Dr. Samir Kumar Saha :
Amid the Covid-19 crisis, the world has understood well how much it is important to invest in the health sector. Corona taught us that it is very tough for human beings to survive in the world without health protection. So, now it is the need of time to recast our health sector, including a robust investment growth in this sector. The next national budget should be done to help sustain life and livelihood of people keeping in mind the issue of people’s health protection. I hope that the matter would get due priority in the next national budget.
According to a joint survey report (2019) of USAID and several organizations titled “Building awareness for universal health coverage: advancing the agenda in Bangladesh”, per head out of pocket health expenditure is 69.3pc for taking health service, which is the highest in the South Asia.
According to the report, there are several reasons for the highest cost for treatment in the country. These are inadequate expenditure, lack of control in government expenditure, less allocation in budget, allocated money not properly distributed, excess pocket money, huge gap between government and pocket money, uncontrolled private health sector, lack of interest in health insurance, reduction of assistance by donors and less participation by private organizations.
On the other side, there are some successes also such as reduction of child mortality, improvement of nutrition condition and increased rate of vaccination in our health sector. But the private sector had no role in those matters. People’s personal health cost is rising due to uncontrolled private sector. Many people turned into poor while meeting their health expenditure. It is a big hindrance to achieving universal health coverage.
According to World Health Organization (WHO), about 52.50 lac people are falling to poverty every year while meeting their health expenditure in Bangladesh. About 2.25 core people are on the verge of big health risks. About 70 lac people from Bangladesh go abroad in the hope of getting better treatment facilities every year as they fail to get it in the country. In a bid to prevent it, those who are involved in the health sector should be aware of it and new technology be introduced in our health sector.
It is needed to further increase the involvement of private sector along with the government if we want to achieve the target of universal health coverage. It is required to take proper steps to provide necessary support to the private sector along with effective control over it.
Research findings said that, 60pc of our people get health services from disorganized sector, 14pc services are provided by the public sector and 26pc provided by the private sector. No country in the world has been able to achieve the target of universal health coverage without the contribution by their private sector.
Most of our health infrastructures are located in town areas while most of people live in rural areas. It can be termed as severe discrimination. Tendency to go to town by both doctors and patients will increase if health service system is not decentralized. Traffic jam will increase in towns where standard of health service will also deteriorate.
Ensuring participation of people, coordination among all departments, formulation of suitable strategy and ensuring quality healthcare is important if we want to ensure universal health coverage in the country.
The outbreak of Corona pandemic exposed a dismal picture in our health system. We have built up hospitals upto upazila level, but basic facility of health service is not ensured there. Riddled with corruption, incompetence and negligence for a long time, public health is now facing a grim reality. Present crisis in the health sector gave us an opportunity to recast it. We, taking the opportunity, can of make our health sector modern and international standard by making adequate allocation in the national budget.
Priority in the budget can be done in two categories-one is by facing corona and the other is by improving public health sector such as building infrastructure and of renovation of current infrastructures. Hence, short, medium and long term road map should be chalked out. There should be increased budgetary allocation to implement those plans.
(Dr. Samir is former executive director, Public Health Foundation, Bangladesh).
