Developing curative capacity of primary health facilities

There are allegations galore that many people with Covid-like symptoms have been failing to get tested at the government-designated hospitals and other makeshift sample collection booths. The surge in infections has made the seeking of such diagnostic help far more troublesome. In most cases, patients coming from poor and low-income families do fail to have access to such diagnostic facilities. Others belonging to the middleclass and above can have easy access to PCR tests against the payment of a few thousand bucks. Thus, the statistics that the DGHS (Directorate General of Health Services) releases daily on the novel corona virus infection are only partial.

The lack of access of the poor and low-income people to health facilities is one of the major weaknesses of an otherwise robust healthcare infrastructure of the country. The Covid-19 pandemic has again brought the issue to the fore. Notwithstanding all weaknesses, the overall performance of the country's health sector, according to the World Health Organisation (WHO) rating, is among the best 100 in the world and it is better than that of India, Brazil, Russia and South Africa. However, the WHO's performance evaluation, naturally, did not take into account the difficulty that the poor people encounter in accessing health facilities in case of emergencies such as the present one centring the Covid-19.

The government has spent funds worth billions of taka over the years in building health infrastructures and ensuring manpower and logistics for those. A part of that fund has gone for developing a primary healthcare system in rural areas. However, that system focuses more on preventive aspect of healthcare and does have inadequate capacity to handle patients needing emergency curative services. The people living in both rural and urban areas are now in a helpless state following the outbreak of Covid-19. Not to speak of treatment, access to diagnostic tests has become a serious problem.

The research director of BIDS (Bangladesh Institute of Development Studies), Dr.BinayakSen, who has a number of research publications on different areas of economy and human development, in an interview with a vernacular daily the other day put forward an idea that deserves attention of the health authorities here. Dr.Sen suggested building primary urban healthcare clinics in areas having concentration of low-income people. The clinics will have adequate diagnostic facilities and ability to offer basic treatment for all diseases. In addition, he recommended building similar facilities for the workers in industrial hubs with contribution from industry owners.

The country has a strong health infrastructure in the rural areas. Unfortunately, for lack of proper attention and planning, the same has remained underutilised. The primary healthcare in rural areas is more focused on prevention of diseases through the expanded programme on immunisation (EPI). The upazila health complexes do have curative facilities, but those are highly inadequate and ill-managed.

Undeniably, the country's health system needs revamping and it should start with development of curative capacity of the upazila health complexes. The outbreak of Covid has also laid bare the extremely poor state of the health facilities at district headquarters and those need to be modernised and upgraded on an urgent basis. A part of the additional resources set to be spent in the health sector needs to be diverted to districts for health facilities there.