BD achieves success in health care despite acute poverty: Lancet

Bangladesh has achieved a remarkable success in healthcare contributing a significant improvement in the survival of under-fives, immunisation coverage and tuberculosis control, according to British medical journal The Lancet.

Describing various successes The Lancet Bangladesh series said the country should put more effort to address the poorly-equipped public health sector which, although free to the poor, faces a reported shortage of 0.8 million doctors and nurses.

Bangladesh pushes four to five million people into poverty every year as they have to pay for health services directly due to the growth of an unregulated private sector.

These were revealed during a press briefing on the launching of the special Lancet Series on Bangladesh Thursday at a city hotel.

According to the new series, despite low spending on health care, a weak health system, and widespread poverty in Bangladesh, exceptional improvements in the survival of infants and children under 5 years, life expectancy, immunisation coverage, and tuberculosis control in Bangladesh are part of a remarkable success story for health in the South Asian country.

It, however, marked less successful attempts in improving poverty, maternal and child malnutrition, and access to primary care.

“The stark reality is that prevalence of malnutrition in Bangladesh is among the highest in the world. Nearly half of children have chronic malnutrition. Moreover, over a third of the population (more than 47 million) live below the poverty line, and income inequality is widening”, said series co-leader from International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) representative Professor Abbas Bhuiya.

He pointed out that every year 4-5 million people are pushed into poverty because they have to pay for health services directly, partly due to the rapid growth of the unregulated, low-quality, high-cost private sector.

“Arguably the most daunting challenge is the health of poor people living in urban areas”, said Series co-leader Professor Mushtaque Chowdhury from BRAC.

“In the last 40 years, the proportion of the population living in urban areas has risen from around 5.0 per cent to 28 per cent. This is projected to grow to more than 50 per cent by 2050-roughly 100 million people-putting tremendous pressure on already inadequate water, sanitation, and primary health-care services.”

Despite significant progress, the nation still faces considerable problems, including deep poverty and malnutrition, and this is being exacerbated by an evolving set of 21st-century challenges (eg, massive and rapid urbanisation, an upsurge in chronic and non-communicable diseases, and increasing vulnerability to climate change), said the series.

The six-part Series takes a comprehensive look at one of the “great mysteries of global health”, investigating a story not only of “unusual success” but also the challenges that lie ahead as Bangladesh moves towards universal health coverage.

“Over the past 40 years, Bangladesh has outperformed its Asian neighbours, convincingly defying the expert view that reducing poverty and increasing health resources are the key drivers of better population health”, explains Professor Chowdhury

“Since 1980 maternal mortality has dropped by 75 per cent, while infant mortality has more than halved since 1990, and life expectancy has increased to 68.3 years-surpassing neighbouring India and Pakistan.”

According to the Series, what sets Bangladesh apart is its pluralistic health system in which many stakeholders including the private sector and non-governmental organisations (NGOs) have been encouraged to thrive and experiment. This has led to rapid improvements in access to essential services such as diarrhoea treatment, family planning, vitamin A supplementation, and vaccination coverage.

Source: The Financial Express