Rid public healthcare of chronic shortages and systemic failures

We find it unacceptable that severe shortages of essential medicines and non-functional equipment in diagnostic laboratories continue to wreak havoc in public health facilities across the country. A study by the Power and Participation Research Centre (PPRC), on behalf of the health ministry, has revealed a crumbling healthcare system with an acute crisis of trained personnel, inadequate medicine supplies, disrupted diagnostic services, and missing emergency supplies. This paints an alarming picture of the entire healthcare system.

The study, examining data from 22 public health facilities between August and October last year, found that despite the wide availability of routine medical supplies such as gauze, cotton, syringes, and gloves in public health facilities, many lacked critical emergency supplies, including tourniquets, bag-valve-mask resuscitators, and umbilical cord clamps. This makes little sense given that nearly 94 percent of the facilities ended the last fiscal year with unspent funds. Why weren’t these funds utilised to procure materials which hospitals and patients so urgently and regularly need?

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Furthermore, the findings revealed a worrying trend of a personnel crisis in the healthcare sector: nearly 40 percent—around 2,514 posts—of the sanctioned medical technologist posts remain vacant, contributing to at least 19 percent of the diagnostic service disruptions. The fact that vacancies continue to persist while our youth struggle with unemployment is puzzling and signals a lack of responsibility on the part of the government, which has failed to bridge this gap.

The study also found that laboratory availability and continuity fall drastically at tertiary levels, compared to primary and secondary levels. This is explained by a 36-percent vacancy rate at tertiary hospitals, compared to 27 percent at upazila health complexes, and 12 percent at secondary hospitals. One would imagine there would be a sustained effort to fill the vacancies to improve laboratory facilities. Instead, we see more than 20 percent of the development spending under the Fourth Health, Population, and Nutrition Sector Programme going to constructing new facilities, many of which remain non-operational for years.

We demand that authorities urgently take responsibility for these deficiencies. The aforementioned study highlighted the need for urgent recruitment of medical technologists with a simplified procurement procedure and greater financial autonomy for health facilities. We agree with these recommendations and urge that the reforms be implemented transparently, with qualified professionals appointed on merit and corruption rooted out from procurement and budget execution processes. The health minister has said his ministry will review the report and take necessary steps to address problems. We welcome the commitment and hope this promise will be matched by visible, measurable action.