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Public health care needs to be restructured

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BANGLADESH has walked a long way to attain its health outcome expectations although bumps exist at the ground level and they are encountered now and then. Its health achievements are, in fact, spectacular in comparison with the allocations and expenditures made in the sector historically, as may be seen from the budgets made in the regional countries in or up to 2018.

Human resources for health

BANGLADESH has about six physicians per 10,000 of the population or 0.6 per 1,000. This makes the absolute number to be slightly more than one hundred thousand in total. A government-sponsored study, however, puts it at about 77,000. The total number of registered nurses is almost equal to that of the physicians, but the number of paramedics is abysmally low. The overall density in aggregate of all categories of health workers is 33.17 per 10,000 people — 3.32 per 1,000 people. Of these, 17.6 per cent, including clinicians, works in the public health sector while 82.4 per cent work in the private sector.

The global median for health workforce density is 48.6 per 10,000 people. Among 47 countries which fall below this median, Bangladesh is one. Two ratio-based WHO indicators are pertinent — one is the ratio of healthcare providers to population, which is 1.28 per 1,000 people, for addressing at least 80 per cent of the maternal and child healthcare needs and the other is 4.45 healthcare providers per 1,000 people to attain at least 80 per cent of the 12 health-related SDG targets and universal health coverage that Bangladesh is a party to. A 2006 report of the World Health Organisation suggests a physician, nurse and paramedic ratio to be 1:3:5. Another WHO analysis in 2016 suggested an increase in the number of physicians by 68 per cent, of nurses by 83 per cent and of other healthcare providers by 70 per cent in the South-East Asiam region. If the ratio of 1:3:5 is applied, it comes to 0.14, 0.43 and 0.71 of physicians, nurses and paramedics per 1,000 people for the required level of maternal and child health care. Bangladesh seems to have attained an adequate number of physicians keeping to this indicator, but an adequate number of nurses and paramedics. However, if the 12 SDG targets are considered, even the number of physicians is not adequate for Bangladesh.

Source: https://www.newagebd.net/article/157438/public-health-care-needs-to-be-restructured