Speakers at a programme suggested Saturday more private sector engagements in the health sector to attain Universal Health Coverage (UHC) as the country's 26 per cent population receive healthcare from this sector.
For that the government must regulate the private healthcare providers by enforcing existing laws properly and help increase the skills of the health workforce employed in the private healthcare facilities, they said.
Private healthcare centres are largely dependent on public doctors and patients are often victims to overcharging, poor quality treatment and harassment due to absence of effective regulations, they observed.
There is tremendous growth of for-profit private sector clinics and hospitals. In 2000, the number was 1,032 which increased to 3,026 in 2011 and 5,023 in 2017.
The observations were made at a discussion meeting on 'Engaging Private Sector to Achieve Universal Health Coverage in Bangladesh' at the CIRDAP auditorium in the city. Health Policy Dialogue, a civic platform, in collaboration with European Union and ICDDR,B organised the discussion . Eminent gynaecologist Prof TA Chowdhury chaired the programme.
Universal Health Coverage (UHC) means accessible and affordable quality and need-based healthcare for all anywhere they require. Financial risk protection is a major issue of UHC which means no one should slip into poverty while bearing healthcare costs.
Referring to the HEIS data 2017-18, chairman of Institute of Health Economics Unit of Dhaka University Prof Syed Abdul Hamid said 60 per cent of the country's population receive healthcare from informal sector while it is 14 per cent for public sector. The rest of the people go to the for-profit or not-for-profit (NGO) facilities.
He also said the latest data shows that out-of-pocket expenditure (OOP) increased to 67 per cent in recent years while 70 per cent of it is spent on medicine.
Prof TA Chowdhury said it is not possible for a country like Bangladesh to ensure UHC without engaging private sector. "Only totalitarian countries like China and Cuba can do this."
He alleged that the government has a mindset not to consider the private sector as complimentary although the sector is serving a majority of the country's population. Regulating the private sector is not only function of the government. Here the government develops health workforce for public sector only and it even does not send a private practitioner for training, he said.
"If there is no equal partnership, attaining of UHC will remain a wishful thinking," Dr Chowdhury said.
Acting secretary of public administration ministry Ashadul Islam said people suffer from 14,400 diseases in the country. It is not possible for the government to provide treatment for all. That's why the government has developed an essential service package (ESP). UHC focus should be on coverage, quality and financial protection.
Speakers came down heavily on the quality of service and other irregularities in private sector. They said that private sector had little contribution to the success of reduction in child mortality, nutrition, immunisation. Rather people are becoming penniless while paying for exorbitant hospital charges.
Director General of DGHS Dr Abul Kalam Azad said if people's OOP becomes high, the quality of healthcare will not be good. A national health insurance policy should be launched.
In the keynote presentation, Dr Iqbal Anwar of SHARE project of ICDDR,B said the rules and regulations of the private sector is very much primitive.
The sector has an acute shortage of manpower like full-time consultants, nurses and was totally dependent on public sector. That's why people do not get service after 2:00 pm at public hospitals and before 2:00 pm at private facilities.
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