Though Bangladesh has achieved successes in its economic field, a number of problems have been prevailing in the health sector. Proper attention needs to be given to the sector for ensuring Universal Health Coverage.
At the moment, Non Communicable Diseases (NCDs) have broken out in an epidemic form in the country. According to health bulletin-2015 of Health Directorate, people are facing different diseases in the country. Of the diseases, 61 percent are NCDs, which are preventable. Intake of healthy foods, exercise and stress-free life can ward off the outbreak of NCDs.
Average life expectancy of our people and economic growth has increased. Along with it, the habit of working physically has been reduced. It has intensified the scope of spreading NCDs such as cancer, cardiovascular disease and diabetes among our people. Unhealthy lifestyle and lack of physical labour has been blamed for the appearance of NCDs.
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 to other SAARC countries, Bangladeshi patients have to spend more money from their own pocket for their treatment and the amount is increasing gradually. At present, the government bears only 23 percent of health expenditure. This was disclosed in a report titled ‘Bangladesh National Health Accounts 1997-2015′ published by health economics unit of Health Ministry in September last year.
Bangladesh, in its health index in the last several years, has achieved a number of successes such as reducing mortality rate among under-five children, and average life expectancy of people increased. At the same time, distance between people and health professionals has also been increased.
Many people have been deprived of getting basic health care services. Health related expenditure is increasing day by day. Patients have to bear 77% of their health expenditure. Many people are falling to poverty every year to meet the expenditure while many others are approaching towards death after failing to manage money for their treatment.
According to an estimate of World Bank, about 64 lakh people in Bangladesh are getting poor to meet medical expenses every year. Because, patients bear 77% of total treatment expenditure from their own pockets, while 23% spent by the government.
According to World Health Organization, patients’ own expenditure should not exceed 32%.
The government should take necessary steps by investing in the health sector for reducing the medical cost by people. There has been less allocation in the health sector. People are being deprived of getting necessary services due to the less allocation. The health sector should get due importance.
Average financial allocation in Bangladesh’s health sector from 1990 to 2014 is 6.53%. In the current budget (2017-18), Tk. 20652 crore has been allocated for the health sector, which is 5.2% of the total budget.
According to World Health Organization (WHO), at least 15% of 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 needed to allocate over 10% of the total budget.
If we want to ensure quality in the health sector, we have to create adequate skilled manpower in the sector. There are only three doctors per 10,000 people in the country. Proper guideline and plan is needed for creating skilled manpower and utilizing them.
There is severe discrimination regarding manpower between rural and urban areas in our health system. Large number of health professional is available in urban areas while it is very less in the rural areas.
The matter of drug policy is linked to health care service. Our drug policy 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 for achieving the goals of sustainable development by 2030. If we want to achieve the goals in our health sector by the time, we have to invest more in the sector. If not done so, it will spell a catastrophic situation for us.
We have to take steps for ensuring Universal Health Coverage (UHC). UHC means everyone can access quality health services without financial hardship. It is an inherently political goal rooted in the human right to health.
The World Health Organization’s constitution affirms that the enjoyment of the highest attainable standard of health is a fundamental human right.
More than half of the world’s countries have included the right to health, public health or medical care in their national constitutions. All people aspire to receive quality, affordable health care. The UHC aims to achieve better health and development outcomes, help prevent people from falling into poverty due to illness, and give people the opportunity to lead healthier, more productive lives.
In recent years, the global UHC 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 in our health sector, a multi-sectoral holistic approach can be one of the important strategies. We have to take steps for utilizing traditional medicines such as Ayurveda and Unani for the UHC. Because, it is cost-effective and easily available in our country.
Even western scientists are giving increasing attention to traditional medicines. The ancient system has gained new dimension with standardized forms of formulations and adoption of modern manufacturing methods.
As we have scarcity of manpower in the sector, we can use personnel from the traditional sector. It is time to recognize the natural system of medicine and utilize its workforce.
If necessary steps are taken for recognition and improvement of the traditional system, there would be development in our health sector. Sri Lanka, India and Child derived benefits by utilizing the system.
If all concerned come forward and play their due role, then the traditional medicines can play a significant role in developing our health sector.
The author is Executive Director of Public Health Foundation of Bangladesh