M Mahmud Khan1, Shakil Ahmed. 1. Tulane University School of Public Health, New Orleans, LA 70112, USA.
Abstract
OBJECTIVE: The Bangladesh Integrated Nutrition Programme (BINP) experimented with two models of delivery: the first model uses the Government of Bangladesh's (GOB) own management structure and the second uses the non-government organisations (NGOs) working in the local community. This study compares the relative efficiency of GOB and NGO management in the provision of nutrition services. DESIGN: A detailed costing survey was carried out to estimate the cost of delivering nutrition services from the Community Nutrition Centres (CNCs). The number of individuals enrolled, the number actually participating in the programme and person-days of service delivered were used as effectiveness measures. SETTING: Thirty-five CNCs were randomly selected from five BINP areas, of which 21 were in GOB-run areas and 14 in NGO-run areas. RESULTS: The cost of providing nutrition services per enrolee was US dollars 24.43 for GOB-run CNCs and US dollars 29.78 for NGO-run CNCs. CONCLUSIONS: Contrary to the widely held view, the analysis implies that the NGO facilities are not more efficient in the delivery of nutrition services when cost per person-days of service delivered is considered. The food cost component of BINP is so high that, irrespective of the delivery mode, policy makers should examine carefully the components of BINP in order to find the most cost-effective mix of services.
OBJECTIVE: The Bangladesh Integrated Nutrition Programme (BINP) experimented with two models of delivery: the first model uses the Government of Bangladesh's (GOB) own management structure and the second uses the non-government organisations (NGOs) working in the local community. This study compares the relative efficiency of GOB and NGO management in the provision of nutrition services. DESIGN: A detailed costing survey was carried out to estimate the cost of delivering nutrition services from the Community Nutrition Centres (CNCs). The number of individuals enrolled, the number actually participating in the programme and person-days of service delivered were used as effectiveness measures. SETTING: Thirty-five CNCs were randomly selected from five BINP areas, of which 21 were in GOB-run areas and 14 in NGO-run areas. RESULTS: The cost of providing nutrition services per enrolee was US dollars 24.43 for GOB-run CNCs and US dollars 29.78 for NGO-run CNCs. CONCLUSIONS: Contrary to the widely held view, the analysis implies that the NGO facilities are not more efficient in the delivery of nutrition services when cost per person-days of service delivered is considered. The food cost component of BINP is so high that, irrespective of the delivery mode, policy makers should examine carefully the components of BINP in order to find the most cost-effective mix of services.