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Challenges for urban health sector

Published : Thursday, 16 May, 2024 at 12:00 AM  Count : 236

Challenges for urban health sector

Challenges for urban health sector

With a total index score of 65.9 out of 100, Bangladesh ranks 101st on the Sustainable Development Report 2023, progressively moving closer to the finish line of Sustainable Development Goals by 2030 targeting 100. In recent times, Urban health has emerged as the new "talk of the town" through addressing and accepting its vulnerability and potential involvement in SDGs. In context to that, the urban health might intrigue the new cabinet members of Bangladesh to invest more attention in urban health sector. Congratulating the newly reorganized cabinet members and acknowledging the concerns of Prime Minister, Government of Peoples Republic of Bangladesh, the Minister of Health and Family Welfare (MoHFW), and Local Government Rural Development &Cooperatives (MoLGRD&C) have a lot of work ahead of them in urban health sector.

Urban Health survey 2021 proclaims a significant demarcation of provision of services in urban areas, as example, Antinatal care (ANC) and C-section facilities cover 96% and 59% of women in non-slum areas whereas the coverage in slum areas was low - ANC overage 88% and C-section coverage 31%.Other maternal healthcare facilities, the urban health lacks progress in full immunization coverage (79.2%) comparative to national (83.9%) and rural coverage (85%) [3]. Moreover, the limited primary healthcare facilities from MoHFWimplied less attention towards urban health for ensuring Health for All and "Universal Health Coverage (UHC)".

In addition to this, Health Services Division (HSD) is in charge of health-related issues, medical and health services policies, and promotion, preventive, curative, and rehabilitative aspects in collaboration with the Local Government Division (LGD) including local government institutions like city corporations and municipalities under the MoLGRD&C for primary health care service, water-sanitation etc. While the numbers stated the less interventions in urban areas, it also implied that inadequate coordination between respective ministries, regulatory deficiencies in private sector, effects of climate vulnerability in urban settings, lack of implementation and regulation of existing Essential Service Package (2016), strategies (2014 & 2020), absence of initiatives for developing urban health policies etc. add fuels to the progress of urban development for ensuring sustainable health facilities to the urban people.

Additionally, inadequate health facilities as well as insufficient budget and strong coordination for urban health also contribute to the challenges and hinder the health. In this context, the new ministers for MoHFW and MoLGRD&Care expected to take necessary initiatives to ensure the health of urban dwellers in Bangladesh.

There is a need of revision and upgrading of Essential Service Package (ESP) in alignment with current priorities and increasing financing to health at least 2% of GDP, emphasizing on primary health care for urban areas from Government of Bangladesh. Allocation of budget for planning and implementation of facilities focusing on urban health through strategically purchase. Enhance Public-Private Partnership (PPP) for delivering Primary Health Care (PHC) in urban areas. Establishment of monitoring cell in MoHFW to ensure universal coverage in urban areas. Liability enforcement at all levels through digital technology. Proper regulatory model development for service provision of private sectors. Implementation of strategies: Urban Health Strategy 2020 and Urban Immunization Strategy 2019. Establish of referral system from community clinic to upazilla and only referred cases to district and medical college hospitals. Schedule frequent (three- or six-months interval) meeting to effectively collaborate with MoLGRD&Co

Expectations from Minister of the MoLGRD&C: Develop urban health strategy and career pathway of the urban health service providers including Essential Service Package (ESP) and Universal Health Coverage (UHC) under the MoLGRD&C. Revision and redesigning the organ gram of Local Government Institutions (LGIs) and creation of positions for PHC services under the MoLGRD&C. Engage private sector in the urban health care services and monitor their quality services by them. Identification and mitigation of the limitations of running three models (Urban clinic model, UPHCSD, GOD model) with the aim to ensuring Universal Coverage in every corner of Bangladesh. Allocation of separate budget for health, specially for urban health considering the current need and demand in urban areas. Creation of a model or chain of regulation for accountability of LGIs towards MoLGRD&Cfor urban health. Frequent monitoring, regulating and reporting of private sector initiatives and creation of accountability of private sectors towards local government. Creation of a separate wing or department in MoLGRD&C for monitoring and regulating the health-related agendas in LGIs. Meeting with MoHFW at regular (three- or six-months interval) basis for effective delivery of health services in urban areas.

Ensuring technical and logistic support in every corner throughout the fiscal year
Dr. Md. Shamim Hayder Talukder, Chief Executive Officer, EminenceAssociates for Social Development, Member Secretary of the BUHN and Dr. Maliha Khan Majlish, Senior Technical & Development Officer, Eminence Associates for Social Development

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