Essay : Healthcare in Bangladesh

Healthcare in Bangladesh

Introduction : Health is one of the most important sectors which generates intense emotional debate and ideological divisions. It is sometimes described as a fundamental human right. However, during the past few decades, it becomes clear that the right to healthcare is far from absolute in our country. Inadequate funding, inefficiency and corruption in our country restricted the access of the population to free medical care services. Thus, ‘right to health services for all’ has always remained neglected. 

The present state of healthcare in Bangladesh : According to the constitution of Bangladesh, healthcare is a fundamental constitutional right of the people. But the actual picture of our health sector is gloomy and people are being deprived of their fundamental right of health services. 

A World Bank report says 'Bangladesh is at the top of the list with regard to malnutrition, maternal and infant mortality'. In Bangladesh- 
  • 70 per cent of mothers and children suffer from malnutrition; 
  • Every year 28000 mother die due to pregnancy-related diseases and complications. 
  • Every year more than 3330000 children are born out of which one third are born with lesser than normal birth weight. 
  • Among children under five year of age two-third suffer from malnutrition. 
  • Children between age 6 to 7 months do not have proper growth. 
  • During childbirths, 5 expecting mothers die out of 1000 births. 
  • Almost 95% of deliveries take place at home. One-third of these deliveries suffer from pregnancy-related post-delivery diseases. 
  • It is reported that due to various diseases, mortality rate of under-five children is between 7-8.2% 
  • One out of nine children dies before the age of 5. Among the hardcore severe poor, the rate is one out of six. 
  • Number of below five children is 20 million in the country. Out of this twenty million 3,80,000 die every year. 1,20,000 die due to pneumonia, 95000 due to diarrhoea, 19000 due to measles-related tetanus and 15000 due to measles. 

Achievements : The major successes are our health sector during last decades may be mentioned as under : 
  • Smallpox, cholera and malaria have been eradicated or are no longer major killers. 
  • Life expectacny at birth reached at 71.6 in 2018 which as only 45 in 1970. 
  • Total fertility rate was reduced from 6.3 in 1975 to 0.051 in 2018. 
  • The crude death rate dropped from 12.0 in 1990 to 0.187 in 2018 and is declining further. 
  • EPI coverage had been over 66 per cent which is around 95 per cent at present. 
Suggestions for further improvement : For providing better health care to the people and ensuring health care for all, the following suggested measures deemed to be considered : 
  1. Primary and secondary healthcare facilities should be given under supervision and management of the local government authority. 
  2. Ambulance service should be made adequate with a cost recovery strategy. 
  3. Medicines and examinations should be made free only for the poor. Those who are solvent should pay. 
  4. Poor, unemployed and destitute should get full-fledged healthcare service free of cost. 
  5. Patient counselling knowledge should be introduced in under and postgraduate medical studies as a full-fledged subject. 
  6. There should be independent council set up by the Govt. to monitor and regulate the standard of service in private clinics. 
  7. All the doctors, clinics and pathological laboratories should be brought under malpractice insurance scheme so that patients can get compensation through insurance company if any wrongdoing is committed to them. 
  8. Prohibiting private practice by professors of medical colleges who are teaching clinical subjects and attached with the college hospitals and by all other govt. doctors. Their pay packages should be decent and should be allowed special stunts. 
  9. Arrangements made to ensure adequate supply of medicines and other paraphernalia constantly. 
Conclusion : Above discussion shows that the key challenge in the health and family planning is to expand access to basic services and improving the quality of services both in the public and private sectors. The utilization of existing capacities and facilities, particularly rural health infrastructure can also be markedly improved. This will require prioritizing of public expenditure to ensure wider and more equitable access to basic services and improving the quality of services. The efficiency of public sector programs needs to be enhanced through appropriate organization and management improvements.
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