (6.9% vs 0%). Pediatricians were available for extended consultations at a greater proportion of public hospitals compared with private hospitals (71.4% vs 26.5%).

These findings show substantial disparities in the availability of pediatric health care services between public and private hospitals in Bangladesh. Addressing these disparities through workforce investment and infrastructure improvements is crucial for equitable child health care and better health outcomes.