Among the SAARC countries, Bangladesh is ahead of India, Pakistan, Bhutan, Nepal and Afghanistan, but below Sri Lanka and the Maldives, when it comes to health care indicators. Should this ranking inspire hope or disappointment?
In the study released by the British medical and public health journal Lancet on Saturday, Bangladesh ranked 133 among 195 countries. India, Nepal and Pakistan ranked 145, 149 and 154 respectively. Sri Lanka and the Maldives were 71 and 72 in the rankings respectively. Iceland topped the list.
Other international studies also touch upon Bangladesh’s success in health services. It is a great leap forward in comparison to the post independence period or the seventies and eighties. But we cannot be complacent and halt here. A study titled Global Burden of Diseases states India’s health care quality has improved since the nineties. In 1990 its score was 24.7. Its 2016 its score scaled up to 41.2.
The Lancet study states, Bangladesh, Myanmar, Bhutan, Cambodia, Laos and Rwanda are among the countries that did initially well in the health sector from 2000 to 2016. The director general of the health directorate has expressed satisfaction about Bangladesh’s position. Bangladesh has made progress in the health sector but there is no room for complacence. It is very important to determine what is to be done now onwards. The health secretary has spoken about starting up a National Health Care Quality Assurance Cell. It is to be seen what such a cell can contribute to improving the quality of health care for 170 million people.
This year the slogan for World Health Day was ‘Universal Health Coverage: Everyone, everywhere.’ First we have to admit that we haven’t been able to take health services to everyone. The government may claim success in taking community clinics to each and every union, but a large number of people still remain outside of these services. We feel that it is most important for the government to first bring each and every man, woman and child under health care coverage.
Along with health care, proper nutrition is also imperative. No one may die from starvation anymore in Bangladesh, but it cannot be said that everyone has access to nutritious food. Maternal mortality and child mortality rates may have fallen, but malnutrition remains high.
For health services to reach everyone, people’s standard of living must also improve. Where 22 per cent of the people are living below the poverty line, it is certainly difficult to imagine that health care reaches everyone. The government’s health workforce and infrastructure is inadequate. The common people cannot afford the steep costs of private hospitals. The government hospitals are overcrowded. Along with infrastructure, the number of physicians and nurses must also be increased.
Towards the end of the nineties, the popular slogan had been ‘health for all by 2020.’ The millennium development goals also laid stress on health. If the sustainable development goals’ commitment is to be fulfilled, then allocations to the health sector must be increased.