Public Health Sector in Bangladesh

DR. MUHAMMOD ABDUS SABUR Adjunct Professor Institute of Health Economics University of Dhaka

Pre-Covid era

Bangladesh has one of the best health net-work in the public sector. As many as 47,678 domiciliary workers with 13,907 community clinics at the ward level and 4,646 at the union level facilities are there to provide health services while 424 upazila health complexes, 59 district hospitals, 18 medical college hospitals and 12 specialized health institutes/hospitals are there to treat patients. Some other types of health service facilities are also there. However, shortage and skill-mix imbalance of human resources, limitations as regards equipment, medicines and other supplies often stand in the ways of accruing adequate benefits from these resources.

Then, due to compromise about life for livelihoods, the lockdown was eased and everything (except education sector) was gradually opened. Meanwhile, inertia among most people to follow the health regulations keep on increasing the number of infection and death. Treatment facilities now remain unutilized.

Major challenges facing by the public health sector

The government’s Health Care Financing Strategy 2012-2032 identified three challenges: i) inadequate health financing; ii) inequity in health financing and utilization; and iii) inefficient use of existing resources. Together with these, management inefficiency, lack of governance, transparency and accountability and failure to regulate private sectors remain the major challenges of the public health management.

Ways to meet the challenges

1. Substantial increase in the government budget for health sector together with appropriate allocation and efficient utilization.2. Strengthening the management capacities at different levels with the provision of reward and punishment.3. Enhancing coordination among the different segments of the public health system together with the determinants of health.4. Improving regulation for the private sector health management.

Ways forward for post-Covid era

The government authorities of the public health sector needs to regulate the growing private sector health management system properly so that adequate healthcare can be provided to the people. With enhanced finance and management efficiency, the public health sector needs to concentrate on providing care for the poor, the vulnerable and the marginalized sections of the people, on the one hand, and giving more emphasis on the public health interventions through promotion and prevention and coordination with the determinants for health, on the other.