Go for major reform, not just small-scale health initiatives

Health experts and professionals yesterday suggested that the new government undertake major institutional reforms in the health sector from the start; otherwise, small-scale initiatives would not be sustainable.

The comments came at a dialogue titled “Actionable Priority Agendas for Achieving UHC” at CIRDAP auditorium, organised by Power and Participation Research Centre (PPRC) and the Universal Health Coverage (UHC) Forum with Unicef’s support.

The country has an extensive health infrastructure that is trapped in low productivity with the service coverage index at 54 percent only.

Hossain Zillur Rahman Executive chairman, PPRC

Speakers also asked to remove barriers holding back service delivery in the health sector and to place greater emphasis on primary healthcare to achieve UHC by 2030.

Aminul Hasan, member secretary of the UHC Forum, said the sector is facing several system constraints, including high out-of-pocket expenditures, fragmented service delivery systems and weak referral systems.

Bangladesh will not be able to achieve UHC without reforming the existing system, he added.

Public Health Expert Mushtuq Husain said the government has to go for major institutional reforms like forming a permanent health commission and a separate directorate for public health and health services.

Hossain Zillur Rahman, executive chairman of the PPRC, said the country has an extensive health infrastructure that is trapped in low productivity with the service coverage index at 54 percent only. Although, our health sector is underfunded, a significant amount of annual budget allocation remains unused.

He suggested proper integration of three key organisations -- union sub-centres, family welfare centres and community clinics -- and to immediately fill the 40 percent vacancy at the field level.

MA Muhit, state minister for health ministry, said the recommendations presented here are mostly identical to those outlined in BNP’s manifesto and the government has already formed a special cell to implement the manifesto.

The government will introduce e-health card and appoint one lakh health workers in primary healthcare in phases, he added.

Prof Syed Abdul Hamid of Institute of Health Economics; Prof Syed Akram Hossain, a member of the Health Sector Reform Commission and Prof Abul Kalam Azad, former director general of DGHS, gave presentations.