Merger of health divisions: Focus now on mid-, field-level integration

Following the merger of the health ministry’s two divisions yesterday, health authorities will now reorganise services at directorate and field levels to improve coordination and service delivery, officials said.

Under the plan, the entire health system will be divided into three parts -- clinical and hospital services, education and research, and primary and public healthcare -- with reorganisation beginning at the directorate level.

“We have already completed our homework in consultation with stakeholders. Implementation will now begin in phases. It will not be completed within two or three months, but we will initiate as much as possible,” said Prof Sayedur Rahman, special assistant to the chief adviser for the health ministry.

Earlier in the day, the National Implementation Committee on Administrative Reorganisation, with Chief Adviser Prof Muhammad Yunus in the chair, approved the merger of the two divisions. 

On October 29 last year, the pre-Nicar meeting recommended merging the two divisions.

The pre-Nicar, headed by the cabinet secretary, scrutinises proposals for forming new ministries, city corporations, municipalities, divisions, districts and upazilas, as well as approving manpower. 

It submits recommendations to Nicar, which is chaired by the chief adviser.

In March 2017, the government split the Health and Family Welfare Ministry into two divisions -- the Health Services Division and the Medical Education and Family Welfare Division -- to improve management of health services.

Various departments were reorganised under the two divisions, each headed by a secretary.

However, the split failed to deliver the expected benefits and instead led to deterioration in the functioning of both divisions, according to minutes of the pre-Nicar meeting. The committee therefore recommended merging the divisions to restore coordination and efficiency.

Contacted, Health Secretary Saidur Rahman said a committee headed by an additional secretary has been formed, comprising officials from both divisions, to begin the unification process.

The committee will determine how manpower at the ministry will be deployed and which functions need to be merged, he told this correspondent last night.

THE NEXT STEP

Prof Sayedur said the merger would help ensure better coordination, reduce duplication of services and simplify budgetary allocation.

“Merger at the top level was necessary because the previous split had bifurcated services all the way down to the field level. As a result, the entire health and family planning system had become completely divided. Yet proper service is not possible without integration,” he said.

He said a meeting on the unification process at the ministry would be held within two to three days, after which reorganisation would begin at the directorate general level.

Several directorates general -- including DG Health Services, DG Medical Education, DG Nursing and Midwifery, DG Family Planning and DG Drug Administration -- are currently operating under the two divisions.

Prof Sayedur said the entire hospital network, from upazila-level facilities to tertiary hospitals, would be brought under clinical and hospital services. All primary healthcare services in both rural and urban areas would fall under primary and public healthcare, while medical education and research would be organised as a separate stream.

He said at the field level, the work of health assistants, family planning assistants and community healthcare providers would be merged to deliver coordinated primary healthcare services.

The Health Sector Reform Commission, in a report submitted in May last year, also recommended forming a unified health service with three major sectors -- clinical, academic, and public and primary healthcare.