Ensure health services for marginal people

A resolution on community-based healthcare has been adopted unanimously for the first time in the United Nations. This is an achievement for Bangladesh as well. The proposal titled 'Community Clinic Based Primary Health Care Services: A Unique Participatory Approach to Universal Health Coverage' is a community clinic based model run under the public-private partnership in Bangladesh.

A press release sent by the Permanent Mission of Bangladesh to the United Nations on 17 May said that the United Nations has recognised prime minister Sheikh Hasina's outstanding innovative leadership in establishing a community clinic-based model of primary healthcare in Bangladesh. Earlier, a World Health Organisation pamphlet termed community clinics a revolution in the health sector.

Notably after coming to power in 1996, the Awami League government decided to build a total of 18,000 community clinics, one for every 6,000 rural people across the country. Prime minister Sheikh Hasina first inaugurated this clinic on 26 April 2000 in Gimadanga village of Patgati union of Tungipara upazila of Gopalganj.

As many as 10,723 infrastructures were built and about 8,000 community clinics came into operation by 2001. Then the BNP-Jamat coalition government came to power in 2001 and stopped the operation of community clinics. In 2009, Awami League came to power again and resumed the work of building community clinics. A total of 14,158 community clinics have been completed and 14,127 community clinics are delivering primary health, family planning and nutrition services at present.

The main feature of the community clinic is, it is a successful joint initiative by the government and the people, under which the local residents provide the land and also play a role in the management of the institution. On the other hand, the government bears all the expenses of running the clinic including the appointment of staff. The clinic offers healthcare for mothers, newborns and children under an Integrated Management of Childhood Illness (IMCI), reproductive health and family planning services and treatment for general injuries.

Each clinic has immunisations facilities for children and mothers. Non-contagious diseases such as diabetes or hypertension are diagnosed in the clinic. It also provides education on nutrition beside health education. The health workers provide symptom-based treatment and counselling to the elderly, adolescents and the people with disability. Children are provided with micronutrient packets from the clinic in addition to essential medicines. Last March, the prime minister also directed community clinics to provide free insulin to diabetic patients.

Global recognition of such a great initiative in healthcare will be considered as a great achievement for Bangladesh. But this is not the end. There is a long way to go. World Health Organisation's Alma-Ata Conference declared 'Health for All' by 2000 in 1978. It has not been implemented in many countries including Bangladesh.

Despite the success of the community clinic project, the overall condition of the health sector is not very pleasant. The government has announced to provide healthcare for all by 2030. But for implementing that, the manpower and infrastructural facility of the upazila health complexes should be expanded in addition to enhancing community healthcare facilities to the remote areas. The marginalised people in both rural and urban areas should benefit from the healthcare service. The allocation in the health sector should be increased for that and proper utilisation of that fund should be ensured.