Changed vision imperative for health sector
IN fact, achievement of super specialties in different faculties, enrichment of diagnostic procedure and excellence in technology are not enough to be acclaimed where poor and distressed people are deprived of desirable service easily and efficiently. Health service can claim credit and excellence when it can attend a patient in time with appropriate medication and client's satisfaction.
Besides the globalization of health and invention of tele-medicine, medical transcription and gene-mapping etc, the confidence building in health service depends on many choices and preferences which in turn call for new vision in the policy and service delivery system.
The vision of the health policy should, therefore, be the creation of enabling environment where people can get the opportunity to reach and maintain the highest attainable level of health service. The vision should recognize health as a fundamental human right to promote health care as imperative for social justice.
Such a vision is attainable at a stage where political commitment with adequate mobilization of resources can promote sustainable programme approaches. Political parties in their election manifestoes must make commitment of prioritizing health care and ensure good governance at any cost. Weak governance in health sector might cause the poor and vulnerable members of the society to suffer in terms of both costs and deficient service delivery as evident in our country at present. The weak governance is characterized by staff absenteeism, pilferage of drugs and essential supplies, maltreatment and negligence of the poor clients, illegal payments to service providers at the public health premises.
In the Ministry of Health and Family Welfare and its directorates, corruption has been noticed by Anti-Corruption Commission during its drive against institutional grafts in 27 areas like project formulation, appointment and transfer, posting, promotion and deputation, allocations and grants, training, procurement of logistics and even processing of pension cases of their own colleagues.
The meeting held on 19.11.2008 in the Health Ministry agreed to build up resistance and awareness within the institutions and amongst public against corrupt practices. The changed vision must concentrate on eradication of corruption of any nature in the health service delivery system.
The mobilization of domestic resources for health sector financing is the critical issue to get rid of donor dependency and pursue visionary planning suitable to the genius of the nation. Presently, private and public sources of health financing are insufficient to achieve full coverage with even a basic package of health services.
On an average, about 3.2 per cent of GDP is allocated to health, nutrition and population sectors in Bangladesh. The per capita expenditure on health is only about US$ 13.0/year, of which public spending on health care is hovering around US$ 4-5 /year. The rest is privately financed through out-of-pocket spending. The annual per capita spending is US $ 34.0 in the developed world.
Therefore, the priority should be radically changed in the investment criterion and fixing the budgetary provisions to address the health care system provided significant improvement is made in the production and distribution of drugs and medicines and other logistics required for extending quality services.
The most important intervention is the programme planning and implementation. The Ministry of Health and Family Welfare has adopted the Sector Wide Approach and planned to implement Health, Population, Nutrition Sector Programme worth Tk. 37,348.11 crores by 2011 AD.
To maintain the trend of success stories and also to address issues of climate change and globalization of health, there must be new strategies to develop human resources, establish good governance in logistics management, continuos focussing on ensuring proper safety net for the poor, vulnerable and marginalized population.
Health sector's financing by the government alone is insufficient. Expansion of private sector investment to bridge the gap, cost sharing by well-to-do patients when treated in the public hospitals, health insurance as alternative source of financing and outsourcing for the maintenance of few infrastructure might be considered as changed vision for ensuring better health service.
Above all, the implementation of changed vision requires direct partnership and active participation of mass media, academia, professional groups, community based organizations, civil society organizations etc not only to generate health care awareness but also as right to know the ways of availability of quality services.
In conclusion, it can be stated that a well-organized and sustainable health system with changed vision must be in force to respond to the needs of the community for improving the health condition of the poor and serve the distressed in particular.
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