United States Agency for International Development (USAID)/Bangladesh issued a Broad Agency Announcement (BAA) on October 18, 2016 seeking game-changing solutions to advancing universal health coverage (UHC) in Bangladesh. The purpose of the BAA is to utilize the Smiling Sun network of clinics to effectively introduce and expand UHC through innovative health financing approaches including, but not limited to, health insurance and payment linked to credit and/or performance. USAID has long-invested in the nationwide Smiling Sun network of 399 clinics, and recognizes the importance of leveraging this program to advance UHC in Bangladesh.
Achieving UHC is a critical priority in Bangladesh because:
• Out-of-pocket expenditure (OOPE) on health care continues to rise and was around 64% of total health expenditure in 2012 (up from around 57% in 2007), while the government’s share of the total dropped over the same period (from 36% to 26%).
• Development partners have made up some of the difference, but the level of investment is expected to decrease as Bangladesh’s economic growth continues.
• As a result, there is now an urgent need under the Government of Bangladesh’s (GOB) Health Care Financing Strategy 2012-2032 to:
– Increase financial protection for the entire population, but particularly for the poor, for whom over-reliance on OOPE is especially inequitable and inefficient.
– Raise the overall level of financing to the health sector.
– Increase the efficiency with which health resources are used.
A specific aim is to halve OOPE’s share of total health expenditure by 2032 – by introducing a large measure of social health protection through innovative financing. USAID’s BAA is designed to contribute to these objectives.