Govt focuses on urban primary healthcare, reducing out-of-pocket expenses

The upcoming 5th Health, Population, and Nutrition Sector Program (HPNSP) focuses on urban primary health care, reducing Out of Pocket Expenditure for urban populations who are overall underserved, the health ministry has said. 

At a Policy Dialogue on the draft Strategic Investment Plan (SIP) of the 5th HPNSP on Wednesday at a city hotel, health sector stakeholders said, currently, the urban population depends on secondary or tertiary hospitals due to the low quality of services at urban primary healthcare facilities. This dependency creates an extra burden on tertiary hospitals.

Once the 5th HPNSP is approved, primary health services for urban people will be available at urban primary healthcare facilities. By introducing the referral system, tertiary hospitals will provide medical treatment to referred patients, they opined at the dialogue hosted by the health ministry. 

At the dialogue chaired by Health Minister Zahid Maleque, the ministry shared the draft SIP of the proposed 5th HPNSP with all the relevant stakeholders for their comments/feedback, and suggestions.

The draft of the 5th Health, Population, and Nutrition Sector Program (July 2024 to June 2029) also focused on public health, mental health, non-communicable diseases, and pandemic preparedness. 

Zahid Maleque said common people have to bear high out-of-pocket expenditures in the medical sector for buying medicines. Many complained that physicians prescribe more drugs in the prescriptions than needed. 

"Prescriptions should be appropriate, as needed. No business intuition should work here. We have to focus on that," the minister said.

The draft SIP mentioned prevention, control, and treatment of non-communicable diseases, maternal and child health, primary healthcare, urban health, medical waste management, nutrition, reducing out-of-pocket expenditure, pandemic preparedness, introducing functional referral system, disease burden due to climate change, strengthening emergency care and geriatric care as major focus areas for the 5th HPNSP.

The SIP also lays out a strategic framework to guide investments in the Health Population and Nutrition (HPN) sector and highlights the government's intentions to be pursued during the next five years for overall HPN sector development. 

At the dialogue, participants suggested creating the post of medical pharmacists in the sectoral plan, removing the conflict between line directors and directors, introducing the referral system, strengthening the Institute of Epidemiology Disease Control and Research (IEDCR), including medical waste management in the 5th sectoral plan.

They also said that once the upcoming 5th HPNSP is approved and implemented, the Health Ministry will also cover urban primary healthcare too, with coordination of the local government ministry and non-government organisations (focused on public health, mental health, non-communicable diseases, and pandemic preparedness). 

Currently, two different ministries are implementing primary healthcare service delivery in rural and urban areas. The health ministry manages general health and family planning services through district hospitals, upazila health complexes, union health and family welfare centres, and community clinics. The local government ministry manages the provision of urban primary care services.

Secretary to the health services division, secretary to the medical education, and family welfare division, high officials of the health ministry, representatives from various ministries/divisions, director generals of the agencies of the ministry, line directors, the development partners, and representatives from the private sector, civil society, and NGOs were also present.