Meeting the challenges in healthcare
Dr Tareq Salahuddin and Md Rajib Hossain
The healthcare landscape of Bangladesh continues to face challenges. Health of the general population remains unsatisfactory. We can access primary healthcare through different gateways. We suffer because of the huge difference in the quality and standard of healthcare we receive. We are also vulnerable to maltreatment in the hands of non-qualified practitioners (e.g. quacks, rural medical practitioners, traditional medical practitioners and so on). Besides, over the years, the situation has become so difficult that it may take years to put primary healthcare on the right track in Bangladesh. Recently Dr Husayn Al Mahdy, a Medicine and Healthcare Management Specialist from the United Kingdom came to Bangladesh on a short visit. He has experience on the healthcare system of different developing countries. Dr Mahdy shared about different issues to meet the challenges in the healthcare system of Bangladesh with Dr Rubaiul Murshed, Chief Consultant of Healthcare Services Management of STS Group. The points came out from the discussion is projected here. The government is the main provider of healthcare services to the population and has developed a network of primary, secondary and tertiary healthcare facilities. The services are mainly curative, rather than preventive. There are some 650 government hospitals, and one doctor for every 4,500 people. Long queues at hospitals have been established as a norm. Doctors frequently exhibit marked lack of care. Medical facilities and standard of hygiene are poor. The physician: patient ratio in Bangladesh is 1:4775. Most physicians are based in urban areas. The scenario is poorer in the rural communities, where primary healthcare is provided by quacks, rural medical practitioners, traditional medicine practitioners and paramedics. Only 30 percent of the population of Bangladesh has access to primary healthcare. In the urban areas, big cities, district towns and municipalities, people mainly depend on few medical specialists for their everyday health needs. No referral is needed to consult a specialist physician here. Whenever a patient feels problem, s/he directly go to the specialist at the very beginning and very often visit the wrong consultants. In order to get benefit decentralisation of the healthcare facilities is a vital. In most instances, doctors, health workers are not willing to go to rural areas. Less income, facilities and flat salary make the situation difficult. This problem can be solved by giving incentives to the healthcare professionals who work with constraints. This way, rural doctors must be paid more than urban doctors to ensure proper healthcare services. Doctors must be involved in health policy level as well. In fact, they realise the problems in this sector properly and can suggest fruitful solutions. There are some 300 private hospitals, clinics and diagnostic laboratories in Bangladesh – mostly in urban areas. The reputed institutes should be recognised to provide quality care. In case of serious or life-threatening health concern, people who can afford think mostly about medical services in overseas like India, Bangkok or Singapore. Local private hospitals should be up to the mark of international standard and should introduce latest facilities with cutting edge technologies. Understandably both public and private health service are inadequate with limited facilities and shortages of trained medical staffs. By offering technical assistance at all levels, developing new programmes and directly helping them to develop as skilled manpower, we can improve the quality of care for the people. Dr Rubaiul Murshed and Dr Husayn Al Mahdy can be contacted through e-mail addresses respectively rm@dhaka.net and pablomartinez400@hotmail.com
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