Clustering Health Services in Bangladesh: Applying Lessons Learned from Dubai
Before last week, I had never heard of the knowledge management theory of “Clusters,” and I also probably would not have thought that the wealthy and cosmopolitan city of Dubai had much in common with Bangladesh. However, after attending the 6th Knowledge Management International Conference (KMICe), organized by the Universiti Utara Malaysia, I am considering how to apply lessons learned from Cluster theory in Dubai to the health care industry in Bangladesh.
Professor Dr. Julia Connell presented her research in Dubai where government tax policy has produced “clusters” – geographic concentrations of companies and institutions working in the same or similar industries. These clusters exhibit “co-opetition,” the coexistence of cooperation and competition. For example, many IT companies are located in the same neighborhood and can benefit from sharing resources, knowledge, staff, training, and even work, but they also benefit from a healthy competition between companies that foster innovation and drive for improvement. If one company has more work than it can handle, it can refer clients to a trusted neighbor company. Companies can also share specialized training opportunities and specialized equipment that would be costly to duplicate for each company. Clusters can be very beneficial for their members, but as Dr. Connell’s research showed, productive clusters do not just happen with geographic proximity alone; clusters need to be facilitated.
There is little literature on how to facilitate clustering and co-opetition, but Dr. Connell showed that clusters depend on mutual trust and require opportunities for interaction and sharing. Successful clusters organize networking events and training opportunities.
In Bangladesh, in a very different industry, government health clinics run by the Directorate General of Health Services (DGHS) and clinics run by the Directorate General of Family Planning (DGFP), as well as private and NGO sponsored clinics, are scattered throughout the country, often in close proximity to one another. At present, with no facilitation of clusters, there is largely unproductive competition between these different clinics. With more co-opetition between clinics, overcrowded clinics could refer patients to trusted neighboring clinics, health providers could share training opportunities and lessons learned through practice, and clinics could even share expensive medical equipment or specialized expertise that is not available in all facilities.
The Bangladesh Knowledge Management Initiative (BKMI) will be rolling out an eHealth pilot in the coming months that will engage frontline workers from DGHS, DGFP, and NGO clinics in the region. By training these frontline workers together in using integrated health communication resources in family planning, maternal, newborn, and child health, and nutrition, the BKMI Project will begin to facilitate co-opetition. Shared training and opportunities for interaction and shared learning can foster trust, cooperation, and healthy competition between workers from different directorates and organizations. With time and facilitation, we hope to nurture a shared vision through cooperation and competition for the improvement of health in Bangladesh.