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Meager health facilities

Bangladesh is better than India and Pakistan in health facilities

Good health is important to live a healthy, peaceful and prosperous life. Our citizens are suffering from poor health conditions since ages. Health care sector in Pakistan consist of private and public sector. The private sector serves nearly 70 percent of the population.

A survey by the Federal Bureau of Statistics in Pakistan indicated that about 50 percent of the basic health units were without doctors and that about 70 percent of government health facilities were without any female staff. Only about 56 percent of the country’s people have safe drinking water and just 24 percent have good sanitation.

Pakistan’s health system comprises many institutional actors. 26.32 percent of the population is covered for health care costs to a varying degree. Majority pay out-of-pocket (73.68 percent)

With more than 25 percent of the population below the poverty line of less than $1.00 a day, many are pushed into the worst trap. In Pakistan majority of those living in poverty are unable to purchase health care. The inequality in access and utilization of health services is increasing among different economic classes.

Lower health status in Pakistan includes lack of education, poverty, and high fertility, urban bias in health services provision, lack of planning and poor management and unnecessary delay in implementation.

About 80 percent of all major diseases such as diarrhea, cholera, typhoid, hepatitis are due to unsafe drinking water, inadequate sanitation and poor hygiene. Health and hygiene are causing major disruptions in the lives of people of Pakistan.

Many children in Pakistan are suffering from nutritional disorders which are common and particularly effect women and children.

According to statistics, 27 infant deaths occur per thousand, 19 child deaths per thousand and 11 percentage babies are born with low birth weight. The child mortality in Pakistan is a major cause of concern, with every 1 among 10 children dying before reaching the age of five and 1 among 30, just after they are born. Pneumonia and air pollution seem to be the factors affecting the health of the children.

Women in rural Pakistan have lesser access to health care than men, because of absence of female doctors. Low literacy ratio, low social status and civil constrains on females are responsible for women’s below standard health.

In the current situation, there is much that needs to be done, possibly in every sector of the health sector. Women and children still have the most to lose.

There is a much need of health services, expand the outreach of health programmes and introduce technologies to improved monitoring and strengthening health care system.

Pakistan is where the government spends less than 2 percent of the GDP on healthcare. The major portion of taxpayers does not enjoy health insurance. In spite of having many laws of providing basic health care facilities to every citizen the implementation is nil.

The BGHI is one of the most popular health indexes. It tends to report mainly the top 50 countries with best healthcare. Pakistan doesn’t feature on the latest report by BGHI, which indicates a lower quality and lower life expectancy (below 85 years old).

The World Health Organization (WHO) analysis placed Pakistan as number 178 in 2015. It also revealed very high maternal mortality rates, low life expectancy (58 years old) and high overall mortality. The UN’s human development program placed Pakistan as 146 in 2015. It remains consistently as a country with low quality healthcare.

Although Pakistan’s economy has improved in the last few years, but is not reflected in the amount of money invested in healthcare. A great number of health issues persist like severe parasitic/viral diseases, harsh weather conditions, low access to healthcare and others.

Immunization is also an important element. Vaccination programs are not very common and a large percentage of the population remains vulnerable to diseases eradicated from other parts of the world.

Bangladesh is ahead of India, Pakistan, Nepal and Afghanistan in providing access to quality healthcare to citizens, according to a study of leading British medical journal The Lancet. Bangladesh ranked 133rd among 195 countries in providing access to quality healthcare, according to the study.

Bangladesh, however, fell behind Sri Lanka and China in the areas. The study revealed that Bangladesh has seen improvement in healthcare access and quality since 1990, with its Healthcare Access and Quality (HAQ) index increasing from 17.8 in 1990 to 47.6 in 2016.

 

The average HAQ index in South Asian countries is 40.4 in 2016 while the average HAQ was 23.8 in 1990.

Improvement rate of Bangladesh is better than its South Asian neighbours.

India’s HAQ index was 24.7 in 1990 and 41.2 in 2016.

Pakistan’s HAQ index was 26.8 in 1990 while 37.6 in 2016.

Despite the gains, Bangladesh continues to lag behind China (48) and Sri Lanka (71).

Myanmar ranked 143rd, India 145th, Nepal 149th, Pakistan 155th and Afghanistan 191st.

According to the study, Bangladesh performed poorly in tackling cases of skin cancer, testicular cancer, lymphoma, leukemia, uterine cancer, neonatal disorders, and stroke, among others. Despite Bangladesh’s progress in healthcare compared to India and Pakistan, it cannot be complacent as yet, experts said. They pointed out high out-of-pocket expenditure in Bangladesh, which is highest in South Asia. But Bangladesh still lags behind in using modern healthcare technology, they said.

The latest reports of the government’s Health Economics Unit show that people in Bangladesh have to bear 67 per cent of their medical bills.

The out-of-pocket medical expenses of fellow South Asians are far below that of Bangladeshis, 18 percent for the Maldivians, 25 percent for the Bhutanese, 47 percent for the Nepalese, 56 per cent for Pakistanis and 62 per cent for the Indians. In the UK a citizen bears nine per cent of his or her medical expenses while an American has to bear 11 per cent.

A study done by ICDDR, B and BRAC James P Grant School of Public Health and published in January this year, showed that 68.9 per cent of the country’s citizens find it hard to bear their medical bills.

The annual medical expense per household could be as high as Tk 40,000, the average being Tk 18,000, found the study.

Bangladesh Health Rights Movement chairman Dr Rashid-e-Mahbub quoted as saying that the government sector healthcare services in Bangladesh was better than India and Pakistan which lifts Bangladesh in terms of quality and accessibility of healthcare. “We could do better if we could invest more on government hospitals, provide them with more manpower and modern technology,”’ he said. Rashid said enabling government health services more effective would help reduce the out-of-pocket expenditure in Bangladesh.

According to The Lancet study, the five countries providing the highest access to quality healthcare were Iceland (97.1 points), Norway (96.6), the Netherlands (96.1), Luxembourg (96.0), and Finland and Australia (each with 95.9). The countries with the lowest scores were the Central African Republic (18.6), Somalia (19.0), Guinea-Bissau (23.4), Chad (25.4), and Afghanistan (25.9).

The study pointed out that sub national inequalities were particularly pronounced in countries such as China and India, although high-income countries, including England and the US, also saw considerable local gaps in performance.

In 2016, the global average healthcare access and quality score was 54.4, increasing from 42.4 points in 2000.

Some steps are necessary in order to improve its citizen’s quality of life. Corruption within the healthcare industry must be addressed and managed. A large amount funds remain without use even when both the government and the needs of the people agree on its implementation.

Pakistan faces a severe lack of trust from the people towards healthcare professionals and the health industry. A more well-spread health centers should help with this phenomenon.

National Health Insurance program can be a positive change in Pakistan as it will help the most vulnerable sector of the population. Awareness campaigns related to lifestyle diseases need to be created to deal with obesity, heart conditions, and type-2 diabetes.

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