In Bangladesh, the Ministry of Health and Family Welfare (MOH&FW) has introduced Citizen Charter at of all its health care facilities. As a part this initiative, important information for patients related to health services will be displayed in health facilities ranging from tertiary level hospitals to primary health care centers. The clearly visible information promotes citizens’ rights to information and further encourages claiming rights to services. When a patient arrives at any point of service (e.g. medical college hospital) he/she can see clearly displayed information about topics such as types of emergency care available, service provisions of this particular facility, the nature of outpatient and inpatient care, the availability of drugs, and the number of service providers at any point. Further, the displayed information informs patients about their entitlements to get services and commodities with privacy and confidentiality.
As part of Citizen Charter, facility managers must show increased care towards women and infants through measures such as supplying safe drinking water, and providing breast feeding corners and clean lavatories; none of this was available in the recent past. A list of available drugs are also displayed in each ward in inpatients department of hospitals, along with information about user fees or cost of services. An additional component of this initiative is that all government facilities now have information corners in order to help patients get proper services. Patients are also given methods for registering complaints if sanctioned services are not available or any disagreement arises.
During a recent visit to some government facilities, it was clear that there had been big changes from before the Citizen Charter. It is a positive step for accessing information about quality services and to reduce inequities in health care. However, I noticed discrepancies between displayed information and practical implementation (though this is expected to be overcome soon). It is further expected that all the stakeholders will come forward to exercise the citizen charter. This will help to improve relation among patients and providers/managers and contribute to the better utilization of scarce resources in the Bangladesh health system. An individual monitoring and evaluation system can be commissioned to assess the outcome of this Citizen Charter initiative to strengthen the health care system.