Are voluntary agencies helping to improve health in Bangladesh?

Since independence in 1971, a large number of health programs run by local and foreign voluntary organizations have been started in Bangladesh. This paper is the result of a survey undertaken on behalf on the Oxford Famine Relief Committee of ten of the most interesting of these projects. On the basis of an analysis of the underlying causes of ill health in Bangladesh, a criterion for the assessment of these health programs is developed. Following an overview of the performance of these "innovative" projects, the pertinent issues which have been and have to be dealt with by appropriate projects are addressed by means of a case study of one of the best of these projects. A basic premise of this analysis is that ill health in particular communities is not simply a result of local conditions; rather, the structural determinants of ill health are frequently national and even international in scope. The effect of these structural determinants of the presence and funding policies of the many voluntary agencies in Bangladesh is assessed by analyzing the performance of the Oxford Famine Relief Committee, one of the more enlightened of these agencies.