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Governance, financing, and service-delivery challenges in urban healthcare require urgent structural reforms, according to a consensus experts reached at the Urban Health Policy Workshop held in the capital on Tuesday.
The multi-stakeholder discussion was organised by Power and Participation Research Centre (PPRC), partnered by Universal Health Coverage (UHC) Forum, and supported by United Nations Children's Fund (UNICEF).
The programme brought together experts from government agencies, development partners, academia, and healthcare to address critical gaps in urban healthcare.
Chaired and moderated by PPRC founder-chairman Dr Hossain Zillur Rahman, participants in the discussion included UNICEF Bangladesh Chief of Health Maya Vandenent; ADB Health Specialist Rui Lui; Professor Dr Liaquat Ali and Professor Dr Syed Md Akram Hussain from Health Sector Reform Commission; Former secretary Md Ashadul Islam; UIU Professor Khondaker A Mamun, and, UNICEF Health Specialist Dr Margub Jahangir.
While many initiatives such as: Surjer Hashi, Alo Clinic, Urban Primary Healthcare Service Delivery, Brac health centres, Sajeda Foundation clinics, Grameen primary healthcare, and urban health programme Gano Shasthay address some of the needs of the urban poor, there is a pronounced lack of ownership and dedicated structures in urban healthcare governance, experts said.
Participants urged revisiting the national urban health strategy and creation of an independent apex health authority to address system gaps in governance, financing and service-delivery.
Experts also called for a clear commitment to 3-5 per cent of GDP to be devoted to health of which at least a quarter should be earmarked for primary healthcare in both urban and rural areas.
Financing urban healthcare sustainably remains a challenge, they said, while also adding that attention has to be given to overcoming allocative, cost, and distributive inefficiencies.
Experts also urged greater attention to community engagement, allowing community voice to contribute to service design solutions. Better use of digital technology to improve health information, monitoring and service solutions was also stressed.
In conclusion, Dr. Hossain Zillur Rahman emphasised the need to revisit an act formulated in 2009, as overlapping responsibilities between two ministries create inefficiencies in urban healthcare governance.
A clearer delineation of roles is essential to ensure practical and implementable solutions, he said.
Consensus was reached at the discussion for pursuit a 'menu-of-options' approach to urban primary healthcare delivery instead of being stuck in a 'single solution' mindset to leverage existing infrastructural and institutional assets generated from the health, local government, NGO, and social sectors, he said.