Maternity, infant and family planning services have decreased by 50 per cent due to the outbreak of coronavirus in Bangladesh, the United Nations has said.
Experts have warned that there is fear of the health situation worsening further unless concerted initiatives are taken up in a planned manner.
Even before the first wave of coronavirus infection has ended, there are talks of a possible second wave.
Prime minister Sheikh Hasina on Sunday sounded a warning that coronavirus is likely to worsen in winter.
In the virtual cabinet meeting on Monday , she asked the administration to take preparations to tackle the second wave of coronavirus.
Earlier, the National Technical Advisory Committee on COVID-19 expressed concern over the risk of a second wave of coronavirus infection.
The risk of mental health is increasing due to isolation, economic pressure and violence against women. The gap between the demand for health service and the delivery has widened
At a meeting on 18 September, the committee observed that communications between different countries are resuming on the one hand, and the people are ignoring health rules for coronavirus on the other. So there is a fear of coronvirus recurring in the country.
Health expert and member of Public Health Advisory Committee at the Directorate General of Health Services, Abu Jamil Faisal said, “The right task was not been at the right time to control the coronavirus infection. Now we have to place emphasis on wearing masks and following hygiene rules, otherwise harm done to the health sector will worsen further.”
The United Nations in a report titled “Immediate Socio-Economic Response to COVID-19’ has depicted a gloomy picture of damages caused by coronvirus in Bangladesh.
UN resident coordinator Mia Seppo in the introduction of the 118-page report said Bangladesh's economy has been hit by the coronavirus pandemic.
Crisis in health
According to UN, Bangladesh has gradually made progress in essential health services and nutrition in the recent years. The country has improved from 32 per cent to 54 in the index of universal health coverage. Bangladesh has also made progress in prenatal care.
But still there are deficiencies in delivering service complying to international standards. In the case of deaths under five years old, 60 per cent of the infants die before 28 days. Before the outbreak of coronavirus, the main cause of child mortality was pneumonia.
The entire health system was suddenly engaged in treatment and management of COVID-19. Physicians, nurses and health workers are engaged in tackling coronavirus and many of them are infected. When fear of coronavirus infections spread, people refrain from seeking health services. The use of medical equipment dramatically decreases.
As per UN report, as many as 41,271 infants were delivered at different hospitals in January. The number decreased to 17,237 in May.
Some 252, 567 patients with cough and pneumonia came to hospitals for treatment in January whereas the number decreased to 52,476 in May. Family planning services are also hampered. The distribution of birth control pills and condoms has decreasesdin the field. Services for newborns decreased by 31 per cent while prenatal services by 33 per cent. The rate of admission of children with high malnutrition decreased by 73 per cent. HIV services decreased by 86 per cent.
UN said violence against women has increased, but no statistics have been given. The risk of mental health is increasing due to isolation, economic pressure and violence against women. The gap between the demand for health service and the delivery has widened.
Speaking to Prothom Alo, a health and family planning official of an upazila adjacent to Sundarbans, said fear spread in the beginning of coronvirus outbreak. The number of patients decreased in the hospital, and physicians and nurses were reluctant in delivering services. This situation remained in May-June, but things have improved now.
What is the government doing?
Health division secretary Abdul Mannan said the measures to tackle the second wave of coronvirus and possible outbreak in winter will be discussed at an inter-ministerial meeting on Tuesday.
The officials said the government has appointed 3000 nurses and 2000 physicians to tackle the situation. Besides, steps have been taken to recruit 3000 medical technologists.
Two projects are being implemented at a cost of Tk 17 billion funded by WB and ADB. Besides, the government is formally contacting different countries for vaccines.
When asked about the steps by the government, DGHS acting DG Abul Bashar Mohammad Khursid Alam said they are working to increase the number of tests and health facilities at the hospitals.
The UN recommends 12 steps in the health sector during the coronavirus and post-COVID-19 period.
The steps are: Promoting rights-based approach to health services during and after COVID crisis, determining the needs of the health workforce, strengthening Bangladesh’s Health Resources Information System, initiating a review of the health financing strategy, and introducing health financing options for vulnerable populations to advance progress to Universal Health Coverage, strengthening infection prevention mechanism and referral systems, streamlining appropriate use of and access to quality drugs, medical equipment, vaccines and diagnostics, developing data intelligence systems for real-time tracking, predicting and modeling, strengthening data governance for evidence-based policy making, establishing monitoring and mentoring system for quality MNCAH services, developing digital training platforms on health, integrating waste-management and WASH plan in the next national health strategy and preparing a proof-based nutrition policy.
National Technical Advisory Committee on COVID-19 president professor Mohammad Shahidullah said there are risks, despite some improvement in maternity, child and nutrition services following some steps in May and June. "We have to bring some changes to our plans in the health sector, and to focus on prevention of infection. The public awareness campaign must continue."
This column appeared in the print and online editions of Prothom Alo and has been rewritten for the English edition by Rabiul Islam