One in every three is victim of medical negligence: BBS survey

One in every three persons in the country has experienced negligence, carelessness and mistreatment in government or private hospitals. This rate is higher in cities than in villages. Around 91 per cent of the people in this country want that the government be legally bound to provide primary healthcare to all.

This opinion on country’s health sector came from respondents in the public opinion survey on the health sector reforms. The Bangladesh Bureau of Statistics (BBS) conducted this national survey at the request of the concerned reform commission.

BBS submitted the initial survey report to the health sector reform commission on 18 February. The survey reveals various pictures related to the health sector including where people go to seek medical care, how many people go abroad for treatment, their views about medicines and more.

The health sector reform commission is working under the leadership of national professor AK Azad Khan. The commission is supposed to submit their report to the chief adviser of the interim government on 31 March.

Professor Abu Mohammad Zakir Hossain, a member of the health sector reform commission, told Prothom Alo that the survey came up with highly valuable and important opinions. The statistics and opinions found in the survey have further strengthened and supported the thoughts of the commission members for health sector reforms. The reform commission report will have a reflection of the public opinion.

The BBS conducted the survey on 8,256 households in urban and rural areas across 64 districts of the country during January and February this year. The survey collected opinions of one male or female member aged 18 years and above from each household. Public health experts assisted in creating the questionnaires used during this survey.

In Bangladesh, complaints of medical negligence are reported in all types of hospitals and clinics, both public and private. The survey has come up with specific statistics on this matter.

As much as 38 per cent of the people in this country fall victim to negligence, carelessness or maltreatment while seeking medical care in hospitals. Around 36 per cent people from rural areas and 44 per cent from urban areas have raised these complaints.

The rate of complaints are almost equal for women and men. These complaints have been found equally among people of all age groups. Regardless of gender and age, the complaint rate is the highest in Mymensingh division with 44.2 per cent and the lowest in Khulna division with 32.3 per cent.

However, there is a lack of awareness among people about reporting such complaints. In the survey, 65 per cent of the respondents said that they do not know where to report a complaint while, 11 per cent of the respondents have zero idea about this issue. However, 24 per cent of the respondents said that they do know where to report a complaint.

The awareness rate is higher among men and city dwellers than among women and village residents. Notably, any complaint of negligence, carelessness or maltreatment while seeking medical care should to be reported to the Bangladesh Medical and Dental Council (BMDC).

As much as 62 per cent of the respondents of the survey said that they have sought medical services from government hospitals or healthcare centers in the past year. The rate of seeking medical services from government hospitals is higher in villages than in cities.

Among government hospitals, the highest number of people goes to seeks treatment from Upazila Health Complexes. The survey shows that 38 per cent of the respondents have reported seeking treatment from Upazila Health Complexes.

Next comes Zilla Sadar Hospitals and Government Medical College Hospitals with respective rates of 27 per cent and 25 per cent people seeking treatment there. Besides, a significant number of people (20 per cent) seek services from community clinics also.

However, people simultaneously seek medical services from different government institutions as well as from private hospitals, clinics and NGO operated institutions. The number of people seeking treatment in private hospitals and clinics is way higher than that of NGO-run facilities.

Statistics show that people go to community clinics the most when it comes to seeking services frequently. The respondents of the survey have reported visiting the community clinics seven times a year on average. On the other hand, people talked about visiting private hospitals or clinics on average four times a year.

The issue of Bangladeshi patients seeking treatment abroad is a major aspect of weakness in the health sector. However, there were no accurate statistics on how many people go abroad for treatment. The survey states that 2.4 per cent of the respondents said that they themselves or another member of their family has gone abroad for treatment in last five years.

The respondents mentioned going abroad seeking treatment for 11 diseases or conditions. These are cancer, cardiovascular disease, kidney disease, infertility, diabetes, road accidents and burns, orthopedics, vision impairment, neurological disease, mental issues and respiratory problems.

The maximum number of people travels abroad for treatment of cardiovascular diseases. As much as 29.8 per cent of the people who seek treatment abroad go there for cardiovascular treatment. After that, 17.3 per cent people go abroad for kidney disease treatment and 14.8 per cent people go for cancer treatment.

During the survey it was asked whether the respondents support the idea of ​​pharmaceutical company representatives meeting physicians at their chambers. As much as 67 per cent of the respondents said they do not support the idea while 28 per cent said they are in favour and the remaining five per cent said they have no opinions about it.

In response to the question, whether the physicians should write the generic names or the company-labeled names of medicines on their prescription, 44 per cent of the respondents said it should be the generic names while 17 per cent opted for the company-labeled names. However, 32 per cent of the respondents said that the generic and the company-labeled names both should be written on the physician’s prescriptions. Seven per cent of the respondents said they have no idea about it.

Irresponsible use of antibiotics has increased as the patients get antibiotics from the drug stores. The survey enquired whether the respondents support the sale of antibiotics in drug stores without the prescription from an MBBS physician.

As much as 27 per cent of them said that antibiotics may be sold at drug stores even without a prescription from an MBBS physician while, 71 per cent of them did not support the idea and the remaining two per cent said they have no knowledge about this.

More than 13 per cent of the respondents stated that the price of medicines ranges from high to very high in the country while, 84 per cent think that medicines are available at affordable prices in the country. Three per cent of the respondents had no idea about this and some respondents expressed their reluctance to answer this question.

The public complains that the physicians do not spend much time on attending patients. When the respondents were asked to state clearly how much time the patients want the physician to spend on them, 28 per cent said that a physician should spend at least 20 minutes on each patient in the outpatient department or chamber. Then, 26 and 19 per cent of the respondents respectively suggested 15 minutes and 10 minutes.

Meanwhile, 23 per cent of them said that it should be at least 25 to 30 minutes. Only, four per cent of the respondents said that it’s still okay for a physician to spend five minutes or less on attending one patient.

Experts have long been saying that the healthcare is a vital sector. In order to achieve universal health coverage, countries like Bangladesh need to allocate at least five per cent of the GDP to the health sector. However, the government allocation to the health sector is only one per cent or slightly higher in our country.

As much as 88 per cent of the respondents in the survey talked of increasing government allocation while, nine per cent of them said there’s no need for that. The remaining three per cent of the respondents did not have any opinion on this matter.

Our constitution categorises healthcare as a fundamental right. All citizens can avail services in government institutions. There’s no provision of legal action against the government if a person does not receive medical services. However, the issue of legal obligations has been in discussion for many years now. People were asked about their opinions on the issue in the survey.

As much as 91 per cent of the respondents said that access to primary healthcare should be a mandatory constitutional right. Four per cent of them replied in negative and the remaining five per cent had no opinion on this matter.

Public health experts believe that many important issues have emerged in the public opinion survey on health sector reform. Speaking on this matter public health expert Khairul Islam told Prothom Alo, “We have been raising many issues including budget increase for years.”

“The public opinion survey has revealed the pictures of many weaknesses of the health sector. People have also expressed the expectations of common public. Hopefully the report of the health sector reform commission will have a reflection of public opinion,” Khairul Islam added.