Even now, leading cause of child death in the country is pneumonia. More than 24 thousand children die of pneumonia in the country every year.
However, it’s possible to reduce deaths in number through a collective effort from both government-private organisatioons and individuals.
Government officers, specialist physicians and donor agency officials said this while participating in a roundtable titled ‘World Pneumonia Day: Unified Initiative Needed to Eradicate Pneumonia’, at the Prothom Alo office on Thursday.
UNICEF Bangladesh organised the roundtable jointly with Prothom Alo. The roundtable was held in keeping with 12 November, World Pneumonia Day. This year the day is being observed with the theme ‘Stop Pneumonia: Every Breath Counts’.
It was stated at the roundtable that in Bangladesh, many children die of malnutrition, fatal infection, neonatal tetanus, immature birth, birth injuries, newborn respiratory distress syndrome, diarrhoea and pneumonia.
Of them, pneumonia claims the highest number of lives. Pneumonia is the reason behind 18 per cent of child death. Pneumonia is a preventable disease. Yet, 24,300 children die of this disease every year.
President of national technical working committee for newborn health and child specialist professor Mohammad Shahidullah said, “It’ll be a sin if any children die because of oxygen scarcity.”
He added, if government agency EDCL starts producing dispersible tablet (DT), the crisis of this life-saving medicine will reduce. He also talked about ensuring pulse oximeters and nebuilizers at the hospitals.
Additional director general (administration) of the directorate general of health services (DGHS) Ahmedul Kabir said that pneumonia is not an isolated issue.
Without an integrated development of the healthcare system, pneumonia condition cannot be improved. For this the way of universal health coverage has to be accelerated and everyone has to work together.
Former director general of BIRDEM Hospital and child specialist Nazmun Nahar mentioned, a study done by Dhaka Medical College in 1990 showed that mothers delay in bringing their pneumonia affected children to hospital.
Even now, the situation remains the same. The exact reasons behind this should be explored. She also said though the number of children dying of pneumonia is available, no records can be found on how many children are being affected by this.
Participating in the discussion, Maya Vandenent, chief of health, UNICEF Bangladesh, said that Bangladesh has reduced child mortality as well as child death from pneumonia.
There is a monopoly business going on in the manufacture and marketing of pneumonia drugs. And, this needs to end, said deputy project manager of newborn and child healthcare programme of DGHS Md Jahurul Islam.
The deaths still occurring are preventable. However, it’s not the job of DGHS alone.
Water and sanitation, exclusive breast feeding until six months and complementary feeding thereafter as well as environmental health issues need to be addressed, she added.
She further said that UNICEF is assisting the government in strengthening oxygen supply system and hypoxia treatment in hospitals.
She stressed on developing a trained and quality workforce for primary healthcare at community clinics and union clinics. and, high level commitment is required for pneumonia control.
Towards the beginning, deputy project manager of newborn and child healthcare programme of DGHS Md Jahurul Islam presented the concept paper of the roundtable.
He said that malnutrition, air pollution and low birth weight increase the risk of pneumonia. 28 per cent of the children under the age of five in the country are shorter for their age. Meanwhile, 50 per cent children are beyond primary healthcare coverage.
Pointing out some setbacks of pneumonia treatment he said, there is a monopoly business going on in the manufacture and marketing of pneumonia drugs. And, this needs to end.
Meanwhile, 60 to 70 per cent people seek treatment in private hospitals and clinics. But, data on pneumonia cannot be acquired from private institutions, he added.
Executive director of NGO Projahnmo Research Foundation Salauddin Ahmed commented, there is a lacking in the guideline used for the treatment of pneumonia in the country.
He added, more money should be allocated in the research of pneumonia. And based on the research, specific measures have to be taken in Bangladesh to deal with pneumonia.
Sabbir Haider, manager of DGHS’s community based health care programme said that awareness activities on pneumonia are conducted from more than 14 thousand community clinics.
There are pulse oximeters in the community clinics. In future, nebulizers will also be provided in all community clinics, he added.
World Health Organization's national consultant on maternal and child health Nurul Islam Khan said that arrangements have to be made for the hospitals and clinics to be prepared so that treatment can begin right away whenever any serious pneumonia patients arrive.
The blood oxygen level of a pneumonia patient drops down at a point. This situation is called hypoxaemia. The patient then suffers from breathing problems.
Muhammad Shariful Islam, project manager of DGHS’s national newborn health programme and integrated management of childhood illness (NNHP and IMCI) said, pulse oximeters are very useful for measuring oxygen level.
He added that special emphasis has to be put on making sure that no child dies for not knowing the oxygen level.
Acting line director of DGHS’s maternal, neonatal, child and adolescent health (MNC&AH) programme Azizul Alim said that the work of creating a database on pneumonia will be completed within this year.
Taking part in the discussion deputy director (services) and programme manager (newborn), MCH-Services Unit, DGFP Farid Uddin Ahmed said there’s a manpower crisis in various institutions of the directorate general of family planning.
He added that it’s crucial to ensure that all public and private hospitals follow the same guidelines in treating pneumonia.
On the opposite, acting line director of DGHS’s maternal, neonatal, child and adolescent health (MNC&AH) programme Azizul Alim said that the work of creating a database on pneumonia will be completed within this year.
Health specialist at UNICEF Bangladesh Shamina Sharmin said, the MOHFW is developing its next health sector plan (HPNSP), so this is the right time to develop a unified comprehensive plan for pneumonia prevention and management.
Different operational plan of MNCAH, national nutrition programme, EPI, CBHC, upazila health care, water and sanitation (WASH) and climate change department should come together so that all the risk factors for pneumonia can be prevented, she added.
Feroz Choudhury, assistant editor at Prothom Alo moderated the roundtable.
The keynote presentation stated that pneumonia control strategy paper, improvement of primary healthcare, increased allocation in health and nutrition sector, good governance in health sector, increased vaccination coverage, donor’s cooperation, private sector’s engagement, partnership of all parties along with research can help improve the pneumonia situation.