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Filter health plan thru climate change, culture lens

Says Prof Ainun Nishat

Published : 17 Jan 2023 09:56 PM | Updated : 18 Jan 2023 04:19 PM

Professor Emeritus Ainun Nishat on Tuesday urged the policymakers to take climate change and local culture into account while devising any plans and programmes for the health sector.

He was speaking at a learning event - Integrated Community Development for Better Health: Perspectives from Bangladesh - organised by University Research Co (URC), an international organisation based in the U.S., at the Sheraton Dhaka Banani.

Ainun Nishat is best known as a water resource management expert. He also works on disaster risk reduction and environment. He was also the vice-chancellor of BRAC University.

He referred to the cold wave warning in northern India, cyclones in US, hot and warm weather in Europe and increasing salinity in Southern Bangladesh even in Gopalgnaj district, and said “all the thinking, programming and planning must be filtered through the process of climate change”.

“In planning, we always base our plan on past experiences. Past is no longer the indicator of future,” he said.

“The first problem of climate change is salinity. Water in Gopalganj is saline today. Hypertension is on the rise in both male and female. Female reproductive health is under threat. In Bangladesh on the curative side we have improved with lots of hospitals, clinics, and good doctors here. We need to pay attention to preventive side and public health activities”.

He advised the development partners to pay attention to local culture while taking any initiative.

“In our health sector, there were home to home government employed staff. They were taken out and put under the green umbrella. I didn’t like it,” he said, referring to ‘Sabuj Chata clinics’ which were run by the USDAID.

“Please understand the local culture. Without understanding the culture, excellent knowledge from US would not work in Bangladesh. You have to take something to the door of the person whom we want to influence,” he said, adding that there can be an excellent health center at the middle of a market place, but one cannot expect housewives to go to that place through the crowds.

“This is not the right advice (in Bangladesh context). You are doing lot of activities. So filter those through the lens of local psychology and anthropological approaches.”

 Sharing his experiences with BRAC, the largest NGO in the world, he said he visited community level works during that time.

“They are very selective,” he said. “They will go to a thana, to a union and pick up a village and take credit of the whole thana without giving good coverage and select the ultra-poor people. What is the difference between the poor and the ultra-poor?” he asked.

“Going to a village and covering 10 homes is not enough. Please go for the coverage of the whole thana”.

“In Bangladesh at the public level we have good institutional framework. We have the union level health clinic. Do we have sufficient people to take the message to the villagers? Do you have the people to give the support for the private sector collaboration?” he asked.

 USAID Mission Director Kathryn Stevens and Director of Board of Social Marketing Company (SMC) Dr Jahir Uddin Ahmed presented keynote papers at the event where representatives of different NGOs and private initiatives spoke, among others.

 URC’s chief operating officer Maureen Shauket moderated the event.

 The organiser in a statement said the event provided an opportunity for government of Bangladesh officials, the international donor community – including the USAID – and representatives from Bangladesh’s NGO and university community, to discuss how to best ensure delivery of high-quality care at all levels of the health care system in Bangladesh and beyond.

“To achieve improved health outcomes, public, private, and non-governmental (NGO) health care providers must join forces to collaboratively improve the quality of health care services and build resilient health systems.” 

Two panel discussions at the event featured voices of individuals with experience designing, implementing, and sustaining health systems that are responsive to the needs and preferences of the communities where they work.

Panelists discussed how incorporating strong community actions and voices into health systems strengthens societal partnerships, builds capacity in communities, and promotes trust and shared accountability for health system performance. 

Panelists included:  Riad Mahmud, Country Director, Max Foundation; Dr. Najmus Sadiq, Public Health Physician and URC Technical Advisor; Dr. Abu Muhammad Zakir Hussain, CEO (Honorary), Social Sector Management Foundation;  Mostafa Nurul Islam Reza, Head of Agriculture and Environment Programs, RDRS; Toslim Uddin Khan, Managing Director and CEO, Social Marketing Company (SMC); Jean Margaritis, Portfolio Director, URC; and Md. Mukhlesur Rahman, Deputy Director, Health Sector, DAM.

Conference moderator, Maureen Shauket, commented: “New thinking and learning from the experiences of others is key to improving the quality of care and health outcomes in the communities where we work.”

The URC works to improve health systems through empowering communities in their mission-driven and results-focused effort.

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