Experts believe that structural change is necessary to eliminate inefficiency and mismanagement in the health sector. At the same time, there is a need for coordination between the public sector, the private sector and non-profit organizations. They said the government must take responsibility for decentralization and coordination.
In an hour long webinar held on Saturday (July 25) afternoon organized by Health System Improvement Forum former World Bank's Lead Private Sector Specialist Dr. Akhtar Mahmood, Bangladesh Institute of Development Studies (BIDS) Senior Research Fellow Dr.Nazneen Ahmed and senior health economist at the Liverpool School of Tropical Medicine Dr. Jahangir Khan said this.
The program was moderated by Zia Uddin Haider, Senior Health Specialist of the World Bank. The Health System Development Forum has been regularly organizing weekly events on contemporary issues related to the health sector.
Dr. Akhtar Mahmud said, there is still a lot of unification in our country. A lot of things are happening in Dhaka. To change this situation there must be decentralization within the government or someone else outside the government must be responsible to ensure health care for all through public policy. It may not be possible to sort it out completely. Need to change gradually.
‘We see in the health sector, we see in other sectors too, magistrates, police, RAB go on operations. There is noise but the problems are not removed because they are not regulators. We need to increase our regulatory capacity. Young officers have to believe. They have a desire to do well. Dr. Akhtar Mahmud said that they are more familiar with technology.
Three things are important when we talk about health administration, said Dr. Nazneen Ahmed. How much financing will be there, inequality and efficient use of resources? Through these three, we have to ensure how to provide more services to the common people. It is not necessary to keep a hospital only for those who are extremely poor. Special projects are needed in special cases such as cancer, tuberculosis and maternity care because many people cannot afford to go to private hospitals. Out of the pocket costs could be reduced if those projects were used properly, as seen in some projects in the government's social security perimeter.
In this case, she said, those who are extremely poor move away from health care. Being poor, they cannot eat nutritious food. They live in unhealthy environment. They suffer the most in any disaster and have less ability to spend for their health. The mother of such a family gives birth to a weak child, and so on. We have to think about it.
Dr. Nazneen Ahmed said that if we increase the use of information and communication technology in the health sector and observe through it, it will be possible to go where we dream.
Dr. Jahangir Khan said it was important to ensure that government hospitals, the private sector and non-profit organizations were playing a complementary role. If we work in the same place then many of our resources will be wasted.
The budget is always higher than our capacity, he said. The question is, is the money ready according to the budget or did we say we will spend this money, is that the case? The money that is supposed to come from NBR or other sectors does not come. As we have seen in the World Bank report, this is a major failure. It is said that even if there is an allocation but there is no expenditure. We also have to see why it is not being spent. Those who are reporting the demand of the hospital to the Ministry of Health, are they efficient? I think they need training because we do not see the budget according to the demand. Is it increased proportionately?
I compare the privatization of the health sector with transport. There is no problem if someone rides a Mercedes but another person should get a seat on the bus, said Jahangir Khan.