We bid farewell to the old year 2022 and entered a new year 2023. Let’s hope the new year brings us happiness and joy, especially in the global post-pandemic health sector.
One of the important sectors of a country is the health sector. It is said that if there is an improvement in the health of people in a country, it means that the country is in a good economic condition. Despite our many achievements in the health sector, the health system has failed to meet our expectations due to several problems.
Take this for example, even though there are posts in upazila level hospitals, many posts are vacant. Inpatients receive medicines free of charge, while outpatients are largely deprived of such benefits. Due to the pressure of large number of patients, it is not possible to ensure quality treatment in medical college hospitals and specialized hospitals.
Patients usually do not get doctors at upazila level, so they come to district level hospitals and specialized hospitals. District level hospitals and specialized hospitals fail to provide quality treatment to the patients due to the large number of patients.
If the quality of treatment in district and upazila level hospitals is improved, it is possible to ensure quality treatment for 60 to 70 percent of patients in those hospitals. Therefore steps are required to ensure quality of treatment in upazila, union and community clinics.
Hopefully, we have achieved many positive things in various sectors, but due to lack of proper management, we have failed to meet the expectations of the people in the health sector. So to bring about positive changes in the health sector, proper management is now required.
Although there is talk of creating posts in our health management, the reality is different. There is only one registered doctor for 1,581 people in the country. Absence of doctors is more in rural, remote and remote areas.
There is also the issue of trained nurses. Although many hospitals have medical equipment, there are vacancies for technologists. There will be no solution to such mismanagement if the management of recruitment of manpower (doctors, nurses, paramedics, lab-technicians) is not decentralized.
The solution is not only to appoint doctors, but also to take necessary steps to retain them in their respective workplaces. Besides, necessary steps should be taken to increase the training and skills of the health workers. It has been observed that the functioning of modern health facilities is hampered due to lack of qualified personnel. Gradually such equipment became useless and patients died of neglect.
Immunity health care is an important branch of health science. Regrettably, such a healthcare system has not yet been developed in our country. Therefore, education in medicine should be classified into four stages: physician, teacher, administration and disease prevention. From such four levels of health system a student will determine his future activities and participate in health management.
Maintaining cleanliness is essential to improve hospital environment. Humanistic manpower should be employed to provide information about hospital and supervised services.
Mismanagement is one of the main complaints against the country’s health sector in the last 50 years. In real sense, professional health management has not yet developed in the country.
The World Health Organization (WHO) has advised countries like Bangladesh to allocate 5 percent of their GDP to the national budget for the health sector. For more than 12 years, less than 1 percent of GDP has been allocated to the health sector in Bangladesh. About 70 percent of the allocated funds are spent on salaries, while the remaining amount is spent on health care, which is very inadequate.
Taking into account the overall development of the health sector, financial allocation should be increased in this sector. Proper utilization of the increased allocation should be ensured by keeping this sector free from corruption.
Hence regular research, proper action planning and regular monitoring are required. To ensure comprehensive health protection of our people, there is a need for proper planning and implementation time with transparency to eliminate the shortcomings of health management.
Many people in the country have fallen below the poverty line due to high expenditure on medical care. On the other hand, patients are deprived of proper treatment in government hospitals.
Manpower shortage is creating problems at every stage of treatment like Upazila Health Complex, Community Clinic, Union Health Center and District Level General Hospital.
Despite the increase in average life expectancy, lack of access to quality healthcare continues to burden the country’s elderly population at the end of life. Therefore, it is necessary to form a health commission.
There is no effective health policy in the country. Now we have to think about the contours of the health sector for the next 50 years. One of the main tasks of creating a discrimination-free society is to build a discrimination-free health system. This is also clearly mentioned in our national constitution.
Health management is a complex subject. Good knowledge of health as well as administrative skills are required to run this sector smoothly. As it turns out, very few of those holding high positions possess this quality. Therefore, those who have experience working at various levels of the health sector and have studied subjects like public health, health economics and health management, should be promoted to higher positions in this sector.
Corruption in Bangladesh’s health sector mainly centers around buying and selling. So it is important to make the procurement process more transparent.
In many countries of the world, it has been possible to reduce corruption to a large extent through reforms in public financial management. The establishment of independent specialized audit institutes has succeeded in reducing procurement and mismanagement corruption in those countries.
It is also important to ensure free flow of information. Research studies have shown that when sector-wise allocations (with top-down expenditure details) are readily available, corruption becomes more difficult to resort to.
Author: Former Executive Director, Public Health Foundation, Bangladesh
