Sunday | 6 October 2024 | Reg No- 06
বাংলা
   
Sunday | 6 October 2024 | Epaper

Management factor in our health sector

Published : Saturday, 31 December, 2022 at 12:00 AM  Count : 652
Samir Kumar Saha
Health sector is one of the important sectors of a state. It is said that in a country where people's condition in terms of health shows improvement, indicates that country economically remains at good condition. Despite many achievements in our health sector, our health system failed to fulfill our expectation because of some problems.

Though there is post in upazila level hospitals, many posts remain vacant. Patients admitted into hospitals get free medicine, while outdoor patients are mainly denied such facility. It has not been possible to ensure quality treatment at Medical College Hospitals and specialized hospitals due to pressure of large number of patients there.

Patients generally do not get doctors at upazila level, hence they come to district level hospitals and specialized hospitals. Because of the rush of a huge number of patients, district level hospitals and specialized hospitals fail to provide quality treatment to its patients.

If the quality of treatment at district and upazila level hospitals can be improved, then it is possible to ensure quality treatment to 60% to 70% patients at those hospitals. So, it is needed to take steps for ensuring the quality of treatment at upazila, union and community clinics.

We have achieved many positive things in different sectors, but we failed to meet people's expectation in the health sector due to lack of proper management. So, now we need proper management for bringing positive change in the health sector.

In our health management, there was mention of creating post but the reality is different. There is only one registered physician for 1581 people in the country. The absence of physicians is more acute in rural, remote and inaccessible areas.

There is also problem of trained nurses. Many hospitals have medical equipment but the post of technologist is lying vacant there. If management of recruitment of manpower (doctors, nurses, paramedics, lab-technician) is not decentralized, there will be no solution to such mismanagement.

Merely appointing physicians will not be solution, it is also important to take necessary steps for keeping them in respective work places. Alongside this, necessary steps should be taken for training and enhancing skill of health workers. It has been seen that lack of qualified workers hampered the operation of modern health equipment. Gradually such equipment turned out of order and patients died of negligence.

Immune boosting health care service is an important section of health science. Regrettably, it can be said that such health care system is yet to be built up in our country. So treatment-education system should be categorized into four steps such as clinician, teacher, administration and disease preventive. A learner, from such four tier health system, will decide his/her future activities and participate in health management.    

Maintaining cleanliness is essential for improving the environment of hospitals. Manpower familiar with humanitarian sense should be appointed for giving information about the services provided by hospital and supervision.

Mismanagement is such an issue which is the main allegation against the country's health sector in the last 50 years. In a true sense, a professional health management system has not yet been established in the country.

Many people in the country went below the poverty line due to excess expenditure to meet their medical treatment. On the other hand, patients are being deprived of getting proper treatment at the government-run hospitals.

Crisis of manpower shortage at every stage of treatment such as upazila health complex, community clinics, union health centers and district level general hospitals is creating problem.

It is needed to establish district-based health system. Hence, it is imperative to ensure the availability of necessary facilities including physicians, technologists and relevant medical equipment for ensuring the district-based health system. Until we can establish the referral system, there is no chance of change in the situation.

It is generally seen that if an upazila level physician goes for a two-week leave, another physician is brought in for few days in his place. If there were sufficient physicians, no such situation would have happened, and service seekers have not been deprived of necessary health services. Our infrastructure is very good. If necessary facilities are ensured along with it, people's need for health services can be fulfilled.

Though average life expectancy has increased, old people are turning to burden at the end of their lives because of the non-availability of quality health services. Hence, the formation of a health commission is important.

There is no effective health policy in the country. Now we have to think over the modality of health sector for the next 50 years. One of the main tasks of building a discrimination-free society is to build a health system free of discrimination. Our national constitution also clearly mentioned about this matter.

In Bangladesh's health sector, corruption mainly takes place over buying and selling. So, it is urgently needed to make the buying process more transparent.

In many countries of the world, it has been possible to reduce corruption to a large extent by reforming the government financial management. Establishing autonomous special audit institute brought success in reducing graft on buying and mismanagement in those countries.

Besides, ensuring free flow of information is important. Research studies showed that when sector-wise allocation (mentioning the detailed amount of expenditure from top to bottom) is easily available, it is tough to resort to corruption.
Dr Samir Kumar Saha, former Executive Director of Public Health Foundation, Bangladesh









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