Social safety programmes can protect against medicine costs

Only 22 per cent of children in the country’s cities receive vaccinations, while 24 per cent of children in urban slums are stunted.

In some cases, life-saving medicines are not available in urban hospitals. So, a separate social safety programme needs to be formulated to protect people from medicine expenses.

Economists, public health experts, and health researchers made these remarks at a national dialogue titled “Urban Health and Engagement of the Private Sector” held at the CIRDAP auditorium in the capital on Monday.

The dialogue was jointly organised by the non-government organisation Eminence Associates and Social Development and the Bangladesh Urban Health Network, with support from UNICEF and the Swedish Embassy.

Noted economist and former adviser to the caretaker government Hossain Zillur Rahman attended the event as the chief guest.

Citing a recent study, Hossain Zillur Rahman said that 52 per cent of households in the country have patients with chronic diseases. These families will have to continue buying medicines for a long time.

He recommended introducing a social programme to protect such families from medicine expenses.

Hossain Zillur Rahman further said just like other social safety programmes, there is a need for a safety programme in the health sector. This would ensure people’s medicine security.

According to him, there is a lack of speed in almost all sectors of the country, including the implementation of reform proposals. The country is moving forward, but at a slow pace. This is like a luxury. What is needed at this time is speed. That demand is not being met.

He further said that filling the 40 per cent vacant posts would immediately bring momentum to the health sector, and, for this, no reform is necessary.

In the first presentation, Md Shamim Haider Talukder, chief executive officer of Eminence Associates and Social Development, said that India, Kenya, and Thailand have achieved success in improving urban health. But there are gaps in urban health in Bangladesh.

He said 66 per cent of children in urban areas of the country receive healthcare services, compared to 95 per cent of children in rural areas. Ninety-three per cent of rural children receive vaccinations, while only 22 per cent of urban children do. On the other hand, 83 per cent of rural children are under family planning services, compared to only 39 per cent in urban areas.

In the second presentation, Ahmed Ehsanur Rahman, scientist at icddr,b and member of the Health Sector Reform Commission, said that the health of people living in slums is poor, in some indicators even worse than rural people. 

As an example, he said that according to the latest national survey, 22 per cent of children under five in villages are short for their age. In urban slums, it is 34 per cent.

Presenting information on medicine availability in urban hospitals, Ahmed Ehsanur Rahman said that in the latest health facility survey, the medicine oxytocin, used to save mothers’ lives, was available in 27 per cent of district hospitals. On the other hand, for the treatment of children’s pneumonia, amoxicillin was available in 39 per cent of urban hospitals, compared to 95 per cent of rural health centres.

Presentations by Shamim Haider Talukder and Ahmed Ehsanur Rahman highlighted that, in several primary health indicators, the situation in urban areas is worse than in villages. In some cases, conditions in urban slums were found to be even poorer than those in rural communities.

Demanding an increase in the health sector budget, Professor Syeda Sayeeda Akhter, president of Bangladesh Medical Research Council and member of the Health Sector Reform Commission, said, “We are not seeing the implementation of the reform commission’s recommendations in the health sector. This is unfortunate.”

Ziauddin Haider, adviser to the BNP chairperson and former World Bank nutrition specialist, said that the BNP is considering introducing a single health card for every citizen in the country.

Taking part in the open discussion, several speakers alleged that the primary health situation in urban areas is poor due to a lack of understanding between the Ministry of Health and the Ministry of Local Government.

Some said that public health problems cannot be solved with a clinical mindset. Others said that the entire authority for urban health services should rest with the Ministry of Health.

Participating in the discussion, Professor Syed Abdul Hamid of the Institute of Health Economics at Dhaka University said that it is not possible to provide health services in cities by excluding the Ministry of Local Government.

Professor Shakhawat Hossain, dean of the Dental Faculty of Bangladesh Medical University; Zahidul Islam, health adviser of the Swedish Embassy; and Professor Syed Akram Hossain, member of the Health Sector Reform Commission, among others, spoke at the event.

Kazi Saifuddin Bennoor, convener of the citizen organisation Healthy Bangladesh, moderated the event.