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Health Sector                                                                      CHAMPIONING
                                                                                                 CARE





             country has received around 16 international      country has progressed in leaps and bounds, even receiving a                Bangladesh seems to be something of a “negative
             awards and prizes, out of which, three were       UN Award for the same, in 2010. As per data pertaining to                   outlier” among similar, low income (LIC) or low
             United Nation awards for the incredible           2019, the under-5 mortality rate was 28 per 1000 live births.               middle-income (MLIC) countries. Statistics report
             development in the health sector. According to    Infant and neonatal mortality rates stood at 21 and 15,                     that the percentage of out-of-pocket (OOP)
             the foreign secretary of Bangladesh, Masud Bin    respectively. Where global life expectancy was 72 years,                    spending on healthcare for this country stands at
             Momen, a good way to describe the healthcare      Bangladesh, thanks to the above mortality rate reductions                   a giant 72% compared to other LICs (39.6%) and
             system of Bangladesh is “good health at low       stood at 73, above all but one South Asian country- Sri Lanka               other MLICs (39.4%). This spells bad news for the
             cost”.                                            which was topping the charts at 76 years.                                   poor of the country as it implies that the country
             Some particularly notable milestones in the       Child nutrition is a problem that is being faced by most                    is not beside its disadvantaged population in
             history of the health sector in Bangladesh are    developing countries in the world, with successes and failures              financially supporting their basic healthcare
             its achievements in mass inoculation for          constantly warring against each other, hindering progress.                  rights. Currently, OOP expenses make up roughly
             different, preventable diseases, reducing mother,   Bangladesh recognizes the dilemma, and it has taken steps to              67% of a household’s total expenses.
             infant and below-5 mortality rates, family        mitigate malnutrition, demonstrating a steady improvement in                In its war against the mighty COVID-19,
             planning, and, to some extent, child nutrition.   the last decade. The stunting (impaired growth due to lack of               Bangladesh has dedicated a number of beds and
             In keeping with article 15 of the constitution of   nutrition) rate among children under the age of five has                  ICU beds in all of its government run hospitals
             the People’s Republic of Bangladesh, where it     dropped down 10% from 41.3% in 2011 to 31%in 2018, and                      and quite a lot of private hospitals as well. In
             states that "It shall be a fundamental            wasting (low weight for height) has gone down from 15.6% to                 addition, when the cases peaked, the country     country’s health sector. This backing from development
             responsibility of the State to attain, through    8.4%. While the development has been consistent, it is still not            built some isolation centres and hospitals fully   partners like the UN, World Bank and Asian Development
             planned economic growth, a constant increase      enough and more needs to be done for these figures to fall                  dedicated to patients of Covid-19. Tackling an   Bank have been a pivotal source of funds generation for the
             of productive forces and a steady improvement     lower.                                                                      unprecedented crisis such as this is an arduous   country’s health sector. For instance, WHO, as part of its
             in the material and cultural standard of living of   Bangladesh boasts one of the best health networks in the                 task for any government, and Bangladesh too,     response efforts has helped to provide Bangladesh with 200
             the people, with a view to securing to its        public sector. As per recent data, there are 47,678 domiciliary             faced its challenges with testing, contact tracing,   oxygen concentrators, 400 pulse oximeters, 100 venturi
             citizens the provision of the basic necessities of   workers with 13,907 community clinics at ward level, 4,646               isolating people and the expected challenges with   masks, and 100 nasal cannulas to 17 district hospitals, as
             life, including food, clothing, shelter, education   union level facilities, 424 upazila health complexes, 59 district        doctor availability per patient. Inoculation     well as 65 patient monitors to 10 Covid specialized health
             and medical care.", the country undertook                                   hospitals, 18 medical college                     campaigns are ongoing in Bangladesh and the      facilities. Similarly, the World Bank and the ADB have agreed
             family planning through fertility regulation   The country has              hospitals and 12 specialized                      government is working to get its hands on the    to aid the country with $100 million each for emergency Covid
             right after gaining independence in 1971.   received around 16              institute hospitals, as well as                   vaccines through agreements with producing       response.
