{
  "abstract": "Introduction Rapid urbanisation in Bangladesh has posed significant challenges to the urban health system, particularly in the delivery of primary healthcare (PHC). The country’s PHC system is fragmented, involving public, non-government organization (NGO), private and informal providers, leading to inequitable access, high out-of-pocket expenditure and inefficiencies. Strategic purchasing, which links resource allocation to health priorities and outcomes, offers a potential pathway to strengthening urban PHC systems. This study aims to assess the current urban PHC system, examine stakeholders’ perspectives on the feasibility of strategic purchasing, understand community health needs and preferences and develop a policy framework for strategically purchasing PHC services in urban settings.Method and analysis This study will follow a sequential mixed-methods approach, integrating qualitative and quantitative data. A scoping review will be conducted to assess the characteristics and funding modalities of the existing urban PHC purchasing mechanisms. Key informant interviews with stakeholders, including policy makers and health experts, will explore the strengths and challenges of the current urban PHC system and the feasibility of implementing strategic purchasing. Community healthcare needs and preferences will be examined through in-depth interviews (IDIs), focus group discussions (FGDs) and a discrete choice experiment (DCE) survey in urban informal settlements. Insights from IDIs and FGDs will inform the DCE survey, which will present hypothetical scenarios to participants to identify the most important attributes for improving PHC services. Qualitative data will be coded deductively and inductively, and DCE data will be analysed using latent class models, with sensitivity analyses conducted using the multinomial logit model. Findings will contribute to the development of a strategic purchasing framework, validated through consultation workshops with health system stakeholders.Ethics and dissemination Ethical approval has been obtained from the ethics committees in both Bangladesh and the UK. Findings will be disseminated through workshops, peer-reviewed publications, policy briefs and conference presentations.",
  "authors": [
    {
      "affiliations": [
        "Center of Excellence for Urban Equity and Health, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Baby Naznin"
    },
    {
      "affiliations": [
        "ARK Foundation, Dhaka, Bangladesh"
      ],
      "name": "Fatema Kashfi"
    },
    {
      "affiliations": [
        "Center of Excellence for Urban Equity and Health, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Farzana Sehrin"
    },
    {
      "affiliations": [
        "Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"
      ],
      "name": "Bryony Dawkins"
    },
    {
      "affiliations": [
        "School of Politics and International Studies, University of Leeds, Leeds, UK"
      ],
      "name": "Garrett Wallace Brown"
    },
    {
      "affiliations": [
        "Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK"
      ],
      "name": "Timothy Ensor"
    },
    {
      "affiliations": [
        "ARK Foundation, Dhaka, Bangladesh"
      ],
      "name": "Rumana Huque"
    },
    {
      "affiliations": [
        "Center of Excellence for Urban Equity and Health, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Zahidul Quayyum"
    },
    {
      "affiliations": [
        "Hull and York Medical School, University of York, York, UK"
      ],
      "name": "Helen Elsey"
    }
  ],
  "title": "Designing a strategic purchasing framework for urban primary healthcare services in Bangladesh: a protocol for a mixed-method study with a discrete choice experiment",
  "uid": "3b3930a2-b912-5a40-96a0-5f513765005e"
}