The publicly run health sector of the country presents a mixed picture of significant progress, some unattained objectives and few cases of back sliding

A mixed picture in the health sector

The  publicly run health sector  of the country presents a mixed picture of  significant progress,  some unattained  objectives and few cases of  back sliding. The incumbent government had promised a great deal in its last two election manifesto and must be credited for  having worked hard to  considerably keep its promises.
For example,  it was stated in the election manifesto of the Awami League  that in order to  expand and strengthen  health services  at the grassroots level in the country, some 18,000 community  clinics would be established at ward level under a new health policy. Some 10,000 of these community clinics have been set up throughout the country.   This could be accepted as a very  laudable achievement but for the fact that in most cases these clinics are not delivering amply health services consistent with their potentials. A  dearth of doctors, nurses, technicians and medical equipment are noted  in these clinics in many cases. Thus, the challenge remains to  provision these clinics adequately and run them efficiently.
From 2009, government introduced the so called user fees in the publicly run medical and health care system. Under 23 categories,  user fees were introduced for 470 types of services in the public hospitals.  The public medical care institutions were  obliged, at least in theory, to extend free medical services or at nominal costs till the introduction of this fee.
But in the backdrop  of such free and nominal payments  leading to poor or  even no treatment of patients, it was decided that users’ fees would  be applied to  bring about positive changes through users bearing a part of the real costs of treatment.   But the real experience after introduction of the users’ fees is that patients’ treatment costs, on average, have  increased  compared to the  time when they were treated for free or at nominal costs.. Thus, it requires a rethink whether the user  fee system  should be given up with restoration of the  previous system of free treatment or treatment at nominal costs only.
If it is decided  to go back to the older system, then it must be ensured that the free system or nominal payment system do not make the patients suffer like in the past  due to corruption and  neglect.    

 

The publicly run health sector of the country presents a mixed picture of significant progress, some unattained objectives and few cases of back sliding

A mixed picture in the health sector

The publicly run health sector of the country presents a mixed picture of significant progress, some unattained objectives and few cases of back sliding. The incumbent government had promised a great deal in its last two election manifesto and must be credited for having worked hard to considerably keep its promises. For example, it was stated in the election manifesto of the Awami League that in order to expand and strengthen health services at the grassroots level in the country, some 18,000 community clinics would be established at ward level under a new health policy. Some 10,000 of these community clinics have been set up throughout the country. This could be accepted as a very laudable achievement but for the fact that in most cases these clinics are not delivering amply health services consistent with their potentials. A dearth of doctors, nurses, technicians and medical equipment are noted in these clinics in many cases. Thus, the challenge remains to provision these clinics adequately and run them efficiently. From 2009, government introduced the so called user fees in the publicly run medical and health care system. Under 23 categories, user fees were introduced for 470 types of services in the public hospitals. The public medical care institutions were obliged, at least in theory, to extend free medical services or at nominal costs till the introduction of this fee. But in the backdrop of such free and nominal payments leading to poor or even no treatment of patients, it was decided that users fees would be applied to bring about positive changes through users bearing a part of the real costs of treatment. But the real experience after introduction of the users fees is that patients treatment costs, on average, have increased compared to the time when they were treated for free or at nominal costs.. Thus, it requires a rethink whether the user fee system should be given up with restoration of the previous system of free treatment or treatment at nominal costs only. If it is decided to go back to the older system, then it must be ensured that the free system or nominal payment system do not make the patients suffer like in the past due to corruption and neglect.