Healthcare system needs urgent reforms: Experts

The health sector gets a poor budgetary allocation every year. But still, it does not have capacity to make use of that. Urban primary healthcare is neglected.  There is a severe crisis of doctors in remote areas.

A big portion of the health budget is spent on salaries, infrastructure and medical equipment purchases. But now there are shortages of intensive care units, oxygen and skilled workforce. Covid-19 has exposed the country's healthcare system vulnerabilities.

In this situation, experts have urged to ensure universal healthcare coverage and make reforms to the country's healthcare system.

They were addressing a webinar titled "Future health systems for Bangladesh: The case for Universal Health Coverage", organised by Bangladesh Health Watch on Friday.

Bangladesh Health Watch, a multi-stakeholder civil society advocacy and monitoring network, is dedicated to improving the health system in Bangladesh through a critical review of policies and programmes and recommendation of appropriate actions for change.

Experts said proper planning, management and audit of everyone's activities are necessary for the development of the health sector. 

Hossain Zillur Rahman, former adviser to a caretaker government, said. "A large part of our budgetary allocation goes to the construction of hospital buildings. A 250-bed hospital does not have the manpower for 50 beds and people are deprived of treatment. So, before approving a new hospital, the manpower to run that hospital must be ensured. Urban healthcare needs improvement."

"Public health and hygiene should be given importance in the healthcare plan. Our out-of-pocket expenditure is much higher because of unnecessary tests and high drug prices. Steps must be taken to reduce people's out-of-pocket expenses. These reforms are urgent now. Everyone talks about reforms but who will do the reforms has to be decided quickly. Because the economic recovery is not possible without improving the healthcare system", he added.

Prof Dr Mohammad Shahidullah, president of Bangladesh Medical and Dental Council said, "To tackle Covid-19, our first challenge is to ensure tests and treatment in hospitals. We can see that we have a crisis of doctors and nurses. There is also a shortage of skilled manpower. Moreover, hospitals do not have adequate numbers of intensive care beds and enough oxygen supply."

Dr Fahmida Khatun, executive director of Centre for Policy Dialogue, said the allocation for the health sector in the budget is very low, but still that is not used correctly. Again, a large portion of the budget goes to salaries officers and employees and infrastructure. But doctors do not want to stay in villages. Not only salaries but other facilities have to be ensured to keep them in the villages."

Primary healthcare needs further improvement. Besides, an individual's share in out of pocket expenditure has to be reduced from 67 percent. People are becoming poor while carrying medical expenses, she added.

The number of doctors, nurses, technologists needs to be increased. Hospitals are being built, equipment is being procured, but there is no skilled manpower to manage them, Dr Fahmida pointed out.

"In our budget, a very small amount of money is spent on researches. There is no real-time data on health. That is why problems appear in policymaking. We have to pay attention to this issue. Money must be used properly. Besides, the private health sector needs to be monitored," she said.