Bangladesh has good physical structure for healthcare in rural area called Thana Health Complex, thefirst referral level of health care institution Butunfortunately But Thana Health Complex are underutilized especially the inpatient department.Therefore, the study has intended to search possiblecauses for that and to find measure for improving theunder utilization problems. It is clear that the government can not do something better alone when the health care system is taxfinanced and tax collection system is very weak.Therefore, involvement of patients as well as privateproviders and NGOs are needed to do something betterthan present. Private Public mix in health care is thesolution. There are many types of p/p mix in healthcare but for Thana Health Complex contracting out isone of the suitable ways to solve some problems ofunder utilization. Cataract care is chosen forcontracting out as visual disability is the highestcause of disability in Bangladesh and cataract is thenumber one cause for visual disability. The objectives of the study are to explorecontracting out as a remedial measure of P/P mix toimprove the problem of under utilization of ThanaHealth Complex of Bangladesh and assess the additionalcost and potential benefit of contracting out modelsfor cataract surgery and to explore possible design ofcontracting out for Thana Health Complex. To assess additional cost for contracting out thestudy considers capital cost and recurrent cost and toassess potential benefit it considers equity,efficiency, quality of care as well as patient'ssatisfaction. Finally, the study has chalked two designs forcontracting out for cataract surgery at Thana HealthComplex

one is Purchasing model to buy service fromprivate providers and share the finance with patientand the other one the Leasing model to give lease theOperation Theater of Thana Health Complex for cataractsurgery to NG0 or private provider. Compare andcontrast between two models has placed in terms ofadditional cost and potential benefit. Enforcement of government regulation andcons,umer education is recommended for properutilization of Thana Health Complex and changing healthseeking behavior of people.