Inclusion or Exclusion of the Urban Poor? The case of the UPHCP, Rajshahi, Bangladesh:

Abstract

Bangladesh has gone through many colonial experiences. Like many colonial rulers, the British rulers (1757-1947) provided limited hospital-based curative care to their own people and local elites in order to restore administrative and business interests in Bengal (Eastern part now called Bangladesh) (Navarro,1982: 27-28; Osman, 2004: 71-72). After the partition of 1947, the Pakistani rulers (1947-71) also provided health services to the urban elite to remain in power. Consequently, Bangladesh got the administrative-headquarter based and urban centered health care system from both the British and Pakistani rulers after the independence of 1971(0sman, 2004: 76). The health care delivery system in Bangladesh is based on primary health care concept. This system provides health services at five levels: Home and Community level; Union level: Union Health Sub-Centre (UHC) /Family and Welfare Centre (UFWC) ; 'Upazila' level: 'Upazila' Health Complex (UHC) ; District level: District Hospital; and National level. The focus of the system is to provide health services at the rural countryside. No health services are provided at Home or community level in the urban areas. The urban poor receive their health care services from district or city hospital or the national hospital at the upper end of the national referral system.