Impact of low-cost bidding on a Contracted-Out (CO): urban primary health care project in Bangladesh: Implications for change

K E Y M E S S A G E S
In phase III of the Urban Primary Health Care Service Delivery Project (UPHCSDP), a low-cost bidding system and a
high cost recovery target were introduced as criteria for NGO selection.
At the service level this translated into fewer free services for the poor, reduced staff training, and an overall
compromise in service quality.
To avoid the experience described above, economic planning, risk assessment, and financial management skills are
needed for decision making in Contracted-Out (CO) arrangements.