Razu Ahmed
Over the last few decades, Bangladesh has made commendable progress in the health sector and crossed so many milestones which could be possible because of the contributions by the public and private medical colleges & hospitals, research centers, district and upazila hospitals, urban and rural health care centers and community clinics.
Nevertheless, Bangladesh, one of the most densely populated countries of the world having around 18 crore of people, faces a number of challenges in the health sector.
Recently, the deadly coronavirus pandemic has brought the real picture of our healthcare system to the fore. It has proved that our health system is not capable of handling such an emergency. Most of the prominent health experts believe that our healthcare system is not developed enough to manage a health disaster of such scale with cent percent efficiency.
As a result, many people, particularly people from low-income families, have suffered a lot during this pandemic. Well, it is a bitter truth that the health sector of our country is suffering from various kinds of challenges.
Some of the major challenges include limited public health facilities, corruption, lack of essential medical equipment and state of the art labs, unavailability of adequate health workers, lack of grassroots level planning and accountability, inadequate financial resources, weak information flow system, inactive referral system and low budget allocation for health sector.
Lack of adequate human resources in the health sector is a major problem.
Our healthcare system doesn't have the standard ratio of health personnel.
According to WHO, Bangladesh’s doctor-to-patient ratio is 5.26 per 10,000
people, the second lowest in South Asia whereas WHO recommends 1 doctor
per 1000 people. Another problem is that our physician-nurse ratio is not so
good. In our country, physician-nurse ration is 3:1, but it should be 1:3 for a
well-functioning health care system.
It has been reported that many people of our country, particularly those belonging to the working class and disadvantaged groups, have little access or no access to health care services. According to the Bangladesh Health Watch Report, only 18% of people get proper treatment while 75 percent of people are deprived of health care services because of many drawbacks in our health sector.
Low budget allocation for health sector is one of the most serious drawbacks. In the budget for the 2020-21 fiscal year, Tk 41,027 crore has been allocated for the health sector, which is 7.2 percent of the total budget. But according to the World Health Organization (WHO), at least 15 percent of the total budget should be allocated for the health sector. Meanwhile, most of the patients of our country have to bear 77 percent of their health expenditure whereas the World Health Organization (WHO) recommends that patients’ own expense should not exceed 32 percent.
As a result, many people cannot access the healthcare system properly owing to shortage of adequate amount of money. Under such circumstances, the government should take necessary steps by allocating more budget for the health sector to reduce the medical expense of mass people.
Lack of adequate human resources in the health sector is another major problem. Our healthcare system doesn't have the standard ratio of health personnel. According to WHO, Bangladesh’s doctor-to-patient ratio is 5.26 per 10,000 people, the second-lowest in South Asia whereas WHO recommends 1 doctor per 1000 people.
Another problem is that our physician-nurse ratio is not so good. In our country, physician- nurse ration is 3:1, but it should be 1:3 for a well-functioning health care system. So, the government should take some immediate steps for enhancing the doctor-patient ratio as well as the doctor-nurse ratio for an active and well-functioning healthcare system.
Furthermore, a shortage of medical instruments and equipment has been working as a serious impediment to providing proper health services to cross-sections of people. Most of the hospitals have a shortage of medical equipment.
Bangladesh Health Facility Survey 2017 reported that only around 25 percent of our health facilities have some basic equipment, like stethoscope, thermometer, blood pressure apparatus, adult weighing scale, child or infant weighing scale. Many health experts have expressed concern that in the hospitals, there is a serious shortage of ICU beds along with facilities like ventilators, PPE, kits and other resources.
Next, corruption is probably the most staggering problem in our healthcare system. In recent times, we have seen a number of reports in different national dailies exposing the extent of corruption done by a group of unscrupulous people in the health sector.
However, allegations of corruption in the country's health sector is not a new phenomenon. But recent high-profile incidents of irregularities in different hospitals have taken all of us aback. If such incidents of irregularities in our health sector cannot be reduced, the healthcare system will fall apart.
It is commendable to see that the government has already decided to go tough against those carrying out such loathsome activities in the health sector. On top of that, anti-corruption monitoring cells should be formed and the concerned people in this sector should be made accountable for any irregularity.
In the light of the afore-mentioned discussion, it can be said that Bangladesh has a lot of drawbacks and challenges in the health sector. These challenges must be addressed in order to improve the existing situation so that the people of our country, the disadvantaged and the vulnerable to be particular, can better access basic health care services.
Although, Bangladesh has achieved praiseworthy success in many indexes of the health sector, yet we have miles to go. The government, I think, should consult with the health experts, concerned ministry, national and international NGOs working in the health sector, international health organizations such as WHO and other stakeholders to formulate a policy with a view to bringing about positive reforms in our health sector.
The writer is a student of the Institute of Social Welfare and Research, Dhaka University. He can be reached at ‘[email protected]’.
