Urban healthcare centres, run by the local government bodies, are failing to provide even the basic reproductive health and nutrition services due to a lack of human resources. The local government healthcare centres cannot afford the necessary manpower due to fund shortages, which stems from the fact that the local government bodies have to spend from only their own earnings.
The city corporations and municipalities are responsible for delivering the primary health services to the urban population. Outside urban areas, the Ministry of Health and Family Welfare is responsible for providing the services. Apart from vaccination campaigns, most of the healthcare centres under the local government institutions have no role in providing health services.
Experts said there is a problem with the existing structure of the health departments of the local government institutions in urban areas. It is depriving the urban people, especially the poor of primary healthcare. A study shows only Sirajganj and Feni municipalities, out of all 53 district-level municipalities, had a doctor each. In 15 of the municipalities surveyed, 29-82 per cent of posts for healthcare personnel were vacant. Of the 30 upazila-level municipalities surveyed, the average vacancy rate was more than 80 per cent and five of them provide no healthcare services, not even regular vaccinations. Only one of the 30 provides family planning services. Of the 12 city corporations surveyed, only Dhaka south, Chattogram and Khulna city corporations deliver some healthcare services.
As the urban population is growing and more than 50 per cent is expected to live in urban areas by 2035 due to facility concentration in cities and climate-induced migration, the government should lay emphasis on affordable healthcare facilities. Poverty also shifts from rural areas to urban slums, where healthcare, hygiene, and sanitation is challenging, the city authorities must invest in healthcare improvement for the poor as they have less affordability and opportunity. In a short-term fashion, the vacant post in the urban healthcare system should be filled up for better service delivery.
