When the Universal Health Coverage Day was celebrated this year with the slogan ‘Build the world we want: A healthy future for all’, the healthcare scenario in Bangladesh remains disappointing.
Even our constitution recognises improving people’s nutritional level and public health as one of the primary duties of the state. But the truth is that even after 51 years of independence, we haven’t been able to ensure healthcare for all citizens.
Many are finding themselves unable to get treatment due to lack of money while many others are falling victim to wrong and maltreatment.
According to Prothom Alo report, there have been several improvements in the healthcare sector of Bangladesh over the past decade like the reduction of maternal and child mortality rates, improvement of child nutrition and increase in children’s vaccination rates etc.
In their report from 2010, World Health Organization had talked about equity in case of financing in the health sector.
It was stated there that people will bear the cost of treatment during sickness, according to their capability. No one has to be at financial risk in seeking healthcare.
But when it comes to Bangladesh, the reality is that 24 per cent of the families are falling into a catastrophe in paying up the medical expenses.
This rate is the highest among our neighboring countries with Bhutan holding the lowest rate. Only 1.8 per cent of families of that country finds themselves in such crisis.
In India the rate is 16 per cent, in Myanmar it is 14 per cent and in Nepal it is 10 per cent. In other countries the rate remains below 6 per cent.
If a household has to spend more than 10 per cent of its income on healthcare, it is called catastrophic health cost. If medical expenses are high, many people become poor while many others go destitute.
The number of people who have become destitute seeking healthcare in Bangladesh isn’t that low either. What’s even more worrying is that, people stop seeking medical care when the cost of treatment is high.
In Bangladesh, the per capita income of people has increased, but the cost of living has increased manifolds compared to the rate of income going up. There are even examples of many becoming completely broke in meeting the medical expenses, especially.
The rich ones of the society can afford to get treatment abroad or in reputed private hospitals of the country by spending extra money, they even do so.
But the overflowing government hospitals with almost no room available are the only hope for the poor and lower middleclass people. It’s even more difficult to access healthcare at the government hospitals and upazila health complexes, outside of the big cities.
There is no required number of physicians, nurses and technicians present in many upazila health complexes.
Then again, examples of people losing everything and being cheated while seeking medical care at private hospitals and clinics are not so low either.
Even after the flaws of Bangladesh's health care sector appearing loud and clear during the Corona period, no news of any effective measures being taken in this sector can be found.
Health experts have emphasised on increasing government allocation to the health sector as well as on improving the manpower and infrastructure to achieve universal health coverage. Currently, about 6 per cent of the national budget is allocated in the health sector.
According to experts, this allocation should be doubled to 12 per cent. Because spending on health is also a big investment for the future.
So, in addition to increasing the allocation, there has to be strong monitoring on where and how that allocation is being spent. The matter of bringing all the people of the country under the coverage of health insurance also has to be seriously considered.