EVERY year, about five million people die as a result of sub-standard care in low- and middle-income countries. Nearly six in 10 deaths from treatable conditions in these countries result from low-quality healthcare — a bigger killer than insufficient access to treatment, says a report published by the Lancet medical journal. The report said that providing health services ‘without guaranteeing a minimum level of quality is ineffective, wasteful and unethical.’ Substandard care was a factor in 84 per cent of cardiovascular deaths, 81 per cent of vaccine-preventable diseases, and 61 per cent of post-birth complications. Diagnoses are frequently incorrect for serious conditions’ such as pneumonia, heart attacks, or newborn asphyxia which can cause death from suffocation. Mothers and children in low- and middle-income countries receive less than half the recommended interventions, including blood pressure monitoring during birth, and newborn checkups. Less than a half of suspected tuberculosis cases were correctly managed and fewer than one in 10 people with a major depressive disorder received minimally adequate treatment, the report says.
That healthcare system in Bangladesh is in an abysmal state is evidenced in the fact that emergency and primary healthcare facilities are not ensured by the government as many posts of doctors remain vacant in public hospitals while drugs have gone beyond the purchasing capacity of people. If expired reagents are used in hospitals, as has earlier been reported, anybody can understand how irregularities result in health hazards. A large segment of mothers after delivery still does not get the required care in terms of getting sufficient nutritious food, rest and medical care. The factors that have compounded the problem of tuberculosis as a disease are, needless to say, lack of training programmes on tuberculosis for physicians, an absence of proper equipment for identifying the disease and want of effective medicines. But one must not lose sight of another important factor — an absence of ‘referral linkage’ between physicians in child hospitals and TB specialists — for the control of child tuberculosis. In South Asia, pneumonia is the leading killer of children under the age of five. Of 15 countries that account for three quarters of childhood pneumonia cases, Bangladesh is one with the northern districts being especially vulnerable to the disease as diagnoses there are often found incorrect.
Concerted effort from health services authorities and non-governmental organisations is needed for the prevention of these diseases, which are assailing us as an insurmountable impediment to the achievement of the SDGs. Children also need to be immunised with vaccines free for vaccine-preventable diseases. The government needs to formulate a policy and institute an independent healthcare commission whose responsibility would be to take measures for monitoring and regulating the healthcare sector. Indeed, a comprehensive strategy is needed to successfully combat these diseases.