The health care system in Bangladesh is mainly urban-based, elite-biased and curative-orientated. Even though nearly 75% of the population lives in rural areas, the public and private health care development has concentrated mainly in urban areas. The standard and the level of health care provided by the public sector is inadequate due to low investment, bureaucratic mismanagement, and the lack of equipment, facilities, and trained medical professionals. The strengthening of public sector health care by successive Bangladeshi governments has not improved the availability of health care services for the rural poor and in particular for poor women in rural areas. With around 3,100 persons per hospital bed and 23 doctors per 100,000 people1, only the upper and middle classes and those with political influence have access to the public health care system. The poor are unable to penetrate the bureaucracy and the deliberately biased system. Thus, they have access to public health care only in theory. These circumstances highlight the need for alternatives, including the provision of inclusive health insurance. This comparative study looks at three health insurance schemes in Bangladesh, namely those run by BRAC, Grameen Kalyan (GK) and the Society for Social Services (SSS). All three organizations are NGOs registered with the NGO Affairs Bureau under the Foreign Donations (Voluntary Activities) Regulations Ordinance of 1978.
CGAP Working Group on Microinsurance