Health risks are posing as the greatest threat to the lives and livelihoods of the people. According to a study, the country's healthcare system gets ineffective frequently in reaching the poor, generates less benefit for the poor than the rich, and imposes repressive cost burdens on poor households.
Consistently inequitable nature of healthcare system in Bangladesh limits the access to healthcare by the poor who need it the most. Many raised concern about attaining the health-related Millennium Development Goals (MDGs) in countries like Bangladesh without improving the ability of healthcare systems to reach the poor effectively.
The poor and disadvantaged households with very few assets struggle to meet even small extra-budgetary expenses. Thus, improving the ability of the health system to reach the poor and disadvantaged populations is essential to mitigate the income-erosion effect of ill-health and poverty alleviation.
Capacity constraints in the public hospitals are prohibiting a lot of patients from getting fair treatment. Despite serious limitations, most of the public hospitals are offering emergency services. But the quality of treatment is not at all satisfactory. They can hardly cope with the ever-rising demand for treatment. Doctors and nurses seldom take care of the patients in most of the public and private hospitals. Free medicare facilities and medicines are rarely available.
Private hospitals have created options for the people to seek health services from various facilities other than the government ones only. But these hospitals are allegedly exploiting the patients due to lack of their knowledge and helplessness. The laws too are not effective and there are problems with compliance, too.
What is surprising is that more than 40 per cent of private hospitals, clinics, blood banks and diagnostic centres are not registered with the relevant government agency. The hospital and clinic wing under the Directorate General of Health Services does not have the capacity to regularly monitor mushroom growth of the clinics, hospitals, blood banks, and diagnostic centres in the private sector. Moreover, activities of the wing are limited to the Dhaka city only as there is a lack of adequate manpower.
Apart from the government-owned hospitals, the situation in private clinics and diagnostic centres outside Dhaka is even worse. They do not have proper equipment, manpower, doctors, nurses, emergency, ambulances and authorised blood bank needed for a full-fledged clinic.
The quality of services the healthcare workforce is providing in these clinics and diagnostic centres is simply awful. The government recognises three types of degrees for medical technologists - one-year diploma, three-year graduation and four-year BSc in laboratory technology course. It is easily understood that the quality between one-year and four-year degree holders will not be the same.
Sometime back, the World Bank (WB) asked the Bangladesh government to contract out some of the medical services to the private sector 'at certain levels.' The WB recommendation followed a study on the state of affairs relating to the country's medical services. The study found a state of anarchy prevailing in the sector. Common people, especially the poor ones, are not getting medicare services at all.
The Bank also advised the government for contracting out medical services to the non-government organisations (NGOs), private institutions of fame etc. Such contracting-out should be based on win-win situation. The private sector organisations must be chosen from among the lists of transparent and accountable firms and organisations.
In the wake of chronic mismanagement, negligence and widespread corruption in the public sector healthcare entities of the country, it is necessary that there should be an effective mechanism to streamline their activities. Treatment through alternative medicines should also be encouraged to make 'Healthcare for all' a success.
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