Health for all

Quality, accessible primary health care is the foundation for universal health coverage. Primary health care should be the first level of contact with the health system, where individuals, families and communities receive most of their health care. Primary health care covers the majority of your health needs throughout your life. A health system with strong primary health care delivers better health outcomes. But primary healthcare is grossly neglected and hardly accessible in the rural areas though palpable advancement is seen in the highly institutionalised city and urban areas. In community primary health care we need DEVOLUTION instead of decentralization and need COMMUNITY EMPOWERMENT instead of community participation which means: access to information, participation in decision making forums, ability to demand accountability from decision makers, capacity to work in partnership with public service. Also we need comprehensiveness of care, continuity of care and community empowerment.

The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. In Bangladesh the health system faces multifaceted challenges such as lack of public health facilities, scarcity of skilled workforce, inadequate financial resource allocation and political instability. But Bangladesh has demonstrated much progress in achieving the health-related Millennium Development Goals (MDGs) especially MDG 4 and MDG 5. Bangladesh still does not have a comprehensive health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall health system.

However, a large number of Bangladeshis, particularly in the rural areas have little access to healthcare facilities. It may seem that access to healthcare services for the insolvents, poor and the destitute countries to remain a day dream in one hand and on the other hand private sector healthcare service delivery with most modern and advanced facilities has developed remarkably for the affluent section of the society.

In Bangladesh there is common mistrust of the public health services and wealthy patients tend to bypass the national health care system and seek treatment abroad. Research suggests that the quality of health services is more likely to be compromised in the public health care institutions than in the private ones in the country.

Government health services play a major role in providing critical services, either free or at heavily subsidised prices. The focus on the poor is especially important in the context of their large share in the total population. To be effective, health care services should be available, accessible and affordable. There are a number of macro decisions that need to be considered while redesigning the health care system for the country. These macro decisions determine (a) what kind of health care services will exist in the society, (b) who will get them and on what basis, (c) who will deliver them, (d) how the burden of financing them will be distributed, and (e) who will control and monitor these services.

Several promises and commitments made in the past by the government, to step up investment in public health system, must be realised. The government must turn its attention to providing free medicines to the poor and make it a reality. But notable success has been achieved in the delivery of EPI, ORS, sanitation and family planning services for which Bangladesh is internationally recognized. So, this is expected to improve health outcomes significantly, reduce the burden of costs and improve equity and access to health care in Bangladesh.

Unsafe and low-quality health care ruins lives and costs the world trillions of money every year; we must do more to improve the quality and safety of health services in Bangladesh.  Bangladesh’s commitment to join the movement towards ‘universal health coverage’ also demands that the country should take definitive steps for guaranteeing minimum level of quality in healthcare. It is imperative that the foundations of the health system be strengthened to focus on improved quality of healthcare in the public and private domains.

Without health, everything else becomes meaningless. It may be mentioned here that better health is one of the prime objectives of development. Our national economic and social development depends on health care sector. We know universal health coverage is possible, so, let’s make it happen!

The writer is a consultant nutritionist

 

Health for all

Quality, accessible primary health care is the foundation for universal health coverage. Primary health care should be the first level of contact with the health system, where individuals, families and communities receive most of their health care. Primary health care covers the majority of your health needs throughout your life. A health system with strong primary health care delivers better health outcomes. But primary healthcare is grossly neglected and hardly accessible in the rural areas though palpable advancement is seen in the highly institutionalised city and urban areas. In community primary health care we need DEVOLUTION instead of decentralization and need COMMUNITY EMPOWERMENT instead of community participation which means: access to information, participation in decision making forums, ability to demand accountability from decision makers, capacity to work in partnership with public service. Also we need comprehensiveness of care, continuity of care and community empowerment. The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. In Bangladesh the health system faces multifaceted challenges such as lack of public health facilities, scarcity of skilled workforce, inadequate financial resource allocation and political instability. But Bangladesh has demonstrated much progress in achieving the health-related Millennium Development Goals (MDGs) especially MDG 4 and MDG 5. Bangladesh still does not have a comprehensive health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall health system. However, a large number of Bangladeshis, particularly in the rural areas have little access to healthcare facilities. It may seem that access to healthcare services for the insolvents, poor and the destitute countries to remain a day dream in one hand and on the other hand private sector healthcare service delivery with most modern and advanced facilities has developed remarkably for the affluent section of the society. In Bangladesh there is common mistrust of the public health services and wealthy patients tend to bypass the national health care system and seek treatment abroad. Research suggests that the quality of health services is more likely to be compromised in the public health care institutions than in the private ones in the country. Government health services play a major role in providing critical services, either free or at heavily subsidised prices. The focus on the poor is especially important in the context of their large share in the total population. To be effective, health care services should be available, accessible and affordable. There are a number of macro decisions that need to be considered while redesigning the health care system for the country. These macro decisions determine (a) what kind of health care services will exist in the society, (b) who will get them and on what basis, (c) who will deliver them, (d) how the burden of financing them will be distributed, and (e) who will control and monitor these services. Several promises and commitments made in the past by the government, to step up investment in public health system, must be realised. The government must turn its attention to providing free medicines to the poor and make it a reality. But notable success has been achieved in the delivery of EPI, ORS, sanitation and family planning services for which Bangladesh is internationally recognized. So, this is expected to improve health outcomes significantly, reduce the burden of costs and improve equity and access to health care in Bangladesh. Unsafe and low-quality health care ruins lives and costs the world trillions of money every year; we must do more to improve the quality and safety of health services in Bangladesh. Bangladeshs commitment to join the movement towards universal health coverage also demands that the country should take definitive steps for guaranteeing minimum level of quality in healthcare. It is imperative that the foundations of the health system be strengthened to focus on improved quality of healthcare in the public and private domains. Without health, everything else becomes meaningless. It may be mentioned here that better health is one of the prime objectives of development. Our national economic and social development depends on health care sector. We know universal health coverage is possible, so, lets make it happen! The writer is a consultant nutritionist