             According to the National Population Census of                              other facilities. Despite the                     nations fast in order to immunize as many of its   While Bangladesh has seen incredible success in its health
             1974, the total fertility rate (TFR) per female   international awards      large set up, shortages of                        population as it can against the deadly          sector in a very short time, the major challenge that remains
             stood at 6.9. By 1989, it saw a decline and   and prizes, out of            human resources, shortages                        pandemic.                                        to be conquered is its overall spending in this area. While
             stood at 5.1 while by 1996 it was down to 3.3   which, three were           of the specific skill sets, and                   One of the few contingency measures that came    optimists argue that Bangladesh’s outstanding achievements
             births per female. After a 10-year hiatus in                                scarcity of equipment,                            out strongly from Bangladesh during the          have come in spite of this low per capita GDP spending,
             fertility during the 1990s, the TFR further   United Nation awards          medicines and other supplies                      pandemic era is telemedicine. Online activities as   experts do recognize inequities and vulnerabilities within the
             declined to 2.3 births in 2011. The most recent   for the incredible        hinder stakeholders from                          a whole saw a rise in Bangladesh during the      country, despite its progress. The government may argue that
             data shows that in 2019 the TFR in Bangladesh   development in the          maximizing the optimum                            months long lockdowns and in the interim,        it has increased its healthcare spending in the face of the
             was 2.0, at par with Sri Lanka and Nepal,   health sector.                  level of output from this set                     mobile applications were launched, 29 solely for   global pandemic, but in essence, the increase in the healthcare
             whereas the TFR in India was at 2.3, and in                                 up.                                               telemedicine, two online helplines were dedicated   sector has only increased from 257.3b to 292.5b, marking a
             Pakistan at 3.3.                                                            A longstanding challenge                          only to foreign workers, 16 different portals and   nominal increase of 13.7% increase. In fact, without the
             The other success story associated with           with the public health sector of Bangladesh has been the lack               websites were created, 10 kinds of covid testing   support of non-governmental bodies, the year’s health
             Bangladesh’s health sector is the one on mass     of public expenditure on this sector. This year, the country’s              tools and seven chatbots were constructed for a   allocation may have rested at 4.8% of the entire budget,
             inoculation. In 1979, Bangladesh devised a        allocation to the health sector is only 5.14% of the total budget           variety of medical and other emergency purposes.   instead of the 5.14% it now allotts.
             supremely effective national immunization         and less than 1% of GDP, despite Covid challenges. Public                   One of the more outstanding applications is the   Covid-19 has come as a fresh perspective for Bangladesh and
             campaign called the Expanded Programme on         expenditure on health in Bangladesh is one of the lowest, not               one called COVID-19 DSS (Digital Surveillance    its leaders, shining light on the glaring cracks and issues
             Immunisation (EPI). The program gathered          only in the world, but also compared to other lower                         System), where a user provides their information   within its systems such as shortages in the areas of trained
             speed after 1985 when Bangladesh committed        middle-income nations averaging 2.8% or even the South                                                                       human resources, medical equipment, and supplies. Experts
 made praiseworthy progress in the healthcare   to immunize every child in the country by the   Asian average of 2.1%.  The country not only has a   to an AI system. The system can then create   feel that even outside the pandemic, increased funds are
 sector, ever since the independence year, 1971.   next 5 years, to the UN, thereby reaching   concerningly low expenditure rate on the sector, the   awareness, help with digital screening, patient   required to mitigate these crucial shortcomings. As
 Given that the country is only 50 years old and   universal child immunization. According to   expenditure is also not divided judiciously among all   identification, identifying high risk COVID zones,   Bangladesh strides towards attaining the Sustainable
 was essentially a hard-hit nation when it gained   research, by 2017, 89% of children between the   geographical and residential divisions.  and to integrate and analyze crucial data. The   Development Goal (SDG 3) for Universal Health Coverage and
 Economic strength and a wealth of health resources are   its independence, Bangladesh has often been   ages of 12–23 months were fully immunized   Taking advantage of this disparity, is the private health sector   COVID BD tracker application is another risk   becoming a middle-income nation, it may see a decline in
                                                                                                                                           assessment software that specializes in
 known to be crucial drivers to the success of healthcare   called a “positive deviant” for exceeding   against major vaccine-preventable diseases such   of Bangladesh with healthcare facilities under the Directorate   financial support from its development partners which the
 sectors worldwide. Most countries who boast of strong   expectations despite widespread challenges.   as tuberculosis, diphtheria, pneumonia, measles   General of Health Services (DGHS) being 2,258 registered   predicting probable rates of infection in a person.  government would have to work to cover on its own. The
                                                                                                                                           Bangladesh is said to have undertaken a
 healthcare systems often have these two propellants   According to “The Lancet”, one of the most   and others.  private hospitals and 5,321 clinics. Hospital beds amount to               country, known for its determination to survive the worst, may
 backing them up. However, one country that may have   revered medical journals of England,   One of the Millennium Development Goals that   54,660 under DGHS and 91,537 under private owned   “pluralistic” health system where resources from   well come out shining in the years ahead, once it addresses
                                                                                                                                           public funds were passed on to
 proved this theory wrong is Bangladesh. Outperforming   Bangladesh’s admirable success in this sector is   Bangladesh had committed to, was reducing    hospitals. As privately owned medical establishments require   these challenges.
 many of its South Asian neighbours, Bangladesh has   “one of the mysteries of global health.” The   maternal and child mortality, and in it, the   people to pay for their services out of their own pockets,   non-governmental organizations to work in the



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