Integrating global strategies to make Bangladeshi healthcare robust

Bangladesh's healthcare system is greatly influenced—directly and indirectly—by a complex interplay of political and economic factors, which shape policy decisions, funding allocations, and overall effectiveness. The government often emphasises combating communicable diseases due to current health challenges and international funding priorities, sometimes at the expense of non-communicable diseases. 

The significance of political stability cannot be overstated, particularly in a country like Bangladesh, where political instability and crises are not uncommon. In such circumstances, healthcare services are frequently and severely disrupted, as exemplified by the challenges faced in accessing medical facilities during hartals or strikes initiated by political parties.

Instances such as embezzlement scandals related to the procurement of medical equipment reveal how corruption and incompetence worsen pre-existing problems, directly compromising the quality of medical services. 

The decentralisation of healthcare, aimed at improving efficiency, may result in an unequal allocation of resources, often benefiting regions with political power. Political lobbying and advocacy influence is so strong that health policy legislation, such as the Health Care Act, which aims to regulate and maintain quality in private healthcare, is sometimes subject to manipulation. 

The crucial roles played by international influences and aid, such as those from the WHO or the World Bank, are of great importance. These international organisations affect national health policy depending on the criteria associated with their support. Frequently, public health campaigns, particularly those motivated by political agendas like polio eradication, tend to receive excessive financing and attention, thereby impacting the distribution of resources to other health sectors.

If not for election cycles, there might not be significant increases in healthcare spending or the implementation of new health initiatives as political parties attempt to gain favour with voters. The regulatory environment, especially in terms of pharmaceutical pricing and healthcare fees, is strongly impacted by political interests. This has a direct impact on both the affordability and accessibility of healthcare. Integrating health education into public school curricula is a strategic political decision to enhance long-term health outcomes. 

There is a significant imbalance in the allocation of resources and attention towards healthcare in urban and rural areas. Urban areas tend to receive more focus and resources, even though many of the population live in rural areas. The distribution of healthcare resources can become highly biased, favouring constituencies aligned with the ruling party. Additionally, the policies governing healthcare worker wages and conditions are crucial in this skewed distribution. These policies not only impact the migration of skilled workers but also affect healthcare quality.

To improve Bangladesh's healthcare system, it is crucial to integrate effective policies from both developed and developing countries. However, these strategies should be customised to address the specific difficulties and opportunities unique to the local context. Central to this improvement is the reinforcement of governance and the vigorous addressing of corruption. By implementing an e-procurement system with robust control and auditing, 

Bangladesh might effectively reduce corruption by adopting Finland's transparent healthcare procurement techniques. Additionally, drawing upon Rwanda's successful anti-corruption strategies in its healthcare industry, such as regular audits and community oversight, could significantly enhance integrity by implementing whistleblower protection and incentives for upholding ethical norms. 

Implementing a decentralised healthcare management system similar to the one in Canada, where responsibilities are handled at the provincial level, could enable the provision of healthcare services in Bangladesh that are specifically tailored to meet local demands. This model would improve local governance, allowing for more targeted healthcare services and regional investments.

To bridge the gap between urban and rural healthcare provisions, Bangladesh should develop its rural healthcare infrastructure by adopting a similar approach to India's National Rural Health Mission. This mission has successfully enhanced rural healthcare by allocating more resources. In the context of policy creation, the practice of involving a wide range of stakeholders, as seen in Sweden, guarantees that policies are thorough and incorporate many perspectives. 

In Bangladesh, the implementation of this strategy might be achieved by establishing a healthcare policy council that includes representatives from the government, private healthcare providers, non-governmental organisations (NGOs), and patient advocates. If Bangladesh were to implement community health initiatives similar to Brazil's Family Health Programme, which involves the use of multidisciplinary teams for community-based treatment, it could enhance access to healthcare and preventive services by actively involving local healthcare personnel.

If Bangladesh were to emulate Estonia's national digital health system, it could achieve a significant improvement in healthcare management through technology and innovation. This would require the establishment of a digital health framework that combines electronic health records with e-prescription services, resulting in improved efficiency and quality of patient treatment. 

Implementing public-private partnerships (PPPs) similar to those in South Africa, which focus on improving hospital facilities, could enhance healthcare infrastructure and services in neglected regions of Bangladesh. Efficient crisis management and prompt healthcare responses are equally vital. 

By implementing South Korea's strategy of comprehensive testing and contact tracing, as exemplified during the COVID-19 pandemic, Bangladesh might proficiently handle health emergencies. Implementing comprehensive public health surveillance systems will allow Bangladesh to effectively respond to health emergencies. 

Additionally, applying sustainable healthcare finance models based on the successful example of Thailand's universal healthcare system, which is funded through government taxes, has the potential to decrease the financial burden on Bangladeshi residents by reducing out-of-pocket spending. This would involve a combination of public and private funding sources for health insurance programmes to increase coverage and reduce the burden on individuals.

Careful and detailed planning, adequate financial resources, and strong political dedication are paramount to successfully implement these strategies. It is increasingly crucial to consider Bangladesh's distinct socio-economic and political conditions to ensure that these strategies are feasible and enduring.

Bangladesh can greatly recover and advance its healthcare system by implementing and customising some foreign ideas, resulting in a fairer, more effective, and responsive system that meets the needs of its population.

Md Abdullah-Al-Mamun is an experienced researcher and analyst specialising in security analysis, public policy, diplomacy, and international politics and economy.