Facing health sector challenges

Samir Kumar Saha | Published: 00:00, Apr 07,2019 | Updated: 23:47, Apr 06,2019

 
 

— devex.com

WORLD Health Day is celebrated in Bangladesh as elsewhere across the world today under the leadership of the World Health Organization. The day is an annual event that has been celebrated for years to create awareness of health issues and concerns among the ordinary people.
The celebration focuses on increasing life expectancy by adding good health to the lives of people and promoting healthier living habits.
Although Bangladesh has achieved successes in its economic areas, a number of problems have been persistent in the health sector. Proper attention needs to be given to the sector to ensure the universal health coverage.
Non-communicable diseases have now broken out in an epidemic form in Bangladesh. According to Health Bulletin 2015 of the health services directorate general, people now face different diseases and 61 per cent of them are non-communicable disease, which are preventable. The consumption of healthy food, exercise and stress-free life can ward off such non-communicable diseases.
The average life expectancy of Bangladeshis and the economic growth have increased. But the habit of physical work has reduced. It has intensified the scope for the spread of non-communicable diseases such as cancer, cardiovascular diseases and diabetes among people. An unhealthy lifestyle and the lack of physical labour are blamed for the appearance of non-communicable diseases. We need to take firm steps to face the challenges in the health sector. Intervention by the government is a must in the present perspective.
Compared with other SAARC countries, Bangladeshi patients have to spend more money from their pocket on their treatment and the amount is increasing gradually. The government now bears only 23 per cent of the health expenditure, as is disclosed in a report titled ‘Bangladesh National Health Accounts 1997-2015’ published by the health economics unit of the health ministry in September 2017.
Bangladesh, in its health index in the past several years, has achieved a number of successes such as reduction in mortality rate among under-five children and an increase in the average life expectancy of people. At the same time, distance between people and health professionals has also increased.
Many people have been deprived of basic healthcare services. Health related expenditure is increasing day by day. Patients have to bear 77 per cent of their health expenditure. Many people are falling into poverty every year to meet the health expenses while many others are approaching towards death after failing to manage the money needed for their treatment.
According to an estimate of the World Bank, about 64 lakh people in Bangladesh are becoming poor just to meet medical expenses every year. Because, patients bear 77 per cent of the total treatment expenditure from own pockets while the government pays for only 23 per cent. According to the Word Health Organisation, patients’ own expenditure should not exceed 32 per cent.
The government should take necessary steps by investing in the health sector to reduce the medical cost by people.
There has been less allocation in the health sector. People are deprived of necessary services because of the less allocation. The health sector should get its due importance.
The average financial allocation in Bangladesh’s health sector from 1990 to 2014 is 6.53 per cent. In the budget for 2017–18 financial year, Tk 20,652 crore has been allocated for the health sector, which is 5.2 per cent of the total budget.
According to the World Health Organisation, at least 15 per cent of the total budget should be allocated for the health sector.
The government has taken up a project to turn Bangladesh into a middle income country by 2021. In order to achieve the target, it is required to allocate more than 10 per cent of the total budget.
If we want to ensure quality in the health sector, we have to create adequate skilled human resources in the sector. There are now only three physicians per 10,000 people in the country. Proper guidelines and plans are needed to create the required skilled human resources and use them properly.
There is severe discrimination in healthcare human resources in rural and urban areas in the present health system. A large number of health professionals are available in urban areas while they are very few in rural areas.
The matter of drug policy is linked to health-care services. The drug policy that we now have has not been changed or updated since its inception in 1982. The government prepared a draft drug policy in 2005, but it is yet to be adopted.
Bangladesh is working to achieve the goals of sustainable development by 2030. If we want to achieve the goals in the health sector by the time, we have to invest more in the sector. If it is not done, it will spell a catastrophic situation for us.
We have to take steps to ensure the universal health coverage, in which everyone can gave access to quality health services without financial hardship. It is an inherently political goal rooted in the right to health.
The World Health Organisation’s constitution affirms that the enjoyment of the highest attainable standards of health is a fundamental human right. More than a half of the world’s countries have included the right to health, public health or medical care in their constitutions. All people aspire to receive quality, affordable health care.
The universal health coverage aims to achieve better health and development outcomes, help to prevent people from falling into poverty because of illness, and give people the opportunity to lead a healthier, more productive life.
In recent years, the global universal health coverage movement has gained momentum, with the World Health Assembly and the United Nations General Assembly calling on countries to ‘urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality health care services.’
To overcome the challenges of the health sector, a multi-sectoral holistic approach can be one of the important strategies. We have to take steps to sue traditional medicines such as ayurveda and unani for the universal health coverage. Because, it is cost-effective and is easily available in our country.
Even western scientists now give an increased attention to traditional medicines. The ancient system has gained new dimension with standardised forms of formulations and the adoption of modern manufacturing methods.
As we have scarcity of human resources in the sector, we can use personnel from the traditional sector. It is time to recognise the natural system of medicine and use its work force.
If necessary steps are taken for the recognition of and improvement in the traditional system, there would be development in the health sector. Sri Lanka, India and China have derived benefits form the use of tranditional medicines.
If all concerned come forward and play their role, traditional medicines can play a significant role in developing the health sector.

Dr Samir Kumar Saha is is executive director of the Public Health Foundation, Bangladesh.

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