Health care centres not ready to deliver required services


The public and private health care centres across the country are not still ready to deliver necessary services to the people, reveals a study commissioned by National Institute of Population Research and Training (NIPORT).

The survey report says only four per cent of the public and private health care centres and clinics have available technical support to carry out basic tests to diagnose diseases.

Just one-third of the health centres keep six essential drugs while 78 per cent of the centres cannot deliver family planning services.

‘Bangladesh Health Centres Survey-2017’ by NIPORT reads that the situation has rather deteriorated in some areas including drug supply and prenatal health care services in comparison to 2014.

As a result, the child mortality rate continues upward. As the contraception services lack quality, the curve of using contraceptive methods slumped downward, giving a rise to the rate of birth.

Asked about the matter, Bangladesh Medical Association’s former president Rashid-e-Mahbub told Prothom Alo that the government wrongly believed that the presence of physicians will ensure services. The system for hospital management and logistics supply is weak. There is a scarcity of human resources and a lack of proper monitoring.

When informed about the research findings, the Directorate General of Health Services’ director general Abul Kalam Azad questioned the results of the study.

He told Prothom Alo that the environment at the hospitals and clinics was not that to bad. If it was that bad, Bangladesh could not have advanced in the global health index.

However, the facts about the hospitals and clinics were collected from 1,524 institutions between 30 July and 19 October of 2017. The list includes community clinics, union health centres, union health and family planning centres, upazila health centres, mother and child care centres, district hospitals and medical college hospitals. But, specialised and private hospitals were out of the purview of the study.

The study was also conducted on certain private and NGO-run hospitals and clinics. The researchers interviewed 5,000 health officials.

The research report shows some positive improvements in supply of water and electricity, number of washrooms and maintaining confidentiality of the patients.

Infrastructure and management
The survey report shows each and every institution promises to give prenatal and postnatal medical support, treatment for ill children, child health care and nutrition guidance. But, only 28 per cent of the institutions have the necessary technical support to provide the services.

The survey report also said only 4 per cent of the health care centres had capacity to perform necessary medical tests like blood tests, urine tests and pregnancy tests.

Newborns and child care

The government often says it wants to increase normal deliveries. But the study shows the government’s initiatives for the normal deliveries are not enough.

World Health Organization (WHO) suggests, to facilitate normal deliveries, a health institution must have 13 types of technical support. But, only one per cent of the health centres have that capacity. On the other hand, many institutions do not have lifesaving medicines and technical support for newborns and mothers.

The study also states that a health centre must have six drugs – Amoxicillin syrup, paracetamol syrup, vitamin A capsules, Albendazole, zinc tablet and oral saline.

But, only 33 per cent health centres have capacity to provide the six necessary medicines. The number of health centres is much lower than that of 2014. The percentage was 42 in that year. Though, the child treatment capacity of the health care centres has increased since 2014.

Family planning and prenatal services

The capacity of a family health care centre depends on some basic issues. A family health care centre must have printed family planning guidelines, at least one trained medical officer, blood pressure monitor and fertility control tools.

But, only 22 per cent of the health centres have the necessary preparations.

Each of health centre provides women antenatal medical services, but many institutions do not have the printed medical guidelines.

As high as 10 per cent institutions lack necessary prenatal health care services.

Despite a spike in preparations for health services at the union level, the situation did not improve in 2017 than that of 2014.

The NIPORT study was technically supported by an American institution ICF while International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) assisted supervising the field works and data collection.

Bangladesh government and USAID funded the study. The health survey was earlier conducted in 2009, 2011, and 2014.