Decentralisation can ensure healthcare at doorstep of 60-70% patients: Study

Decentralisation of the country's healthcare system can ensure quality treatment for 60-70% of patients at their doorsteps, finds a study.

Former health minister Dr AFM Ruhul Haque, in collaboration with the non-government organisation Eminence Associates for Social Development, conducted the study last year and revealed the report on Sunday at a hotel in the capital. 

"This is praiseworthy that our healthcare system has improved. However, people are yet to find doctors, medicine and other facilities at upazila and district levels," he said, adding that the people were still rushing to medical college hospitals and hospitals in the capital as a result. 

The centralised system caused indiscipline in the sector – many hospitals struggled to provide service while others saw very few patients, he added. 

The former health minister suggested the government decentralise the healthcare system by boosting root-level medical facilities. "It will ensure quality medication for 60-70% patients," he added. 

"We observed that the majority of posts at upazila hospitals remain vacant. It can be filled with local arrangements. Many countries have such systems. We must determine our ways to ensure sufficient manpower in the root-level health sector," said the former minister.

The Eminence Associates for Social Development organised a total of 11 policy dialogues with the participation of leading physicians, educationists, politicians, journalists and civil society people between March to July last year to help conduct the study. 

Titled "Bangladesh health sector: present challenges and future guidelines", the study identified lack of cleanliness, mismanagement of resources, shortage of medicine, ineffective and insufficient equipment, carelessness in repairing those, and lack of medical teachers and trainers as key problems of medical facilities – from tertiary level to community clinics. 

It suggested the government address the issues as early as possible. Besides, the study also recommended an overhaul of medical education and an introduction of the much-talked-about digital referral system.

"The Bangladesh health sector is totally centralised, with which we will not be able to attain sustainable development goals," Dr Shah Munir Hussain, executive member at the Eminence Associates for Social Development, said. 

Decentralisation of the sector was imperative, he added while addressing the study report revealing programme. 

Emeritus Professor Dr ABM Abdullah said a counselling system for physicians was a must so that they could realise the patients' psychology. He suggested adding a counselling-related course to the medical syllabus.