Bangladesh ahead of India, Pakistan in healthcare access

Manzur H Maswood | Published: 18:20, May 24,2018 | Updated: 23:45, May 24,2018


A May 17, 2017 photo shows a doctor examines a Chikungunya patient in Dhaka Medical College Hospital as there was an outbreak of the disease. — Sony Ramany

Bangladesh is ahead of India, Pakistan, Nepal and Afghanistan in providing access to quality healthcare to citizens, according to a study of leading British medical journal The Lancet.
Bangladesh ranked 133rd among 195 countries in providing access to quality healthcare, according to the study.
Bangladesh, however, fell behind Sri Lanka and China in the areas.
The study revealed that Bangladesh has seen improvement in healthcare access and quality since 1990, with its Healthcare Access and Quality (HAQ) index increasing from 17.8 in 1990 to 47.6 in 2016.
The average HAQ index in South Asian countries is 40.4 in 2016 while the average HAQ was 23.8 in 1990.
Improvement rate of Bangladesh is better than its South Asian neighbours.
India’s HAQ index was 24.7 in 1990 and 41.2 in 2016.
Pakistan’s HAQ index was 26.8 in 1990 while 37.6 in 2016.
Despite the gains, Bangladesh continues to lag behind China (48) and Sri Lanka (71).
Myanmar ranked 143rd, India 145th, Nepal 149th, Pakistan 155th and Afghanistan 191st.
According to the study, Bangladesh performed poorly in tackling cases of skin cancer, testicular cancer, lymphoma, leukemia, uterine cancer, neonatal disorders, stroke, among others.
Despite Bangladesh’s progress in healthcare compared to India and Pakistan, it cannot be complacent as yet, experts said.
They pointed out high out-of-pocket expenditure in Bangladesh, which is highest in South Asia.
But Bangladesh still lags behind in using modern healthcare technology, they said.
The latest reports of the government’s Health Economics Unit show that people in Bangladesh have to bear 67 per cent of their medical bills.
The out-of-pocket medical expenses of fellow South Asians are far below that of Bangladeshis, 18 per cent for the Maldivians, 25 per cent for the Bhutanese, 47 per cent for the Nepalese, 56 per cent for Pakistanis and 62 per cent for the Indians.
In the UK a citizen bears nine per cent of his or her medical expenses while an American has to bear 11 per cent.
A study done by ICDDR,B and BRAC James P Grant School of Public Health and published in January this year, showed that 68.9 per cent of the country’s citizens find it hard to bear their medical bills.
The annual medical expense per household could be as high as Tk 40,000, the average being Tk 18,000, found the study.
Bangladesh Health Rights Movement chairman Dr Rashid-e-Mahbub told New Age that the government sector healthcare services in Bangladesh was better than India and Pakistan which lifts Bangladesh in terms of quality and accessibility of healthcare.
‘We could do better if we could invest more on government hospitals, provide them with more manpower and modern technology,’ he said.
Rashid said enabling government health services more effective would help reduce the out-of-pocket expenditure in Bangladesh.
According to The Lancet study, the five countries providing the highest access to quality healthcare were Iceland (97.1 points), Norway (96.6), the Netherlands (96.1), Luxembourg (96.0), and Finland and Australia (each with 95.9).
The countries with the lowest scores were the Central African Republic (18.6), Somalia (19.0), Guinea-Bissau (23.4), Chad (25.4), and Afghanistan (25.9).
The study pointed out that subnational inequalities were particularly pronounced in countries such as China and India, although high-income countries, including England and the US, also saw considerable local gaps in performance.
In 2016, the global average healthcare access and quality score was 54.4, increasing from 42.4 points in 2000.

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