Status of Bangladesh Public Healthcare System in the World -Zannatul Mouwa Naz
The concept of world health is born from the concept of public health. Public health refers to the well-being of a community. When it comes to world health, there are a few things that need to be clarified at the outset. For example, we need to understand Public Health, International Health and Global Health. Public health is simultaneously called science and industry. The concept of international health was introduced during the colonial period in order to gain an idea about the disease in the colonies of Asia-Africa. But under the influence of globalization, the concept of international health has not survived. As a result, it became global health. Although the term World Health is used interchangeably, the terms International Health and World Health are used interchangeably. There are several reasons why we need to think about world health. Such as: ensuring equality among all countries of the world; Humanitarian assistance to reduce maternal, infant and maternal mortality rates; Direct effects of diseases like SARS, bird flu, AIDS; Global security questions and mutual knowledge, exchange of experiences. In the historical context of world health, health and medical communication has taken place between the colonial powers and the colonies in two ways the preaching of Christian missionaries and the influence of the colonial rulers. Since the colonial powers became independent, international organizations such as the World Health Organization (WHO) and UNICEF have taken steps to prevent and eradicate the disease. In the context of global health, Bangladesh has also made some progress in the health sector, such as: declining population growth rate, increasing average life expectancy, reducing maternal mortality rate, reducing infant mortality rate. But changes in the global environment have had an impact on local health in countries like Bangladesh.
We live in a discriminatory world. It has been found that 90 percent of the world’s health problems are in the region of the world, only 10 percent of the resources. Conversely, where there is only 10 percent problem, there is 90 percent wealth. This is called 90/10 division. For example, the population of Malawi, an African country, is 12 million. Now there is only one orthopedic surgeon in the whole country as of 2010. London, on the other hand, is a city with a population of 12 million, but this city alone has over 200 orthopedic surgeons. In Malawi, where the per capita expenditure on health is 3 dollars in Britain the per capita expenditure on health is 1,600. Or let’s say, in Nepal, the infant mortality rate is 55 per thousand, while in Britain, the infant mortality rate is only four per thousand. There are countless examples of global inequality. In order to protect the health of the people of the world, it is necessary to allocate money and resources in the health sector. To ensure a fair distribution in the global health sector, we need to think about global health.
Just as poverty causes disease, disease also gives birth to poverty. Outbreaks of tuberculosis, malaria, AIDS, etc. are on the rise in various countries, giving rise to poverty and unemployment. From this poverty and unemployment are born various political instability, people are leaving their country as immigrants, in many cases illegal immigration is increasing. Poverty in a certain country, unemployment is therefore becoming a threat to the security of another country. So, there is an indirect addition to the security of the world with the disease. If we want to think about world security, we have to think about world health. When it comes to world health, it will also affect the economic conditions of the poorer countries or the poorer regions of the rich countries, which will ultimately play a role in establishing world peace.
There have been several positive changes in the health sector in Bangladesh since independence. Bangladesh has made steady progress in some public health indicators over the last four decades. Since independence, Bangladesh’s population growth rate has been steadily declining, life expectancy has increased, maternal mortality rate has decreased, infant mortality rate has decreased. The biggest achievement in this case is to reduce the infant mortality rate. In the seventies, the number of infant deaths per thousand was 150, in 2006 it stood at 52. This rate is very significant in terms of South Asia. Even India, a country with a strong economy, has a higher infant mortality rate than Bangladesh. Bangladesh has proved that even if it lags behind in economic indicators, significant gains are possible in some public health indicators. This is an example for many developing countries in the world. The United Nations has rewarded Bangladesh for this achievement in preventing infant mortality.
In Bangladesh, besides the public sector, private sector, various NGOs and international organizations are working in healthcare. In the public sector, the Ministry of Health and Family Welfare acts as the apex body for policy formulation, planning and decision making at the individual and collective levels. The four departments under the Ministry are the Department of Health, the Department of Family Planning, the Directorate of Nursing Services and the Department of Drug Administration providing health services to the citizens. Bangladesh has done a great job on healthcare since independence. The government is working to formulate health policies to ensure the basic health facilities of all people, especially the underprivileged. The main goal of the Health, Nutrition and Population Sector (HNP) sector is to achieve sustainable development. National Health Policy, National Food and Nutrition Policy and National Population Policy are being implemented under the Ministry of Health and Family Welfare. NGOs have a significant role to play in health, nutrition and family planning services in both rural and urban areas. They mainly work in the field of family planning, maternal and child health. NGOs have recently expanded their services and are playing an important role in providing primary services in the city. Medicine policy formulated in 1972 has played an important role in restructuring the health sector of Bangladesh. Its main objective was to remove harmful, worthless and unnecessary drugs from the market and to ensure fair supply of essential medicines at all levels of healthcare. The successful implementation of the National Pharmaceutical Policy of 1972 has resulted in tremendous progress in the pharmaceutical sector in Bangladesh. In achieving the Millennium Development Goals (MDGs), remarkable achievements have been made in the field of health indicators such as reduction of infant mortality rate, immunization of infants and mothers, elimination of Vitamin A deficiency, etc. As Bangladesh lags behind in other indicators, concerted efforts need to be made to achieve the Millennium Development Goals.
The author of this article is an, Executive Editor of ‘The Environment Review’.