Aid effectiveness in working with private sector health organizations: The smiling sun franchise

Abstract

Bangladesh has been able to greatly reduce maternal mortality in less than one decade, from 322 down to 194 per 100,000 (NIPORT 2011), and increase life expectancy to 69 years; an achievement that took European countries not decades but centuries (http://www.gapminder.org/). Along similar lines, with an economy that has expanded more than 6 % annually in the last years, foreign aid is now hovering around 1.5–1.9 % of GDP (http://www.dfat.gov.au/geo/bangladesh/bangladesh_country_brief.html), just a fraction of country’s garment exports (http://www.epb.gov.bd/bdprofiledetails.php?page=56). In spite of its amazing progress, Bangladesh has not been able to leave behind its image of impoverished and overpopulated, basket case kind of country. The reason for it is the stubborn perception that lies on the fact that Bangladesh still has almost half of its population living under $1.25 a day (UNDP 2011), and with close to 160 million inhabitants in just over 144,000 km2, Bangladesh is one of the most densely populated spots in this planet. So, in the same space and time, Bangladesh conjures great hopes based on impressive results, while still facing huge challenges. This discussion no longer happens in other countries that not long ago were where Bangladesh is today, like Colombia—considered a high middle income country—or the Philippines—low middle income, but that once received much more foreign aid than they do today.