Primary health care is a public sector responsibility in most countries, and it is a challenging task for any government to ensure its universal access and good quality. The problems arise not only due to lack of financial resources but also poor organisation and management at different levels of service delivery.

This volume, taking examples from India and Bangladesh, investigates the role of the central government in delegating the responsibility of primary health care services to local level bureaucracy and non-governmental organisations (NGOs). It also emphasises the importance of social accountability/client participation in improving the quality of care in which both India and Bangladesh have poor records.

“This important collection of essays on India and Bangladesh helps understand functions, responsibilities and obligations of the providers of primary health care. In doing so, the authors note that decentralisation or devolution of functions, finances and functionaries in health care delivery has not happened in both the countries because of lack of social mobilisation. On the other hand, public-private partnership (PPP) in health care services may be a viable option. The NGO sector in Bangladesh has been quite successful in health care delivery, however, its heavy dependence thus far on external resources raise questions about the long term sustainability. In India, PPP is in nascent stage, but there is evidence that people are willing to pay for certain health care services, including access to essential drugs, thereby raising hope that some innovative variants of PPP may succeed.”
— Leela Visaria
Honorary Professor, Gujarat Institute of Development Research, Ahmedabad

"Important advances have been made in the provision of basic services to marginalized groups in recent years, but there remains an enormous gap between what is promised and what is actually delivered. One avenue for closing this gap entails implementing innovative strategies for strengthening the accountability mechanisms linking providers, citizens and the state. This impressive volume shows us how this might be done."
— Michael Woolcock
World Bank and Harvard University

“Public Health Care (PHC) is essentially a public sector responsibility, but continues to be neglected both in India and Bangladesh. The primary aim of this study is to shed light on the institutions and players to be involved in the efficient delivery of PHC. The Primary Health Care Centres (PHCC) can play an important role in creating awareness about health, sanitation and malnutrition, especially among expectant mothers and infants. An important suggestion emerging from this study is to make Panchayats and grassroot NGOs as primary channels for the delivery of PHC, in rural areas.”
— C.J. Shishoo
Honorary Director, B.V. Patel PERD Centre, Ahmedabad

Alia Ahmad worked as Associate Professor at the Department of Economics, University of Lund, Sweden, until 2009. She taught courses on development economics, gender studies, economic growth in South Asia, and water/sanitation/environment in developing countries. Her research concentrates on agriculture, rural development, population issues and recently, institutions and social capital related to education, health care and common-pool resources mainly in South Asian countries.

She has written books on agriculture and population growth in Bangladesh and recently, edited a book on community management of inland fisheries in Bangladesh and India.

N. Lalitha obtained her PhD through Institute for Social and Economic Change, Bangalore. She is a Professor of Economics at Gujarat Institute of Development Research, Ahmedabad, Gujarat. Her research focusses on development and trade issues. In the recent decade, she has been focussing on intellectual property rights in the pharmaceutical and agricultural sectors. She has published in peer reviewed journals on issues relating to access to medicines and agri-biotechnology. She has co-edited a book on intellectual property, pharmaceuticals and public health.