Private Health Care, Quality and Corruption

Abstract

This chapter describes the functioning of the formal private health sector in the rural area and attempts to analyse what rural people actually experience in seeking health care from these private health care providers. It also concerns the professional qualifications of care providers, unnecessary medical tests, unethical drug promotion, the rights of the individual as patient and the conflicts of interest of health officials which are found in private sector health care. I argue that the notion of corruption is not straightforward in rural Bangladesh. Rather, it is an ambiguous phenomenon due to its diversity across social understandings and cultural beliefs. Thus, I provide the narratives and representations of corruption through the “corruption talk” of local people. A common definition suggests that corruption is the abuse of public power for private benefit; instead, my understanding is that this definition of corruption is too narrow as it is confined only to individual’s “dishonesty” and neglects the greater context of corruption. I identify how corruption structures the operation of the private health care sector through multiple actors. I explain how the mutually reinforcing networks of the local elite, political leaders, health officials, public physicians, businessmen who deal in pharmaceuticals and corporate forces have all made the sector worse in terms of standard of care, service fees and accountability.