Without waiting the perfect set of conditions to address public health issues, Bangladesh has achieved the Millennium Development Goal (MDG) on maternal health.
“Bangladesh focussed strongly on the disadvantaged section of society, particularly women, in the past three decades that led to employment, availability of micro-credit, education and overall empowerment. These were the building blocks of good health in the country,” according to Timothy G. Evans, Dean of James P. Grant School of Public Health at the BRAC University in Dhaka.
Talking to The Hindu , Dr. Evans said from having an extremely low life expectancy in 1970s, Bangladesh moved to impressive longevity figures in 2000s. “Bangladesh focussed additionally on primary healthcare requirements and adopted innovative, low-cost but effective methods of interventions that helped the disadvantaged sections whose health is most vulnerable.”
Dr. Evans was here to participate in international consultations with the expert group on universal health, organised by the Public Health Foundation of India
Low-cost interventions
Citing examples of low-cost effective interventions, Dr. Evans said oral rehydration therapy (ORT) was one such method that was promoted to prevent diarrhoea, which was a major cause of infant mortality. It was the group of non-governmental organisations under the BRAC that popularised the ORT with remarkable results.
Another challenge the country faced was improving the pre-natal and post-natal healthcare for women. This was done by entrusting the NGOs to get expectant mothers into the formal system of healthcare to ensure the safety of both the mother and the child. “The interventions proved extremely helpful and effective wherever healthcare was inaccessible or technology was not available,” Dr. Evans said.
NGO health workers in Bangladesh worked almost on the same pattern as the Accredited Social Health Activists (ASHAs) under the National Rural Health Mission (NRHM). Dr. Evans said if implemented in right earnest, the NRHM could do wonders. But the results would be visible only after some years when the programme became fully operational and adequate funds and skilled health workers were available. “The NRHM will eventually reduce the burden on secondary and tertiary healthcare facilities.”
According to Dr. Evans, the civil society sector in Bangladesh worked along with the government to ensure that the disadvantaged sections got access to primary healthcare.
Bangladesh was also working towards a universal health insurance scheme. “People in Bangladesh, just like Indians, spend a huge amount from their pockets on healthcare, which leaves people impoverished. Healthcare has to be funded publicly through taxation because it cannot be left to market forces that would make it further inaccessible to a majority of the poor population,” he said.
